I have been contacted by a producer for the Australian public television broadcaster, SBS. She works on a weekly current affairs discussion program called Insight. They are planning a show about what it is like to unintentionally cause someone’s death and would very much like to hear from Australians (only) who are CADIs. You can contact Madeleine.firstname.lastname@example.org. Thank you!!
Many years after my accident, I was shocked to learn that the road where I was driving at the time, U.S. Route 27 in Butler County, Ohio, was considered one of the most dangerous highways in America. It had even been nicknamed the Highway to Heaven. I had always considered the accident a very personal encounter between two unlucky souls – the child who ran into the road and me behind the wheel – but had given little thought to the road safety conditions that contributed to the accident. Although bad luck certainly played a part, so did external factors such as a narrow road with no shoulders, heavy traffic, and a relatively high speed limit. Worst of all, in that rural environment, all the mailboxes were located on one side of the street, which forced residents to cross the highway in order to retrieve their mail.
Only after the residents of Butler County along with local elected officials advocated fiercely for road safety improvements did the State of Ohio allocate funds to mitigate the worst problems. Today, the road is wider, with better signage and a lower speed limit. The mailboxes now sit in front of their houses so no one has to cross this busy highway. Butler County residents still consider Route 27 to be dangerous, but it is better than it used to be.
My experience is just one example of the ways in which individual behavior combines with environmental conditions to increase or decrease risk and road safety. In addition to the choices that individuals make, collisions and crashes are affected by policies/laws and how they’re enforced, urban planning and design, engineering, education, social norms, and more.
Despite many years and many millions of dollars devoted to improving road safety, traffic fatalities are on the rise. According to the National Highway Traffic Safety Administration, 37,500 people died in traffic accidents in the US in 2016, which was the highest number of fatalities since 2007. Distracted driving (e.g., texting, telephone conversations) surely contributes to this unfortunate trend. Too many people still neglect to fasten their seatbelts and/or drive after drinking. And the improved economy correlates with an increase in the miles that Americans drive each year, which leads to more crashes.
Recently, I have been learning about an international movement of sorts to improve road safety, especially for pedestrians and bicyclists. The organizations spearheading this movement are giving careful consideration to the external conditions that help to prevent traffic deaths. For example, the Vision Zero network seeks to “eliminate all traffic fatalities and severe injuries, while increasing safe, healthy, equitable mobility for all.” Vision Zero advocates for steps that help to prevent accidents, such as reduced speed limits, better road design, improved pedestrian cross-walks, and education and awareness-building to promote safe driving.
Some of the people in the front lines of this kind of advocacy have lost loved ones in traffic crashes. CADIs, too, have much to contribute to this issue. If you’re interested, here are a few links:
Several months ago the writer Alice Gregory posted on this site her interest in talking with CADIs. Many of you responded by generously sharing your stories and insights. Her article on the experience of accidental killing and the lack of resources to support CADI’s (my acronym for those who have “caused accidental death or injury”) has been published in this week’s New Yorker magazine:https://www.newyorker.com/magazine/2017/09/18/the-sorrow-and-the-shame-of-the-accidental-killer.
I think the article shows great compassion and insight, and I hope it will make a difference by raising awareness and motivating some psychotherapists, trauma specialists, or others to focus on this neglected group. It is already helping individuals (and their friends and family members) struggling with the experience of accidental killing. For instance, the article has dramatically increased traffic to this website. If you see more comments than usual showing up on the site, that is why.
The vast majority of comments I’ve received about this article, and other published work on CADIs, have been appreciative and supportive. A number of people have written to me about urban planning, public policy, engineering, and other programs and interventions intended to prevent car vs. pedestrian, car. vs. bicycle or car vs. car collisions. I will be looking into these programs more and will post about some of the more promising efforts. If you know about this, please write to me and share your experience or recommendations. I’m also interested in efforts to prevent other kinds of accidents, including workplace accidents, gun accidents, boating accidents, and the like.
Of course I strongly believe that CADI’s are deserving of compassion and support. With that comes an acceptance of responsibility and accountability. As awareness and understanding increase in our society, I believe that people will be more willing to invest in whatever steps are needed to reduce the number of accidents — better roads, bike lanes, improved lighting, new technologies, and so forth. This will make our world safer and, over time, the number of CADIs will decline.
