© Erwin Randolph Parson, Ph.D., A.B.P.P.
Article Courtesy of Gift From Within-PTSD Resources for Survivors and Caregivers
When disasters strike they are sudden, unexpected, and "earth-shattering" to those affected by them. Often those who are exposed directly talk about how their lives of relative tranquility before the disaster has been radically changed, and how peace of mind has evaporated and replaced by worry and catastrophic expectations. They describe their new post-disaster reality as living life "upside down," in a state of confusion, and pervasive anxiety, and helplessness. Disasters are generally defined as mass environmental stress affecting a large number of people. Terrorism, like no other mass disaster event, smashes to smithereens a victim's sense of normality and reality, while eroding the sense of safety and general well-being.
Disaster victims also speak about things not being the same, of how their inner sense of safety and the ability to count on the stability of the environment (for even a modicum of predictability) has been lost. Some also speak about feeling powerless, having lost the structure of their daily lives and associated routines, and about the collective emotional distress caused by the abrupt depletion of resources and altered physical environments.
The contents of this article is based on: (1) the author's over two decades of clinical, consultative, scientific, instructional, and administrative expertise in the area of traumatic stress, (2) the author's direct professional activities with victims of disasters, to include the September 11th attack by terrorists on the World Trade Center in New York City during seven trips to the City beginning October 10, 2001, and (3) knowledge gleaned from decades of clinical and field studies on specific disasters in the United States and in many countries of the world. Specifically, the author has participated in helping victims exposed to the Loma Prieta Earthquake of 1989 in northern California, the Perryville Explosion of 1991 in Perryville, Maryland, the Oklahoma City Bombing of 1995, the Polish Flood of 1996, Hurricane Floyd of 1999, and the World Trade Center (WTC) attack of September 11, 2001.
Disasters are found everywhere in the United States and around the world, and can be traced throughout the history of human existence. Historically, we find various parts of the world had endured tidal waves, famines, earthquakes, floods, mining accidents, bombings, industro-chemical explosions, bush fires, mudslides, and pestilence, to include the Great Plague of Europe between 1347 and 1350.
Though most victims interviewed in New York City by this writer showed symptoms of Acute Stress Disorder or Post-Traumatic Stress Disorder, responses were diverse. This diversity of stress response can be expected given the differing personality styles, prior experiences, prior traumas, and the general mental health of these individuals prior to the flood, typhoon, earthquake, or industrial accident.
Disaster stress research studies have revealed that these untoward events affect the lives of people for years and even decades. Understanding the effects of these disaster events upon victims' minds, bodies, relationships, and behavior, is crucial for survivors and therapists. This understanding may serve preventive ends in guarding the individual against traumatic symptoms that may potentially undermine personal, social, and occupational (economic) functioning.
In Brende's (1998) article, "Coping with Floods: Assessment, Intervention, and Recovery Processes for Survivors and Helper," he discusses "unprecedented and destructive flooding in various parts of the United States … particularly during 1997 and 1998" (p. 107). He notes that flooding represents about 40% of all natural disasters.
There are a wide variety of natural disasters—tornadoes, floods, hailstorms, hurricanes, droughts, heat wave, Western fires, tropical storms, ice storms, and earthquakes. Disasters are very costly to victims—in terms of money, life disruption, loss of resources, loss of a sense of community, loss of property, and becoming homeless for a protracted period of time. Two noteworthy examples of high cost disasters in the United States both in 1989 were the Loma Prieta Earthquake, and Hurricane Hugo. According to the United States National Committee for the Decade of National Disaster Reduction, thousands were homeless for over a year, while the economic cost exceeded $15 billion.
Technological accidents are examples of human-caused disasters. These are disasters characterized the unintentional action (or inaction) of an individual, group, or organization resulted in an overwhelming environmental situation that resulted in mental, physical, and economic harm to people. Technological disasters are human-caused events, but are not by design. Examples of this class of disasters are the 1986 Chernobyl nuclear accident in the Soviet Union, the 1984 gas leak in Bhopal, India, and the 1979 Three Mile Island of nuclear leak in Harrisburg, PA. and a number of serious mining accidents, and devastating explosions due to bombings over the years. Scientists have found that, compared to human-engineered disasters, technological disasters are significantly less distressing, with lower prevalence rates of post-traumatic stress disorder (PTSD). This is also true for acute stress disorder (ASD) rates: industrial accidents produce a rate of 6%, compared to a 33% rate for mass violence (shooting)(Bryant, 2000; Bryant & Harvey, 1997).
Terrorism-related and technological disasters inflict serious injuries, caused by flying debris, and intense thermal exposure. The victims of terrorism explosions often report varying degree of burns and blast injuries that produce hearing loss, serious internal injuries—to the intestines, to the head (to include closed head damage), abdominal contusions, facial and orbital lacerations, and injuries of pancreas, heart, lung, and parts of the central nervous system.
The terrorism waged against the World Trade Center in 1993, and the hijacking of four planes on September 11, 2001 that resulted in the worse terroristic attack on the United States, are examples of human-engineered disasters. Clinicians and scientists believe that human-engineered disasters have a greater and more profound and enduring effect on the victim than natural disasters in which no human design existed (Parson, 1995a, 1995b).
Disorders - Post-Traumatic Stress Disorder
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