Coping with Injury

Coping with INJURY

Mothers Against Drunk Driving 24-Hour Victim Help Line 877.MADD.HELP madd.org/help

I was ten years old when the crash happened. I can remember singing “O Holy Night” which was on the radio in the car before the crash but don’t remember the crash itself. I was in a coma for three days and suffered a traumatic brain injury. After being released from the hospital I went to outpatient therapy for 6 months where I learned to move and walk again. I’ve come to understand that I won’t be 100% again, that I won’t be the person I was before the crash. But I’ve developed a passion for running, for sharing my story and for trying to prevent this crime from happening to someone else. If you are going through what I have, don’t lose hope. Stay positive and keep moving forward.

Jonathan was 10 years old when he and 3 others were hit by a drunk driver, who also killed a pregnant woman driving a separate vehicle that night.

Index

Substance Impaired Driving Complicated Feelings and Reactions Physical Impact Physical Healing Mental Impact Emotional Impact Traumatic Grief and Injury

Changes at Home Coping with Injury Coping Tips Accepting Limitations

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Helping Family/Friends Cope Helping a Loved One Injured in a Crash Resources

Substance Impaired Driving

Substance impaired driving can be defined as the use of alcohol and/or drugs to the point where the driver is considered impaired in such a way so to be unable to drive safely and is a danger to themselves and others on the road. Substance impaired driving crashes cause hundreds of thousands of injuries each year to victims/ survivors who, through no fault of their own, must now cope with the aftermath of a crash.

Complicated Feelings and Reactions

When you have been injured in a substance impaired driving crash you may have many different physical and emotional consequences you might never have expected. You may be experiencing physical pain beyond anything you have ever felt before. In spite of the pain, you may rejoice simply because you are alive. Or you may truly wish that you had died, feeling that freedom from your pain would be a blessing. Your mood may

vary and life may seem unbalanced. How you feel about your future may depend on your emotional and physical pain, success or failure on any

Your feelings may change from hour to hour or day to day.

given day, and the amount of hope you have for the future. You may fluctuate on a daily

basis between feeling angry and hopeless to remaining committed to getting better as soon as you can.

Physical Impact

After a crash the first thing people naturally focus on are the physical injuries. There are all different kinds of physical trauma that can

occur as a result of a substance impaired driving crash. Some crashes will cause non-permanent injuries, while others may have long lasting effects. If you have recently experienced

It’s important to seek medical assistance after a crash.

a crash but haven’t seen a physician, you should consider getting checked by a medical professional to make sure you haven’t sustained injuries you aren’t aware of. The timeframe for your physical recovery depends upon the seriousness and permanence of your physical injuries. Physical recovery may or may not ever be complete. Even if your injuries are not severe, you may move a little slower than others or may experience intermittent pain. If you sustained serious injuries after the crash you have probably already seen a

number of doctors and may have spent a significant amount of time in a hospital setting. You may have been released from a hospital and subsequently going through rehabilitation.

The healing process looks different for each person.

At any point in the process, recovering to the best of your body’s ability may depend on the hope and courage you have in following the advice of your physicians, no matter how tired and frustrated you get. Physical Healing Learn all you can about your injuries. The more you understand about them, the more patience you will have with yourself and your doctors as you progress through healing. Many people suffer from a closed head injury after a serious car crash. Severe cases of head injury are obvious. The victim suffers from loss of physical coordination, speech, and many thinking skills. However, mild head injuries are not as easy to identify. It is often after the physical injuries, such as broken bones and internal bleeding, have been treated and even after the patient has left the hospital that head injury becomes apparent. It is called mild closed head injury if the skull was not fractured. You may notice that you can’t concentrate or think as clearly or quickly as you once did. You may experience relationship problems, headaches, mood swings, dizziness, or difficulty with your memory. Specific symptoms vary from individual to individual, but there is almost always a personality change. Because it is difficult to

determine whether you have head injury or are depressed about what happened,

Some injuries may not show up until after you are released from the hospital.

