On the fifth day of the Eastern Airlines disaster, search and rescue are still ongoing.
At the press conference on March 25, Zhu Tao, director of the Aviation Safety Office of the Civil Aviation Administration, said that search and rescue is still the top priority of our work. s hard work."
On the afternoon of March 21, 2022, a Boeing 737-800 passenger plane of China Eastern Airlines with flight number MU5735 lost contact and crashed over Wuzhou City, Guangxi during its Kunming-Guangzhou mission.
On the day of the accident, the families of the passengers on the plane rushed to the local area one after another.
According to the press conference on the 25th, as of 10:00 on the same day, the emergency headquarters had arranged for 375 family members of the missing passengers to come to the scene of the accident to offer condolences.
A total of more than 500 person-times of psychological counseling have been provided for family members, and family members with physical symptoms have been arranged to seek medical treatment in a timely manner, and medical staff have been on call 24 hours a day.
Psychological comfort to the families of the crashed plane passengers is one of the priorities after the accident.
Trauma psychology expert Zhu Zhuohong told The Paper that generally speaking, the psychological trauma period of the family members of air crash passengers can be roughly divided into five stages, namely the acute stress stage, the release stage of anger, the bargaining stage, the depression stage and the acceptance and recovery stage. five stages.
"Without appropriate psychological intervention, for many, the psychological trauma caused by the sudden loss of a loved one can be lasting."
Then, when a disaster occurs, how does the psychological rescue team work, how to avoid secondary injuries, and how to better help rescue objects get out of their grief?
In this regard, The Paper (www.thepaper.cn) interviewed two experts with rich experience in psychological rescue to talk about the emergency rescue system behind public events.
The two experts are: Zhu Zhuohong, professor of the Institute of Psychology, Chinese Academy of Sciences, secretary-general of the Social Psychological Service Special Committee of the China Disaster Prevention Association, who has visited the Wenchuan earthquake, Yushu earthquake, Zhouqu debris flow, Huangdao explosion and other incidents; Wu Kan Kan, senior engineer of the Institute of Psychology of the Chinese Academy of Sciences, secretary-general and member of the Psychological Crisis Intervention Working Committee of the Chinese Psychological Society, has traveled to the scene of the Kunming Railway Station violent terrorist incident, the Tianjin Port explosion, and the Sri Lanka terrorist attack.
The following is the dialogue between The Paper and the two experts:
Watch, listen and make connections
The Paper: Generally speaking, how to organize and carry out psychological first aid work after a large-scale public incident?
Wu Kankan: my country's "psychological assistance" has been gradually standardized since the Wenchuan earthquake. The National Health Commission and relevant industry associations and academic organizations have formulated basic psychological assistance principles. The first principle is to carry out under the unified command of the local government. Scientific, orderly, effective and continuous psychological assistance.
After the China Eastern Airlines crash, the China Eastern Airlines Flight Accident National Emergency Response Headquarters was temporarily established, and the psychological rescue team should work with life rescue and other teams to carry out rescue work.
Generally speaking, in addition to experts from the National Psychological Rescue Team, local psychological assistance teams will also be deployed, such as psychiatrists, nurses, psychotherapists, counselors, psychological social workers, etc. from local hospitals, as well as experienced psychologists. Volunteers etc.
The Paper: What preparations will be made before the official launch of psychological rescue?
Zhu Zhuohong: First of all, we will check the relevant disaster information, have a clear understanding of the scale and severity of the accident site, and understand the current rescue progress.
Then, according to the type of disaster, the members of the expert group of the rescue team will organize and carry out emergency training, which mainly covers basic psychological rescue principles, organizational management principles, self-protection principles, etc., generally no more than one day, and often time does not allow too much training, so recruiting The volunteers need to be experienced psychologists.
The basic principles of psychological emergency rescue can be summed up as "3L principles" - Look, Listen and Link, that is, observe, listen and establish connection.
During the Wenchuan earthquake, I compiled a formula for volunteer training, which is easy to remember.
The core of self-protection is to require rescuers to rest well under stressful situations, adopt a rotating work system, and support each other within the team.
After the training, according to "one family, one book", experienced first aid members usually lead the team into groups, with each family as the center, with a team to form an aid file.
On average, each team consists of 3-5 people, including psychiatrists, psychological counselors, social workers, etc., and sometimes nurses, physicians, and each person has a different role and work focus.
