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For the living cell and for the organism as a whole life is one
catastrophe after another. - Scientific American, March 1976, pp 60D-61
EMOTIONAL IMPACT OF DISASTER:
SENSE OF BENIGN WORLD IS LOST
By Daniel Goleman
IN a major catastrophe like the Mexican earthquake and the mud
slides in Colombia, experts say, the psychological
world collapses just as resoundingly as the physical one.
The most prominent psychological casualty is the sense of
invulnerability with which most people manage to
face the risks of daily life. Also shattered,
psychologists are finding, are a person's sense that
his or her world is comprehensible and has meaning,
and for many years after the trauma a person's very
sense of worth may be damaged.
''The common belief
that people recover after a few weeks from disaster
is based on mistaking denial for recovery,'' said
Dr. Mardi Horowitz, a psychiatrist at the University
of California medical school at San Francisco.
Delayed Psychological Reactions
research has shown that many psychological symptoms
do not appear until long after the victim seems to
have fully recovered from the disaster, and when the
problems do arise - such as difficulty
concentrating, depression or sleeplessness - their
causes may go unrecognized.
The study of the
psychological impact of trauma of all sorts has
become a major topic for researchers. While
psychoanalytic theories have dealt in the main with
the devastating effects of emotional trauma in early
childhood, the new work examines the emotional
aftershocks of disasters of every sort.
As psychologists and
psychiatrists assess the impact of catastrophes
large and small, they are finding that the worst
natural disaster holds something in common in its
psychic impact with what may seem a minor crisis,
such as a witnessing a brutal crime. And they find,
for example, that children come to grips with
disaster in ways that are very different from those
of adults. Moreover, the evidence is that rescuers
and even bystanders also can be vulnerable to
Basic Assumptions Crumble
becomes victimized by a disaster, whatever its
nature,'' said Ronnie Janoff-Bulman, a psychologist
at the University of Massachusetts, ''their most
basic assumptions about themselves and the world are
undermined. Psychological recovery, to a large
extent, requires rebuilding those assumptions.''
The key assumption
that crumbles in a disaster, according to Dr.
Janoff-Bulman, is that of invulnerability, the sense
that the world is benevolent, controllable and fair,
and that so long as one acts as one should, nothing
untoward will happen. ''The assumption of
invulnerability begins very early in life, as early
as the first two or three years of age,'' Dr.
Janoff-Bulman said in an interview. ''That is when
the child forms a sense of basic trust, the feeling
that the world is a predictable place in which good
things will come to you. And from that the child
comes to see himself as worthy of that kind of care.
These beliefs are at the core of a person's most
basic sense of himself and the world.''
attacks those deeply held beliefs,'' Dr.
Janoff-Bulman said. ''Suddenly all the world seems
malevolent. And because the two beliefs are so
intimately linked, you lose not only your sense that
the world is safe for you, but that you are worthy
of that safety.''
People who have suffered catastrophes afterward may undergo a
diminished sense of self-worth for 10 or 15 years,
or even longer, Dr. Janoff-Bulman has found in her
research. ''When you've been victimized,'' she said,
''it leads you to ask, 'Why me?' You may start
looking at yourself to find something in you to
blame it on, to justify and make some sense out of
such a horrible fate. That leads you to highlight
the negative aspects of yourself, which lowers your self-esteem.''
Some research suggests that the more benevolent a person had
assumed the setting of a disaster to be, the worse
its psychological impact can be. A study at the
University of Illinois found that women who had been
raped in settings they once thought were safe were
more fearful in general afterward than were women
who had been raped in dangerous settings.
Effects on Children
Children vary in
their reactions depending on their age, according to
research by two psychiatrists, Dr. Robert Pynoos of
the University of California at Los Angeles and Dr.
Spencer Eth of the University of Southern
California, who have studied children who witnessed
brutal crimes. The severest impact is on the
youngest children, those of preschool age. ''They
feel the most helpless and passive when confronted
by overwhelming danger, and require the most
assistance to re-establish psychic equilibrium,''
Dr. Pynoos and Dr. Eth wrote in an article in
''Trauma and Its Wake'' (Bruner/Mazel).
Young children in
severe danger often react by a mute, stunned
withdrawal; one 3-year-old sat next to her murdered
mother for eight hours until a roommate discovered
them. After the disaster has passed, preschool age
children often regress, acting like an anxious
younger child, whining, clinging or throwing
tantrums. Children at this age are most likely to
dwell on the fantasy that the tragedy has not
occurred, and that everything is magically all
Children of school age, on the other hand, have a much broader
repertory of responses. Some children at this age
will spend an inordinate time retelling the
traumatic incident in detail, but with a lack of
emotion. Others will become fixated in a state of
constant guardedness, as though braced for danger at any moment.