you may hesitate to check it out. It is recommended to consult a

neuropsychologist or neurologist specializing in head injury if you suspect that head injury may be responsible for your symptoms. Because your body is complex, your physician may be unable to predict the course or completeness of healing. Nevertheless, you can expect your doctor to discuss your case. If you are not satisfied with treatment, talk that over with your physician. You may find that a second opinion from a specialist gives you peace of mind or helps you decide to change doctors or medical providers. Do not stay with a doctor simply because he or she is familiar. You need the best care possible while your body has the most ability

to benefit from it. Being treated as a “patient” may leave you with little sense of control over your own life. It is important to

You have the option

to get a second opinion.

regain some control by making your own decisions about treatment using the best medical advice you can find. There may be difficulty healing physically and/or emotionally if you focus on the past and have no commitment to the present or future. Often, healing takes place when victims/survivors accept their new limitations and seek constructive ways to compensate for them.

Your ability to accept temporary or permanent limitations will also add

considerably to the quality of your life and lives of your family and friends. If you are having a difficult time coping with your injuries, whether emotionally or physically, it’s

often helpful to talk openly about the trouble your injuries are causing you and seek help. Therapists, specialists, and pain management professionals may help you cope with the ongoing traumatic effects of injury.

Mental Impact

You may struggle with direct, personal memories of the crash in unanticipated flashbacks or nightmares. You may have night terrors – violent dreams from which you awaken but remain frozen, unable to speak or move,

It’s common to experience vivid dreams, even if you don’t remember the crash.

even though you are aware that you are in your bedroom and awake. You may recall that you seemed to

be moving in slow motion, believing you were going to die, while somehow reviewing much of your life and thinking of those you love. Although frightening, these are normal reactions after a traumatic event. Alternatively, you may experience moments of amnesia. Perhaps you became unconscious at the point of impact, or trauma to your brain may have affected your memory. You may not remember

crash details. Sometimes, a wall of denial, a protective device within human beings, takes over to keep from remembering painful details when you are not ready.

Emotional Impact

You may be experiencing feelings that seem foreign to you. You may be frustrated that you are having such a difficult time coping with your injuries, especially if you were a strong, independent person who usually saw crises as challenges. Feelings of helplessness and powerlessness may continue long after the crash. You may not only feel angry, but enraged. Your anger may focus on the substance impaired driver for having made the unthinkable choice to

Try not to push loved ones away as you experience emotions related to the crash.

drive impaired. You may have vengeful thoughts and wishes about the driver that trouble you, even though know you

wouldn’t act on such fantasies. Your anger can spill over onto others who may or may not deserve it — your family and friends, doctors and nurses, insurance agents and attorneys. You may be angry at yourself for not being able to avoid the crash, even though you know that you did everything you could to prevent it. If you are feeling angry, give yourself permission to feel it. You will benefit from learning to accept and express what you feel. Bottling up your feelings only increases your frustration.

It is far better to express your anger when you feel it, cry (even wail and moan) when you hurt or are frustrated. If you do, you will probably find that you can then think more clearly. Share your feelings with those who are willing to be in your presence. Feeling guilty for being alive, especially if someone you love was killed in the crash, is common. You may feel that the death was your fault, even though you know it wasn’t. You

Share your feelings with those who will listen and care.

might be feeling guilty for being a burden on others or for not carrying

out your normal responsibilities. You may be frustrated with those who attempt to comfort you, or misunderstood by those who say, “You’re just so lucky to be alive,” because you don’t feel lucky at all. You may struggle with a response when they say, “You are feeling better, aren’t you?,” knowing they want you to feel better so they will feel better… but you don’t. The word “time” may become a four-letter word you hate to hear. You are tired of hearing, “It will just take time,” or “In time you’ll learn to live with the pain.” You wish people would stop asking, “Are you okay?” It can be helpful to express your feelings by writing in a journal. Some people benefit from attending support groups with people who are also recovering from injury. Pain clinics often have such groups. Others find professional counseling helpful and say they could not have survived emotionally without it. Each person grieves in their own way

