Psychological Effects of Disaster

The physical impact of a disaster is obvious to anyone who has seen the dramatic scenes of destroyed communities and ravaged landscapes. People lose their possessions, their homes, their livelihoods, and their loved ones. Disaster leaves in its wake.

Of course it is easy to see the physical impact of disaster, but what about the psychological impact - the hidden wounds? There is now a substantial body of literature documenting the immediate and long-term psychological effects of disasters. These studies have been done in countries around the world, with victims of all ages, and about all types of disasters. The research has studied both those who have been direct victims of violence, as well as the indirect victims - witnesses, coworkers, friends, relatives, rescuers, and other members of the community.

In general, these studies have revealed two important findings. First, they have consistently found that the greater the exposure to the threat or the greater the violence, the more likely it is that victims will have a variety of psychological stress reactions. These various reactions are described in detail in the following section. However, it is also encouraging to note that the studies have also found that victims who receive immediate help following the traumatic incidents are less likely to have disabling and long-term stress reactions. The guidelines for providing this immediate help are described later.

The BASIC IDS Model of Psychological Reactions

The research has clearly demonstrated that the psychological reactions to disaster have been powerful, long-lasting , complex and multi-faceted. The BASIC IDS Model is a useful tool for organizing the research findings because it shows the psychological reactions from eight important perspectives:

The acronym BASIC IDS is a helpful mnemonic device to remember these significant facets of the psychological reactions to disaster.

Behavior

Victims of a trauma often act in certain typical ways. At first, the victims may be crying out in distress, pleading for help, wandering aimlessly or fleeing from the danger. Later, they may continue to feel that something - anything! - has to be done right now. They may be pacing, or rocking, or fidgeting. Or at times they may feel so discouraged that they do nothing.

Even if they were not injured, the victims of a traumatic incident are generally not as capable and adaptive. They will not be able to perform their duties at the same level as before the incident. Work problems, such as absenteeism and inefficiency, may increase. Traumas usually disrupt the everyday living patterns of people. For months, they may find that they are unable to control episodes of crying.

Both adults and children may be telling the story of their experience many times. Even shy individuals will open up to strangers about what they saw, heard, felt and did during the incident. Many children who were witnesses of a disaster will worry about what happened to others and will ask many questions. Children may be re-enacting the experience in their play. It is common to see children acting out the events and drawing pictures of the scenes.

Affect

For the sake of simplicity, the affective reactions to disaster can be divided into yellow, red and black emotions, or no emotional reaction at all. Yellow reactions, like the yellow traffic light that signals caution, are those characterized by feelings of anxiety, fear, and panic. The disaster experience is a dramatic reminder of one's vulnerability and mortality. Many survivors remain hypervigilant, constantly on guard, and, in the words of one survivor, "as tight as a coiled spring," apprehensive that another calamity threatens them around every corner. They may be easily startled by unexpected sights and sounds. They find it impossible to relax and be at ease. As a result, they are constantly on edge. Survivors may also be extremely fearful, even when there is absolutely nothing threatening nearby.

Red reactions are those characterized by feelings of anger, resentment and hostility. At times, the survivor may burst into a rage and become violent. Often, survivors may be easily irritated by petty annoyances. They may feel resentful, embittered, and mad at the world.

Black reactions are those of depression, hopelessness, shame, and grief. The victims may have lost their health, a loved one, or their way of life. It is only natural for them to go through a time of grieving for these losses. It is also not uncommon for someone to feel a powerful sense of shame about this victimization. In extreme cases, these black reactions have led to suicide.

At some times, particularly in the beginning, victims may have no reactions at all. They may seem apathetic or numb with a sense of emotional anesthesia that deadens and dulls the pain.

Sensation

In addition to the physical pain they may experience from their injuries, those who have been exposed to disaster will likely have many physical sensations, such as headaches and stomach aches, muscle tension, nausea, sleep problems, shortness of breath, and fatigue.

Imagery

Like a VCR, the human mind is able to picture and replay mental images. This capacity to visualize images from the past can be particularly upsetting for victims of disaster. Months and even years later, certain sights or smells may still trigger in some survivors vivid and upsetting memories or "flashbacks" of the disaster. Most victims can close their eyes and picture in their minds a detailed scene of the incident.

For some survivors, a recent disaster may also reopen older emotional wounds that have yet to heal. Witnessing a disaster may be particularly traumatic because it stirs up frightening images, powerful emotions, and painful memories of past traumas.

Other victims may not remember anything at all about a traumatic incident. It is common for people to have amnesia about parts or all of such a terrible experience.

