How do caretaking agencies protect citizens in a time of crises?
In the aftermath of a horrific or life-threatening event 90 % of survivors will experience symptoms of distress which include fright,confusion, impaired concentration,worrying thoughts and sleep disturbance.
Biological probes attribute this to excitation of the Hypothalamic-Pituitary-Adrenal Axis which mediates all stress reactions
These symptoms will usually dissipate after days or weeks, provided that the "situation on the ground" is stabilized. This consists of appropriate rescue operations and restoration of normal social infrastructure.
In order to minimize the impact of trauma, the survivor has to feel the unimpeded ability to travel, communicate with significant others, safe access to food, shelter, and medical assistance.
Those united with a familiar or empathic person, are more likely to recover if they have healthy cognitive and emotional resilience. Survivors who are emotionally resilient also seem to be more effective in mobilizing external resources (such as friends, pastors, or therapists).
Once a sense of safety has been restored a natural resolution of symptoms will usually ensue over a period of days or a few weeks, even without treatment. This natural decline in levels of hyper-aroual is called habituation.
Biologically, the re-establishment of safety allows the Hypothalamic-Pituitary-Adrenal Axis to "switch off" its stress response and the toxic production of stress hormones such as CRF, cortisol, adrenaline, and glutamic acid.
When the sense of danger has subsided, survivors experience a gradual lessening of turmoil and distress, and begin to make sense of their experience.
The majority of survivors of an acute trauma will be able to resume their usual routines, unfettered by fear.
Even without formal treatment, trauma survivors benefit from empathic social -bonding and emotional support from friends or colleagues at the work-place. The capacity to self- reflect and constellate other "good objects" is healthy, and used by victims with good survival skills.
Healthy survivors will unconsciously mobilize strategies acquired during childhood that enhance their sense of inner-cohesion.
Throughout development a child learns to manage external threats by identifying with and modeling the responses of good caretakers.
Early in life, parents will function as an external regulator of your stress responses. You are at an advantage if your caretaker identified your stress signals and responded supportively.
Over time, children internalize their parents` coping skills. These include the belief that things will turn out "all right", and the capacity to confront rather than avoid problems, plan solutions, and seek support when needed.
During the "Battle of Britain" children suffered fewer stress-related symptoms when they remained with a psychologically healthy parent.
Abusive and neglectful parents lack the empathy or skills to provide the protective function of preventing or rescuing children from predatorial violence.
Information sharing is another critical aspect of social bonding that alleviates fear.
In the immediate aftermath of a terrorist attack, studies showed a very high percentage of New Yorkers, Londoners, and Israelis attempting to make numerous cell-phones calls to friends and family.
In the London transit attacks in 2005, seventy six percent of the population attempted to contact familiar others in the immediate terrorist aftermath, to check on their safety.
Individuals experiencing Mobile phone network failure, which occurred to a greater extent in New York, and less so in London, were more likely to experience substantial stress.
Maintaining contact with significant others during a traumatic event plays a vital role in maintaining psychological cohesion.
Since establishing the well-being of family and friends plays such a crucial role in reducing emotional over- arousal, this highlights the importance of back-up communication networks in anti-terrorist preparedness.
Recent examples of failure to provide such rescue services to civilian populations include the civil war in Darfur, and following Hurricane Katrina. In all of these cases the trauma of displacement, separation, temporary make-shift accommodation, and poverty, has caused devastating and probably permanent damage on core ego functions, children bearing the main brunt.
Many of the damaging effects of rescue-failure will only emerge later,and this subject has been well documented in long-term studies of the effects of the civil wars in Bosnia and Somalia, as well as the holocaust.("Modern Terrorism and Psychological Trauma" published by Richard Altschuler @Associates 2007)
In the 9/11 attacks, the general population was also desperate to be informed about the extent of immediate threat, the identity of the perpetrators, and whether the world’s “Superpower” could identify and contain any ongoing threat. There was a surge of Nationalism.
Within hours the country was addressed by the President of the United States and informed that America had declared war on Al Quada. Within weeks, sustained aerial bombings and ground offensives were launched against terrorist training camps.
This deifinitive response served a “containing” function for a damaged "collective- ego", so crucial in warding off a contagious chain-reaction of dread and chaos.
However, if leadership fails to provide appropriate trauma-prevention or rescue functions, trauma symptoms are far more likely to evolve into one of the more serious syndromes such as "Acute Stress Disorder", or PTSD.
Recoveries for these states will be described in future blogs.
