Mental Health Matters: Not Just One Trauma, Not Just One Loss

M. Regina Asaro, M.S., R.N.

If you have lost someone through an air disaster, you know it is a loss unlike any other you may have experienced. So many factors combine to make this kind of an event much more difficult to grieve. This column will explore some of the factors that make these disasters so traumatic, as well as some of the obvious and secondary losses that may occur in the aftermath. Future columns will look at the reactions typically experienced after any loss, the “tasks” of grieving, posttraumatic stress symptoms and how the intrinsic nature of airline crash-related deaths may at the same time compound and interfere with the grieving process.

Why Are Air Disasters So Traumatic?

Some of the factors which affect one’s ability to deal with a crisis are the perception of the event, the effectiveness of one’s usual coping mechanisms and the availability of and capacity to use the support of friends and family. It would be easy for even highly functioning people to feel overwhelmed when dealing with the aftermath of an air crash.

An individual who survived an air crash often has to deal with physical injury as well as intense psychological issues. While some would argue that any loss is, in a sense, traumatic, loss of a loved one in an air disaster is unusually difficult for the following reasons:

• the suddenness of the death and the inability to prepare;
• the violent nature of the deaths and that loved ones’ remains often cannot be recovered intact;
• the very public nature of the crash and the media response;
• the possibility that the crash was caused by human volition or negligence;
• the location of the crash site and the ease with which rescue operations and investigations can be conducted;
• the way family members first learned of the crash and how they are treated in the immediate aftermath and over the long term;
• how many family members, friends or co-workers were killed;
• the total number of people who were killed in the crash; and
• other situational factors which affect the context in which the crash occurred.

Each of these factors has the potential to overwhelm the normal coping mechanisms and inflict trauma on crash survivors as well as loved ones of the victims. In addition to the horror of the crash, however, they may then experience any number of what are termed “secondary injuries,” that is, post-crash emotional injuries:

• those responsible for the crash cannot be located;
• excessive time passes while extradition hearings are conducted;
• those perceived to be responsible for the crash are not held accountable;
• what is perceived to be a “just” finding is not made; and/or
• financial awards are perceived to be incongruent or distributed unevenly to surviving families.

In cases where a large number of people from one location are lost, the social fabric of that community might be irreparably torn. If the crash occurred far from home, family, friends or co-workers left behind might feel disconnected from the rescue/recovery efforts or the investigation and may feel disenfranchised from their right to grieve together as a community, as a part of the air disaster.

Law suits against the airline or individuals or states sponsoring terrorism might result in substantial awards, which, although they will never compensate for the loss, will almost certainly take a great deal of time, energy and determination to pursue. Sometimes people find that receiving financial compensation is very stressful and may experience feelings of pain and/or guilt.

Losses Connected with an Air Disaster

After an air disaster, there are many obvious and secondary losses. Many air travelers have had to cope with the loss of a sense of invulnerability and safety following the “9-11” terrorist attacks. While added check-in time needed for personal and luggage search has hopefully increased the safety, it has also decreased the convenience of air travel.

Sadly, many people have lost much more than a sense of innocence after an air disaster and their losses, in addition to that of their loved one(s), are often immeasurable.

Crash survivors often experience dramatic change and loss in the aftermath.

People often say they feel “changed” from the person they were before the crash to the person they are now–and many losses may accompany that process. These changes might include a feeling of loss of control over their lives or external events, an altered level of independence, or a jolt to their spiritual beliefs or assumptions about their and their loved ones’ safety. Because of all the stressors associated with such a traumatic loss, many people find that they may not be able to handle the same work load. They might lose so much time attending hearings in an attempt to find out what happened and why that they may lose their jobs or a good part of their income. Financial losses might further result in a change in lifestyle, possibly including a move to another community.

For those whose loved ones are among the casualties, there is great variance in the type and range of losses which may occur simply because of the differences in the nature of the relationship each survivor had with the deceased.

When a loved one dies, so are the expectations of a future life or plans which included that person. If a child dies, gone are the hopes and dreams, echoed when other young people graduate from high school or college, get married or have a family. Parents may have other surviving children but no one can ever replace the one that was lost. For siblings, loss of a sister or brother can be quite devastating, making it sometimes difficult to move on with their own normal developmental changes such as going to college, getting married or having children.

Parents and children usually grieve their losses differently and, often, separately. Some family members may want to talk about what happened and others might want to avoid it at all costs; children, young or old, often try to protect their parents from the pain of the loss by not talking about how they are feeling. These dynamics often serve to separate family members emotionally and keep them from giving and receiving support from each other.

The victim may have been a best friend–the one leaned on when times were tough. That person is not there now when they are most needed, often leaving a sense of abject emptiness, helplessness and isolation.

Flight crews may have lost a number of close friends and/or co-workers and find themselves experiencing severe stress reactions when they think about going back to work. Many find their feelings of safety and security in the workplace affected after an air disaster, and they may never feel as comfortable in an airplane again.

Conclusions

There is an array of factors surrounding an air disaster which have the potential to cause trauma, secondary injuries and/or subsequent losses for those who have either survived the crash or lost a loved one. Additionally, the individual’s perception of the disaster, usual strategies for coping with stress, ability to use these strategies, and the availability of and capacity to use support from friends and family may all have an impact on the reactions that might be experienced in the aftermath. Certainly, an event of this magnitude can easily cause even highly functioning individuals to feel overwhelmed or fear they are “going crazy.”

If you have survived a crash or have lost someone in an air disaster, remember that this type of trauma is like no other. Sometimes, it seems the process of dealing with the impact of the crash just goes on and on–that it will never end: some new aspect to the investigation arises; some new piece of information is revealed; some new rumor is circulated; civil and criminal trials proceed; the cause of the crash is released; and/or a request is made to survivors to provide testimony for proposed air safety legislation.

For these and many other reasons, it must be noted that the process of coping with the impact of an air disaster is just that– a very long process and that, if you are going through this experience, you must also remember to take care of yourself for the long haul. Just as it takes a great many community resources to cope with the physical impact of the crash, it also takes a goodly number of psychological resources, often including professional counseling, for survivors to cope with the emotional side. You are not alone. Reach out and take advantage of all that is out there for you.