Toolbox: Recovering From Crashes, Part 2

After a crash – whether you’re in it, see it, or hear about it – it can be difficult to get your mojo back. And even when you’ve had a complete physical recovery, the mental side of your recovery can lag behind. When you focus on developing and using specific mental skills, you can speed both sides of your recovery and accelerate your return to optimal performance.

By Marvin Zauderer

In our last Sport Psychology column, Garmin-Slipstream pro Steven Cozza, his coach, and his doctor described Steven’s recovery – and lessons learned – from a traumatic crash. This month, we add to the Advanced Skills of the mentally fit cyclist covered in past columns by exploring further how to recover from crashes.

This week, I heard Terry Gross interview the great comic Robert Schimmel on her NPR radio program, Fresh Air. I laughed and cried as Schimmel told the harrowing and ultimately redemptive story of his near-suicide, near-death and full recovery from cancer. (It’s worth hearing the interview just to hear him tell the story of having his 70-year-old mother, a concentration camp survivor, buy him rolling papers for his medical marijuana.) And of course, another cancer survivor – once near-death himself – is on my mind this week as he resumes his cycling career Down Under.

A crash isn’t always as frightening as being on the brink of death. Or is it?

When you crash, or see one, or perhaps even hear of one, something very powerful can be revealed within you, something that each of us has, something that most of us keep hidden from our moment-to-moment, day-to-day awareness: mortality. And of course, as far as things that terrify us go, that one tends to be way up there on the list. (The eminent psychiatrist Irv Yalom, in his new book “Staring at the Sun: Overcoming the Terror of Death,” explains how the fear of death is at the heart of much of our anxiety.)

But a crash can do more than evoke your mortality. Even if your brain wasn’t injured in the crash, research shows that the brain can change as a result of emotional traumaexperienced during and after the traumatic event. That can make you fearful and anxious, too. And of course, you may simply be worried about feeling pain again (what a surprise, right?), and may act in various ways to reduce the chances of that happening: going slowly on descents, avoiding certain races or rides, backing off during the sprint, and so on. So, depending on your genes, personality, and history, there are all sorts of opportunities for our old nemesis, anxiety, to interfere with your recovery.

You’ll recall from Part 1 of this two-part series that
Dr. Judith Herman, in her pioneering book “Trauma and Recovery,” emphasizes restoring both inner and outer strength in recovering from trauma:

“The first principle of recovery is the empowerment of the survivor. [S/he] must be the author and arbiter of [his/her] own recovery. Others may offer advice, support, assistance, affection, and care, but not cure….Trauma robs the victim of a sense of power and control; the guiding principle of recovery is to restore power and control to the survivor.”

You’ll also recall that Dr. Herman identified three stages in recovering from trauma: Establishing Safety, Telling the Story, and Re-engaging With Life. (These stages are usually non-linear, so unlike a stage race, there’s no need to rush!) Let’s take a look at some skills you can use and some steps you can take in each of these stages. We’ll be ably assisted not only by Steven Cozza, but also by my friends and fellow Masters racers Lloyd and Ted, both of whom are recovering from a crash at the moment.

Establishing Safety
As I noted above, a crash can be an experience – literally or internally – of having your life threatened. It can violate your inner sense of safety, and can trigger profound feelings of powerlessness and helplessness. As you experience any new limitations after the crash, those feelings can linger and even intensify. If they’re powerful enough, they can cause and be sustained by depression. To avert all that and rebuild your sense of safety, some or all of the following may work for you:

• Learn, learn, learn. Recall how much better Steven Cozza felt after he spent a ton of time on the Internet learning about his brain injury. With insufficient information, your mind may rush into the void and start catastrophizing (ie. creating worst-case scenarios). And the catastrophizing is likely to create more powerlessness, helplessness, and anxiety. Cast away the catastrophizing, and get busy: Find out whatever you can about your condition. Remember, information is power!

