The illness process. Psychosocial hazards of disability programs

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Abstract
Recent studies of disability following industrial accidents illustrate an "accident process" in which social and emotional conflicts are resolved by substituting the "acceptable" disability of injury for the "unacceptable" disability of tension and depression. Aid to the Needy Disabled and other disability programs can become part of an analogous "illness process" in which medical impairment becomes the "acceptable" solution to a patient''s longstanding conflicts in living. When disability programs serve this purpose, they vitiate efforts to reduce the social and emotional tensions which really disable the patient. Physicians can be trained to elicit and interpret the information necessary to understand the development of the "illness process." Health professionals must learn how to help patients find less costly ways of coping with conflict than through the pseudosolution of chronic disability.

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