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Archive for July, 2015

Post Accident Trauma – a psychological perspective

Thursday, July 23rd, 2015

When we think of road traffic incidents we generally think of the incident itself, or perhaps the physical injuries that can occur, but there are serious psychological issues as well.
Road traffic incidents have all the ingredients necessary for post-traumatic stress disorder. It’s entirely possible that someone could survive a road traffic incident physically uninjAttractive business woman with eyeglassesured but suffer psychological trauma, due to other occupants in the vehicle either being killed or injured. In some cases just the sudden violence of the incident is enough to trigger post-traumatic stress disorder.
Post traumatic stress disorder is often associated with soldiers in active service abroad but our minds work the same way, whether the trauma is a bomb or an incident on the road. Road incidents can happen very quickly. If the driver and car occupants are conscious, the stress reaction will kick in straight away. The heart will begin racing to get blood to muscles that may be used for escape, and the part of the brain we think with, the pre frontal cortex, will reduce activity as we rely on our reactions. That is one reason why it’s good to practice controlling skids or slides in controlled circumstances. If the manoeuvre becomes a reaction rather than a conscious thought, you have a better chance of getting it right when something really goes wrong.
Back to the stress reaction though. In itself the stress reaction can help us in emergency situations. It can help us get out of the car because our bodies are prepared to respond quickly and strongly. That’s what the response is for. The incident itself will be stored as an emotional response, so that, if similar circumstances happen again, the body will react even faster.
That reaction was great when it helped our ancestors deal with a predator. They would have a near miss with a predator and then, if later something reminded them of the incident, the reaction would kick in and help them escape before trouble got any closer. They would even have flashbacks, as the memory bedded in and they learned to react to it.
The problem arises when we have an incident in a car and then later the flashbacks go on too long or things unconnected with the incident create the reaction. It’s normal for some reactions to a serious incident to go on for a couple of weeks but a definite diagnosis of post traumatic stress disorder would only be made if the reaction went on for months.
As a result it’s often an invisible problem that can affect people’s lives for some considerable time. As always the question remains as to what we can do about it.
Interestingly, there are things we can do that will help. The mechanism within the brain that leads to traumatic memories being stored can be interfered with. Studies into post traumatic stress disorder done in laboratory settings have shown that there are benefits to undertaking a rational, logical task, such as playing a brain game or doing a maths problem, following a traumatic event. This diversion activity can prevent the stressful emotional memory forming fully and thus prevents a long term problem.
Of course it might be impractical to carry a game with you at all times but it’s worth remembering that you can set yourself a series of logical tasks to complete as soon as an incident happens. For example, most of us know we have to get the other persons insurance details and we can work through the logical stages of assessing injuries calmly, calling the police if necessary and so on. Planned distractions of this sort can go a long way to preventing longer term psychological damage.

 

References: Holmes E.A., James E.L., Kilford E.J., Deeprose C. (2010) Key Steps in Developing a Cognitive Vaccine against Traumatic Flashbacks.

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