January 8, 2022

Mental & Emotional Health

How do you move forward after making a fatal mistake?

Accepting the limits of  personal control

Read Time 3 minutes

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No one – not even the boy’s family – blamed her for the accident, yet in the months that followed, Gray became socially withdrawn, experienced hallucinations, and seesawed between numbness and debilitating grief and guilt.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.

Disclaimer: This blog is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this blog or materials linked from this blog is at the user's own risk. The content of this blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions.
  1. Moving forward is not optional for most of us. Measuring high on the conscientiousness scale is both a blessing and a curse.

  2. When I read the title, I was reminded for a recent shocking incident. Four adolescents died in a crash at a railway crossing, when their car was hit by a train. It happened at the first day of this year.

    Even though I feel condolence for the families and acquitances for the passed, I’m also very concerned about the man driving the locomotive. Because the lights were working, and probably the passangers in the car were oblivious.

    How will the poor soul cope with this event? Though most are convinced, it was not his fault, and he didn’t commit a mistake, he must still believe himself to be the murderer of four teenagers.

    He is most likely to going through hell, and the echoes of guilt will definitely resonate endlessly in the times to come. I hope he will find peace with himself and will be able to forgive himself for simply being there in the wrong time.

    I wish the best for him and also for everyone involved. : ( : /

    • And what if the person who makes a decision and action that even obliquely does harm?

      What atonement is available? Whence is redemption?

  3. Why do we feel guilt? In some cases because we were shamed as children for things that weren’t our fault to promote conformity or behavior desired by the parent – or just because – it’s the American way of child-rearing. It might be productive to ask Gray of the history of shaming in her family …

  4. I had the opportunity to meet a railroad engineer who had been at the controls during multiple fatal crashes, all caused by the automobile drivers. To say he was in mental distress is an understatement. I hope somehow he found some peace.

  5. Excellent insights as always, Peter. This article brought up Conti’s epic podcast he did with you when his voice was all Godfathery, for sure. Think I’ve listened to that one 7x and read his new book 3x.
    A lot in here smacks of Moral Injury but I did not see the term used. Most times when you look up Moral Injury, largely considered a kind of subcutaneous super-symptom of PTSD and most often discussed around extreme experiences lived through by combat vets, this kind of nagging guilt is front and centre. *What I did*. *What I failed to do*. *What I allowed someone else to do*. And, in my notion of it at least, the guilt here is a precursor to shame — and that is where the real damage is done. The chewy nougat centre of the suffering goes from being guilt over the event and one’s role in it, however accidental or unfortunate, to a shame that eats you up inside as you ruminate 24/7 on variations of “what kind of person would be part of something like that,” and, still more damaging, “how can I live in a universe where morality is a fictional construct?”Truly recognizing that bad things happen to good people sounds inane but if you start pulling on that philosophical thread hard enough, your entire worldview can fall to the floor and get tangled around your feet — fast. Thanks, Peter, for continuing to put out this more mental health-focused content. You do it really well and in an accessible way and I appreciate it greatly. Discovering Conti through you has been a real boon to my healing.

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