This June marks the 40th anniversary of the accident that has so affected my life – an 8 year old boy darted in front of my car and was killed. Not a single day has gone by since then when I have not thought about that child. For the first year or two, in the grip of acute and post-traumatic stress, memories of the accident dominated my consciousness. In the middle of a meeting at the office or an evening out with friends, an image of the child would flash into my mind, pulling me away from the here and now and stoking my grief and guilt. Later, the memories became a harsh way of punishing myself. Whenever I felt celebratory or proud, some inner voice would say, “Remember what you did. You don’t deserve happiness. And it can happen again, so keep your guard up.”
I still think of the child every day, and occasionally the memories can still jolt me. For the most part, however, my thoughts and feelings about the accident and my role in it are far gentler than they used to be. I choose to honor this child, his family, and my own suffering by striving to live with purpose, appreciation and awareness. I regularly fail at this of course but I keep at it.
I hope and believe that better support for CADIs will lead to a more compassionate society – and that is helpful to all of us, whatever our life circumstances – victim, CADI, bystander, etc.
As our communities begin to understand how common accidents are and how many people are suffering because they accidentally killed or injured someone, we might see declines in risky behaviors such as distracted or drunk driving. As more people understand the pain that CADIs experience and extend support, we can create a more caring society. And, with such support, as CADIs learn to transform guilt and post-traumatic stress to post-traumatic growth, we will be able to give more of ourselves to others.
I still mourn for the child who died on the road that horrible day. I grieve for the pain that his family – and mine – endured. But I am committed to the effort of channeling this grief in productive directions, by offering support for others, by writing, and most of all by trying to show kindness toward others. To me, it’s the only response that makes any sense at all in the face of senseless tragedy.
The holiday blues is a well-known, even clichéd, phenomenon, but it’s true that this season can be especially challenging for CADIs. Some CADIs tell me that they are unable to muster the celebratory spirit that others expect of them. Some feel stricken with guilt and grief, knowing that another family is mourning a loss. Some feel that they do not deserve to be happy or receive gifts.
If you are in this situation, it is helpful to simply acknowledge your feelings, doing your best to withhold judgement. This might mean finding some private time every day to write in a journal, meditate, pray, rest, or cry. You don’t have to put the full scope of your distress on display, but neither do you have to fake happiness.
If you can, consider providing some form of community service during the holiday season. I believe that we honor the memory of our victims when we do this. You can serve Christmas dinner at a homeless shelter or VA hospital, visit children in the hospital, or deliver a meal to a homebound senior. There are dozens of choices – if you are not up to interacting with people, you can pick up litter on the beach, bring a few bags of old clothes to Goodwill, or offer to help out at your local animal shelter. You can also draft a guest blog and submit it to me for consideration for the website.
As most readers know by now, I believe in the healing powers of art and nature. This season, let’s take some time to listen to music that moves us, wander through a museum, or bundle up and take a walk in the woods. Let’s play an instrument, paint, draw, or write – and if you don’t have artistic talents, consider writing a poem anyway. These activities get us out of our heads and connect us to soul and spirit.
As I write this, I am popping chocolate candies into my mouth at an alarming rate! Sugar is my way of dulling unpleasant feelings like the holiday blues, but it leaves me feeling even worse, physically and mentally. So I hereby resolve to be more mindful of my eating this season. You might want to do the same, not to deny yourself the pleasure of delicious food but to help you feel better. The same goes for drinking, of course – remember that alcohol is a depressant.
Many therapists take some time off around the holidays, and the temporary absence of this support can be difficult. Your therapist should have someone “on call” to talk with you if needed. You can also call the suicide prevention line at any time of the day or night; and you can go to the ER if you need immediate attention.
Finally, remember that your accident does not define you. You could not control what happened, but you do have choices about how to respond. Even if you feel utterly stuck, the truth is that you are on a journey. It may be a challenging trip, full of unexpected obstacles, but you are moving toward solace, personal growth, and acceptance. Wherever you are in this journey, I hope you will take a few minutes over the next few weeks to look up at the night sky, or a snow-covered tree, or a simple wooden cross, or the flickering Chanukah candles, or a child’s face — and remember there is beauty in this world.