Finally, each group conducts work under the unified guidance of crisis intervention experts after interviewing, accompanying, and making a preliminary assessment and judgment of the psychological assistance object.
The Paper: How to carry out rescue after entering the scene?
Zhu Zhuohong: Psychological crisis means that the individual's pressure pump is broken, so psychological first aid is not based on technology, but on the rescue object. It is necessary to pay close attention to the needs and reactions of the rescue object, mainly to solve some current practical problems and satisfy The basic needs such as food and travel of the rescued objects should be strengthened, and basic security should be strengthened, especially to prevent relatives suffering from some basic diseases from appearing in crisis due to emotional fluctuations.
From the news reports in the past two days, I found that some relatives of the passengers on the flight have shown signs of stress disorders, such as emotional outbursts, collapses, acute mental disorders (trance, cognitive disturbances, insomnia, immobility, etc.) ), at this time, the psychiatrist must evaluate their psychological state and deal with them in time.
In the actual rescue process, we follow the "3L principle" just mentioned, specifically:
Observation is to observe the words and deeds of the rescued objects in an all-round way, so as to know whether their physical condition is safe, whether their basic needs are met, and whether they have some serious physical or psychological problems. If they are found, they should be dealt with in time.
Listening means that we should talk less as much as possible, observe words and expressions more, and feel the current inner needs and demands of the rescued objects, such as getting the latest information on the incident, holding memorial services at the scene, and searching for relics.
Of course, we can't all help it achieve, but we can try to satisfy it in another form.
For the rescuers, this is not only a process of evaluation, but also a process to satisfy the rescue objects to vent their emotions and express their needs.
Generally speaking, the rescued objects are accompanied by relatives and friends at this time, so we also need to help relatives and friends to provide emotional support, which is very important.
To establish a connection, on the one hand, we need to upload a report on the common appeals we have collected, and on the other hand, we need to connect various resources such as incident notification information, medical resources, aid materials, and claims settlement with the recipients, and provide emotional support within our ability. , information support, social support and material support.
It is especially important to connect various information and resources within 1-3 days after the disaster.
It is the purpose of psychological first aid and a humanitarian way of caring to help rescue objects as much as possible to stabilize their body and mind.
From this point of view, psychological first aid is actually not mysterious. Everyone can receive training and learn psychological massage.
Psychological intervention must be acceptable and non-invasive
The Paper: What are the methods of psychological first aid, and what should be paid attention to?
Zhu Zhuohong: Different types of accidents and disasters, different groups of people, use different intervention methods and means, and even the methods used by each rescuer are also different, but the most important thing is to judge and deal with emergencies.
It should be noted that psychological intervention must be a non-invasive method acceptable to the other party, so be careful.
For example, before the Huangdao explosion accident, there were two old ladies sitting on an old sofa near the accident site chatting. They were directly lifted into the air, and they were shaking on the ground, until I arrived on the scene on the third day of the accident, and they were shaking when they mentioned it.
At that time, we first let them do deep breathing to stabilize their emotions, and taught the method of "belly breathing".
Then we used a "screen technique" based on this traumatic scene - asking them to imagine that this scene was seen on a TV screen, and that they were just a spectator, creating a sense of boundary.
Then pull the screen away, and the color gradually fades to help its cognitive dissociation and reduce the stimulation of recalling again.
In fact, this method can be used for on-site search team members, because the wreckage is a strong shock to them, and if they have flashbacks, nightmares, etc., they need to be stabilized.
During the Ya'an earthquake, we organized local children to do some group psychological counseling and intervention, such as using the method of "big tree meditation", imagining ourselves as a tree, from a small seedling to a towering tree with deep roots and swaying with wind and rain .
After meditating, help them gain a constant sense of stability.
There is also a common method called "light beam" scanning technology - the process of imagining a blue light shining down from the top of the head, scanning all parts of the body from top to bottom, is also a relaxing process.
At present, methods such as "Eye Movement Desensitization & Reprocessing" (EMDR) including multiple stabilization techniques are still widely used internationally.
The Paper: Witnesses and rescuers mentioned that there was a strong smell of fuel at the core search and rescue site of the China Eastern Airlines disaster.
So does olfactory memory also trigger severe psychological trauma?
