Two Years After the Accident: Sarah and Tom's Journey Through Trauma
Friday, August 16, 2024.
On a bitterly cold winter’s night, in the quiet, wooded landscape of Western Massachusetts, Sarah and Tom’s lives were forever changed by a late-night collision with a deer.
The accident left them both with minor physical injuries but significant emotional scars.
Now, two years later, they are sitting in my office, trying to navigate the long-lasting effects of that traumatic night.
Re-Experiencing the Trauma
Replaying the Memory
For Sarah, the night of the accident plays on an endless loop in her mind.
She recalls the moment when the deer appeared out of nowhere, the violent thud as it hit their car, and the sound of shattering glass.
Despite the two years that have passed, these memories remain vivid and intrusive. As their therapist, I explained that this is a common reaction to trauma. The brain, particularly the hippocampus, struggles to properly encode the traumatic experience, leading to persistent and distressing recollections (Brewin et al., 1996).
Nightmares
Tom, meanwhile, has been tormented by nightmares. Although the collision itself was horrifying, his dreams are filled with abstract scenarios of being trapped or chased through dark, wooded roads. These nightmares, which echo the trauma without directly replicating it, are the brain’s way of processing unresolved fear and anxiety.
Research by Nielsen and Levin (2007) supports this, showing that post-traumatic nightmares often reflect the emotional themes of the trauma rather than the exact event.
Flashbacks
Even now, two years later, a sudden movement on the road can send Sarah into a flashback. The sight of a deer grazing by the roadside or a shadow crossing her path triggers a visceral response, as though she is back in that moment, reliving the impact.
Flashbacks are a hallmark of PTSD, where the brain is triggered into re-experiencing the trauma with all the accompanying emotions and physical sensations (Van der Kolk, 2014).
Emotional Reactions
Fear and Anxiety
Since the accident, Sarah has developed a deep-seated fear of driving on Route 9 at night. The anxiety is overwhelming, often causing her to avoid situations requiring driving altogether. This hypervigilance is a natural response to trauma; the amygdala, responsible for processing fear, remains on high alert, interpreting even benign situations as threats (LeDoux, 2000).
As we work through these emotions in therapy, we focus on gradually reintroducing Sarah to drive in safe, controlled environments to help her rebuild her confidence.
Anger
Tom’s emotions took a different turn. He has been struggling with intense anger—anger at the deer, at the circumstances, and even at himself for not being able to prevent the accident.
This rage often spills over into their relationship, creating friction between them. Anger is a common reaction to trauma and can stem from the frustration of feeling helpless or out of control during the event. According to Orth and Wieland (2006), anger after trauma is a way to regain a sense of power, but it can also impede the healing process.
Sadness
Both Sarah and Tom have experienced deep sadness, mourning the loss of their peace of mind and the ease with which they once navigated the world. This sadness is often accompanied by tears, which serve as a physical release of the emotional pain they are carrying.
Crying is linked to the parasympathetic nervous system, which helps the body calm down after stress, but it also signifies the profound impact the trauma has had on their lives (Gračanin et al., 2014).
Guilt
Tom has been grappling with guilt since the accident. “I should have seen the deer sooner,” he often says in our sessions. This self-blame is common among trauma survivors, who believe they could have prevented the event if only they had acted differently.
This kind of thinking is particularly harmful because it creates an unrealistic sense of responsibility for something that was largely out of their control. Kubany and Manke (1995) explain that guilt is a significant barrier to recovery and must be addressed with compassion and realism in therapy.
Feeling Numb
As time has passed, Sarah has begun to feel emotionally numb. While she continues to go through the motions of daily life, she often feels disconnected from her surroundings and even from Tom.
This numbness is the brain’s way of protecting itself from overwhelming emotions by creating a buffer.
However, it can also prevent Sarah from fully engaging in her relationships and enjoying life’s positive moments (Foa et al., 2006). Our work together focuses on gently reconnecting her with her emotions in a safe and supportive way.
Avoiding Things Related to the Trauma
Trying Not to Think About the Event
Both Sarah and Tom find themselves avoiding any discussion of the accident.
They have tried to bury the memory, distracting themselves with work, hobbies, and other conversations. While this avoidance is understandable, it can hinder the healing process.
The mind, in an attempt to protect itself, pushes away the traumatic memory, but this also prevents the necessary processing that leads to recovery (Rauch et al., 1996). In therapy, we are working on gradually bringing these memories into the open, allowing them to be examined and integrated.
Avoiding Triggers
Tom has also developed a strong aversion to driving on Route 9 at night. For Sarah, the sight of a deer—whether in real life or on television—sometimes elicits an intense emotional response.
Avoidance of these triggers is a common coping mechanism, but it can reinforce the fear and prevent healing.
Foa and Kozak (1986) found that exposure to feared stimuli in a controlled environment is often necessary to reduce the power of these triggers. I’mn slowly introducing Tom and Sarah to engage in these situations in a way that feels more safe, helping them reclaim their sense of security.
Changes in Worldview and Self-Perception
Difficulty Trusting People
The accident has shaken Sarah and Tom’s trust in the world around them. They find it hard to believe that the roads are safe or that they can predict and prevent future dangers.
