I had a very difficult June, losing both my daughter-in-law and best friend to cancer. During that time (and since), my mind did something predictable.
I replayed the circumstances. The extended battle, the moment, the preparation of my BFF’s eulogy / watching my son eulogize his wife, the fond memories of the past that remind me there will be no future memories to make.
The replays only helped let something in the past occupy my present. The more I replayed them, the more power I gave it.
Then I remembered cognitive reappraisal, a concept that psychologists have shared with me over the years in one-on-one conversations and from conference stages.
Reframe.
Reframing doesn’t change what happened. It changes the frame (or prism) through which we look at what happened. The facts remain the facts. Instead of asking, Why did this happen to me?, the question becomes, What can I do with where I am now?
Instead of counting my problems, I started deliberately counting my blessings (yes, I sang that song to myself). Instead of continually looking backward, I tried to redirect myself toward the present and eventually toward the future.
I did not pretend the difficult things didn’t happen. I simply decided they did not deserve unlimited reruns.
How often do we make injured workers replay instead of helping them reframe?
Think about what happens after a workplace injury. The supervisor, then HR, asks what happened. The initial medical provider asks. The nurse asks. The claims adjuster asks. The nurse case manager asks. Maybe an investigator asks. If litigation occurs, attorneys, experts, and others may eventually ask.
Tell me what happened.
Again. And again. And again.
Obviously, that information is necessary. Clinicians need an understanding of the medical history. Claims professionals need to investigate the compensability of the claim. Employers need to understand how an accident occurred so they can mitigate future accidents. There are legitimate medical, legal, safety, and administrative reasons for asking questions.
I wonder whether we sufficiently appreciate what we may also be asking the person to do: Replay one of the worst moments of their life.
For us, it may be another claim intake.
For them, it may be the moment the machine caught their hand, the ladder moved, the truck crossed the center line, they heard the pop in their back, they looked down and realized something was terribly wrong.
We need the story. But perhaps we don’t need to keep making them live in it.
What if we changed the questions? This is where reframing becomes interesting to me from a work comp perspective. After we have the facts we legitimately need, what if more of our conversations shifted from:
What happened to you?
to
How are you doing today?
Followed by:
- What’s better than it was last week?
- What can you do today that you couldn’t do a month ago?
- What are you looking forward to getting back to?
- What’s important to you outside of work?
- What would progress look like to you?
- What can we help you accomplish next?
Notice what those questions do. They don’t deny the injury, minimize pain, or promise an outcome. They certainly don’t eliminate legitimate claims investigation or medical history-taking. They simply move the center of gravity. The injury becomes part of the person’s story rather than the only part of the story.
That is a very different frame.
We tend to measure what is wrong. Workers’ compensation is remarkably good at documenting deficits …
- Pain is 7 out of 10 (FYI … I have not been a fan of the visual analog scale since 2003)
- Range of motion is limited
- MRI shows this, restrictions prohibit that
- Employee cannot lift 20 pounds
- Employee cannot stand longer than 30 minutes
- Employee has not reached maximum medical improvement
Those measurements matter.
But imagine experiencing your recovery primarily through a system that continually catalogs everything you cannot do.
What happens if we also start measuring what is returning?
- I walked to the mailbox today
- I drove for the first time
- I slept through the night
- I picked up my child
- I made dinner
- I worked four hours
- I laughed with my coworkers
- I went fishing
- I had an entire afternoon when I didn’t think about my injury
Those things may never appear in a claims system, but they are evidence of recovery. Some of our most important milestones don’t have billing codes.
This connects directly to empathy. On September 3 I wrote about empathy not being soft, but strategic. To me, reframing is a natural extension of that idea.
Empathy asks us to understand what an injured worker may be experiencing. Reframing asks us what we can do with that understanding.
We cannot change the accident. We cannot un-break the bone. We cannot erase the surgery. We cannot give someone back the Tuesday morning before everything changed.
But we can be intentional about where our interactions direct their attention next.
- Toward the injury or toward recovery?
- Toward everything they’ve lost or toward what they’re regaining?
- Toward what happened or toward what happens next?
That doesn’t require becoming someone’s therapist. It requires becoming more thoughtful about our words.
To be clear, reframing isn’t positive thinking. Telling someone who is hurting to “look on the bright side” isn’t reframing. It could actually be perceived as dismissive, condescending, or invalidating.
Reframing doesn’t replace reality with optimism. It expands reality.
- Yes, this happened … and this is where we are now.
- Yes, you still have pain … and look at the progress you’ve made.
- Yes, your life may be different … and let’s talk about what you want that life to look like.
Both things can be true.
That’s what I had to (re)learn this summer. Counting my blessings didn’t dry my tears. Being present didn’t rewrite the past. Looking toward the future didn’t mean pretending everything behind me was wonderful. I just stopped giving the replay button quite so much attention. Instead, I focused on supporting both surviving spouses and my two granddaughters.
Workers’ compensation professionals encounter people during seasons they didn’t choose.
We cannot control how someone responds to an injury. We cannot manufacture resilience. And we should never trivialize the emotional consequences of having health, independence, income, identity, or purpose suddenly disrupted. But we can influence the environment surrounding their recovery.
Every conversation can reinforce the injury or create a little more room for the person beyond the injury. Every question can pull someone backward or help them look forward. Every interaction can focus exclusively on what’s wrong or remind someone of what’s becoming right again.
We will always need to ask: “What happened?”
Maybe we just need to become equally good at asking: “What’s possible now?”
The past deserves to be understood, but it doesn’t deserve to be lived forever.
