Dear Dr. Neimeyer,
I was recently in a deadly car accident that took the lives of my two beautiful, funny, and loving baby girls, ages 6 and 8. The accident also resulted in my surviving teenage year old daughter being a paraplegic, and my husband having a TBI, and several fractures in his face, arm, leg and hip. He’s non-weight bearing on 3 limbs and is also wheelchair bound. I was the least injured with a broken leg and arm, and am no longer using any assisted devices.
Night time is the worst for me. I have PTSD from the accident, and re-live it almost every night. I’m back in the car, looking around, telling my teenager that everything will be okay, and that the ambulance is on the way. I look to see my unresponsive husband face down on the steering wheel, but snore-breathing. I hear my youngest crying, telling her teenage sister to “get off” of her but my teenager could not move, I just continued to tell them that it will he okay and help is on the way. I saw a pedestrian with my 8 year old, lying on the ground outside of the car after other pedestrians took all of my kids out. When the ambulance finally arrived, and put my oldest daughter on a stretcher, I saw her pale blue arm fall to the side as she looked asleep. I had no idea that my kids were that bad off. I just yelled to the paramedics “please hurry, she’s turning blue!” I had all the faith that in their care, my kids would be fine.
I was the last to be taken, and due to my small collapsing veins, no meds were given to me. The 40 min ride to the hospital was torture as I had an open tib/fib fracture and broken arn/wrist. While in the ER, a nice man introduced himself as a chaplain, to tell me that my 8 year old did not survive. I just cried and could not believe or comprehend what was going on. A while later, two men came to me, one on either side, introducing themselves as chaplains. I just yelled “No!” As he then began to tell me that my 6 year old did not make it. These memories are so vivid and although my husband has lost over 2 months of memories at the time of the accident, I wish it were me who did not have the memories sometimes. However, I’m sure that if I did not remember, I’d wish I had… I just want to be able to lie down at night, say my prayers, get comfy in bed, and fall asleep, without reliving that night over and over again. I’ve been told that medication can help, but I’m hesitant to try them, as I really don’t like to take meds. Is there a moment where one decides that NOW is the time to start a medication regimen?
Some days I feel so depressed, angry, and cheated. Even while helping my daughter shower, change her clothes or her ostomy bag, or even helping her cath herself, I feel like my attitude stinks, and she can see it. I fear she thinks I’m angry with her, when I’m really angry at this whole situation. I find that I feel guilty when doing things that bring me joy, and I worry that my responsibilities to help my husband and daughter will prevent me from grieving appropriately, finding meaning, or even finding a new hobby (as taking care of my family kept me pretty busy). I mostly worry about allowing my anger build to create relational problems with my husband and daughter.
I’d really like to find a group of grieving mothers to join, and a group for my whole family to join (or for my husband and daughter to join individually).
(I am a Mental Health Therapist, myself, and am less than a year away from my licensure , but since this accident, everything has been out on hold. )
I’m not sure exactly what I’m asking you here, but maybe just some guidance and/or some validation? Thank you, for your time.
I am sure that every reader who absorbs your story with an open heart will feel some version of the great sadness that wells up in me as I read your words; one would be hard put to imagine a loss scenario more graphic, traumatic and heartbreaking than the one you and your family have suffered. In a single horrific accident two precious lives were ended, along with the life the survivors had known to that point, and that a lifetime will not return. Any thoughts I offer here presuppose this hard reality: there is no simple fix for a life story so tragically broken as the one you describe. But with effort and support, I am hopeful that a life worth living, and less anguishing, might be reconstructed in its wake.
You ask directly, “Is there a moment where one decides that NOW is the time to start a medication regimen?” Yes, there is, and that time could be now. Antidepressants are at best a partial answer to the many questions posed by your compound loss, as they don’t resolve the heavy traumatic overlay of your bereavement, or the acute separation distress you must feel in relation to the death of two of your children. But when the right medication and dosage are found–and this may take a few trials with a responsive psychiatrist–it can help establish a stronger emotional foundation under you on which to build. Beware reliance on fast-acting but addictive anti-anxiety drugs, but do consider speaking with a patient and wise physician about antidepressants that can help stabilize your mood over time.
Second, as you are clearly aware, the nightmares of the horrific accident represent the tip of an emotional iceberg that calls for a trauma-informed approach to therapy. EMDR and other prolonged exposure therapies, which require you, with therapeutic support, to re-engage the hardest details of the accident story, would likely be a core part of such treatment. This requires careful management by a therapist specializing in trauma and its treatment, rather than a generalist counselor or therapist. Ask around, and consult with any therapist you consider seeing for a single session without commitment to go further, and in that session, describe the general details of your experience as you have here, and ask for his or her approach to treatment. Make sure, with his or her response, that two key conditions are met: (1) that you feel safe and understood, and (2) that the therapist can offer specific, trauma-focused processing of your horrific experience. Slow motion review of the imagery and feelings associated with the accident would be key to this, though the specific procedures (prolonged exposure, restorative retelling, EMDR) will vary. If either of these conditions is not met, thank the person for the session, ask to think about it, and go elsewhere. More than general support or even grief therapy is needed in the face of losses like yours.
Third, despite the emphasis on the trauma symptoms that therapy might need to tackle first, recognize that profound grief is also central to the suffering you are enduring. And unfortunately, many trauma therapists are unfamiliar with this dimension of therapy, which may entail a close review of your distinctive grief responses for each of your little girls, and the reconstruction of a non-physical bond with them, of a psychological and perhaps spiritual kind. This may therefore call for distinctive grief work with a therapist who specializes in this, of which–fortunately–there are several to be found in your part of the country. Inquire widely and wisely, and consider this as a third step on your road to rebuilding.
Fourth, as you recognize every minute of every day, your grief is about more than even the tragic death of your two youngest daughters: the “living losses” suffered by your daughter and husband greatly compound your bereavement. When the losses keep going and going, with no end in sight, survivors often experience a kind of “chronic sorrow” that defies the usual expectations for grief “recovery” (if indeed one can ever truly use that word when losses are profound). Different from both major depression and angry resignation, chronic sorrow can entail a sense of disillusionment in life, a recognition of our collective vulnerability, and an impatience with the petty preoccupations of many in the social world. Integrated in an adaptive way, it can in time become a source of depth and wisdom–though the price paid for this, with no prospect of a refund, continues to feel disproportionate. You might find reading about this, and also engagement in some form of caregiver support group, helpful in this regard.
And finally, as the months make tragically clear that your old life will never return, strive to hold firm to the knowledge that many people bravely find a way forward through very great adversity to lives that are worth living. Finding support for the caregiving your loved ones will continue to require, in a way that permits you to pursue your own career as a mental health counselor (as well as simply find some respite to recharge your badly depleted batteries), will probably need to be a part of this. You cannot tend to your loved ones’ lives if you neglect your own. Compassion is the fuel you will need to care for them in the years to come, and self-compassion needs to be the additive required to do so.