Car Accident Therapy

By Dr. Batya L. Ludman, Psy.D., FT · Published October 20, 2019

Working at my desk, my concentration was broken by a loud bang. Running outside, calling to my daughter to call the police, I sensed that this was no small accident. I got outside just as a mom and daughter were emerging from one car and a man across the street from another. The woman, barreling down the street, and the man backing out of a driveway, collided. The woman lost control of her car, crossed the road, smashed my parked car and came to a stop after hitting my neighbor's car. It was a miracle that no one was physically injured. Given that motor vehicle accidents (MVAs) are such a frequent occurrence in this country, we have so many potential miracles to be thankful for, but sadly, most of us are too busy or too angry to take notice. One can't change the fact that the accident happened, but one can definitely reduce the traumatic impact it has, both at that moment, and for the future.

It is precisely because this accident was handled so well that I believe it can serve as a model for an appropriate and healthy response on the road. It was a surprising moment really: four cars seriously damaged and yet all involved remained surprisingly calm. With so many MVAs in our small country, learning how to cope effectively both before and after a situation arises can be a matter of life and death. The first goal is that of prevention, and the second, to minimize physical and emotional harm. A MVA, no matter how serious, can be potentially traumatic, and if dealt with poorly, can result in symptoms far exceeding the original medical concerns. By the time those involved reach my office as patients, they are often displaying signs of post-traumatic stress. Those who return to driving may be anxious, hypervigilant, have panic attacks, sleep disruption, pain, nightmares, intrusive thoughts, headaches, anger outbursts, depression, and more. Some clients who refuse to drive ever again, suffer tremendously, even as passengers. Others have lost their jobs, have had subsequent marital and family issues and feel scarred for life, even if physically all their wounds seem to be healed. With so much happening so quickly and so unexpectedly, a MVA can overwhelm the nervous system, leaving one feeling out of control and unable to cope.

Running out of the house that day, my first concern was to ensure that no one was physically injured. In spite of airbags inflating and debris scattered across the road, at that moment, no one seemed hurt, or if so, not seriously. The next step is what I believe changed the entire response of all participants in the accident. Trained in providing psychological first aid, I was able to go over to each person: the mom, her 9 year old daughter, the man, his wife who came out from the house, and our neighbor- all in some degree of shock - and focus them on the key issue . With no one seemingly hurt, I looked each in the eyes and said, "Thank Gd, no one is hurt. You are safe, you are okay, you will be okay and everyone is okay". Reassuring the injured reorients them and lets them know that at this particular moment they are, or will be, okay and are being cared for. It gives their nervous system, which just got a jolt- physically and mentally - time to slow down, regain a state of calm, and settle naturally. This first step helps them to focus on what is important, keeps them in the present moment and most importantly helps the healing process begin. The purpose here is to give your body the necessary time it needs to recover from the normal flight/fright/ freeze response that may have occurred upon impact. Your understanding of your body's response to a traumatic event and your subsequent actions and behavior will help determine the outcome. Your body literally needs this time to recalibrate, orient itself to what just happened, realize that all is okay, and then recover from the shock and adrenaline surge. Psychological first aid focuses on the body in a way that promotes physical healing, through enabling one to slow things down, use techniques that promote "relaxation", and work through potentially traumatic events without becoming overwhelmed in the process. You can be trained to effectively heal yourself and help others become more resilient and cope better with life's surprises.

With respect to prevention, I leave you with just a few thoughts:

  1. Put yourself in the best emotional and physical state before starting the car. Fatigue, hunger, preoccupation etc. can affect your driving. Take a few slow deep breaths, scan your body to ensure that you're calm and relaxed, and only then, start the car, in a mindful state. Red lights rather than being stressful, can be seen as opportunities to take a few more relaxing breaths.

  2. Model good driving habits. Teach your children early on that your car only starts when everyone is belted. Make helmets compulsory when cycling and remember that electric bikes can be lethal.

  3. Drive with both hands on the wheel and your entire focus on the road. Cell phones are an extremely dangerous distraction. Use them appropriately and don't multitask. If you must talk, or text, pull over to the side of the road.

  4. Your teenager is checking out your behavior. Be polite, considerate, and respectful of others. Teach your child to yield the right of way and never assume that just because it's "his turn" that he can actually go. Teach him that drivers will cut him off, fail to signal, tailgate, toot their horn while the light is still yellow, pass on the shoulder, and double park. Don't drive illegally just because others do. Drive defensively.

  5. Don't fight with anyone on the road. It just isn't worth it. People will scream, yell, gesture and get out of their car. Remember, road rage can kill.

  6. Don't drink and drive, and don't let your children go into any car with a driver who does. Ensure them that you'll always drive them home or pay for transportation, no questions asked. Talk to your children about peer-pressure and let them know their friends may be the death of them-literally. Make sure your child has had a good night's sleep before getting behind the wheel of a car. If you don't like your child's driving, take away the keys until you do.

  7. Take a course in defensive driving and basic first-aid. Get involved with Hatzalah, MDA, the local citizen's watch and the traffic police.

Car accidents are not something we generally like to think about. While an ounce of prevention is worth a pound of cure, it helps to know that your first response can potentially save lives.

A version of this article suitable for printing is available here.