Zhu Zhuohong: Vision, taste, smell memory, etc. will all become "trigger clues" that trigger psychological trauma, and there are corresponding intervention methods.
For example, if there is a strong smell of oil or gasoline, you can consider activating positive resources or resource implantation methods to help traumatized search team members connect this smell memory with other positive and beautiful scenes to dilute the traumatic memory feelings.
For the trauma trigger points that are easy to associate with people in daily life, also known as "trigger points", I recommend the use of "mindfulness" or "contact with the present" method, which everyone can learn and slowly develop into a habit.
For example, when we are suddenly pulled back to the traumatic memory by the smell of gasoline, we need to consciously smell the current smell, such as taking a sip of the tea in front of us, smelling the aroma of the tea, touching other objects around us, or Listen to a piece of music, adjust your breathing, focus on your body, and stay focused in the present moment.
Air crash trauma may persist for a long time, and continuous social support is needed
The Paper: What was the biggest challenge you faced in carrying out first aid at the scene?
Do you have the most memorable experience?
Zhu Zhuohong: In many cases, we cannot find an effective method immediately, and the response of the rescue target is not very good.
There was an earthquake, the wife of the victim had hoped for a hug before going out, but she did not agree. Her husband was killed in a car, and she fell into deep self-blame.
"If I agree and delay going out for a while, he won't have an accident." When the rescue object's brain forms such an inner cognitive logic, it is difficult to break, and rescue and treatment are also very difficult, not just one or two. Sub-stabilization technology can be solved.
In fact, the air crash is special because it is not a natural disaster, and it will involve complex issues such as finding the remains of the victims, tracing the cause of the accident, and making subsequent claims.
As long as these problems are not resolved, this wound may exist for a long time and it is difficult to heal on its own, so continuous social support and follow-up are more necessary.
The Paper: After leaving the rescue scene, how to carry out subsequent psychological treatment?
Is there an important time point?
Wu Kankan: Psychological first aid is mainly used in the early stage, and psychological crisis intervention is adopted for those who have stress reactions and some psychological disorders, and if necessary, psychiatric drug treatment is adopted.
One month later, it is necessary to assess whether the rescue object suffers from psychological disorders such as PTSD, and to intervene in psychological or drug intervention.
In addition, the people who need to focus on are the front-line search and rescue personnel. More than 10% of the people may experience a relatively severe stress response, and they will not sleep well or eat well after a month.
There are also some people who still have a small reaction after three months, and even about 1% of the population may not be able to cope with high-trauma work after that.
Half a year is a window period.
Some people develop delayed PTSD from other events that require ongoing follow-up and attention.
Close contacts of rescue targets can also receive grief counseling to provide emotional support.
Avoid getting caught in the ripples of trauma and learn to face the disaster
The Paper: When some large-scale disasters come, there will be a phenomenon of "collective social trauma". While the disaster of China Eastern Airlines is distressing, some netizens are also panicking about it. So how should the public adapt and adjust their mental health?
Wu Kankan: The superposition of media information may cause short-term vicarious trauma.
When a similar disaster occurs, the general public, some survivors, or people who have had similar experiences, such as those who have suffered severe turbulence by plane, other air crash survivors, other traffic disaster survivors, etc., may pay attention to this report. And there is a strong sense of substitution, and even being pulled back into his own traumatic event, flashbacks and nightmares occur again.
At this time, you can communicate more with family members and colleagues, seek social support, and accept some objective scientific data, because the probability of an air crash is still low, and at the same time reduce the intake of trauma information, and regularly pay attention to official information.
Zhu Zhuohong: This is what we often call the "ripple effect" of trauma. The outer circle of the ripple includes assisting rescuers and ordinary people who receive information through the media.
The outer circle seems far away from this catastrophe, but in fact every one of us may be affected.
So learn to control the intake of information reasonably and find a balance - neither ignoring disasters, nor immersing in them.
On the positive side, human beings actually develop along with various disasters and traumas. Post-traumatic growth is an important form of human civilization development. Disasters continue to educate human beings, make them better adapt to the changing world, and make human beings better adapt to the changing world. We appreciate what we have now.
On the negative side, disasters often impact and reconstruct a person's three views and way of life.
Therefore, we must face up to the disaster and re-establish a sense of security, stability, and connection.
Physical security can be obtained through the "light beam" body scanning method, "abdominal breathing" method, etc., and emotional security can be achieved through interpersonal communication.
