Strategies for Surviving Accidental Limb Loss in Families
“It’s an awfully risky thing to live.”
– Carl Rogers
Sometimes there are unexpected traumas in life for which we are totally unprepared. When someone loses a limb accidentally, it is life-altering for the family as well. The family system that we depend upon has been disrupted. The consistency in life that helps us feel secure is now gone. The trauma’s impact is magnified if it was caused by a family member’s negligence. There will be questions of cause and feelings of guilt that run through all levels of the family. The world they once knew has changed.
Trauma is defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM) as “anything beyond the range of normal human experience.” A traumatic experience occurs when a family member loses a limb through an accident, especially if the accident is caused by another family member. Examples of this include farming, boating, machine and lawn-mowing accidents. The emotional consequences can be disastrous. At the same time that the amputee is adjusting to the consequences, the person responsible for the limb loss feels a tremendous sense of guilt and responsibility. Carrying this much self-blame and other negative emotions can take its toll on the entire family, including the victim.
When someone we love loses a limb as a result of our negligence, the guilt feelings take on monstrous proportions. They are fierce and long-standing. When our careless behavior brings suffering to another person, it’s virtually impossible not to blame ourselves. It’s realistic to feel guilt and remorse in accidents that result in another person’s limb loss. Sometimes these initial feelings of guilt can be so unbearably bitter and overwhelming that the individual may deny the event has happened as a temporary survival mechanism. Psychologically, the person is in a state of shock.
Following this period of shock and denial, the individual will begin to obsess over the incident by rehashing the details: “What did I do to cause this? What could I have done to prevent this? Why me?” These tormenting thoughts can undermine our sense of worth and wellbeing. We must forgive ourselves for all of the “shoulds” that didn’t happen.
The entire family, including extended family members and friends, is affected by the trauma. The status quo has changed. The family system must adjust to the fact that one member is an amputee and another member may be to blame. Some of the family members go through the same questioning and self-blame that the person responsible for the accident goes through. Spouses or siblings often question whether they could have done something to keep the accident from happening.
Even the victim may experience self-blame. Family members must adjust their role or function in the family to accommodate the amputee’s needs. Sometimes this goes smoothly. Sometimes it generates resentment, as all the focus is on one family member’s adjustment. Each person is hurting and needs some acknowledgment and support.
At the same time, the family is our greatest support system, pulling together to help in the amputee’s healing process. The support and encouragement of extended family members, such as grandparents, and friends can be crucial to the amputee’s adjustment. Friends, being less overwhelmed by the same emotions as family members, can be the ones to explore resources on the Internet and at the library, such as support groups and organizations such as the Amputee Coalition of America (Amputee Coalition).
As the amputee’s needs begin to dominate the family, siblings may feel neglected. The amputee is now more dependent on the parents and siblings. Some siblings thrive on being able to help; others may feel jealous. During this time, it’s important that the parents do not ignore the needs of the other children. They need to communicate to the children that as their injured sibling adjusts and gains greater independence, the family will return to “normal.”
The marital relationship is the core of the family system. If it’s a healthy, loving relationship, the family system will run smoothly. If one spouse was responsible for the accident, the other spouse may express blame and anger. This generates a vicious circle of more anger, blame and self-blame. At this point, the couple would benefit from intervention of some kind, such as counseling. If the anger continues, the marriage bond may be broken, resulting in either divorce or ongoing unspoken resentments expressed behaviorally. Children experience the emotions of their parents. Emotions don’t have to be spoken for the children to absorb them. The parents’ unspoken negative emotions may even be “acted out” by the children through various unhealthy behaviors such as school problems, violence, promiscuity, etc.
Guilt needs to be felt and it needs to be expressed. But more importantly, it needs to be released. Holding on to guilt can lead to unhealthy coping styles such as alcoholism, drug use, working until you drop, isolation, less interest in pleasurable activities, depression and becoming void of all emotions, even positive ones. These are ways of unconsciously saying: “I’m guilty; therefore, I am unworthy and should be punished.”
It takes a lot of energy to hold all of this inside. Not only does this affect you mentally and physically, it also affects your relationships with your family and friends. One thing that will destroy a relationship faster than anything else is unspoken hurt or anger. Our relationships are the most important thing we have, so they are worth the time and energy it takes to make them work.
By holding on to guilt and anger, we are dragging the weight of the past with us everywhere we go. It consumes us and drains our energy, leaving less available for life in the present. Learning to let go of these negative emotions isn’t easy. Dealing with guilt isn’t something that happens right away. Sometimes we end up living with our guilt for years before we finally deal with it.
