Bruce H. Young, LCSW, Julian D. Ford, PhD, and Patricia J. Watson, PhD
The terrorist attacks on New York and Washington are, together,
the greatest man-made disaster in America since the Civil War.
Lessons learned from natural and human-caused disasters can help us
understand the unique stressors faced by rescue workers such as
police and firefighters, National Guard members, emergency medical
technicians, and volunteers. Past experience may also help us
recognize how these stressors may
affect response workers. Rescue workers face the danger of
death or physical injury, the potential loss of their coworkers and
friends, and devastating effects on their communities. In addition
to physical danger, rescue workers are at risk for behavioral and
emotional readjustment problems.
What psychological problems can result for rescue workers
following disaster experiences?
The psychological problems for workers that may result from
disaster experiences include:
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
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
What severe stress symptoms can result for disaster
Most disaster rescue workers only experience mild, normal stress
reactions, and disaster experiences may even promote personal
growth and strengthen relationships. However, as many as one out of
every three rescue workers 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
Intrusive reexperiencing (terrifying memories, nightmares, or
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)
Who is at greatest risk for severe stress symptoms?
Rescue workers who directly experience or witness any of the
following during or after the disaster are at greatest risk for
severe stress symptoms and lasting readjustment problems:
Life threatening danger or physical harm (especially to
Exposure to gruesome death, bodily injury, or dead or maimed
Extreme environmental or human violence or destruction
Loss of home, valued possessions, neighborhood, or
Loss of communication with or support from close
Intense emotional demands (such as searching for possibly
dying survivors or interacting with bereaved family members)
Extreme fatigue, weather exposure, hunger, or sleep
Extended exposure to danger, loss, emotional/physical
Exposure to toxic contamination (such as gas or fumes,
Studies also show that some individuals are at a higher than
typical risk for severe stress symptoms and lasting PTSD if they
have 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
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.
How can you manage stress during a disaster operation?
Here are some ways to manage stress during a disaster
Develop a "buddy" system with a coworker.
Encourage and support your coworkers.
Take care of yourself physically by exercising regularly and
eating small quantities of food frequently.
Take a break when you feel your stamina, coordination, or
tolerance for irritation diminishing.
Stay in touch with family and friends.
Defuse briefly whenever you experience troubling incidents and
after each work shift.
How can you manage stress after the disaster?
After the disaster:
Attend a debriefing if one is offered, or try to get one
organized 2 to 5 days after leaving the scene.
Talk about feelings as they arise, and be a good listener to
Don't take anger too personally - it's often an expression of
frustration, guilt, or worry.
Give your coworkers recognition and appreciation for a job
Eat well and try to get adequate sleep in the days following
Maintain as normal a routine as possible, but take several
days to "decompress" gradually.
How can you manage stress after returning home?
After returning home:
Catch up on your rest (this may take several days).
Slow down. Get back to a normal pace in your daily
Understand that it's perfectly normal to want to talk about
the disaster and equally normal not to want to talk about it; but
remember that those who haven't been through it might not be
interested in hearing all about it -they might find it
frightening or simply be satisfied that you returned safely.
Expect disappointment, frustration, and conflict -sometimes
coming home doesn't live up to what you imagined it would be -but
keep recalling what's really important in your life and
relationships so that small stressors don't lead to major
Don't be surprised if you experience mood swings; they will
diminish with time.
Don't overwhelm children with your experiences; be sure to
talk about what happened in their lives while you were gone.
If talking doesn't feel natural, other forms of expression or
stress relief such as journal writing, hobbies, and exercise are
Taking each day one at a time is essential in disaster's wake.
Each day provides a new opportunity to FILL-UP:
Focus Inwardly on what's most important to you and your family
Listen to learn what you and your significant others are
experiencing, so you'll remember what is important and let go of
Personally what these experiences mean to you, so that you
will feel able to go on with your life and even grow
See last Reviewed/Updated Date below.