I wish us all a year of peace.
If you are a relative or friend of a CADI, one of the major challenges you may face is managing your own anxiety. This person that you love and perhaps rely on is suddenly in deep distress. It is extremely upsetting to see him or her suffer and to feel helpless in the face of it.
On top of this, you may have a whole set of worries – will he be arrested or sued? Will she be able to take care of the children or go back to work? Will he get over this distress, or will he have some kind of breakdown? What will this trauma do to the family, to your own relationship, and to your broader social and community networks?
For a while, the CADI may not be fully available as a partner, friend, or co-worker. All of a sudden you find yourself attempting to manage your own responsibilities and those of the CADI as well (e.g., covering for him at work or taking care of the kids), while also helping him deal with psychological distress along with possible physical injuries, legal issues, car insurance, and the like. On top of that, other people may be texting and emailing to find out what happened, share their own concerns and compassion, and all too often offer advice you really don’t want or need, at least at the time.
As if this isn’t stressful enough, we often have unrealistic ideas of how we are supposed to respond to such tragedies. For instance, you might feel like you have to be available 24/7 to deal with any needs the CADI may express. You might fear that you’ve said something wrong and made everything worse. You might believe you have no rights to anger, fear, or grief. You might be confused or uncertain about how to help. You might also disagree with the CADI about certain issues, such as whether to retain a lawyer or whether to tell friends or family members what happened.
The CADI’s accident may create trauma not just for him, but also for family and friends. Just as you strive to support the CADI, you must also strive to support yourself. Reach out to your friends and relatives, consider psychological counseling, and allow yourself to take some time out to rest and recharge. You may even find that you are experiencing some trauma symptoms yourself, such as intrusive thoughts, flashbacks to the moment you learned of the accident (or witnessed it), difficulty sleeping, and so forth. If such symptoms are very distressing to you or last for more than a few weeks, I encourage psychotherapy.
You will have to decide how much of your own thoughts, feelings and experiences to share with the CADI. It will not be helpful to “unload” your feelings and fears in his or her presence. Save that for others. This does not mean you should avoid intimacy or communication; it does mean that you should recognize and respect the stress and trauma that the CADI is experiencing.
Thank you for caring about the CADI in your life. I cannot express how important – and how beautiful — your love and support are for all of us who have caused accidental deaths or injuries.
Have you ever heard anyone say, “There’s no such thing as an accident?” There is plenty of support for this view in books and popular culture. It’s more or less a staple of new age thinking that we call all experience to us, including accidents. Even Sigmund Freud, the father of psychoanalysis, did not believe in accidents and considered them manifestations of unconscious desires or impulses.
These ideas upset me after my accident – did my accident mean I put out into the world some terrible, fierce energy? Did my unconscious hostility lead to someone’s violent death? Did the accident emerge from some inexplicable spiritual deficit or need?
Today, I do not believe that “there’s no such thing as an accident.” I know too many lovely, caring people who are CADI’s. I do not think their accidents reveal anything about their psychological make-up or their soul. I think the accidents demonstrate that we, like everyone else, have imperfect control over ourselves and over the world around us.
To me, calling a car crash or some other incident an “accident” does not mean one is blameless. It means that no harm was intended. It’s still incumbent on us to ask ourselves if we made a mistake and, if necessary, to take action such as seeking treatment for alcohol or drug abuse. We can also identify other steps we can take to improve safety, such as advocating for a stop light at a busy intersection.
Having completed this appraisal process, perhaps we should try to accept that certain things are simply unknowable, including some of the whys and what-ifs of serious accidents. We can say with some assurance, “the accident occurred because a little boy ran across the road without looking for cars,” or “the accident occurred because I was texting and didn’t notice that the car ahead of me was stopped.” It’s another thing entirely to wonder if the accident occurred as a result of Karma or some spiritual deficiency or need. We probably won’t have the answer to that, at least in our lifetimes.
What we can do, however, is let the experience of being a CADI motivate us to put our best selves into the world. We cannot change what happened, but we can resolve to live and love with greater mindfulness. It’s easier said than done, especially when PTSD gets in the way, but it’s the only way I can make any sense at all out of these tragic accidents.