At night, many victims are plagued by horrible nightmares that play out the events of the trauma once again. Children may have night terrors, which are especially vivid dreams that re-enact traumas.

Cognition

In addition to mental images, the human mind can create cognitions - thoughts that take the form of words. Victims of disaster may at first be in a state of denial, in which they do not accept that this event has happened, or they are so disoriented, dazed, stunned and bewildered that they are in a state of shock. Later, they may be able to acknowledge what has happened to them, but they may remain in a state of confusion, unable to think clearly or completely about the current difficulties that the victims face.

At some point, many victims may find themselves plagued with thoughts of self-blame, in which they irrationally believe that they are responsible for failing to prevent the disaster or the tragic consequences. This self-blame is especially true for children who are in a stage of development where they believe that events are caused by their own wishes, fantasies and behavior.

Victims may be preoccupied with the traumatic incident to the point of obsession, wondering why this tragedy happened to them, trying to find meaning in this suffering, and attempting to gain some understanding of how to handle their present problems. Their thoughts may be marred with constant worries. Workers and students may find themselves being easily distracted and having problems remembering important facts.

Children who experience traumas are particularly vulnerable to developing a profound cynicism and excessive pessimism about their future.

Interpersonal Relations

At first, many victims enjoy a "honeymoon" phase in their relationships after exposure to a trauma. There is a strong sense of having shared with others a dangerous, catastrophic experience and having lived through it. After an incident, victims may be very talkative and want to tell their stories to others, including virtual strangers. Many friends and families grow closer as a result of the experience. However, some victims often develop problems with their friends, coworkers, neighbors, and relatives. The victims may unexpectedly lash out at others or isolate themselves for long periods of time, leading to marital turmoil, separation or divorce.

While many people may reach out to victims by offering assistance and support, there is a tendency among some others to avoid, and sometimes even blame, the victim of a trauma.

Drugs/Health

Victims are at a high risk for abusing substances. Troubled by their physical and psychological distress, they often attempt to find relief by medicating or numbing themselves to their strong reactions of distress. Exposure to violence, like other forms of stress, also reduces the effectiveness of people's immune systems. They are much more vulnerable to illness after they have been victims of disaster.

Spirituality

People who survive a disaster often struggle with the meaning of this experience. When they are in denial, they claim, "Not me!" When they try to incorporate this event into a meaningful framework, they ask, "Why me?"

The Process of Recovery

A disaster represents more to the victim than a single point in time - the effects that can linger for months and even years after the critical incident. While the event itself is terrifying and traumatic for many victims, it is just the beginning of a long series of problems. The survivors of disaster have to cope with chronic medical problems, loss of property and possessions, physical pain, and economic hardships that continue even years later.

The victim's first reaction to the disaster may be an outcry, a reflexive emotional response. Or, psychologically recoiling from the trauma, victims may immediately turn to a period of denial, during which they do not accept the reality of the event. To help avoid any awareness of the event, they may dissociate and have a sense of "emotional numbing."

However, sooner or later, for most victims there comes a period of intrusiveness, during which there is a flooding of images and feelings about the event. Distracting and unwanted thoughts about the disaster may plague the victim throughout the day during this period of recovery. In describing these common periods of recovery, there is a danger of considering the process as simple steps that progressively and inevitably lead to a resolution. In reality, there is much ebb and flow to recovery. Victims may go for some time without thinking about the event and be unprepared when the images and feelings once again intrude.

The longest period in the process of recovery is that of working through the trauma. Working through the trauma takes place at several levels. At the cognitive level, they begin to recognize more completely the enormity of what has happened and its consequences. They start to collect the information needed to assess the impact. They are thinking more clearly and completely about the situation. And, perhaps most importantly, they are working to find some meaning in the event that has taken place. At the affective level, they face a struggle with their emotional reactions to the traumatic event. In that struggle, they may need to acknowledge certain painful feelings they are having. They may have some difficulty in accepting these feelings in themselves. And, finally, they may grapple with the problems of expressing the feelings they are having. At the behavioral level, they begin to take actions that address the problems created by the traumatic event.

The final period in the process of recovery is that of completion. By this point, the survivor has integrated the trauma into his or her identity and has rebuilt his or her life. In a real sense, survivors never truly reach a point where a crisis is forgotten or "behind" them. Instead, they incorporate that experience "within" themselves. As a result of this recovery, they have learned some important lessons about life and about themselves. They are different persons because of the recovery and they carry those memories, discoveries and lessons with them as they continue on with their lives.

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The Virginia Disaster Stress Intervention Site
Last update: November 10, 1997

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