The insurability and ‘curability’ of stress related disorders

Listening to Jean Paul Samputu[1], the Singer Songwriter from Rwanda, speak at the conference on Just Governance for Human Security in July 2017 in Caux, Switzerland, was a perspective altering experience.

Jean Paul suffered the loss of his parents by the hand of a ‘good family friend’ and also lost four siblings in the Rwandan Genocide in 1994.  Following the trauma of the genocide he spent nine years indulging in the pain numbing relief provided by alcohol and drugs before commencing the Samputu Forgiveness Campaign that saw him reconcile with the murderers of his parents and family.  He has since become an international ambassador for peace, speaking at the United Nations and universities throughout the world, as well as performing in six languages on a global stage.

Jean Paul’s story is tragic, violent, moving, inspirational and educational. It is a story which the audience views in awe, yet at a comfortable arm’s length distance, relating to his experiences with a somewhat removed level of empathy and admiration. This is not however, how I heard him share his experiences.

In addition to Jean Paul’s quiet strength, courage and beautiful voice, aspects of his life journey thus far profoundly align with the stories of many of the accident victims I have had the privilege to meet and assess, as well as those who have suffered the trauma experienced via the impact of medical negligence, injury and or illness on their functionality.

While it may seem impossible – unreasonable even – to put the trauma of genocide and the kind of losses suffered by Jean Paul alongside those of the survivors of accidents and individuals living with life altering disabilities or illnesses, one cannot divorce the mutually devastating impact of these events on their lives.  Ultimately, each of these events result in the experience of trauma and are all devastating in their own way, to which each individual responds in his or her unique and personal manner.

When given the task of assessing the impact of trauma and illness, particularly in the context of determining the ability of an individual to return to gainful employment and ‘back to the functional world’, it is imperative that one carefully considers, weighs up and balances the unique characteristics, personal strengths and energy with the facts specific to the party concerned.

In my professional experience no two individuals can be assessed in exactly the same way.  And no two sets of test results with a similar score can be properly interpreted in the absence of understanding the uniqueness of the story of the individual concerned.  While some are able to dig deep and engage with the kind of personal power Jean Paul ultimately found within himself, nine years later, some are not.  Some may not yet be ready to do so, and some may require specific professional and or supportive assistance.  There is no way to pre-determine how a particular individual will react to the stress created by unexpected, or diagnostically expected, incapacity.

In other words, the impact of stress and trauma on any given individual’s life is a factor that cannot be ‘rated’ at underwriting stage or pre-morbidly, nor assigned to or determined by a stand-alone score at claims stage.  Stress, and how one manages it, is entirely and uniquely personal.

In many instances it has been my professional experience that the stress of the claims process itself, and the need to attend a lengthy, personal and detailed assessment, renders an additional level of dysfunction through uncertainty, anger and fear.  I have also seen the process induce a degree of determination to ‘make somebody pay’ for the trauma suffered.   In other instances, when the extent of physical dysfunction is determined to be relatively minor, the emotional and psychological stress created by trauma may be unusually intense and incapacitating.  And then there are situations in which the individual is driven to ‘rise above’ their challenges, irrespective of what it takes attain success.

The bottom line is that no two individuals react in the same way to stress – and no specific method of treatment is guaranteed to provide the solution.

The only steadfast and reliable method of determining the impact of stress and trauma on an individual, and the successful management thereof that I have seen over the past 30 years, is to actively listen and fully engage with the person with a neutral and unbiased mind set in the time allowed.  It is through such active interaction that one can best determine what lies at the heart of the individual and whether there is a suitable means via which to assist them from a state of dysfunction to restored functionality.

For Jean Paul Samputu his ‘cure’ to the enormity of the stress that he had suffered and rendered him dysfunctional for a nine year period arose from his choice to forgive.  A choice he made for himself, not the offender.  In his words: ‘People often think that forgiveness is a gift to the offender. But forgiveness is for you, not for the offender.’

While stress may be uninsurable in-so-far as its causation and reaction is so very personal and unique, it is in fact ‘curable’ via the very same principles – i.e. personal and unique intervention.

Our duty as professionals working in the domain of assessment related to disability and incapacity is to acknowledge, identify and work within the context of the personal story of the individual concerned in parallel with the context of the brief that has been entrusted to us.  Striking the correct balance between the above-mentioned contexts is the cornerstone of robust objective and independent opinion.

Elise 

[1] http://www.samputufc.org