Compensation‐neurosis and the psycho‐social requirements of the family

Abstract

This paper discusses the application of basic theories of family functioning to understanding the syndrome consisting of abnormal-illness behaviour centred around a recompensable illness or injury. It sets out the socio-cultural matrix out of which it arises and postulates that compensation-neurosis may be viewed as a homeostatic response of the family system when major psycho-social requirements are not being met and the family is under stress or in crisis. It looks at two common paradigms of compensation-neurosis as met in the rehabilitation unit of a large hospital, and at the application of the theory, and gives further examples of homeostatic adjustments to meet family requirements such as those of attachment. It also uses group and inter-group dynamics to further clarify the syndrome in psycho-social terms. It goes on the discuss the implications of these theories for prevention and management of this difficult syndrome.

Pseudodementia or Ganser Syndrome in a Ten Year Old Boy

“…G would seem to fit many of Ellard's (1970) features of psychological reactions to injury including: (i) the absence of what one might describe as the objective signs of suffering; (ii) the absence of objective clinical signs to support his specific complaints; (iii) lack of motivation to get well; (iv) an unusual attitude to treatment; (v) the lack of positive features of neurotic illness. Rickarby (1979) has raised the importance of family factors in relation to responses to compensable injury. He suggests that stress on 'the family provider' and circumstances surrounding migration may both be important contributing factors in the development of a compensation neurosis.…”

The Workers' Compensation System in Victoria: Who Takes the Blame?

“…Various factors reponsible for the development of this 'condition' have been described. Yet others are concerned with wider social or family factors such as the changed family dynamics following a worker's injury (Rickarby 1979) or the adverse effects of multiple medical and legal encounters during the litigation of a claim (Lloyd & Stago1l1979). Yet others are concerned with wider social or family factors such as the changed family dynamics following a worker's injury (Rickarby 1979) or the adverse effects of multiple medical and legal encounters during the litigation of a claim (Lloyd & Stago1l1979).…”

“…Some authors simply ascribe it to greed (Miller 1961); others have looked at such psychological variables· as a need for dependency - (Ellard 1969) or lowered pain threshold (Mendelson 1984). Yet others are concerned with wider social or family factors such as the changed family dynamics following a worker's injury (Rickarby 1979) or the adverse effects of multiple medical and legal encounters during the litigation of a claim (Lloyd & Stago1l1979).…”

Die sogenannte ,,Rentenneurose" - psychopathologisches Syndrom oder obsoleter Begriff?

“…Vielleicht sind von den neueren Ansätzen, bei denen der Wunsch nach Entschädigung als Ausdruck einer Dekompensation familiärer psychosozialer Bedürfnisse interpretiert wird, bessere Ergebnisse zu erwarten, wenn es gelingt, die Motivation des Probanden bzw. der Familie zu wecken (Rickarby 1979). Auch der genannte Vorschlag von Tarsh und Royston (1985) scheint bedenkenswert, eine eventuelle Entschädigung an die Mitarbeit bei therapeutischen Maßnahmen zu knüpfen, wobei hierbei die konkrete Durchführung das Problem sein dürfte.…”