Why talking ISN’T the best medicine for disaster victims
SURVIVORS of trage - dies such as this week’s Genoa bridge collapse are filled with a toxic mixture of utter relief ( sometimes disbelief) that they’re alive, and an over - whelming sense of guilt that others perished.
This, combined with the terror they’ve experienced and the horror they’ve witnessed, can put them at a high risk of mental health problems.
Studies show that around 7 per c ent of soldiers who served on the f ront line in Afghanistan or Iraq display signs of post-traumatic stress disorder (PTSD) following their return.
But these are individuals specially selected and trained to cope in highpressure environments: rates of PTSD are far higher in the civilian population following trauma. So what can be done to help the survivors in the aftermath of such a disaster? W ell, it isn ’t what you might think.
My heart sank a little when I read about the hordes of psychologists descending on hospitals in Genoa to support survivors and witnesses. I hope to God they are providing comfort and reassurance — and avoiding therapeutic intervention.
It may sound strange, but that ’s the last thing traumatised people need. The belief that it’s helpful for people to share the horrific experiences they’ve just endured is a myth. Indeed, it could be disastrous for them. Some - times, it really isn’t good to talk.
What we have learned from studies of military personnel in recent years is that the brain is actually rather good at processing terrible events — but quietly and at its own pace.
Problems develop when, in the hours after the event, people are encouraged to recount what happened to them and what they saw. It ’ s no protection at all against related mental health issues in the future. Indeed, it actually raises the risk of mental illness such as PTSD.
We know , for example, that soldiers who attend de -briefing sessions after witnessing traumatic incidents actually do worse in the longer term than those who missed the session.
Going over the experience so soon after it has occurred links it with the powerful, still- raw emotions felt at the time — fear , revulsion, anger , helplessness, despair etc. The survivor’s memories are consolidated and a pathway is created in the brain that allows the mind to run through them again and again, as though it is stuck in a groove.
Of course, I’m not saying that people might not need therapy down the line. But that is very different to giving therapy prophylactically before symptoms have developed.
On July 7, 2005, I was working at a London hospital that had taken in survivors from the terrorist bombings in the capital. As the psychiatrist on call, my job was to go round the wards to ensure that none of the staff was asking patients about what happened.
YOU can hold some - one’s hand and reas - sure them if they’re distressed, I explained, but don’t ask anything that might force them to relive what they went through.
I also made sure that every patient had ‘ night sedation ’ written on their charts as an option if they needed it.
Sleep is the best medicine in situations like this — a chance for the brain to get on and do what it does well: process traumatic experiences and render them ‘safe’ so that the mind can cope.
If sleep won ’t come naturally , then tranquillisers or even a stiff drink may help.
When my partner’s sister rang from the Manchester Arena last summer — she’d been just a few feet from the foyer where the bomb went off and saw some truly horrific sights — that ’s exactly what I advised.
Your brain can do the rest, I told her, if you just give it a chance.