and on their own time table. Some victims/ survivors withdraw, turn inward and cut off their social contacts because they are embarrassed or depressed about their injuries. They can’t accept what has happened to them: their appearance, their changed abilities, their new realities. Even though there may be resources to assist you, you may find yourself focusing only on the despair you sometimes feel. Traumatic Grief and Injury Seeking support is critical to the process of healing. As an injured victim, you may grieve every time you learn more about the seriousness of your injury. Because your family and friends genuinely care about you, they may believe that you can’t cope with knowing the full extent of your injuries; so they break it to you little by little. Sometimes, the full extent of your injuries may not be realized right away, especially if you have a closed head injury. Common reactions of traumatic grief: • crying, loneliness, feelings of isolation • poor appetite, overeating, sleeplessness, overall irritability • need to talk about the crash and the circumstances surrounding it over and over again • feelings of hopelessness, helplessness, and/or depression • feelings of anger, guilt, and/or blame • inability to concentrate or remember • loss of motivation to accomplish goals in the future

Surges of grief may surface each time you try to do something you thought you could do, but cannot do

now. You experience grief each time you are unprepared for the many changes that may occur, such as additional surgeries or medical procedures. Medical

Grief is a normal part of the healing process.

procedures sometimes don’t work. Sometimes the doctor may give you a timeline for healing that doesn’t happen, which may cause you additional grief. You grieve the loss of friends and even family members who may be unable to cope with your injuries, therefore disappointing you. It is painful to realize that those you always thought you could count on can’t be counted on sometimes. Recovery from serious injury takes a great deal of patience and work. You will probably find that you make progress for a while and then either reach a plateau or regress. That ebb and flow is both natural and upsetting. In time, you should be ready to gear up and try again. Reasserting

control over your life is essential. As long as you can see that you are making progress, even though

Reasserting control over your life is essential.

it is slower at some times than others, you will continue to heal both physically and emotionally.

Changes At Home

When you go home from the hospital, everyone in the family will have to adjust. Home is where you and your loved ones had established a fairly predictable routine. Many, if not all, components of that routine must now be re-evaluated in order to compensate for your injuries. Comparing the new life with the old presents a vivid contrast. Climbing stairs or taking a shower at home takes on a different significance than it did in the hospital. You may become angry when you find that you can’t scrub the floor, take food out of the oven, or have the energy to complete household tasks. Adjusting work schedules, budgets,

After a crash, you may need to make adjustments to your life’s routines.

and restructuring the house are big

undertakings. Frustrations, pressures, and

tensions will mount. You must now rely on

others in the family to perform many of the tasks you once were able to do. While they know it has to be this way, they can become exhausted and resent it. Obviously, it’s not your fault, but you wish you could ease

their burden. Even if they willingly help you or care for you, you may feel guilty about needing that help.

Know Who You Can Call Coping with Injury

There are many different things that you can do that will help your mind and body heal. You may have setbacks that frustrate you or challenge you, but continue to focus on the things that will help you get better. What does it mean to heal from the mental, emotional, and physical pain caused by a substance impaired driving crash? It means continuing to seek medical treatment until you are as pain-free and mobile as possible. It means coming to grips with your limitations. And finally, it means doing the perfectly ordinary things you did before the crash such as: • feeling good when something good happens • feeling hopeful about your future • giving attention and energy to everyday life • laughing and being cheerful • feeling at peace with yourself • finding ways to socialize with others These things may not be achieved completely, depending on the seriousness of your injuries, but they can be achieved to a large extent. None of it will be easy or quick. Healing takes patience and hard work. But you owe it to yourself, and to those who need you and love you, to try to recover as much as possible.

Coping Tips

• Take things one day at a time. • Set simple goals • Develop a routine

• Learn to accept responsibility for your physical, emotional and mental healing • Allow others to help you as you learn • Follow the instructions of your doctors and therapists • Attend regularly schedule appointments for therapies and follow- up • Keep the lines of communication open between friends and family • Acknowledge your feelings by sharing them with people you can trust • Consider writing your thoughts and feelings in a journal • Pursue the professional help of a mental health provider if your feelings of sadness, anxiety, and or anger persist Accepting Limitations It is not difficult to remember what happened to you. You may be reminded of it every time you take a shower, look in the

mirror, or take a step. You may be shaped or move differently than you did before. You may become physically and mentally exhausted sooner than you once did. You may need to

