The term “new normal” has been used – some might say overused – since it became popular after the 2008 financial crisis. It was used then to reset expectations of growth from before the crisis to after the crisis. Since that time, it has become the pop-culture way to describe a permanent shift after a major event.
The work comp industry has often used this phrase to describe what happens to an injured worker after an occupational injury or disease that is going to have a lasting effect. MMI, or maximum medical improvement, is a statutory way to determine if someone will not likely improve with any additional treatment. However, MMI is often misunderstood as indicating the injured employee will be back to the same level of function they had prior to the incident. In reality, people are judged to be at MMI whose capabilities have not been fully restored.
This creates a “new normal” that requires an adjustment to how they work and live their life.
The purgatory I mentioned is about the journey TO the “new normal.” It is the recovery process that can often be one step forward and two steps backward. This process can seem overwhelming at the beginning, and so incrementally slow from day to day, that it might seem unattainable. Both of those – overwhelming and unattainable – can be a deterrent to motivation. This creates anxiety, doubt, and a loss of self-efficacy and locus of control (a fascinating concept that I’ve talked about since 2011; read this Psychology Today article for more information).
This was reinforced to me over a recent dinner with a great friend. He had been in the hospital for four out of five weeks at the beginning of this year. I visited him in the hospital on the third day when the prognosis was unknown but serious. I visited him again a few days later when he was better but still not out of the woods. I visited him twice during his second stay in the hospital when recovery was in sight.
Those weeks of lying in a hospital bed sapped his stamina and strength. He also had some new health conditions and medications that will be lasting. He was starting a new job that involves quite a bit of walking and so he was motivated to get back to his robust physical capabilities.
But when he was back home, he didn’t move because he lacked his usual physicality. We texted and he was extremely frustrated, and to some extent, depressed. He knew in his head that the prior five weeks of being sedentary and having new medical conditions had an impact, but when it translated to being out of breath after just a few steps, it still gobsmacked him. And demotivated him. He was in the “purgatory” of recovery – out of the clinical crosshairs but not yet back to his old self.
There was a disconnect. He knew intellectually that he had a “new normal” but he still wasn’t prepared for it. He knew he had to put in the work to rebuild his stamina, but the hill seemed too steep (literally and metaphorically).
So, I texted him … just walk to the kitchen and back to the living room. Every hour. He set a reminder on his phone. I set a reminder on my phone and texted him each hour. In those texts, I let him know that he wouldn’t get better if he didn’t try. He is an extremely competitive person, so I knew that if I gave him a goal and provided accountability that he would rise to the occasion. He did.
He was excited when he was able to go a little farther on the next iteration. The hourly schedule got so baked into his mindset that he provided an update before my reminder text. He was ecstatic when he first went outside to walk around his neighborhood. Slowly but surely, he gained confidence in the simple act of motion because he saw the small but measurable improvements.
When we met for dinner last week, we had a long recap discussion of his journey in three-plus months (it has been a whirlwind). We talked about how he has regained most of his mobility, has adjusted his diet, and embraced his “new normal.” Interestingly, it was so normal now that it was hard for him to remember the “old normal” (before his health concerns) or the purgatory of the recovery process. He has fully acknowledged and accepted his new limitations and it’s just, as a matter of fact, how it is. While he may miss some aspects of his “old normal,” he is living his “new normal” by asserting an internal locus of control. He is in charge of his attitude and actions.
Change is hard. It is manageable. But a person might need some extra TLC to get thru the slog of recovery into their “new normal.”
In work comp, that purgatory is where claims can go off the rails. It is reasonable for individuals to worry about their future. It should be expected they will be anxious working through a system for which they have no experience or education. We should anticipate that when the recovery gets hard or progress is imperceptible, motivation can dwindle. This is the human experience.
Don’t judge them. Help them.
