October 27, 2011
By Dr. Howard M. Rombom, Ph.D.
Jane Doe couldn’t forget the passenger who hit her. Jane operates a New York City bus for the Metropolitan Transit Authority. One day, as Jane’s bus rolled on her regular route, a passenger asked for a transfer ticket. When Jane replied that there were no transfers on her bus line, the passenger shouted that he would punch her in the face.
The passenger reached forward and jabbed the control keys on the fare box, but the machine did not print out a transfer ticket. Then he made a fist and punched at her belly. She turned and his fist struck her right elbow. She tried to stand up but was trapped by the bar, wedged in her seat as the passenger towered over her. Jane stepped on the brake and pulled the level to open the bus door. The passenger hit her hard in the shoulder. He turned and left through the open door.
Once the passenger was gone, Jane called the supervisor on duty — standard procedure when a bus driver is assaulted. The police arrived, along with an ambulance. At the local hospital, doctors treated the pain in her shoulder and elbow.
That evening Jane went home, but she felt “out of it.” She was unable to concentrate or focus. When loved ones spoke to her, she lost the thread of the conversation. The next morning, Jane went to her doctor to check on the bruises. Her arm and shoulder were still sore. But even as the physical injury gradually healed, she replayed the attack over and over in her mind. Could she have stopped the attack from happening? What if someone else attacked her? What if the same passenger returned to attack her again?
The attack exposed Jane to feelings of helplessness, hopelessness and fear, in addition to the bruises and the physical danger she endured. She was surprised and upset when she could not able to control these emotions. Jane withdrew from family and friends. She did not want to speak with anyone. She stayed home from work. Within a few weeks, she began to spend whole days in a dark room in her apartment.
Jane went to her union for help and asked about her rights under the Workers’ Compensation system in New York State. The union suggested she seek psychological care. She came to Behavioral Medicine Associates in one of our Bronx offices.
We found that Jane was suffering from significant symptoms of Post-Traumatic Stress Disorder, including anxiety and depression, a loss of quality of life, as well as a sense of impairment and disability. Without treatment, it is likely she would not have been able to return to premorbid levels of functioning or to go back to working as a bus operator for the New York City Transit Authority.
We helped Jane develop skills to help her relax, process the event and ultimately desensitize from her situation so that eventually she could return to driving her bus comfortably and safely. Over the course of several months, Jane’s symptoms diminished. She was able to ride a bus as a passenger and finally able to return to work on a full-time basis without any residual difficulties.
At the end of her treatment program, when Jane was reevaluated, her scores on all of the psychological measures indicated a total resolution of her difficulties. Subjectively she reported that she was even more comfortable and relaxed than she had been before the incident, having mastered the skills taught to her by her treating psychologist.
It is critical that workers who are traumatized be seen by a psychologist in order to enable them to return to work as soon as is possible. The purpose of psychological care is not only to relieve the negative symptoms but also to equip our patients with skills and understandings that they can use should other issues arise in the course of their employment.
Behavioral Medicine Associates is very proud of our relationship with the transit workers of New York City, these individuals keep our city running. When they need help, Behavioral Medicine Associates is there to allow them to overcome any workplace incidents and return to their jobs.