• Bring yourself back to the present when necessary. Countering any catastrophizing is only one of the ways you can stay appropriately focused on what’s happening now. Sure, you’re going to be piecing your story together, and that’s going to require some visits to the past. And sure, you’re going to be planning your recovery, so that’s going to require some future-oriented thinking. But take care not to spend too much time in the past or future; your mojo needs you now.. Recall how Steven Cozza’s coach, Dario Fredrick, helped Steven by modeling a present-centered attitude:

“My whole approach was to emphasize that these things are temporary, to focus him on the things he could do, and to emphasize that his body was healing itself.”

You might not have visual-spatial and coordination problems like Steven did with his brain injury; you might just be anxious. This doesn’t mean you’re a wimp, or a nutcase, or hopelessly broken. It means you’re a trauma survivor. Fight anxiety’s attempt to drag you away from the present.

• Determine your “triggers” and approach them progressively. Particularly when you start to ride again, even on the trainer, certain things – eg., pain, higher speed, higher wattage, potholes, rain, close proximity to other riders – may cause you to become anxious, perhaps unbearably so. The basic strategy: do you what you can until you become very comfortable there, then push yourself a little bit further. Repeat. The technical term for this approach: progressive desensitization. Whether you’re doing the simplest stretches, exercising, or riding, the idea is that you give yourself – over and over again, with carefully increased levels of intensity – experiences of feeling safe. These corrective emotional experiences can be shots of antidote for your trauma symptoms.

• Treat pain with respect and curiosity. Pain can be a uniquely complex trigger. Ted, who broke his leg severely, advises, “To push through the pain could be disastrous. Let pain become your guide, and try to understand what type of pain it is.” Ensure you can differentiate between injury pain and performance pain. Relearning how to accommodate to performance pain may be part of your progression.

• Notice – and influence – how your body is healing. Particularly if your connection with your body has been a significant source of inner strength for you, you’ll feel safer as your body heals. Even the seemingly small improvements – a little less pain, walking further down the street, getting back on the trainer – can be big contributors to your sense of safety. And, research has shown how the mental side of things – your self-talk, your attitude, your hope, where you choose to put your attention – can have a powerful impact on your physical healing. So, this is another important source of power and control, and thus safety, for you: you can use your mind to help your body heal.

Telling the Story
Recall one of Dr. Herman’s key points about trauma:

“The core experiences of psychological trauma are disempowerment and disconnection from others. Recovery, therefore, is based upon the empowerment of the survivor and the creation of new connections. Recovery can take place only within the context of relationships; it cannot occur in isolation.”

Some things to consider:

• What is your story? You may not know until you start to “give voice” to it (whether verbally, through writing, art….) , get feedback from others, and begin to refine it. Notice that your story may include not just the crash, but certain thoughts, feelings, actions, and events before and since the crash.

• What are you making of it? In telling your story, note the meaning that you’re making of the crash and its aftermath. Your mental/emotional/spiritual response to the crash is going to be profoundly affected by this. (For you technical types, this is known as the “cognitive-appraisal model” of the response to crashes.)

How much of your identity, self-esteem, and self-confidence has been tied up in your cycling? (Check out the article on Recovering From Injury for more on this.)

And, another one of the things you may be wrestling with is: Why did this happen? Are you blaming yourself at all? If so, that’s not uncommon. Dr. Aphrodite Matsakis, in her book “I Can’t Get Over It: A Handbook for Trauma Survivors,” writes:

”Self-blame arises in part from the fact that powerlessness and helplessness are two of the worst feelings any human being can experience. Yet being and feeling powerless or helpless in the face of great danger is the very definition of trauma. However, people prefer to think that they are able to control their lives, so it is easier to blame themselves for negative events than to acknowledge that sometimes life is unfair or arbitrary and innocent people can be victimized for no reason. Consequently, to maintain a sense of being in control, you may view yourself, rather than chance, as responsible for one or more aspects of the trauma – perhaps for all of it. In this way, self-blame can be a means of regaining the power that was lost during the traumatic event.”

“Wait a minute,” you may be thinking, “I was (partially) responsible for the crash.” Maybe. But look very carefully at the bigger picture. Trauma – and sudden threats – frequently create huge anxiety and distort thinking, which can dramatically affect decision-making. If you notice yourself saying things like “I could have….” or “I should have…,” evaluate your guilt against reality. And you may need some help in defining the reality of the situation.