Aware of the irreversiblity of death, they are less prone than
the younger child to dwell incessantly on the
fantasy that a dead loved one will return. But
children of this age will often re-enact the tragedy
in fantasy, imagining themselves as having rescued
the victim, according to Dr. Pynoos and Dr. Eth.
Teen-agers, they write, tend to resemble adults in reacting to
disaster. One common reaction is a premature
entrance to adulthood, a false sense of readiness to
take on adult responsibilities. Teen-agers are also
prone to respond with rebelliousness, such as
truancy and sexual adventures, all out of keeping
with their personality before the trauma. Dr. Pynoos
and Dr. Eth note that teen-agers are much more
realistic in their understanding of the event itself
than are the younger children, who sometimes blame
themselves for the disaster. Teen-agers, on the
other hand, while they can accurately assess how
little their own acts may have figured into the
chain of events, may still inflate their guilt
feelings at having survived, as many adults do.
Symptoms Arise in 'Shell Shock'
Such variations in the impact of disaster must be seen against the
broader background of the normal progression of
psychological responses, which have been recognized
for centuries. When the diarist Samuel Pepys
described his reactions to the Great Fire of London,
which destroyed much of the city in 1666, his
account followed what psychologists have come to see
as a classic pattern: disbelief followed by a
forgetfulness of the disaster, insomnia, disturbing
dreams and extreme anxiety.
Similar symptoms are commonly observed among the ''shell shock'' victims
of the wars. The pattern, now called the
''post-traumatic stress syndrome,'' includes
recurrent dreams of the traumatic event, the numbing
of emotions, and guilt about having survived when others have not.
While there is no prescribed sequence for psychological recovery from
disaster, experts recognize specific stages that
oscillate in ways that can differ from person to
person. Some of the most detailed research on the
emotional aftermath of disaster is described by Dr.
Horowitz in his book ''Stress Response Syndromes,''
published by Jason Aronson.
Normal Recovery Process
The normal immediate
response to a severe trauma, Dr. Horowitz says, is
an outcry of fear, rage or sadness at the terrible
impact on one's life, which is often followed
closely by a state of dazed shock. That shock is the
beginning of a psychological denial of the tragedy,
a denial that seems to serve a positive purpose in
allowing the person to come to grips with his
shattered world at a rate he can manage. For weeks
or even years after the event, denial - blocking the
facts from awareness - oscillates with intrusive
thoughts of the tragedy, as the person slowly comes
to face its full emotional truth.
When that process of adjustment goes awry, though, a variety of more
severe problems can arise, according to Dr.
Horowitz. For example, the immediate impact of the
disaster may be overwhelming, leaving the person
emotionally swamped. If the initial reaction of,
say, distress and fear is not relieved, the person
may sink into a state of total exhaustion or the
feelings may escalate into outright panic.
During the longer course of recovery, Dr. Horowitz has found, people
may either fall prey to extremes of denial or to
being emotionally flooded by thoughts of the event.
Extreme denial can take many forms, including a
general numbing of emotions, serious loss of the
ability to concentrate or to follow a train of
thought, or an avoidance of topics even vaguely
associated with the event. On the other hand, when
memories of the event intrude too much, it can take
such forms as an excessive alertness of dangers that
do not exist, sudden waves of uncontrollable
emotion, bad dreams or constant rumination on the
event that cannot be put out of mind.
psychological process of coming to grips with the
event goes uncompleted, Dr. Horowitz notes, the
dangers can be more subtle, sometimes taking the
form of psychosomatic complaints like stomach
problems, headaches or inability to work or to love.
When the recovery process goes awry in these ways,
Dr. Horowitz notes, psychotherapy that deals with
the original trauma is called for, even years later.
''The sudden emergence of fears or nightmares long after the
tragedy has passed usually surprises everyone else,
who thought the person had already recovered,'' Dr.
Horowitz said. A recent report in The American
Journal of Psychiatry tells of a World War II
veteran who had no post-war problems until, 40 years
later, he became haunted by a repeated nightmare of
an incident from the last days of the war. In that
encounter, he had shot German soldiers who turned
out to be teen-age boys in uniforms with imitation
rifles; in the dream they appeared as his own grandson.
Witnesses Affected as Well
Witnesses to a disaster can be as profoundly affected as the
victims. One risk to bystanders or unseasoned rescue
workers at the scene of a disaster is from
encountering a dead and mangled body, according to
Dr. Horowitz, who said, ''The sight can leave a
person with a profound death fright, feeling that
life has no meaning, or severly depressed if they are prone to it.''
To be sure, disasters can bring out the best in people, who put aside fear
and self-concern to rally to the needs of the
moment. ''Even though people may be dazed,'' Dr.
Horowitz said, ''most function enormously well
during the emergency itself, especially in direct
response to seeing someone in pain or need.''/td>