Emotional stability means knowing how to deal with tension and fear.
During the epidemic, in order to help people better cope with stress and disasters, the World Health Organization recommended a painting e-book "Under Stress, Choose What's Important" on its official website, telling us to embrace and accept what we find ourselves. Any emotion, "We are the sky and emotions are the weather."
The Paper: How can we reduce or avoid the "secondary harm" caused by external interference?
Zhu Zhuohong: After the disaster, the rescue target is in the stage of acute stress, especially in the stage of bereavement and grief. We should give a certain amount of time and space, and be careful to handle all related content without permission. Help is often a distraction or harm.
When reporting, try to be as vague as possible - don't say specific people or things, don't reveal specific identities, and don't record some cases in detail, otherwise it will cause a lot of interference.
At the same time, we should not magnify a certain iconic object of the victims or survivors, which will produce a "spotlight effect", and family members will be easily stimulated by trauma and continuous stimulation in future life.
Especially the current big data has left indelible traces, and the retention of information will bring harm again and again, and often this information is still one-sided and partial.
Wu Kankan: It is necessary to reduce the excavation of family privacy.
The spread of rumors is actually more harmful, and it will have a very big impact on the flight attendants and ground staff of other airlines, especially the maintenance personnel and their families.
They may have had a sense of insecurity and stress before, leading to greater stress.
All airlines should set up emergency crisis intervention teams to conduct psychological counseling for pilots and crew members who are flying, so as to eliminate or reduce the psychological trauma or adverse effects that may be caused by this air crash.
There is room for further improvement in the national psychological assistance system
The Paper: In recent years, what progress and improvement has our country made in disaster psychological emergency intervention and first aid, and where do you think it can be done better?
Zhu Zhuohong: Psychological first aid is temporary. When survivors or bereaved family members are scattered back to the place of origin, what should we do next?
As I mentioned just now, some PTSD symptoms occur in a delayed manner, and patients often do not go to mental health centers or psychiatric outpatient clinics. At this time, local community workers are required to conduct periodic return visits to provide continuous attention and follow-up.
However, it is difficult to achieve this with the strength of an individual or a team alone. Therefore, we should cultivate and expand a professional team of psychological assistance, and train relevant personnel according to the characteristics of psychological intervention work in different stages and groups, and gradually form a national Collaborative network.
At the same time, it is also necessary for relevant national departments to organize professional forces to conduct long-term follow-up interventions on key groups.
The new crown epidemic has actually played a role in promoting the construction of psychological rescue in my country, and established rescue expert teams and psychological assistance hotlines during the epidemic in various places, but this is far from enough.
The national psychological assistance system needs to be further improved, because large-scale disasters such as floods and earthquakes have a large radiation range and affect a large number of people. Even if there are local reserves, it is still unable to meet the huge psychological assistance needs.
Secondly, I call on insurance companies to establish post-disaster psychological trauma treatment insurance, because follow-up long-term psychological treatment requires financial support, especially for PTSD patients.
We have put forward the phrase "20 years of psychological assistance" before, which means that we need to follow up on post-disaster psychological assistance.
For many people, the psychological trauma caused by the sudden death of a loved one can be lasting without proper psychological assistance.
Wu Kankan: The China Eastern Airlines incident has wiped out the 12-year flight safety record of China's civil aviation industry.
As far as I know, some members of the front-line expert team have had similar rescue experience.
But on the whole, domestic psychological assistance teams are relatively inexperienced in plane crashes.
The most important thing now is to establish a supervision mechanism for the front-line psychological assistance expert team to help members solve situations they have never encountered before.
In response to the China Eastern Airlines crash, I think the working groups in Wuzhou and Tengxian should set up their own supervision mechanisms, strengthen communication, and conduct special training on common issues.
The Paper: From past experience, what do you think is the importance and significance of psychological emergency intervention?
Zhu Zhuohong: The significance of psychological rescue is to help individuals regain a sense of security as soon as possible and return to a normal life track as soon as possible. It is very important to give confidence and hope.
Moreover, psychological rescue also reflects a sense of connection and belonging to society, nation and country, so that everyone knows that they are not alone in the face of disasters.
The growth of psychological helpers also often comes from the people being helped.
After trauma, we can grow together.
The Paper reporter Feng Yinlun