TIME: Almanac 1993/TIME Almanac 1993.iso/time/103089/10308900.052

Text File | 1992-09-23 | 6.3 KB | 122 lines

                ╞                                                              NATION, Page 46

And Now, Emotional Aftershocks


Survivors must cope with losses and a new sense of vulnerability


    As the veterans of untold small tremors and countless mock
drills, Californians have long been convinced they were
psychologically ready for a big quake. Last week that
comforting belief was demolished. "I'm scared," confesses Sarah
Ford, 43, who with her three-year-old daughter found temporary
shelter at an Oakland high school. "I need a stress pill. When
I walk, I'm like tipping. I'm looking to see if anything moves."

    The physical shocks may be waning, but the psychological
reverberations are just beginning. In the next weeks and
months, residents will have to cope with an array of symptoms
that are increasingly recognized as the emotional legacy of mass
disasters. Just like soldiers in combat and civilians in
assaults, survivors of quakes -- as well as of floods, fires,
plane crashes, even oil spills -- experience psychic upheavals
so intense that their lives are shaken for years. In 1980 the
American Psychiatric Association formally labeled such
debilitating effects "post-traumatic stress disorder."

    Some experts believe that Bay Area residents may be
peculiarly vulnerable to the syndrome, precisely because they
have been anticipating a cataclysm for years. "Chronic stress
is very harmful," notes Dr. James Shore of the University of
Colorado Health Sciences Center in Denver, who surveyed victims
of the 1980 eruption of Mount St. Helens. "Preparedness can make
people more susceptible."

    Whether or not that proves true, the psychological
buffeting Californians will endure will follow a characteristic
pattern. Initial shock and fears will give way to a burst of
elation. But that will quickly fade as the extent of the
devastation sinks in. While few residents must confront the
death of a loved one, many have lost their homes, which hold
immense emotional as well as financial value. The destruction
of family photographs can be tantamount to obliterating one's
personal history.

    Soon survivors will suffer a host of complaints, from
headaches and stomach pains to flashbacks and suicidal thoughts.
Victims of Hurricane Hugo, which lashed the Southeastern U.S.
last month, are showing the expected strains. "About all of the
people we talk to have sleep disturbances," says Dr. James
Ballenger, head of the psychiatric institute at the Medical
University of South Carolina in Charleston. "They are constantly
fatigued. They leave briefcases at home. They forget
appointments. They cannot concentrate."

    There are other distress signals as well. Interest in food
or sex often flags, while indulgence in alcohol or drugs
deepens. People may be jumpy and their tempers short. In the
first seven months after the Mount St. Helens blowup, reports
of domestic violence in Othello, Wash., increased 45%, and
criminal arrests went up 22%, according to one study. The most
profound impact is a new sense of vulnerability. Victims wonder
when disaster will strike again and conjure up fresh calamities.
"Disasters like earthquakes challenge a fundamental fantasy that
we live with: that we're immortal," explains psychiatrist David
Spiegel of Stanford University's School of Medicine.

    Most people recover their emotional equilibrium in about a
year, though the trauma can easily last longer. In general,
researchers have found that people cope with natural disasters
better than man-made ones. And those who have suffered physical
injuries often fare better ultimately than those who escape
unhurt.

    Rescuers, despite being trained to cope with disaster, may
be particularly troubled by the grim sights and smells. "I don't
care how professional your firemen and policemen are," says Jim
Worlund, an Oakland emergency planner, referring to an
amputation performed on a victim on the collapsed Nimitz
Freeway, "that's hard to live with." Dr. Edward McCarroll of the
Walter Reed Army Institute of Research in Washington last year
conducted a survey of 150 military and civilian personnel who
participated in rescue efforts at military disasters. He found
that many were overwhelmed when they discovered a body that
resembled them or when they handled victims' effects, like
wedding rings. "All they can think of," he says, "is `That could
have been me.'"

    Older people, once considered emotionally frail, are now
regarded as exceptionally hardy. Their wealth of experience
gives them a broader perspective to draw on. Children, on the
other hand, appear to be very fragile. Psychologist Bill Locke
of Texas Tech, who studied the aftereffects of a 1970 tornado
in Lubbock, found that youngsters, even those as old as ten,
regressed into clinging and infantile behavior and that some
residual effects were felt in adolescence. Other high-risk
groups: single parents, especially women, who usually carry the
brunt of their family's emotional needs; and the poor, who are
often already stressed to the limit.

    The key to blunting mental trauma is counseling. Survivors
need to be assured that their reactions are normal and expected.
Talking to family and friends is encouraged, but often it is not
enough. Says Susan Solomon, coordinator of the National
Institute of Mental Health's emergency and disaster research
program: "The thing that makes disasters particularly damaging
is that the people you normally turn to for help are also
victims." Many Alaskans affected by the Exxon Valdez oil spill
last March are finding professional help useful. In the three
months after the accident, the number of people seeking
assistance at the Valdez Counseling Center was three times the
number who came during the same period in the previous year.

    The sooner help comes, the better. A study of 200
traumatic-stress cases by researchers at the Barrington
Psychiatric Center in Los Angeles revealed that the costs of
rehabilitation, disability, absence from work and litigation
were six times as high for victims who received no or delayed
therapy as for those who were treated quickly. That suggests
that California health officials should offer as much counseling
as possible now -- or face even more serious distress in the
future.