Article - EMOTIONAL HEALING IS KEY TO RECOVERY

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EMOTIONAL HEALING IS KEY TO RECOVERY

by ph Gold, PhD

Motor vehicle accidents (MVAs) do not happen in a social vacuum. The injured

party is always a component of a family and a social system. Recovery will

be speedier and more complete if professional care givers can keep this in

mind as they treat the patient.

Marriage and Family Therapists (MFTs) know that family life cannot be the

same after a serious accident: responsibilities, demands, expectations and

entire life stories are profoundly altered and must be adjusted and made

workable in the face of radical and unexpected change.

Chores and obligations shift from one spouse to another, or onto children,

or even to parents and other relatives who may have to be co-opted to

assist. Such shifts alter relationships and can reveal conflicts and

attitudes previously hidden and managed. There is often financial loss, by

income reduction or increased expenses. The sex life of partners is almost

invariably affected. Life plans may be shattered, vacations postponed,

sometimes indefinitely, recreation and pursuits, play with children or

hobbies suspended.

The resultant stress to both family and patient adds considerably to the

barriers to healing and rehabilitation. If the emotional pain and stress are

not effectively addressed, all other treatment of physical symptoms is

significantly reduced in effectiveness. Energy for recovery is diminished by

emotional interference. The patient almost invariably experiences anger and

guilt, though these are often denied. The denial is a serious obstacle to

recovery. A trained therapist is equipped to uncover these repressed affects

and manage the results of their disclosure.

It is not rare for a patient to also experience social rejection, which can

include scepticism and suspicion by involved agencies, including those

contracted to assist in recovery, and this is a powerful discouragement to

positive patient attitude.

The trauma patient typically experiences not only the present physical and

psycho-social fallout from the event, but is also very apt to re-experience

the stored emotional responses to earlier trauma, triggered by the latest

events. If the earlier experience (say a childhood injury and/or long-term

hospital stay) was characterized by fear, helplessness, guilt or

abandonment, and was stressful enough to leave painful or blocked memories,

these will continue to stress the experience of the new trauma.

I know of one case where an MVA let to a serious breakdown of coping

strategies. The patient revealed in therapy a long history of sexual abuse

in a residential school. Prior to his accident he had devised a number of

ways to repress most of his pain and memory and to hold a job and marriage

together. With his accident and injury he became re-victimized, and felt

helplessness. His emotional pain and anger surfaced in therapy and he twice

attempted suicide. Without treatment for the early and primary trauma

history, recovery from the new injury was not possible.

The reluctance of insurers to finance such treatment is perfectly

understandable. However, it is possible to spend more money in a futile

effort to avoid such therapy than to undertake assessment and treatment

quickly and effectively.

A further barrier to rehabilitation may be found in the disposition to treat

symptoms without regard to the sense of self-worth felt by the patient.

While such a concept as self-worth is hard to qualify, it is accessible

through observable behaviours and self-appraisal attitude scales. The

patient who is not " heard " by anybody who is not compassionate,

understanding and interested in the whole person is likely to regard him or

herself as a mere nuisance that everybody would like to " fix " as quickly as

possible and be rid of. If we are dealing with a person whose self-esteem

was low prior to the MVA, we may actually worsen a low self-regard. Recovery

requires confidence, motivation and future thinking.

Patient Awareness

The good therapist is an effective and trusted communicator, skilled at

eliciting feelings and thoughts, intuitive at reading between the lines,

able to ready body language, highly literate at reflecting back alternative

" readings " of the data. The therapist can act as a conduit and mediator

between the patient and the patient's new world.

The family therapist will help the patient regain control of personal

experience, a control surrendered by the patient in the face of an

unforeseen event that could not be controlled. Various physical and

pharmaceutical treatments may increase this sense of passive hopelessness in

the patient, and psychotherapy must serve as a concurrent antidote to this

possibility.

From the Newsmagazine of the Canadian Association of Rehabilitation

Professionals. Ontario Society. January 15, 1996. Reprinted there from Rehab

& Community Care published by BCS Communications.