You may need to plan your time and energy carefully until you are able to do more.

plan your time and energy carefully, possibly on an hour by hour basis. Little by little, your

self-image must be adjusted to your new reality. Understand that you will grieve over what has been lost. As you grow to accept the limitations inflicted by your injuries, try to be in touch with both your feelings and rational thinking. Feel what you feel. It is okay to be overwhelmed by your feelings sometimes, as long as you are not overwhelmed all the time. But try to base most of your behavior on rational and appropriate thinking. At some point it is critical to accept that you are a person who has survived a terrible trauma, that you are changed and that you are going on with your life. It will not be easy; however, it will get easier than it is now. You must set goals for yourself. Spend time with people who accept you as you are and find a way to do meaningful work. Keep your goals realistic. Work on them one at a time so that you don’t overwhelm yourself. Your interests, concerns, and values may be different now. Your life may be divided into two segments: before the crash and after the crash. You will probably discover strengths you never knew you had. As far as possible, move your focus from what you lost to what you can do now.

Helping Family/Friends Cope

You may find that your family and friends avoid discussing certain components of the crash or your injuries with you. They may talk down to you, as if you were a child. When you experience a great deal of pain, you may regress to a more child-like state and need assistance. Later, though, you will decide that you want to communicate with

those around you in a more adult, straight- forward manner and begin to solve some of your problems yourself. Strive for honest communication about what your needs are and how you are feeling. Marriages and significant relationships can be stressed by injury. Some stress comes from financial worries. Simple fatigue from working so hard to keep life functioning is stressful. Relationships suffer when people hide too much of what they feel and think from each other. Some partners may try to protect their injured loved one by not talking and sharing important things. They

may believe they are making life easier for a loved one, who may instead feel left out. Resentments may rise. If it is difficult to talk honestly about concrete circumstances

Talk with your spouse or partner about your concerns.

and feelings resulting from injuries, consider inviting a trusted friend, clergy, or counselor to facilitate such conversations. Children in the home will need special attention. They are vulnerable and can be very shaken by the fact that someone who is supposed to take care of them is now injured and unable to do so. They may be scared by physical changes they see or experience. They may be forced to grow up too quickly by assuming more responsibilities. Children are sometimes overlooked because so much of the family’s resources and energies are focused on the one who has been injured. Observe carefully to see if a child begins to withdraw, becomes noticeably more noisy or quiet, receives poor school grades, or stops

spending time with friends. Teenagers may act out their frustrations by running away, using alcohol and other

Children may need special attention to help them cope with changes in the family.

drugs to soothe themselves, or engage in other disruptive behaviors.

These warning signals indicate a need for you to encourage them to speak out about their fears and frustrations. Counseling may be in order. Talking with someone outside the family offers a healthy and constructive outlet for them. Many find it helpful to ask another family or adult to take their children on special outings or just invite them to spend time in a less stressed home environment.

Helping a Loved One Injured in a Crash

Family and friends can help provide the support you need to aid in your healing. Here are some suggestions for family and friends of injured victims/survivors. • Understand that you too have been traumatized. You probably experienced shock, anxiety, and terrible dread. Seek the help and support you need in order to cope. • Recovery of your loved one will rarely be complete. Even if the physical injuries totally heal, emotional scars will remain. • Try to empower our loved one rather than be a caretaker or rescuer. Be

someone that encourages the victim/ survivor to take care of himself/herself as much as possible and then assists with the rest. Try to be aware of the needs of the victim/survivor and offer your assistance without insisting on it. • Work toward normalizing the victim/ survivor’s experience, not minimizing it. Making light of the seriousness of their injuries or intensity of the pain can be cruel. Helping the victim/survivor understand that others with similar injuries have the same difficulties helps them feel normal. • Learn to be comfortable with rage and despair, and encourage expression of them. Understand that talking about the darkest of human emotions is far healthier than stewing about them inside. Understand that vengeful fantasies and wishes are harmless, and can even be therapeutic. Remove the phrase, “You shouldn’t feel that way” from your vocabulary. • Expect guilt, especially if someone

