Last week my 19YO niece was involved in a car accident; she was turning left and got T-boned by oncoming traffic. It was apparently a pretty violent collision - her dad was in the passenger seat and was grateful for the side-curtain airbag - but no one was hurt.
Immediately after the collision she was reportedly hysterical, screaming and yelling unintelligibly through her tears (not anger, just shock); bystanders had to help her out of the car because she was so freaked out. This was a surprise to me, as she is generally intelligent (straight-A student), focused, and athletic (she’s been on championship-winning soccer teams for the past ten years or so).
More than surprise, it’s a source of concern to me: had there been serious injuries that required first aid to prevent death, she would have been powerless to help herself or anyone else.
Question:
Is there anything I can suggest to my sister or her daughter that might help her maintain the ability for useful action in the aftermath of a disastrous event like a car wreck? a book, or a course perhaps? I read Gonzales’ book Deep Survival a couple of years ago, although it’s not particularly a how-to book, and it seems to focus on survival situations unfolding over longer time scales, things like being lost in the mountains for days rather than acute emergencies like car wrecks.
Sure would be nice. In the military we throw things at troops to stress them out, make them tired, and force them to deal with stressful things after they might be too tired to handle them. Includes a bit of yelling and explosions, anything that just might allow them to work on instinct instead of thinking about what’s going on in real combat.
Takes time though, and still doesn’t help in a lot of cases, don’t know how to apply this to regular people or regular situations.
Martial arts training might help as it involves a lot of muscle memory, but again, takes a lot of time and results may vary.
1.) My not-a-doctor-or-anything-like-that opinion is that the only way to change a panic response would be to train it out by putting the person through many, many simulated stressful situations. If it’s something that snap and instant, anything you’ve just read about isn’t going to help you–that’s all going to be pushed to the back of your brain.
2.) Do you know that she’d react the same way if anyone were injured? It could be that on some level she knew it was “safe” to freak out because everyone was okay.
It might not be a wholly unadaptive response, either. Yelling and crying serves to draw other people to help.
I think it’s kind of unrealistic to expect aid to be rendered by an untrained 19-YO who was involved in the accident. Sure, if she were able to do that, great. But I don’t think it would even be typical.
I’d be interested to hear from our EMT Dopers. But I think panic is probably as much of a natural reaction to the situation as losing consciousness might be.
My college did offer the opportunity to get Red Cross certified and be involved as a volunteer providing first aid at community events. This was not as much of a commitment as EMT training. If she is interested in learning about how to respond to emergencies, she might look for an opportunity like that.
Forgive me for a soapbox moment. I noticed you mentioned that she “wasn’t angry, just yelling.” Does that mean you think it would have been more OK if she were yelling in anger? Some people have a tendency to accept men’s irrational emotional response of anger but reject women’s irrational emotional response of tears. While I’ll grant that a rational response is best, people aren’t Vulcans and anger is no better than tears. They both appear to be influenced by the hormones we have in our bloodstreams. I apologize if I read something into your statement that wasn’t there.
She might take up NASCAR racing, with tongue only partly in cheek. She’ll still be scared but will do the right things. Panic is where you lose control. As the other posters have indicated it’s experience with the given situation that allows you to avoid full panic. As Lanzy and Shot have indicated you really have to practice the very thing that might induce panic, and that’s hard (or impossible) to do for a lot of bad situations.
Yes you can train yourself. For panic the slap to the face you see in TV and movies actually works. When I was little the standard practice to stop a child in a tantrum was throw some water in his/her face. It shocks the kids and he stops.
I would not be so sure that had there been other issues she would’ve been powerless to help. She might have been, but sometimes the shock of seeing other people, say bleeding, might have produced enougth “shock” to keep her focused.
This hysteria she was feeling is a process where it feeds on itself. You start panicky and the more panicky you get the more it feeds. Perhaps seeing a person bleeding would’ve stopped the panic process.
This is why you will see sometimes, people collapse AFTER an event. One thing I’ve learned in my years on earth is, you’d be surprised what you can do when you have to.
I used to have panic attacks and part of getting over this, if you choose not to use drugs is to use relaxation. What you do is train your muscles. You recognize when they start getting tense, and you train yourself to relax any tension. After a few weeks of practice you start automatically relaxing your muscles when you tense up.
The best example of this on TV is on the TV series Seinfeld. Elaine gets stuck in the subway and the lights go out. Elaine says to herself, “Calm down, nothing is wrong, it’ll start up in moment. It’s all right, think about people in concentration camps. They went through worse than this and they survived. This isn’t anywhere nearly as bad. If they can survive I can live through this…” Then she start slowly panicking and she’s like “Think about the concentration camps…No, no this is even WORSE than that.” She’s just about to fly into a total panic when the subway starts up.
The problem is that neither of these things work unless the person is **currently **panicking or having a tantrum. You can train yourself by just randomly slapping yourself or dumping glasses of water on your head.
Agreed, probably not typical/average. I’m not even thinking necessarily of a trained first-aid response, though; I’m thinking of the steps prior to first aid, like checking to see if anyone’s hurt, moving one’s self/others to a safe location while watching for traffic, calling 911 to explain the situation/request help, etc. I was told she would not even have been able to speak coherently into a phone.
