Psychotherapy After the Motor Vehicle Collision.Freely Expressed Observations.

      Looking around we can see different kinds of people: young and old, men and women, wearing pants or skirts and so on. And typically we don’t think about another possible classification: people who have never had vehicle accidents and people who have. In fact – only those who belong to the second group know how radically your life can be changed even by the minor (not catastrophic at all) motor vehicle collision.

     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”.




1 Response to " Psychotherapy After the Motor Vehicle Collision.Freely Expressed Observations."

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