else was killed in the crash. Gently encourage the victim/survivor to approach his/her feelings of guilt with rational thinking. If there are

components of the crash for which the victim/survivor may legitimately be guilty, help him/her understand that this component is only a small part of the complexity of the crash. • Expect anniversary reactions. No one can explain it, but injured victims/ survivors often experience a resurgence of the physical pain as well as depression on or near the anniversary of the crash, even though they may not

realize it’s the anniversary. • Allow the victim/survivor to tell and re- tell the story of what happened. Telling the story helps one come to grips with it and also helps bring to the surface forgotten memories. • Help the victim/survivor label his or her feelings. It helps to more accurately describe what is going on inside. • Understand that it is normal for the victim/survivor to move forward, then fall back as he or she progresses through recovery. • Help the victim/survivor process nightmares, flashbacks, and night terrors. Be available to sit with the victim/survivor following night terrors and talk until he or she can respond. • Give honest, reasonable recognition at signs of healing. Don’t give excessive praise or label the individual as “an inspiration.” The duty to be an inspiration or to be strong can be a burden. But do notice each achievement. • Encourage the victim/survivor to socialize, but don’t insist on it until he or she is ready. Offer to set up links with other injured victims/survivors. Offer to take the victim to support groups. Offer to help the victim/survivor attend plays, musicals, sporting events, or other activities he or she enjoyed before the crash. Try to re-establish hobbies, if possible. • Take care of yourself. Ongoing physical care of the victim/survivor coupled with worries about what the future holds can be both physically and mentally

exhausting. Get regular medical check- ups, and spend some time each week with healthy people who love you. Maintain your social relationships and be with your friends when you can. Don’t be shy about asking them to help you with caring for the victim/survivor

Resources

Finances are often devastated after a substance impaired driving crash causing injuries. The struggle to deal with insurance companies, find resources, or pay the bills is a common occurrence. It’s important to try to identify what resources are available for you, however, that can be especially difficult when trying to focus on healing after a crash. Help can be found in many

Help may be available, find others who can connect you with resources.

different places. Often there are

programs available for victims of crime, or help through local emergency assistance programs. MADD provides support to injured victims/survivors by connecting them with resources that might be available. Seek a local MADD chapter to connect with other injured victims/survivors of substance impaired driving crashes who can help you feel understood. If you do not have family or close friends to depend on for support, regular phone contact with other injured victims/survivors and a MADD victim advocate can be a lifesaver. You may be helped by sharing common feelings and coping strategies.

Later on, if you begin to feel that you have enough energy to volunteer with MADD, you might decide to visit other recently injured victims/survivors to help give them hope and share what you have learned. Many people find that it helps them a lot to do something constructive to stop substance impaired driving. Others are not interested in that at all. It will be up to you to decide if and when you want to get involved. To reach out to talk with someone about what you are going through, to find

resources, or to get involved, you can call the MADD Victim Services Help Line at 1-877-MADD-HELP or 1-877-623-3435 to be connected to a MADD

You are not alone.

Victim Advocate who will be ready and willing to listen and help. You are not alone.

This product was supported by cooperative agreement number 2011-VF-GX-K015, awarded by the Office for Victims of Crime, Office of Justice Programs, U.S. Department of Justice. The opinions, findings, and conclusions or recommendations expressed in this product are those of the contributors and do not necessarily represent the official position or policies of the U.S. Department of Justice.

24-Hour Victim Help Line 877.MADD.HELP

madd.org/help

MADD does not discriminate against individuals or groups, either in employment or in the delivery of services or benefits, on the basis of race, sex, color, religion, national origin, age, income, marital status, sexual orientation, medical condition, disability or veteran status. If you believe your civil rights have been violated please reach out to the U. S. Department of Justice, Office of Justice Programs, Office of Civil Rights (https://www.justice.gov/crt or US Department of Justice, 950 Pennsylvania Avenue, NW, Civil Rights Division, Washington, DC 20530, or phone (202) 514-4609 Telephone Device for the Deaf (TTY) (202) 514-0716).

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