A Life of Accidents, a Quest for Answers

Ask my mom and she’ll tell you I’ve always been a klutz. Since I was a kid, if there was a head to bonk, it would be mine. A toe to stub, a stairwell to trip down, a hot coal to grab? You’ve got the picture.

It’s quite literally a painful legacy that includes one broken wrist, several toes and a rib; concussions, a few; one second-degree burn from a motorcycle tailpipe; sprains too numerous to recall; a cracked coccyx; a torn rotator cuff in my shoulder; and across my knuckles cuts that dug so deep I see the scars when I type.

Then, almost five years ago, my left leg was nearly severed in a horrible mishap on a Malibu canyon trail with my horse: While attempting to lead him through a creek I ended up startling him and was trampled, his powerful hind hoof cutting straight through my left shin like an ax chopping through a tree branch. Thankfully some of my calf muscle and vital nerves remained, but I was unable to walk or crawl. I was saved by a man who heard my screams and literally kept me from bleeding to death by squeezing my artery with his fingers.

During the year and a half it took to recuperate from this level of trauma, I had a lot of time to do nothing but think. I realized that in the months before I was trampled I had experienced a particularly acute rash of accidents--I had fallen down a stairwell and had a painful spill off my horse--and that this began after my then-husband had been released from a drug-rehabilitation program. Clearly my pattern of frequent injury was beyond average and the severity seemed to be intensifying. Could accident-proneness be traced to specific causes, or was it simply bad luck?

The term “accident-prone” entered the vernacular in the early 1900s following a debate between European and American psychologists on the idea that some people were more likely to experience unintentional injury than others. Although the term became part of our language, it has no clinical meaning, says Jess F. Kraus, a professor of epidemiology at the UCLA School of Public Health and director of the Southern California Injury Prevention Research Center.

“People in this research field have divorced themselves from the term ‘accident’ in general, because it carries with it a sense of inevitability,” Kraus says. “Yes, people can move in and out of cycles of injury for reasons that are not quite clear, but the fact is that a substantial number of accidents can be prevented.”

During the last century researchers from various backgrounds--psychiatry, orthopedics, transportation safety and childhood development, among others--have tried to clarify those reasons, without reaching a definitive conclusion. Is it personality? A genetic predisposition to take risks? A form of “acting out” psychological issues? The only concrete statement I’ve been able to pull away from the array of disciplines is that, barring injuries that result from unsafe work environments, frequent accidents are a complex phenomenon that can be a warning sign for physical, psychological or emotional issues. Exploring what reasons might be keeping me in harm’s way became a quest for self-understanding.

Much research has tried to define personality types or traits that would provide a fundamental explanation for who gets hurt more often and why. Risk takers are often pinned as likely suspects: By the law of averages, these personalities will get hurt more often.

Psychologists at the University of Iowa concluded in a 1999 study that, among children, temperament seemed to be a big factor in risk taking. The researchers, who published their findings in the Journal of Developmental Psychology, were trying to determine why some kids continually overestimate their physical abilities and end up having accidents. “Children who are active and think quickly, the ones that seek out new sensations, seem to have more accidents in their history,” the researchers wrote, observing that this described kids who were more extroverted. Another factor in some children who had more accidents was “low inhibitory control”--the ones who got hurt didn’t pause to consider possible dangers associated with their actions. Studying this in children, they concluded, may help explain patterns that endure into adulthood.

Last year, British researchers at the University of Manchester Institute of Science and Technology described three other klutz traits: undependability and disagreeableness, and, on the other end of the spectrum, extreme “openness,” which they defined as the tendency to learn from experience and be open to suggestion from others.

All of these elements no doubt count somewhere in the equation of accidents. But speaking as a person who’s had her share of life-threatening mishaps, I’m left with a feeling of frustration. Besides realizing that I might not be the best person to drive a school bus, how can this knowledge improve my life? By labeling someone as constitutionally more likely to have accidents, where is the possibility for change?

While friends or family might call describe you as a klutz or having “two left feet,” sometimes we place those labels on ourselves. By labeling your personality as accident-prone, says Roger Vincent, a spokesman for Britain’s Royal Society for the Prevention of Accidents, you have something to blame, rather than accepting the responsibility for changing your behavior.

