Bruce H. Young, L.C.S.W., Julian D. Ford, Ph.D. and Patricia
J. Watson, Ph.D.
Every year, millions of people are affected by both mass
violence and natural disasters, such as earthquakes, floods,
hurricanes, tornados, and wildfires. Survivors face the danger of
death or physical injury and the possible loss of their homes,
possessions, and communities. Such stressors place survivors at
risk for behavioral and emotional readjustment problems.
This fact sheet considers three questions often asked by
survivors: What psychological problems might one experience as a
result of surviving a disaster? What factors increase the risk of
readjustment problems? What can survivors do to reduce the risk of
negative psychological consequences and to best recover from
disaster stress?
What psychological problems might one experience as a result of
surviving a disaster?
Most child and adult survivors experience one or more of these
normal stress reactions for several days:
Emotional reactions: temporary (i.e., for several days or a
couple of weeks) feelings of shock, fear, grief, anger,
resentment, guilt, shame, helplessness, hopelessness, or
emotional numbness (difficulty feeling love and intimacy or
difficulty taking interest and pleasure in day-to-day
activities)
Physical reactions: tension, fatigue, edginess, difficulty
sleeping, bodily aches or pain, startling easily, racing
heartbeat, nausea, change in appetite, change in sex drive
Interpersonal reactions in relationships at school, work, in
friendships, in marriage, or as a parent: distrust; irritability;
conflict; withdrawal; isolation; feeling rejected or abandoned;
being distant, judgmental, or over-controlling
Most disaster survivors only experience mild, normal stress
reactions. Disaster experiences may even promote personal growth
and strengthen relationships. However, as many as one out of every
three disaster survivors experience some or all of the following
severe stress symptoms, which may lead to lasting Posttraumatic
Stress Disorder (PTSD), anxiety disorders, or depression:
Dissociation (feeling completely unreal or outside yourself,
like in a dream; having "blank" periods of time you cannot
remember)
Intrusive reexperiencing (terrifying memories, nightmares, or
flashbacks)
Extreme attempts to avoid disturbing memories (such as
through substance use)
Extreme emotional numbing (completely unable to feel emotion,
as if empty)
Severe anxiety (paralyzing worry, extreme helplessness,
compulsions or obsessions)
Severe depression (complete loss of hope, self-worth,
motivation, or purpose in life)
What factors increase the risk of readjustment problems?
Survivors are at greatest risk for severe stress symptoms and
lasting readjustment problems if any of the following are either
directly experienced or witnessed during or after the disaster:
Loss of loved ones or friends
Life threatening danger or physical harm (especially to
children)
Exposure to gruesome death, bodily injury, or dead or maimed
bodies
Extreme environmental or human violence or destruction
Loss of home, valued possessions, neighborhood, or
community
Loss of communication with or support from close
relations
Intense emotional demands (e.g., rescue personnel and
caregivers searching for possibly dying survivors or interacting
with bereaved family members)
Extreme fatigue, weather exposure, hunger, or sleep
deprivation
Extended exposure to danger, loss, emotional/physical
strain
Exposure to toxic contamination (such as gas or fumes,
chemicals, radioactivity)
Some individuals have a higher than typical risk for severe
stress symptoms and lasting PTSD, including those with a history
of:
Exposure to other traumas (such as severe accidents, abuse,
assault, combat, rescue work)
Chronic medical illness or psychological disorders
Chronic poverty, homelessness, unemployment, or
discrimination
Recent or subsequent major life stressors or emotional strain
(such as single parenting)
Disaster stress may revive memories of prior trauma, and may
intensify preexisting social, economic, spiritual, psychological,
or medical problems.
What can survivors do to reduce the risk of negative
psychological consequences and to best recover from disaster
stress?
Researchers are beginning to conduct studies to answer this
question. Observations by disaster mental-health specialists
who assist survivors in the wake of disaster suggest that the
following steps help to reduce stress symptoms and to promote
postdisaster readjustment.*
Protect: Find a safe haven that provides shelter; food and
liquids; sanitation; privacy; and chances to sit quietly, relax,
and sleep at least briefly.
Direct: Begin setting and working on immediate personal and
family priorities to enable you and your significant others to
preserve or regain a sense of hope, purpose, and self-esteem.
Connect: Maintain or reestablish communication with family,
peers, and counselors in order to talk about your experiences. Take
advantage of opportunities to "tell your story" and to be a
listener to others as they tell theirs, so that you and they can
release the stress a little bit at a time.
Select: Identify key resources, such as FEMA (Federal
Emergency Management Agency), the Red Cross, the Salvation Army, or
the local and state health departments, for clean-up, health,
housing, and basic emergency assistance.
Taking each day one at a time is essential in disaster's wake.
Each day is a new opportunity to
FILL-UP:
Focus
Inwardly on what's most important to you and your family
today;
Look and
Listen to learn what you and your significant others are
experiencing, so you'll remember what is important and let go of
what's not;
Understand
Personally what these experiences mean to you, so that you
will feel able to go on with your life and even grow
personally.
* The construct "Protect, Direct, Connect, Select" was developed
by Diane Myers, unpublished manuscript.