Even if you did contribute to the crash, take care not to restrict your story to that fact. For example, the fact that you did not intend to cause the crash may need to be part of your story. The influences on your contribution – a rock, other riders, the weather – may also need to be part of your story. Certain parts of your story may clamor for all of the attention. Don’t let them sway you. Tell the whole story. In the telling, you may discover more of it.

• Confront what’s difficult or confusing about your experience. Lloyd had been agonizing about the possible contribution one of his fellow riders may have made to his crash. After struggling with whether and how to discuss this with the rider, Lloyd had the courage to have the conversation, particularly since he knew he’d be riding with that cyclist again. The rider agreed to change a particular riding behavior, and as a result, Lloyd’s sense of safety on subsequent rides increased.

Re-engaging in Cycling…and Life
After his crash, Ted not only couldn’t ride, but he couldn’t go to work. A major project loomed the following month. He worked very hard on his physical therapy exercises, accepting them, in his words, as his “new job.” He also wanted to do whatever he could to work out and stay active, so he did core exercises and stretches in bed. The first time he stepped outdoors – with a walker – and saw a sunny day, it was a tremendous boost for his recovery. Ted emphasizes the importance of “small wins” andgoal-setting skills in his recovery:

“Prior to my injury, I could set a goal and then choose to achieve it or to let it pass. It was my choice, either way. Now, I make many of my physical [recovery-related] goals with a bit more flexibility. For instance, I might say I want to do a certain race. While I can still attempt to train toward that end, the fact is that it might not happen physically. So, I just do what I can to cheat nature out of my healing time, and learn to accept when I can’t. I think that’s the biggest key to all of this – perspective. Set a goal but keep it flexible, work to achieve it, and then re-focus, re-state and adjust the goal and accept that if necessary.”

Lloyd stresses the need for patience:

“I am definitely forgetting more, sleeping more, and feeling depressed because everything takes me longer to do…I want to recover NOW…I now understand that what I need is patience…When I am patient it makes me much more comfortable and actually seems to diminish the symptoms of the head injury…Getting uptight just makes things worse.”

Speaking of getting uptight: particularly when you re-engage with cycling, it’s very important to have an effective toolkit for managing your anxiety. Effective self-talk – how you coach yourself through your recovery – may be the most important skill of all.

Lastly, if you’re having serious inner distress (eg. depression, recurring nightmares, flashbacks, debilitating anxiety, panic attacks), if you’re using food, drugs, alcohol, or what seem to be other unhealthy behaviors to control your distress, or after all of your work on recovery you still just plain feel stuck, consider seeing your doctor or a mental health professional; asking a trusted friend or family member for their honest perspective on your struggles; reading Dr. Herman’s or Dr. Matsakis’ book, or all of the above.

I’m tempted to end by quoting the wonderful actor Michael Conrad, who played Sergeant Esterhaus on the TV show Hill Street Blues. His signature send-off to the police officers after roll-call: “Let’s be careful out there.” I do urge you to take care of yourself out there, particularly if you’re recovering from a crash. But also dig deep for the courage to fuel an active, tenacious recovery: “play to win,” rather than “playing not to lose.” To quote a favorite saying of that cyclist racing Down Under, Carpe diem! Seize the day!

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About Marvin:

Marvin Zauderer, in his sport psychology practice, coaches athletes from all sports on the mental skills needed for success. He works in person and by phone, and frequently speaks to groups about the mental side of sport. Marvin leads the Mental Training program at Whole Athlete, a performance center in Marin County, California that provides a comprehensive set of coaching, testing, fitting, and consulting services to amateur and professional athletes. He is a licensed psychotherapist, USA Cycling Level 2 coach, and Masters road racer for Taleo Racing. Having had a 20-year career in high-technology R&D, sales & marketing, and management, he also coaches business professionals on improving their performance at work. Marvin welcomes email at [email protected]. His website is www.marvinz.com.