No offense taken, but in fact I was trying to suggest quite the opposite. Many people (myself included) are negatively judgmental toward incidents of “road rage,” and I wanted to make clear that this wasn’t any kind of rage response at all.
It’s true I have absolutely no idea how she would have reacted if there were in fact a need for immediate action; it’s possible that she rapidly noted the presence of her dad and the fact that no one was grievously injured, and immediately started to relax/de-tension.
From my experience, once I feel an inkling of panic starting, deep and controlled breathing has always helped me from spiraling into a feedback loop. 4:7:8 breathing worked for me. Breathe in with your nose to a count of four. Hold for a count of seven. Exhale through your mouth for a count of eight. (I do it with the tongue against the roof of my mouth. Can’t remember why, it was something I had read somewhere.) I don’t know if it works for everyone, but it works for me. But once the panic hits a certain threshold, it’s hard to control and your mind starts spinning out of control, even if you’re fully cogniscent of the reality that your body is having an illogical reaction. The few times I’ve had full panic atticks (it was in response to non-existent threats or claustrophobia-type situations like the Seinfeld example above–in real threats I become somehow superfocused and, like Markxxx mentions, the panic doesn’t start until after the threat is over), it was almost as I’ve gone into some sort of dissociative state. Learning the breathing technique has since stopped me from going out of control like this again.
The mind is an odd thing. I’d start with the 4:7:8 yogic breathing as something to have in your arsenal to reset your nervous system.
That is called a panic attack. It is a fight-or-flight response caused by an increase in adrenaline when your body perceives a threat. The actual response is instinctual, but it can be managed.
Ordinarily there is no need to treat them unless they become repetitive. The treatment for that is usually Exposure Response Prevention therapy, which is just a fancy way of saying teach relaxation techniques, then use them while gradually increasing the phobic stimulus. Soon, your body gets retrained to not view the stimulus as a threat, and you no longer have the fight-or-flight reaction.
Still, it’s an inordinately painful process, and I wouldn’t wish it on my worst enemy, let alone use it on a family member. Especially with the benefit being so low. Her being able to help out probably wouldn’t have mattered then, and it’s unlikely to come up in the future. Think of it this way: to teach it, you’d have to put her multiple times through the anguish she felt during the accident.
As for the breathing thing, that’s one of the relaxation techniques. You can Google “relaxation techniques” if you really want to know them. It wouldn’t hurt for her to know them, but, without the ability to practice using them, don’t expect it to help too much.
I’m sorry that I’m not citing anything, but it is common knowledge in psychiatry. And I take it you have not experienced a panic attack of your own. For that, be grateful. I know this is a predominantly atheist board, but but I can’t imagine Hell being worse than one that won’t go away.
If I understand the situation right, the kid became hysterical after a near-death experience for both her and her father.
Over the years I’ve had the chance to see a few thousand reactions to these sorts of exciting situations, particularly in the context of family members suddenly overwhelmed with the crisis of a loved one; occasionally with folks facing their own near-imminent (or recently near-imminent) demise.
The baseline reaction is definitely part of one’s personality makeup. I think the ability to handle the baseline reaction can be modified. For example, I may be inclined to be hot tempered. I can’t really change the inclination but I can change what I do when the feeling arises.
I would sit down with the kid and talk her through her reaction. In my book it’s pretty much OK for a teenager to panic when she thinks both she and her dad have just been killed. That horrible experience alone is already going to leave her better able to handle the next one, I’d bet, given that her personality otherwise seems so normal. If a kid is otherwise focused in school and has the skillset for championship athletics, she handles predictable stress just fine. I would not be surprised if she handled most emergency situations OK too–a house-fire say.
This kind of incident is a titchy bit different because the panic that arises is over an overwhelming dread that we are already dead–the situation is over and there is nothing left to do. We’ve just been splattered. Talk her through handling that part of the reaction. I will not be surprised if she can analyze her own reaction, realize how unproductive it is, and–from this single event–process it enough to do better the next time.
If, instead, it turns out that she has this sort of reaction over lots of relatively more trivial things, then I think it’s time for professional guidance.
Her reaction was entirely normal, and had nothing whatsoever to do with her being intelligent, focussed and athletic. Her intelligence, focus and athleticism offers no protection against shock. Nor is it in any way diminished for the future by the fact that she has experienced shock on this occasion.
I concur with what others have said; she could learn to react differently, but the cure could be a great deal worse than the disease.
Even if not suffering from shock to quite this extent, the participants in an incident of this kind are not best-equipped to take charge, render first aid, summon help, etc, after the event. It’s those who are peripherally involved, or who are bystanders, who have the most to contribute in this regard, precisely because they haven’t suffered the same shock. When you’ve been through what she’d been through, you’re allowed to be shocked.
One possibility too is that immediate regression we all sometimes get when facing extreme fear, danger or shock. The fact that her dad was with her might well have allowed her to be the child in the situation, crying and yelling as a response would fit into that category of response. Nobody knows, but her reaction might well have been different if she was alone, with friends or even with small children as different priorities take over (in the same way that some parents tend to be calm until the immediate danger to them/their children has passed and only in reflective analysis react with shock and fear).