Psychotherapy After the Motor Vehicle Collision.Freely Expressed Observations.
Pain – is one of the car accident
consequences. Very often – it is a severe
pain in muscles and joints. It doesn’t allow sleeping, interfuses every single
minute of the person’s life, and causes low mood and social withdrawal. Don’t
forget – the reasons for that pain are not visible. Hence the relatives and
friends have real difficulties to realize what kind of hard time their close
ones have. Thus even a minor car accident may seriously affect the person’s
connections with the referent group.
Additionally to the physical injury the
behavioural and emotional resultant from the motor vehicle accident might be
intensive. Many drivers say their driving changed: they became unconfident,
refuse to drive on the highways, prefer not to change the lane any extra time,
have spates of anxiety when passing the place where the accident happened,
obsessively check mirrors and so on. Some people refuse from driving (at least
temporarily). Often together with
anxiety and general tension – depression symptoms come: lack of energy, loosing
interests, avoiding sex, irritability, bad sleep (not only due to pain), etc.
Hypothetically: the worse was the accident
the more significant might be a psychological impact. I dare to say – it is a
myth. Providing people after the motor vehicle collision with psychotherapy at
the rehabilitation clinic I noticed: there is no plain correlation between the
severity of the accident and the severity of the mental and emotional
consequences. Sometimes people develop serious depression symptoms after their
cars were hit at the parking lot or at the red light where no high speed was involved.
And sometimes I have a chance to talk to people with totally different
experience. In the uttermost case they almost “put the car onto the roof” (due
to somebody’s fault), felt seriously stressed out and then – “shook it off”, said
“things happen”, and moved forward. For instance, motorcyclists usually don’t
quit riding the motorcycles even if they barely survived at the collision.
You ma y say: individual traits determine
the reaction. It is true! Similarly some cognitive stereotypes and
introjections actively “participate’ in the processing of the motor vehicle
accident experience. Some clients really struggle to accept the fact of the
accident if they believed that “nothing wrong may happen to me if I do
everything right” or “everything is up to me”. These formulas don’t work at
least for driving: it is clearly dangerous to ignore other drivers’ attitudes
and mistakes.
Meanwhile there is one more observation I
would like to share in this little article. When the psychotherapeutic
relationship achieves the stage of real trust the client becomes able to
explore the emotional content of the moment when the collision happened. People
say – “it happened so fast”. Together we try to stretch the memory image, to
watch it like a decelerated movie. Then more details exude. The regularity is
following: the drivers (passengers or pedestrians) who develop depression
symptoms after the car accident state the moment of the “danger for their life”, “fear
of death” accompanied by the thoughts “I’m gonna die right now”, or “that’s
it”. My question “Have you survived?” causes the clients perplexity I cannot
compare with anything else.
Having said that I am a Gestalt therapist
it is easy to imagine the general psychotherapeutic strategies which may be
applied: work on the awareness that the client’s death “has not come yet, and
you are alive”. Emphasis “here-and-now functioning” and mindfulness procedures
in relation to the current client’s life are the main therapeutic
interventions. It may seem strange, but working on depression and anxiety
issues caused by the car accident I talk to the clients and ask them about
their actual inter-personal communication, their daily routine, parenting
issues, their bosses’ caprices, etc. And it helps!
There is another kind of scenario - when
the psychological consequences of the motor vehicle collision unobviously are
connected with pre-existing issues. I don’t mean now so called “pre-existing
conditions”. I mean that the stress caused by the collision actualizes the
issues which took place way before the accident and were not solved on time.
Surprisingly work on the “pre-accident” difficulties turns worthwhile. We
don’t have to be attached to the “car accident topic” to provide clients with
the help they need due to the unfortunate collision on the road. I like to repeat: “The
better you understand yourself, your feelings, reactions and relationships –
the better you drive”.
