After a Car Crash, Both Body and Mind Need to Heal

As she drove home on a winter night in upstate New York, Dorothy Donath was startled by the glare of headlights on a curve infamous for accidents.

“I was blinded. I went onto the shoulder, panicked, and over-corrected,” she said. Her Nissan Stanza crashed through trees and rolled over in a deep gully. “I can remember being pelted by my tapes. I had a box of them all nice and neat.”

Donath’s back was broken in two places. She spent weeks in a plastic cast, barely able to breathe or sleep. When the cast was removed, Donath said, “My body caved in.” She underwent 12 hours of surgery.

“They cut me through, front and back” and installed permanent metal supports, said Donath, 56. “I’m like a walking Erector set. It feels like the Brooklyn Bridge is in there.” She had another six hours of surgery a year later.

Perhaps more crippling than the physical pain, however, was the psychological trauma. Donath was haunted by memories of the accident.

“It ate me alive,” she said. “I couldn’t sleep, I cried continually. . . . And I was suicidal from the constant pain.”

“The flashbacks are the worst part,” Donath said. She couldn’t pass the crash site even after a year. “You’re going through it again almost physically. The adrenaline starts to pump.”

Four years after the crash, Donath lives with chronic pain. But a treatment program for accident survivors with Post Traumatic Stress Disorder has helped her heal psychologically and cope physically.

Edward Blanchard, director of the State University of New York’s Center for Stress and Anxiety Disorders in Albany, developed the program with psychologist Edward Hickling under a federal grant.

Post Traumatic Stress Disorder, or PTSD, is characterized by flashbacks, mental numbness, nightmares, irritability, anger, sleeplessness, difficulty concentrating and depression.

Blanchard said victims may be unable to experience joy and may avoid things that trigger traumatic memories. They may feel a loss of connection to friends and family.

Blanchard and Hickling describe their research and treatment program in a recent book, “After the Crash,” designed primarily for physicians, psychologists and personal injury lawyers.

Now they’re recruiting accident survivors in the Albany area to participate in a study financed by a $964,000 grant from the National Institutes of Mental Health. The study is to evaluate the effectiveness of the therapy the researchers developed.

More than 3 million people a year are injured in motor vehicle accidents in the United States, according to the Department of Transportation. While PTSD has been studied extensively in war veterans and victims of sexual assault, child abuse and natural disasters, little U.S. research has been done on its incidence after motor vehicle crashes, Blanchard said. More studies have been done in other countries, including England, Germany and Australia.

Researchers have found between 20% and 40% of people injured in accidents suffer from PTSD, Blanchard said.

In their five-year study starting in 1991, Blanchard and Hickling did psychological assessments of 158 people, most within four months of their injuries. Follow-up interviews were done six, 12 and 18 months later.

They found nearly 40% met the criteria for PTSD when first interviewed. Half of those got better on their own within six months. Treatment studies will focus on people suffering PTSD up to 24 months after an accident.

How fast a person recovered mentally was closely related to the level of injury and speed of healing, Blanchard said. Lingering problems like whiplash injuries make it hard to get back to normal life and are a constant reminder of the accident, he said.

Donath learned of Blanchard’s study through a magazine ad a year after her December 1993 accident near her home in Athens, 27 miles south of Albany. The ad sought volunteers to participate in the study.

The initial four-hour interview was arduous.

“I had to go over every detail of the accident,” she said. “One of the hardest things was remembering crying for help. It was agonizing to talk about that. I had blocked it out.”

Over the course of nine weeks, Donath learned relaxation exercises, which she continues with the help of a tape made by Blanchard.

He encouraged her to pursue an interest in painting, to focus on developing a new talent rather than mourning lost physical abilities. “I sell some of my work now,” Donath said. “I’ve won some ribbons. It’s a good feeling.”

Every week, Blanchard gave her a homework assignment. “One was to drive at night by myself. Another was to go back to the accident site. That was very traumatic.”

The gully was littered with pieces of cars. She found her hubcap on a drainage pipe and took it home. A vase of fresh flowers had been placed for a 23-year-old man who died in an accident on the curve five months after her crash.

“It was hard to deal with the idea that I made it but he didn’t,” Donath said. She later dedicated an art show to his memory.

As she went through the therapy with Blanchard, Donath said she gradually let go of her fears, found ways to cope with pain and reclaimed her life. “It was an amazing thing,” she said. “It didn’t seem at the time that anything was happening. It’s subtle, and you have to do a lot of the work yourself.”

Donath, who lives with her husband and has two grown children, said she has learned to regard her accident as something that altered, rather than destroyed, her life.

“If someone said to me now, ‘We’re going to take it back, no accident,’ I don’t know if I’d want to,” she said. “I don’t like the pain, the metal in my back. But I’ve learned a lot.”