This erosion of trust is a common outcome of trauma, as the event challenges the fundamental belief that the world is a safe place (Janoff-Bulman, 1992). In therapy, I’m working on rebuilding their trust, not only in the external world but also in their ability to handle whatever challenges may come.
Believing the World Is Dangerous
Sarah, in particular, has developed a heightened sense of danger. She now sees the rural area he lives in as full of potential threats, from driving to crossing the road.
This shift in perspective is a typical response to trauma, where the brain’s survival mechanisms are on high alert, leading to an overestimation of risks (Ehlers & Clark, 2000). I’m addressing these distorted perceptions through some cognitive-behavioral techniques and helping Sarah regain a balanced view of the world.
Blaming Themselves
Self-blame has been a persistent issue for both Sarah and Tom. They each replay the night of the accident in their minds, thinking of what they could have done differently to avoid it.
This hindsight bias, where the outcome seems inevitable and preventable in retrospect, often leads to unnecessary guilt and hinders recovery (Kubany & Manke, 1995). In our sessions, we are working on challenging these self-critical thoughts and replacing them with a more compassionate and realistic understanding of the event.
Criticizing Their Reactions
Sarah often berates herself for her continued fear of driving, while Tom is frustrated by his lingering anger.
This self-criticism is common among trauma survivors, who feel they should be able to “move on” from the event.
However, trauma responses are not a reflection of personal weakness but rather the brain’s way of coping with overwhelming stress (Shalev, 2009). My scope of work involves normalizing these reactions and helping them develop healthier ways to process their emotions.
Feeling Inadequate
Tom has struggled with feelings of inadequacy since the accident. He questions his ability to protect his family and worries that he has failed Sarah.
This diminished self-view is a frequent reaction to trauma, where the survivor feels that the event has exposed a fundamental weakness (Joseph & Linley, 2005). In therapy, we are exploring these feelings and working on rebuilding his sense of self-worth.
Hyperactive Nervous System
Constant Vigilance
Even two years later, Sarah remains hypervigilant, constantly scanning the road for any sign of danger. This state of heightened alertness is the brain’s way of trying to prevent another traumatic event, but it can be exhausting and detrimental to her overall well-being (LeDoux, 2000). We are working on techniques to help her gradually lower her guard and feel safe again in her daily life.
Startling Easily
Tom finds that he is easily startled by sudden noises or movements, a common symptom of a hyperactive nervous system.
This exaggerated startle response indicates that the brain is still in a heightened state of alert, ready to react to perceived threats (Rauch et al., 1996). Through relaxation techniques and controlled exposure, We’ve had some success retraining his nervous system to return to a calmer state.
Difficulty Sleeping
Both Sarah and Tom continue to struggle with sleep, often lying awake at night replaying the accident or fearing another disaster.
Sleep disturbances are a common issue after trauma, as the brain remains hyper-aroused, making it difficult to enter a restful state (Germain, 2013). I am exploring various strategies, including introducing mindfulness and sleep hygiene practices, to help them regain a healthy sleep pattern.
Seeing Danger Everywhere
Sarah’s heightened sense of danger extends beyond driving; he now perceives threats in everyday situations. Her heightened sense of danger extends beyond driving; she now perceives threats in everyday situations—whether walking through a parking lot or even while at home.
This hyperawareness is a result of the brain’s attempt to protect itself by staying in a constant state of readiness for potential threats.
However, this state is not sustainable and can lead to chronic anxiety and stress, further disrupting his daily life (Ehlers & Clark, 2000). In therapy, we are working on grounding techniques to help Sarah stay present in the moment and distinguish between real and perceived threats.
Loss of Interest in Sex
Both Sarah and Tom have noticed a decline in their sexual relationship since the accident. The trauma has not only affected their mental health but also their physical connection.
The loss of interest in sex is a common post-trauma symptom, often stemming from a combination of emotional numbness, anxiety, and a lack of safety (Reisman, 2009). As we address these underlying issues in therapy, we are also focusing on rebuilding intimacy in a way that feels safe and comfortable for both of them.
Moving Forward: Healing and Reconnection
Two years after the deer collision in Western Massachusetts, Sarah and Tom are still grappling with the psychological aftermath of that night.
However, through their work in therapy, they are gradually learning to manage their symptoms and rebuild their lives. The road to recovery from trauma is often long and challenging, but with the right support and strategies, it is possible to heal.
I’m using a combination of cognitive-behavioral therapy (CBT), Gottman Interventions, exposure therapy, and mindfulness practices to help Sarah and Tom process their trauma and regain a sense of safety and control in their lives.
This journey involves not only managing their individual symptoms but also addressing the impact the trauma has had on their relationship. By working together in therapy, Sarah and Tom are beginning to reconnect with each other, finding new ways to support one another as they heal.
Final thoughts
Trauma can leave deep scars that linger long after the event has passed.
For Sarah and Tom, the collision with a deer on a dark road in Western Massachusetts was more than just an accident; it was a life-altering event that shook the very foundation of their relationship.
However, through their ongoing work in therapy, they are learning that while trauma changes you, it doesn’t have to define you. With time, patience, and the right support, Sarah and Tom are beginning to reclaim their lives and rebuild their relationship on stronger, more resilient grounds.
Be Well, Stay Kind, and Godspeed.
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