The frequency of aircraft crashes and disasters varies greatly. Some years see relatively few accidents and some years like 1974 and 1987, with 42 and 31 air accidents, respectively incurring a relatively high number of accidents.
Nonetheless, it seems an unfortunate reality that aircraft accidents are a consistent occurrence, with about two dozen major disasters having been reported in the past 20 years. And while still relatively infrequent, each airplane crash seems to re-emphasize the overwhelming impact and psychological trauma of such events.
Aircraft disasters may well be the epitome of psychological trauma encountered by emergency responders in the line of duty. These incidents may have the dubious distinction of rivaling any other type of disaster for traumatic impact on responders.
While airplane crashes exhibit many characteristics typical of large-scale disasters and traumatic events, there are also some very specific aspects which may account for the intense nature of their psychological impact. Some of these aspects were recently reviewed by Drs. James Butcher and Chris Hatcher and are summarized in the table on this page.
Airplane crashes are most often sudden and unexpected. There may be little warning and their occurrence may be almost immediate. Typically, many victims are in the most productive periods of their lives and/or on there way to destinations where they have given little thought to their own demise. Therefore, survivors may not only be stunned by the unexpected nature of the loss but they may be unprepared and have to deal with unplanned and unresolved issues.
Airplane crashes are often horrendous spectacles with gory images. The scene of destruction may be almost indescribable in terms of equipment, possessions and scattered human remains. Injuries often involved burns victims and the related horrific sights, sounds and smells.
Comments from emergency responders at the crash of USAir Flight 427 near Pittsburgh in September 1994 were reported as describing the scene as one of "total devastation" and the presence of an airplane that was "in a million pieces and the people inside were in pieces" (see "The Crash Of Flight 427," June 1995). Critical incident stress debriefing and on-site psychological support personnel were reported as having described the situation as "all of the things you have nightmares about..."
Whereas natural disasters often have an effect of solidifying community bonds, air disasters are unique in that victims are usually away from their communities and are among strangers, within the plane as well as within the area of the accident. The situation is heightened should the crash involve a flight to another country. Additionally, because of the nature of emergency response, victims are often quickly removed from the scene to other areas that may be even more unfamiliar to them.
There is often a profound "ripple effect" from an airplane crash. Not only is there an immediate impact on the individuals within the area of the crash, but the effects that also extend to families of crash victims and others that are involved can spread to many different communities and indeed cross the country. Within a large airline, the impact of a crash can spread throughout various levels of the company and in many different locations.
It seems to be part of the human coping response to search for reasons and individuals "responsible" for traumatic events. In natural disasters, this is often difficult, as "an act of nature" may be the best explanation of responsibility available. The search for responsibility is certainly also present with airline crashes but in this situation there are many more potentially available and specific persons who can become the focus of blame and anger felt by victims, families and others affected by the incident.
The anger and search for blame in air disasters can develop into a particularly intense emphasis on litigation and legal remedies. More than other disasters, perhaps, airline crashes highlight the double-edged effects of the litigation process. Offers from attorneys or law firms to represent victims and families injured by the crash may often be seen as crude and insensitive. Inopportune or clumsy solicitation can be very disturbing and troubling. In the case of USAir Flight 427, one family member of a victim reportedly used the term "vultures" to describe individuals who contacted him and further expressed his dismay that here seemed to be no recognition that the situation was not a "used car kind of deal."
The impact of aircraft disasters is also monumental because those affected by it are numerous, not only in terms of actual numbers of people involved, but the many different roles and relationships that individuals have to the crash. Certainly the primary victims are those passengers and crew members killed in a crash and those who survive. But there are other victims too. Family members are directly affected by their loss. Rescue workers and medical teams are subject to the critical incidence stress involved with the rescue, carnage, recovery of remains or other tasks. Witnesses to the accident scene may be affected by what they saw.
