explainer

Amanda's son was in a serious car crash. For weeks after, she felt like it happened to her.

Content warning: This post details post traumatic stress disorder. Some readers may find this triggering. If you are in immediate danger, call 000.

“I’m in the back of the car and I can feel this fear as the oncoming car approaches, then everything goes black, and I can see my son lying in the gutter… there are ambulance sirens around us.”

Amanda* wasn’t there when her 22-year-old son Jake* was in an accident earlier this year, but if you could see the vivid imagery in her dreams, you’d think she was.

Jake was the only passenger injured in the car crash that occurred in the early hours of the morning after a night out with friends.

Due to the severity of his head injuries, he has no memory of the events leading up to the accident. But his mother could see it as clear as day for many weeks following.

“It was so real, it was terrifying,” Amanda recalls.

“I’d have these dreams where I was lying in the gutter, as though it was happening to me, and I could feel the fear as I’m in the back of the car realising what’s about to happen… Even though Jake has never described any fear of his own because he can’t remember.”

“It’s like I was creating the fear he can’t remember,” she adds.

Jake was initially unresponsive after the collision; rushed to hospital in an ambulance with what was soon diagnosed as a cracked skull, fractured spine, and brain haemorrhaging.

He was released from hospital two weeks later – each night spent with his mother at his bedside, and although, luckily, he is able to walk and talk, he required weeks of rehabilitation for his brain injury.

Jake sustained a severe head injury from the accident. Image: Getty

But while the number one focus for Amanda and her family was Jake's recovery, Amanda soon found herself facing her own physiological response to the accident.

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"This was different from the normal concern you have as a parent. It was a fear, it felt like it had happened to me," she says.

"I have experienced something like this before [with my other children], and nothing can really prepare you for it... I'd never really spoken about it with anyone because I was embarrassed.

"I just felt like I was being silly, like I was being a drama queen... I was supposed to be the strong one supporting him, but instead I kept having these feelings of fear and these vivid dreams."

What Amanda is describing is secondary trauma - which mirrors the symptoms of post traumatic stress disorder, according to Perth psychologist Katrina Alilovic.

"Secondary trauma is essentially the traumatic reactions people experience when they hear first-hand about the experience of someone else," Katrina, who has previously worked as a police psychologist, explains.

Much like Amanda's description, Katrina says patients experiencing secondary trauma have "repeated visions" that play on their mind after they've heard details of an incident, either from the person involved, or a professional such as a police officer or doctor.

These visions can appear incredibly lifelike, often making it difficult to differentiate between actuality and imagination.

"People who have been involved in an incident themselves will often find themselves recounting step-by-step the sequence of events that happened, and they will oftentimes freeze on a particular part of that event... Often it's the worst part of the event, and the reason they seek help is because they can't stop replaying the worst part in their minds."

This, she says, is the same as what happens in patients with secondary trauma.

"When you're imagining something, your brain doesn't know the difference between what is imagined, and what is actually happening, so you respond to it as though it was real," she explains.

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With Amanda's experience in mind, Katrina observes: "She might have one or several images that capture the worst part of that event - so it might be imagining [Jake] catapulted out of the car, it might be him lying on the road with blood... she might have specific detailed images, and those images can cause a lot of distress.

"They come in to their mind without warning, they might come in to their mind in nightmares, or when they're trying to get to sleep, they might find themselves reliving the event, and then struggling to sleep - all the physiological symptoms they would have experienced if they were there and if they saw it happen."

In addition to this, Katrina says physiological symptoms of second-hand trauma include an "increased heart rate, they might start to shake, they sweat - maybe they get sweaty palms, and have difficulty concentrating - all the things that get in the way of them continuing to do the things they'd normally do."

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"[In Amanda's case] she might find she's in 'action mode' going about the things she needs to do to support her son with his rehab, but there'll be other times where she's on her own, doing things around the house or driving somewhere, and she'll suddenly feel a fight or flight response come on, or freeze - and feel totally unable to carry on and do what she was doing."

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While Amanda says her secondary trauma has subsided since Jake's accident, she adds that if she hadn't sought help early on, she would have felt like she was going "crazy".

"I'm lucky I have a close relationship with my GP and she pressed me to talk about what was happening [after Jake's accident].

"I eventually opened up to her she told me it was normal, she validated it, and she even shared her own experience with [secondary trauma] after her own son had been in an accident."

Katrina says "validating" the trauma, as Amanda puts it, is the first step to recovery.

"It's about helping them and educating them to understand that what's happening to them is an automatic response, they're not doing anything wrong that's making them have this reaction. It's a normal reaction to extraordinary events.

"It's how the body responds to stress. It's all the adrenaline, it's the stress hormones, the cortisol, all that stuff gets triggered and they can't do anything about that - instead of just saying 'I'm fine, it didn't happen to me, I've got no reason to feel like this' - it's automatic, and that's what we want them to understand."

Secondary trauma symptoms are similar to those of post traumatic stress disorder. Image: Getty.

But Katrina advises that it's not always helpful to talk about the incident itself.

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"Family members or friends might say 'what happened' and that kind of enquiry can be re-traumatising, because when they're telling the story and describing details, the person they're telling the story to might not understand what is happening to them physically, and emotionally... sometimes it can make it worse."

"For treatment, telling the story can help, but it may not be the first part of it... It's about being very careful in trying to understand what stage this person is at, what load can they bear, and sometimes the beginning of the process is getting back to helping them with the sorts of things they can do to control the emotional and physical aspects of what's happening, and begin to feel a bit more in charge of themselves," Katrina says.

She says feeling a "loss of control" over their emotions was normal, as were feelings of guilt and shame - similar to what Amanda described as "feeling silly" about her condition.

"When [people with second-hand trauma] fill in gaps in the story, and fill them in with things that are a whole lot worse than what actually happened, they, particularly a parent, can be left with feelings of 'oh I wasn't there, I should have been there to prevent this from happening'. It's that sense of responsibility - as though it was their fault."

Sometimes, Katrina says, people experiencing secondary trauma may experience survivor guilt - where they wish it could have been them instead.

"They mostly feel all this guilt because they think they're less able to provide support, and the shame that comes into play is different, but connected; they feel ashamed of having something less than an 'I'm alright, I'm coping' reaction, but again, they need to understand that this is just how the body responds to stress."

While in Amanda's case, the visions have gone, and she's ultimately come to terms with what was at the root of her initial reaction to Jake's accident, she says her concerns have now shifted to her son's long-term recovery.

"Once I'd talked about it and it was validated - I knew I wasn't just being silly, the fear went away and turned into something else... You know, you begin to focus on what's next, and how we can help him going forward."

"I don't like to revisit those feelings I had in the first weeks, but when I do, I just remember the feeling of fear," she says.

"It's quite confronting to live through these additional experiences that are not your own, that you don't choose to live through, and that you can't control... but it's happened to me before and I guess you just don't, or can't, let it plague you as a mother."

*Names have been changed.

If you or someone you know is struggling with their mental health, seek help from a medical professional or contact Lifeline (13 11 14), Suicide Call Back Service (1300 659 467), Kids Helpline (1800 55 1800) or GriefLine (1300 845 745).

If you or someone you know is in immediate danger, call 000.

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