Most of us have an implicit belief in our ability to exert control over our own lives.  It’s surely one of the most fundamental principles underlying healthcare: certain decisions – such as which diets to follow, how much to exercise, or which medications to take – have predictable effects on one’s health and longevity. Most of the time and for most individuals, this principle holds true, and it’s a comforting thought. Actions have foreseeable consequences, and the world is governed by order and fairness.

But of course, this isn’t always the case.

Accidents Happen.

Serious accidents – particularly those with fatal outcomes – can shatter that sense of order, fairness, and personal control. This disillusionment is often acutely traumatic, which, as I discuss in my upcoming podcast with psychiatrist Paul Conti, can lead to long-term psychological consequences like anxiety or post-traumatic stress disorder (PTSD) for accident victims, their loved ones, and others who witnessed the event. But as a recent article by Maryann Gray for the Wall Street Journal points out, these consequences can severely affect another, often-overlooked group as well: individuals who, unintentionally, may have acted as instruments in causing the accident.

Gray describes her own tragic experience in 1977, when, while driving safely on a country road, she saw a child suddenly run in front of her car. Despite her attempts to swerve and slam on the breaks, she couldn’t avoid hitting the young boy, who was pronounced dead on arrival at the hospital. No one – not even the boy’s family – blamed her for the accident, yet in the months that followed, Gray became socially withdrawn, experienced hallucinations, and seesawed between numbness and debilitating grief and guilt.

A 2017 article in The New Yorker recounts a series of stories similar to Gray’s, and a common thread emerges: faced with reassurances of blamelessness and a lack of legal culpability, these individuals often nevertheless maintain an insistent belief in their own guilt. Cries a woman who had collided with a motorcyclist: “I hit him! Why does nobody understand this?”

Why do we feel guilt?

Guilt is a prosocial, emotional response that reflects a sense of responsibility to others – it arises from the belief that one has violated a societal code of conduct. Those who cause accidents without acting recklessly or negligently have made no such violation, yet still almost invariably experience a heavy burden of guilt. Such instances offer little opportunity for atonement – after all, there’s nothing to atone for – and the irrational, continued guilt often results in self-imposed social isolation or more severe self-destructive behaviors, and it imposes a barrier to seeking treatment.

In the absence of any moral fault, why do those who cause fatal accidents so consistently battle with guilt? Writing from her own experience, Gray suggests that many may prefer a sense of personal responsibility to a more nihilist alternative view: sometimes, bad things can happen for no reason at all.

Letting go of guilt

Accepting that “accidents happen” requires an acceptance of limitations to the control we have over our own lives. The philosopher Bernard Williams describes the hazy area between intention and outcome, where factors outside of one’s control can influence the course of events and our reactions to them: “anything that is the product of the will is surrounded and held up and partly formed by things that are not.” This thought may be unsettling, but constitutes the first step in letting go of guilt and moving forward along the path of healing, both for those who have caused unintentional harm and for any who are struggling with trauma.

Decades after her accident, Gray opened up about her experience in an NPR segment in 2003. She was surprised by an outpouring of support from friends and emails of gratitude from dozens of others who had also struggled with the guilt of causing accidental deaths. The feedback inspired her to create the website Accidental Impacts, a resource of information and support for those who have caused unintentional harm. In Gray’s words:

We cannot ever make up for taking a life. We can, however, resolve to make the world a better place… In so doing, we regain a sense of agency and efficacy, we restore our sense of belonging, and we find a measure of self-respect.

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