Obsessive compulsive disorder - OCD treatment and therapy from NOCD

I’m having dreams about car accidents. Do they mean anything?

By blue-digits

Nov 30, 20230 minute read

As a therapist, I’ve worked with many people who search for meaning in their dreams, including those about car accidents. Most often, these people are worried that their dreams are highly significant, indicating that they are in danger. 

To put it bluntly, these dreams don’t actually mean anything on their own. However, the fact that they’re causing you such worry, anxiety, or distress? That may signify something about the state of your mental health. Especially intense responses to dreams are associated with a number of conditions—and they’re all highly treatable.

In this article, we will explore what dreams are and what they may or may not signify according to the current scientific consensus. We’ll explore several mental health disorders that could contribute to excessive rumination about the nature of these dreams, including several that I focus on treating professionally. 

What do dreams actually mean? 

Enigmatic and universal, dreams are a mysterious part of the human experience. Nearly everyone dreams, though not everyone remembers their dreams.

The purpose of dreaming remains a subject of speculation. All we can say with any degree of certainty is that, throughout various sleep cycles, the brain engages in complex processes, generating vivid imagery and scenarios. While some adhere to theories that dreams symbolize repressed desires or archetypal symbols, others argue that dreams are simply the brain’s way of organizing and processing complex information. 

The emotional residue from unsettling dreams can linger long after waking, but contemplating the content of your dreams is not an indication of any mental health problem on its own. However, an unreasonable preoccupation with the content of dreams can be associated with several mental disorders. During my years as a therapist, I’ve worked with many people who spend a lot of their waking life thinking about the meaning of their dreams—including ones that are about being involved in car accidents. 

While no evidence suggests that dreams are truly predictive of future events, car accidents are common. For the average driver, a dream of an auto accident might come true three or even four times throughout their lifetime. (This is according to data showing that the average driver will file an insurance claim for an auto collision once every 17.9 years.) 

Why am I so worried about my dreams?

Put simply, it’s not strange to dream about what may have happened to us and could realistically happen again. Nor is it abnormal to reflect on those dreams in the hours after waking. If, however, you find that you can’t stop ruminating on dreams about car accidents—or if you become fearful that your dreams mean something about your life—it could be a symptom of any of the following conditions:   

Post-Traumatic Stress Disorder (PTSD):

Similar to PTSD flashbacks, people with PTSD often experience distressing dreams related to their traumatic experiences, such as car accidents. The dreams are vivid and intrusive, replaying the traumatic event. These nightmares can lead to persistent, distressing thoughts during waking hours, causing significant emotional turmoil. The hyperarousal and intrusive thoughts characteristic of PTSD contribute to the persistent nature of these dreams.

Treatment for PTSD typically involves trauma-focused therapies such as Prolonged Exposure (PE), which we provide here at NOCD. These approaches aim to desensitize people to the traumatic memories and reduce their grip on their lives.

Generalized Anxiety Disorder (GAD):

GAD is characterized by excessive worry and anxiety about various aspects of life, including potential accidents. These persistent, unrealistic fears may manifest in dreams, causing people to ruminate on catastrophic scenarios like car accidents. 

A specific form of behavioral therapy, known as exposure and response prevention (ERP) therapy, focuses on practicing new behavioral responses in the face of uncertainty/doubt, and is highly effective for GAD—we’ll discuss this more later in the case of OCD, as this treatment is the gold standard for OCD treatment. Medications such as selective serotonin reuptake inhibitors (SSRIs) may also be prescribed to reduce this and other symptoms.   

Major Depressive Disorder (MDD):

Depression can intensify negative thinking patterns, leading to disturbing dreams about car accidents. Individuals with MDD may experience pervasive feelings of hopelessness and despair, influencing the content of their dreams. 

Psychotherapy, particularly Cognitive Behavioral Therapy (CBT) or Interpersonal Therapy (IPT), is often a first-line treatment for MDD. These therapies address negative thought patterns, helping individuals reframe their perspectives and develop healthier coping strategies. As with GAD, SSRIs can also be used to reduce symptoms and improve daily functioning. 

Obsessive-Compulsive Disorder (OCD) 

Obsessive-Compulsive Disorder (OCD) is a mental health condition characterized by intrusive thoughts, images, urges, or feelings (obsessions) and repetitive behaviors or mental acts (compulsions) performed in response to the distress caused by these thoughts. OCD can manifest in various different themes or “subtypes,” one of which is known as harm OCD.

Why OCD can make you obsess about disturbing dreams

The harm-themed subtype of OCD involves persistent fears of causing harm to oneself or others, often leading people to engage in compulsive behaviors to prevent the feared harm. 

There’s even a specific subset of harm OCD specifically focused on called hit-and-run OCD, which can be triggered by hearing news stories of hit-and-run accidents, feeling the vehicle go over rough terrain or a pothole in the road, driving in adverse conditions, or feeling distracted while driving near pedestrians. 

Here are some examples of potential OCD obsessions related to dreams about car accidents: 

Obsessions like these would then lead people with OCD to engage in compulsions to feel relieved or to avoid getting into a car accident—or even to avoid having a similar dream in the future. Here are some examples:

  • Frequently stopping while driving to check that they didn’t hit someone
  • Avoiding driving altogether
  • Urging loved ones to avoid driving
  • Mentally reviewing: “Replaying” scenes in their mind of driving to “check” if they are repressing a memory of an accident
  • Insisting on driving with others in the car or demanding that others drive
  • Avoiding driving in the dark or new areas

Now, to meet the diagnostic criteria for OCD, obsessions, and compulsions need to cause distress, reduce normal functioning, or take up a lot of time. If obsessions and compulsions are taking up that much mental bandwidth during our waking hours, it’s pretty reasonable to assume that, at some point, related content will show up in our dreams. 

How can I take the power away from disturbing dreams about accidents?

Exposure and Response Prevention (ERP) is a highly effective approach for treating OCD and anxiety disorders like GAD. This approach involves gradually exposing people to anxiety-provoking situations and preventing the usual compulsive responses. This helps break the cycle of obsessive thoughts and compulsive behaviors.

Therapy exercises specific to dreams about car accidents may include leaning into feelings of uncertainty, while learning to resist compulsive responses done to feel better. Your therapist might guide you in saying to yourself, “I could get into a car accident today. Maybe not, but who really knows for sure?” This will probably make you start to worry about driving, but you’ll choose–in gradual steps—to accept that uncertainty and rely less on compulsions. At first, this might look like allowing your spouse or child to drive to the grocery store without checking in with them while they’re away. Later on in treatment, you might be encouraged to proceed with your usual car commute, even after having a dream involving a car accident.

As a result of exercises like these, you’ll gain a new relationship with uncertainty, and you’ll learn that your dreams don’t actually have an impact on your waking life. After all, uncertainty is a necessary part of life, and no one can control what they dream about. What you can do is regain control of your life, reduce the impact of these distressing obsessions, and become less encumbered by the resulting dreams you ruminate on today. 

You don’t have to be afraid of your dreams forever

If you think you might have OCD and are interested in learning how it’s treated with ERP, I strongly encourage you to learn more about NOCD’s accessible approach to OCD and anxiety treatment. 

Remember, you’re taking a significant step toward reclaiming your life from OCD. With the right therapist and ERP, you’re setting yourself on a path toward meaningful progress and improved well-being. You’re not alone in this journey; there is hope for positive change.

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