Clyde Flanagan, a psychiatrist at the University of South Carolina School of Medicine, likens accident-proneness to a fever. “It’s a symptom of something else,” he says. “It becomes hard to say there is one direct cause of accident-proneness, because a lot of things interrelate.”

Anyone can be accident-prone for different reasons at different times in life. Physical concerns should be considered, especially if a pattern of accidents has a sudden onset. “There could be changes in vision, hearing problems, or even a possible tumor in the cerebellum, the part of the brain that controls coordination,” Flanagan explains.

Attention deficit hyperactivity disorder, or ADHD, is known as a cause of accident-proneness in children because it creates impulsiveness, but it might also factor into adult problems, Flanagan says. After a thorough medical exam has ruled out potential medical problems, he says, psychological explanations have to be considered.

Why? Because if you’ve hurt yourself once, it is likely that you will hurt yourself again, according to research in the field of emergency medicine. A 1996 study from the University of Mississippi Medical Center published in the Journal of Trauma explored why trauma victims are so likely to have a repeat occurrence, even among those whose accidents are unintentional. The conclusion: Traumatic accidents are often rooted in psychological disorders such as depression, which have to be addressed to reduce the risk of being a repeat trauma victim.

“We used to use a term called ‘depressive equivalent,’ where depression in children is expressed through activity,” Flanagan says. In adults the same idea is called “agitated depression,” in which conditions such as low self-esteem are manifested behaviorally.

Sigmund Freud was suspicious of seemingly unintentional injury; he proposed that the greater the degree of injury, the more clearly it expressed a desire for self-destruction. Could accidents be an unconscious way of hurting yourself as a form of punishment for deep feelings of guilt, a misguided expression of grief, or even as a self-defeating strategy to avoid dealing with success?

Freud’s concept of the unconscious, masochistic desire for self-harm has “gone out of style” among psychiatrists, says Stuart Shipko, a Pasadena psychiatrist who evaluates work-related accidents and injury in legal cases. The modern clinician, Shipko says, “is more apt to consider anxiety or depression as the cause of repeated accidents, because those conditions impair attention and concentration. I’ve also observed the phenomenon of accidents and illness as a way to get attention.”

The attention-getting behavior is often seen in professional athletes, says Edd Wilbanks, a sports psychologist in Shreveport, La. Players who frequently visit the rehabilitation room come to be known as “malingerers.” Says Wilbanks: “These are burned-out athletes who have fallen into an unconscious pattern of getting hurt because the attention gained from being injured has become more gratifying than playing on the field.”

One well-documented cause of accident-proneness is also quite common--stress. People who are under heavy stress are often tired and unfocused. In this state of mind, it’s just easier to have an accident while behind the wheel or navigating a steep staircase. One strategy for coping with this problem is to be aware of it and attempt to compensate.

Wilbanks advises his stressed-out clients, who include professional tennis and baseball players, to attempt to focus their attention by visualizing the “biggest, reddest, ugliest stop sign in the world.” “As soon as a negative thought comes into your head--and that means anything that doesn’t have directly to do with what you are engaged in at the moment--throw up that mental stop sign.”

The Zen Buddhist notion of “mindfulness,” the practice of moment-to-moment awareness gained through silent sitting known as zazen, became for me a kind of insurance for living more safely. Before my leg injury I had never considered that sitting still would be anything but a waste of time. Now, taking time to do just that is a requirement for assessing what I’m thinking and feeling--for not being, as my family for years called me, “an accident looking for a place to happen.”

In recovering from my accident I’ve taken my life apart and put it back together to understand what had led me to a life of injury. I think, somewhere along the line, I figured out that letting “the world” hurt me served a few functions extremely well: It provided me with a kind of nurturing I didn’t otherwise know how to attract, I couldn’t be pinned with total responsibility, and it provided physical pain, a reason to cry that others could understand. So much easier than trying to explain all the accumulated rage and numbness and sadness.

This is what I can tell you about me today: The less I accept the label of klutz and the more aware I am about the circumstances of my life and the way things affect me, the fewer accidents I have. Not in my car, not on my horse, not in my house. “Accident-prone” is not a description of my character; it’s a state of mind I enter.

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Samantha Dunn, a Los Angeles writer, is the author of “Not by Accident: Reconstructing a Careless Life” (Henry Holt & Co., 2002).