June 13, 2011
By Dr. Howard M. Rombom
John Smith, a New York City subway conductor, was piloting his train into the station one day when a commuter leaped from the platform onto the tracks.
After Smith witnessed the suicide, he followed all of the appropriate procedures as mandated by the New York City Transit Authority. He contacted the supervisor, spoke to a union representative and underwent testing for drug and alcohol use. Smith went home that evening feeling “okay.” However, the following morning he began to feel uncomfortable; everything started to seem a little surreal.
Over the course of the next several days Smith struggled to keep the terrible images of the incident from recurring in his mind. During the day he experienced flashbacks. At night he was having nightmares. He began to feel detached from his surroundings and relating to family and friends became difficult. Smith only continued acting more and more withdrawn suddenly declining activities he used to eagerly take part in.
After Smith sought help at Behavioral Medicine Associates, he discovered he had been suffering from Post Traumatic Stress Disorder. He was referred to our psychology practice and began treatment so that he could return to work as soon as possible. Smith was given an opportunity to process the event and was provided with a specific program of desensitization techniques. These specialized techniques allowed him to return to operating his train within a brief period of time. Without psychological care Smith’s PTSD symptoms might have been exacerbated and indeterminately prolonged.
There is also the case of Joe Brown a construction worker who fell off of a ladder injuring his head, neck, back and shoulders. Brown received physical therapy, pain management care and the appropriate medications. However, despite the very best care from his physicians his pain persisted. Disabled and down he was in no shape to return to work.
Brown began to develop symptoms of depression and anxiety. His life at home with his wife and children became tense. He felt worthless and began to withdraw from his social network. Unmotivated to the extreme, Brown found he was unable to handle his daily routine without assistance. These limitations to his daily functioning were both physical and psychological.
Brown was eventually referred to Behavioral Medicine Associates for psychological care, where he received a comprehensive program of cognitive behavioral psychotherapy. This program enabled him to cope with his physical pain and deal with his disability. Due to the effective therapies Brown underwent, he was eventually able to adjust to the changes in his life, learning how to better cope with his pain. These coping techniques helped Brown improve his relationships with his wife and children, and re-engage with his social network.
Once Brown’s psychological problems were under control he was able to turn his attention to his physical rehabilitation. He is currently undergoing physical therapy but now has the behavioral skills needed to enjoy life and accept his condition.
These two brief examples show that psychological treatment can be a critical part of the recovery process from a workplace injury. At Behavioral Medicine Associates, we’ve learned from experience that workplace injuries very often require psychological care.
Without behavioral care, these workers would have continued to suffer without relief. Their families also would have suffered. Whether the issue is something solely psychological like John Smith’s post traumatic stress, or Joe Brown’s combination of behavioral and physical factors, in both cases the patients needed psychological care.
BMA is sincerely grateful to have the opportunity to offer workers like these the individualized care they deserve.
Behavioral Medicine Associates provides care for injured workers in offices throughout the New York metropolitan area.
Names have been changed to protect the privacy of the patients involved.