While the psychological trauma present for those involved in recovering body remains is clear, perhaps less obvious, but no less important, is the psychological impact there may be on dispatchers and other emergency communications personnel. Other volunteers and community agencies such as the American Red Cross or Salvation Army that may be involved in support efforts may also be affected. Finally, communities, groups and individuals can feel the painful loss of individuals who filled many different roles such as scout leaders, Sunday school teachers and coaches.
As with other industrial or corporate-site disasters, individuals affiliated with the company (in this case, the airline) are subject to stress from the incident. Other flight crew personnel, ticket agents, mechanics who may have worked on the plane, airport administrators, tower personnel and even airline executives may all feel the impact of the tragedy.
The media may be highly praised or roundly criticized for their reporting of such incidents. Despite whatever view may be taken of editorial judgments, however, it may be remembered that press people can also be highly affected by the trauma and tragedies that they see and report. In fact, in candid moments, reporters may admit that changes in assignments or type of work at times have been requested because of "being tired" (what responders better recognize as cumulative critical incident stress and burnout) of seeing the tragedy of motor vehicle accidents, homicides and other human misery.
Emergency responders too are likely to encounter the very nature of critical moment stress with aircraft disasters. As already noted, the extremely horrific and gory nature of the crash site has a tremendous impact on responders. Airline disasters will most typically involve two of the most profound stressors that emergency responders can encounter: the death of victims and the death or serious injury to children.
Additionally, large-scale disasters such as airplane crashes put tremendous physical strain on responders. Specific attention must be given to adequate breaks and rotation from the scene while on duty, as well as taking care that no responders spend an excessive amount of time on duty overall.
A final aspect that may be particularly difficult or overwhelming for emergency responders is the large-scale emotional devastation that is present at the scene. The degree of emotional response from those affected by an airline disaster is likely to be beyond anything that responders typically encounter in their work.
The psychological reactions to the trauma of an airline crash are reflective of the human response to trauma. Immediate responses are those of crisis for the victims and families. Other typical reactions for both victims/families and emergency response personnel are intrusive images and nightmares about the incident, scene, or related themes or events. There may be a reactivation of these thoughts or images when other similar events are heard about or read about. Various physical and somatic discomforts (including poor sleep or easy fatigue) may be present, as well as behavioral changes such as withdrawal and temporary loss of interest and engagement in activities. While some distress is normal for almost anyone for short periods after a traumatic event, any symptoms or discomfort lasting more than a month signify the need for professional help.
Like other large-scale disasters, but especially because of the unique nature of an airliner crash, the reaction of the loss of the sense of "invulnerability" may be quite common, especially among survivors. The sense of control may be shaken and the sense of being vulnerable may become quite intense.
What has become known as "survivor guilt" is also a typical reaction in such situations. While feeling a sense of joy and relief, those who survive may also have this muted or dampened by feelings of guilt. Questions about why they were "chosen" to survive are prevalent. Also common are questions as to whether they "should have done more" to help others, although there may have been little that they actually could have done.
The tremendous psychological impact of events such as airline disasters argues strongly for carefully thought-out and well-instituted disaster plan that give special attention to the psychological needs of all individuals involved. Disaster plans need to be carefully coordinated with the community, airport and airlines. On-site psychological support as well as continuing and extensive follow-up for the weeks and months after such disasters must be available. And while psychological support for victims and families may be clear to emergency responders, the importance of attending critical incident stress debriefings and dealing with their own emotional reactions to such devastation should not be ignored or minimized by those responders.
FEELING THE PAIN
Aspects of aircraft disasters that increase their psychological impact
- Sudden & unexpected nature
- Degree of devastation
- Lack of "community" among victims
- Large-scale "ripple effect"
- Seemingly clear focus of blame
Michael J. Asken, Ph.D., a Firehouse® contributing editor, is the psychologist consultant for the Camp Hill, PA, Fire Department and an instructor at the Fire Academy of Harrisburg Area Community College Public Safety Institute in Harrisburg, PA.