I often recommend psychotherapy for people who have been involved in serious accidents, but how does one find a good therapist?
Psychotherapists can have medical degrees (psychiatrists), doctoral degrees (psychologists), or masters degrees (social workers or marriage and family therapists). In my opinion, the therapist’s degree or title is not as important as other factors. It is important to choose a licensed therapist or a therapist in training who is working under the direct supervision of a licensed therapist.
There are various ways to find referrals – from your insurance company, from friends or family, or from professional associations such as the American Psychological Association or the American Association for Marriage and Family Therapy . The Psychology Today website also has a good therapist finder.
Give some thought as to whether the therapist’s age or gender matters to you. In addition, if you work and/or have childcare responsibilities, you might need a therapist who can see you on particular days or times.
By far the most important factor is how comfortable you feel with this therapist. Is she or he a compassionate listener? Do you feel that this person understands your feelings? Are the responses you receive kind and helpful? Pay attention to your intuition. It is natural to be nervous or upset when consulting a therapist, and you may not instantly feel relief, but you should feel that the therapist is an attentive listener, is kind, and has knowledge and skills that will be helpful to you. If you do not think that the therapist is a person you can trust, move on and try someone else. A short list of problems — therapists who are distracted (checking their email during a session, for instance), who interrupt the session to take phone calls, who make the session about them instead of about you, who are seductive, or who offer advice that seems off base to you.
It is a good idea to ask questions of a therapist before beginning your work together. For instance, you might ask what training and experience they’ve had related to treating posttraumatic stress and whether they are up to date on recent research about PTSD. You can also ask about their therapeutic orientation — for instance, do they focus on behavioral or cognitive coping skills or are they more insight-oriented?
Therapy can be expensive, although fees vary widely. If cost is a concern, talk with the therapist about whether he or she will reduce their hourly fee for you. Also, most cities and towns have mental health agencies that offer low fee counseling.
A few days, weeks or months after our accidents, we must go out into the world again. We return to work, perhaps, or attend a social event or a family reunion. Maybe we just go out to the grocery store or the gym. Whatever the destination, that first post-accident foray into the world can be daunting, and some coping strategies might be useful.
You might be wondering who knows about the accident. Will people judge you or gossip behind your back? Might someone even attack you? Are they afraid to approach you? Or will they be intrusive, offering sympathy you don’t really want and asking questions you’d rather not answer?
That was my experience, anyway. I wanted to hide at home, but after a week or so I had to go out, and I was frightened.
If you feel the same way, there are simple steps you can take to prepare. First, ask a friend to accompany you and offer calm support while you run errands, attend appointments, etc. If you’re returning to work, contact a sympathetic co-worker ahead of time and ask him or her to check on you a few times during that first day back. Considering talking with your supervisor to discuss what would be most helpful to you. Second, plan modest expeditions before attempting to resume your usual schedule. For example, instead of to visit the grocery store, dry cleaner, pharmacy, and gym, perhaps try a simple trip to the grocery store first. Third, know that you don’t have to engage with people if you’re not ready or don’t feel comfortable. If someone asks you about your accident, you can respond with a simple statement such as, “Thank you for your concern. It’s very difficult, and I’m not ready to talk about it yet.” Fourth, remember to breathe — if you start to feel panicky or distressed, stop and take a few deep breaths.
What other coping strategies have worked for you? Write and let us know.
A special challenge for many is getting back in the car and driving again. That was especially difficult for me after a child darted in front of my car – When I tried to drive, I started to hallucinate people in the road and would slam on my brakes in traffic! If a pebble hit my windshield, I panicked. After a few months I gave up my car and relied on public transportation for almost two years. Many people need to drive, however, and giving up a car is not an option.
If you are having difficult driving, ask a friend or family member to keep you company in the car, remind you that you are a capable driver, and help you manage anxiety. When I started driving again, I signed up for a driving lesson and was reassured when the instructor reported that I was doing fine. Many people prefer to avoid driving by the scene of the accident – if that is not possible for you, I recommend bringing a supportive friend or relative along with you. You can also ask a counselor or psychotherapist for help – there are effective coping strategies for reducing this kind of situational fear and anxiety.
How have other people managed anxiety and distress about driving? Let’s compile a list of useful coping tips. Thank you!