Guilt suppresses our happiness and permeates our lives once it takes hold of us. Our thoughts cause our emotions. If we carry around guilty thoughts such as, “It’s all my fault. I’m a bad person, an unworthy person for causing this accident,” then the resulting emotion is guilt. If your thoughts include the words “should” or “should not,” then you are having feelings of guilt. Prolonged intense guilt and other negative thoughts affect not only your emotions but your body as well. To overcome guilt, you must overcome the negative thoughts. Stop putting negative labels on yourself. Stop the self-punishment.
There comes a time when the pain of continuing the guilt feelings is greater than the pain of stopping. This is when you realize that to continue with the guilt is to choose to live in discomfort, and to stop these negative thoughts is to choose to live freely again without the burden of guilt. Once that realization is reached, you can choose to ignore it or move on in life by doing something about it. Fortunately, there are strategies that can help us alleviate our sense of guilt and live a fulfilling life again.
One of the first tasks is to find a way to stop the guilty thoughts. We experience the guilt on a conscious level but the guilt thoughts are at an automatic, unconscious level, so the first task is to acknowledge the negative thoughts behind the feelings. Thoughts equal emotions and negative thoughts are incompatible with positive thoughts, so replacing negative thoughts with rational thoughts will rid ourselves of negative feelings. For example, if you’re telling yourself, “It’s all my fault. I’m a bad person and should be punished,” you can replace this with a rational statement of the truth, such as, “I caused another person pain and loss of a limb. It was unintentional. I will do whatever I am capable of to ensure his or her success in life. I am a good person and care about and love those who I am closest to.” This will take some effort and time – you are changing a habit. One way to accomplish this is to write down the negative thoughts on the left side of a piece of paper and then write the truth on the right side. Only after you have practiced this many times will the habit change. Then, you will begin to feel better. Each time you find yourself feeling guilt, stop and bring the thought to your consciousness of what underlies the emotion. Replace it with the truth. Practice this each time the guilt feelings return.
Self-forgiveness is the solution to the selfpunishment of guilt. Asking forgiveness of someone else is the antidote to anger. Forgiveness is letting go of the past. The past cannot be changed. We can only change the present to ensure a better future. We must forgive ourselves for all the “shoulds” that didn’t happen.
It helps to remember that most of us live our lives as best we can, given the persons we are and the state of mind or knowledge that we have at a certain point in time. We don’t intentionally set out to harm others. Neither did you intend the limb loss event that you are struggling with. It isn’t necessary for you to become a tyrant to yourself because an action of yours brought suffering to another person. You can welcome yourself back to a fulfilling life without paying the price of punishing yourself for the rest of your life.
In a situation of intense remorse, there isn’t much our friends and family can say to help us feel less guilty. Usually all a friend or family member can do is to make us understand that we are loved and accepted despite what has happened. You will need your friends and family to be understanding when hearing your feelings of regret spoken again and again. Try to believe that others’ love toward you is genuine. It is genuine because, if they are honest with themselves, they know that a similar event could have happened to them.
If you believe in a God who accepts and forgives your humanness, then that belief may help you. With or without this belief, it’s important that you trust in the power of other people who can help you accept and love yourself.
Expressing our feelings and communicating them to those we love is essential for forgiveness. It may help to put your feelings on paper, either through journaling or letter writing. By putting our emotions into written form, we become more aware of them. We gain insights we might otherwise have never seen. Journal writing allows us to gain clarity of our thoughts and feelings. It also reduces their impact.
You may want to write letters to each family member. You don’t have to give it to them unless or until you are ready. By reading a letter from someone, we are more likely to “hear” and understand what they are hoping to communicate. We can answer the letter orally or through a return letter. It gives us time to think more rationally. It opens up communication. Usually, the more one person discloses, the more willing others are to do the same.
One of the hardest tasks in life is to realize that it is not always the way we expect it to be. There are no reasons why some people suffer more than others. If we accept life and let go of the past, we free ourselves to live more fully in the present. We leave ourselves open to a more satisfactory, fulfilling life. Life is still a risky undertaking, but as we survive the losses and traumas we have the opportunity to grow stronger and strengthen our relationships.
About the Author
Sandra Houston, PhD, is a clinical psychologist and retired professor of psychology from the University of Central Florida. She had a private practice for 30 years, specializing in marriage and sex therapy. She has been a hip-disarticulation amputee since 1982. With over 50 professional publications and presentations, she continues lecturing and writing in the field of rehabilitation psychology.