Overcoming Fear

You may be wired to worry, but courage can be learned.

Handling emergencies: A psychological first-aid kit

How psychology can help in a disaster

When tragedy strikes, whether it's caused by humans or nature, psychology has a wide range of ways to intervene.

Let's start with a relatively small-scale emergency. A passenger faints on an airplane. Immediately, the call goes out: "Is there a doctor on board?" This situation occurs with surprising frequency, as reported recently by the New York Times. Medical attention is, of course, appropriate to seek in such situations. However, there are times when psychological attention could be just as- if not more- effective.

Consider the case of a passenger afraid of flying who experiences a panic attack and frantically pushes the call for help.  People on other forms of public transportation such as buses, trains, or even elevators may and often do experience similar episodes. A psychologist can perform a vital role in such a crisis situation. I was recently in an airport waiting in line to descend down an escalator to the plane when a woman stood, frozen in fright, at the top step and refused to get on the first step. The airline personnel literally picked her up and set her down to the side to let the other passengers descend. I expect they had her take an elevator, but I was unable to see what eventually happened to her. I certainly didn't detect any sympathy from the airline personnel (nor the passengers waiting impatiently behind the woman).  Unfortunately, there were too many people in front of me to be able to offer any help.

Why are the skills of psychologists not seen as relevant in such emergency situations? From a practical standpoint it makes sense to enlist the aid of a physician for a person having the kind of symptoms that prompt medical attention such as difficulty breathing, passing out, or sudden pain in the chest. The personnel who work in public transportation don't have the training to discern when these symptoms are physically or psychologically based. However, when it's clear that someone is suffering from emotional difficulties such as anxiety, inebriation, or rage, why not ask if a mental health professional is available to help?

Not only can psychologists intervene to help troubled travelers, but we also have valuable skills that can help defuse tense situations. Airline travelers seem to spend half their time being inconvenienced, especially with cutbacks in flights, increased weather difficulties, and the occasional computer glitch that brings everything to a screeching halt for hours, if not days.  You know the scene- if you haven't been in one you've seen it on television- thousands of angry people frustrated and angry that their vacation or business plans are disrupted. How do airline personnel typically respond in these situations? For the most part, rather badly. In many cases they fail to provide adequate updates. They unwittingly treat passengers like unruly children. They tend to make up arbitrary rules and enforce them in arbitrary ways. Not all airline personnel do this, to be sure. But, they don't take advantage, for whatever reason of behavioral strategies that could lead to lower frustration levels and help passengers through these difficult times. Sadly, those behavioral strategies would also make the personnel's jobs much less stressful.

Treating angry passengers like spoiled children only ensures that the passengers will react like spoiled children. Air travel probably involves the most number of frustrated travelers due to the nature of the industry, but the same principles can apply when services break down on other modes of public transportation.

Frustration, anger, fatigue, anxiety, and stress associated with travel constitute areas in which mental health professionals can usefully intervene. Even more critically, they can play vital roles in life-threatening large-scale emergencies; those in which disaster strikes. We may not be able to set broken bones or deal with other physical trauma, but we can work with victims to alleviate their psychological distress. 

Providing this kind of help is the American Psychological Association (APA)'s Disaster Response Network (DRN), a group of about 2500 licensed psychologists with training in working with disaster victims. They volunteer to assist relief workers and survivors in the aftermath of disaster. They don't provide on-the-spot therapy, but they work with victims to help them mobilize their own coping skills and resources. The network was formed in 1991 with the signing of a Statement of Understanding with the American Red Cross. Since that time, DRN members have assisted in literally hundreds of disasters in local communities including fires, school shootings, transportation accidents, earthquakes, hurricanes, tornadoes, floods, and wildfires.  If you're interested, I'd suggest you follow the links on the APA's DRN website. 

Whether you're a mental health professional or not, there are ways to employ psychology to help engage people's abilities to cope successfully in emergency situations.

1. Listen to people's concerns.  Sometimes people just want to be heard. Showing that you understand how a person is feeling can help that person gain control over his or her own emotions. Often, emergencies bring out our own empathic responses. These can be put to good use in helping victims (and ourselves) to cope more successfully.

2. Put yourself in the other person's shoes.  You may be behind the counter on a Tuesday, serving passengers or others requiring your professional services, but on a Wednesday you may be the one in line waiting for those services. We tend to make the "fundamental attribution error" and make excuses for our own rude behavior but blame the personal flaws of those we serve if they are rude to us. By recognizing the influence of situations on behavior, you'll be more willing to help someone in need.

3. Provide information.  Withholding important details makes people suspicious about what they're not being told. In the case of transportation delays, for example, it's better to know that you're going to be delayed by 3 hours than to be given vague updates every 20 minutes that don't allow people to make contingency plans.

4. Overcome the bystander effect. According to the bystander effect, people will watch but not offer to help when an emergency occurs. Although you may not have the relevant skills to intervenes, if you do then you need to overcome "diffusion of responsibility."

5. Be aware of the limits of your ability to help. As with medical situations, when an orthopedist probably wouldn't be of much help to a heart attack victim, psychologists (and others) can only do so much in cases of severe panic attacks or other psychological emergencies. Depending on the situation, the best way to help is provide referral for psychological treatment.

The next time you hear the request for a "doctor" to help out in an emergency, remember that help can come in many forms and from many types of helpers including, possibly, yourself.

Follow me on Twitter @swhitbo for daily updates on psychology, health, and aging. Feel free to join my Facebook group, "Fulfillment at Any Age," to discuss today's blog, or to ask further questions about this posting. 

Copyright Susan Krauss Whitbourne, Ph.D. 2011

Overcoming Fear