Coping with Injury

Car accidents, work-related accidents, slips and falls, and other types of accidents can have a major effect on our lives. The impact does not necessary correlate with the extent of our physical injuries. Some people who suffer severe physical injuries experience little long-term emotional effects, while others who suffer only minor physical injuries experience serious emotional effects. Why does this occur?

The way we experience any event depends on a complex interaction of our unique psychological and physical factors at that point in time. Our experience of events and reaction to them depend on our previous experiences, our mood, our beliefs about ourselves and the world, our personality characteristics, our emotional and physical resources, the reaction of other people, and a myriad of other psychological and physical factors. For these reasons, it is difficult to predict a person’s experience in a car accident if we look only at the damage to the vehicle. Many times people walk away from totalled cars with little long-term anxiety, while others may experience long-term post-traumatic anxiety after an apparently minor accident.

Whatever emotions we experience following any type of personal injury or accident, we have a right to feel them. They are not a reflection of personal weakness, but rather a reflection of the unique psychological and physical factors that combined to produce those emotions. Our goal at such times is to use our inner resources to cope better and to help our bodies and minds heal.

Pain Problems (see also Pain article)

Some people who are involved in accidents experience acute pain that becomes chronic. When the person has healed outwardly and appears to be physically normal, family, friends, and coworkers may relate to the person as if there is no pain problem. This can create enormous stress for the person with pain and can lead to self-doubt, self-denigration, and depression.

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Emotional and Motivational Brain Connections Predict Chronic Pain

An exciting study reported in the latest issue of Nature Neuroscience from the laboratory of Dr. Marwan Baliki at Northwestern University in Chicago casts light on the changes that occur in the brain when acute pain becomes chronic. The study strongly suggests that subjects’ emotional responses to acute pain play an important role in predicting these changes in the brain. Subjects who are more distressed about their acute pain not only tend to go on to develop chronic pain but their distress actually caused changes in the brain that were observed on brain scans. To my knowledge, this is the first time we have actual observations of the changes our attitude and feelings can cause in the brain over time that can lead to the development of a chronic pain problem.

Dr. Baliki and his colleagues took brain scans of subjects with acute back pain. They also measured pain intensity and the level of distress the subjects were experiencing. These data were obtained 4 times over the course of one year. During this time, some subjects experienced a resolution of their back pain whereas others continued to experience significant back pain which by the one year mark, had become chronic.

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