The majority of research and clinical literature considering the stressful effects of road traffic accidents concentrates on the affect on the claimant. This is emphasised by litigation and treatment. However lawyers and medico-legal experts are aware that a serious accident can result in the de-stabilisation of the victim’s relationship. We decided to use research into other types of trauma and interview 50 claimants as part of a regular medico-legal practice.
We found that experiencing trauma with a partner can mean greater empathy and care-giving, although this depends on the level of the injury (physical or psychological). If the partner is not present at the scene of the accident, this does not necessarily always produce the opposite effect; it can mean greater energy and health for care giving to the claimant.
Both the initial prediction of injury and the medical reality have a stressful effect on the partner who will feel like they have to ‘hold the situation’ for their pain-suffering partner. The way the claimant responds emotionally to the accident initially, and in the first few days, can seriously impact on the partner who inevitably is the main care-giver for non-hospitalised claimants.
All of the above result in the partner feeling a lack of control; not only of the accident initially but of the injuries, both physical and psychological which his/her partner is experiencing and displaying.
Whether at the accident scene or at a hospital, the level and quality of information provided about l:he claimant and professional actions (emergency services, medical services) are crucial to the partner.
Lack of information or, in some cases, ‘It could have been worse’ information can have a significant and adverse effect on the partner and increase already heightened anxiety, Staff attitudes, competence and communication can reinforce and exacerbate this to reassure or frustrate a waiting-partner. This is added to by continuity of care and quality of hospital environment.
irrespective of whether the claimant requires post-hospital or the GP is the first ‘port of call’, ease of access to an appointment and the GP’s responsiveness to physical and psychological requirements also significantly effect the patients’ well-being. Their ability to mobilise a partner’s care-giving can also have a significant positive effect on them and the claimant.
We found that a claimant who has suffered either physical or psychological injuries, or both, is unlikely to place his/her sexual relationship at the top of their priority list. A partner’s reaction to the claimant’s understandable avoidance of intimacy will vary from sympathetic to confusion to feelings of rejection.
Given the accident-related demands (coping with injuries, medical care) and everyday demands (childcare, household and work demands), it can be difficult for couples to find the time to talk to or support one another. However, talking about the accident trauma„ experience and associated difficulties helps create mutual understanding and potential problem-solving. Avoidance of talking, resulted in confusion and lack of care-giving. Lack of partner-empathy adversely affected the relationship.
Feelings of rejection in either claimant or partner (e.g. when a partner returns to work) resulted in negative communication and irritability. A vicious cycle of negative emotion and lack of empathy can stress the relationship and slow or impede recovery.
The difficulty either partner has in coping with the normal lack of control as a passenger can agitate and frustrate the driver (whether they are the claimant or partner) and result in heightened anxiety and reluctance to travel. Both partners should be involved in the resolution of claimant travel anxiety.
RTA-related stress affects relationships in many ways. The impact can vary from strengthening and growth to risk of separation. The level or severity of psychological injury in the claimant (and partner if they were involved in the accident) can have a big effect. This will also be affected by the pre-existing psychological status of either partner, and quality of the relationship before the accident and the presence of other adverse life-stresses.
What does it all mean?
The implication for lawyers and experts is that they need to be more aware of the effect of trauma on partners, both in assessing the social consequences of an accident (relevant to diagnosis and quantum assessment) and increasing the reliability of prognosis by maximising partner involvement.