Near-miss experiences and traumatic events

What is a near-miss experience?

Traumatic events usually happen quickly and chaotically. A near-miss experience occurs when you are involved in a traumatic event where you think you will die or be badly hurt, but are not. This can have a deep psychological impact, sometimes with lasting effects.

Examples of near-miss experiences may include:

• surviving a car or plane crash
• surviving a situation such as an armed robbery
• surviving an explosion or a fire.

People who have had a near-miss experience sometimes feel they have less reason to be upset or to seek help than those who were injured or bereaved. But even if you are physically unhurt, a near-miss experience can cause emotional harm. It’s important for you to understand what has happened and to seek help. It’s also important for your family and friends to support your recovery.

How does the body react to a near-miss experience?

When you face a moment of danger, the instinctive mechanisms in your brain and body create a state of high alert that prepares you for survival. Your senses are heightened, you act instinctively (without thinking), and you react and make decisions much faster than usual as there is no time for emotion or to make sense of the situation.

If the threatened event or anticipated outcome of death or injury doesn’t occur, the danger is replaced by unfamiliar and demanding experiences requiring attention, such as contact with emergency services, police, health workers or other rescue workers.

In this flow of events, there may be no time to take stock of what did and didn’t happen, so the mental and emotional changes you made when anticipating the worst outcome are not undone. In time, this can lead to confusion – leaving you stuck in the terrible moment deep down, while on the surface everything appears normal.

What are some common emotional responses to a near-miss experience?

Common emotional responses (known as survivor reactions) to a near-miss experience can include:

• a constant preoccupation with the event and imagining what you expected to happen
• detachment from loved ones, inability to relate to others, avoidance of intimacy, impatience, irritability and withdrawal
• loss of interest in career, hobbies, activities or social life
• a sense of not belonging, having nothing in common with family, friends or colleagues
• changed views of what’s important in life, or no longer having the same values as those around you
• loss of meaning in life, feelings that there doesn’t seem to be any future, or just ‘waiting for it to all be over’
• a preoccupation with death, suffering and tragedy, or pessimistic feelings such as ‘what’s the point?’
• a feeling that surviving was a mistake, thinking ‘I shouldn’t be here’ or having feelings of guilt or unworthiness.

Self-help for reactions to a near-miss experience

If you’ve had a near-miss experience there are some things you can do immediately to address any disturbing reactions you may have had.

• If you’re constantly preoccupied with the event, when it comes to mind make an effort to think past the moment of danger to remember how you survived. Tell yourself the whole story, then try to put the event aside and return to the present.
• If you’ve become detached from loved ones, remember that if you said ‘goodbye’ during the traumatic event you can say ‘hello’ again and celebrate your survival with your loved ones.
• If you’ve lost interest in your career, hobbies, activities or social life, give yourself time to work the event out, then see if you can get enjoyment from familiar activities again. If not, consider that your priorities may have changed and that you might value different activities more.
• If you’re having feelings of not belonging, try doing things that are meaningful to you and that you enjoy doing with others. A shared bond between people helps to build belonging. It may also help to explain how you feel to people who will understand. This could be a friend or family member, or a counsellor.
• It’s not uncommon for a near-miss experience to change people’s outlook on life and what’s important to them. These experiences give a clearer sense of the importance of people, relationships and making the world better.
• If you feel life has lost its meaning and you’ve lost interest in the future you had planned or expected for yourself, consider what kind of future is important to you now. Whatever you thought was going to happen during the traumatic event you experienced – maybe you thought you were going to die – you do still have a life and future, so think what you can do with it.
• If you’ve become preoccupied with death, think about what is important and will give life meaning now. It may help to avoid news and media until you have found your direction again.
• If you are feeling guilty for surviving, remember that during traumatic events normal order is disrupted. Whether you survive or not, or are injured or unharmed often comes down to luck and has no deeper meaning. You are not responsible for the event or the outcome. Try to accept what happened and give yourself permission to stop trying to find meaning in what occurred.
• It may help to put your thoughts and feelings into words by keeping a journal, talking to family and friends, or participating in recovery meetings or support groups associated with the event.

Consider talking to a trained professional who has experience with traumatic events; they are likely to help you understand what is happening and offer the benefit of their experience and suggest ways of helping yourself through it.

When to seek help for reactions to a near-miss experience

Near-miss reactions are a consequence of facing a tragic or traumatic event. If they do not resolve, or if you feel other previous problems are stirred up, early support from trained professionals can prevent complications and help the recovery process. Seek professional help if:

• the reactions you are having are interfering with your day-to-day life and relationships
• the event does not seem to fade and your feelings about it are not subsiding
• you are having difficulties with sleeping, eating, your mood, relationships, work or leisure
• no matter how you look at it, the event doesn’t make sense
• you have ideas of self-punishment, self-harm or taking risks you wouldn’t normally take
• you continue to feel detached, have lost interest in previously enjoyable activities, or are isolating yourself.

Where to get help for reactions to a near-miss experience

• Your GP (doctor)
• Mental health specialist, such as a psychiatrist, psychologist or social worker
• Community health centre
• Phoenix Australia Centre for Post-traumatic Mental Health Tel. (03) 9035 5599
• Grief Australia Tel. (03) 9265 2100

General telephone counselling services can provide advice:

• Lifeline Tel. 13 11 14
• GriefLine Tel. 1300 845 745
• beyondblue Tel. 1300 22 4636
• Kids Helpline Tel. 1800 55 1800