Officers and men of the Guangxi Armed Police Corps search for black boxes in the core area of the crash site of Flight MU5735 of China Eastern Airlines on March 22 in Teng County, Wuzhou, Guangxi. Xinhua News Agency (Photo by Jiang Huaipeng)
On March 25, the fifth day of the MU5735 crash of China Eastern Airlines, as of 10:00, the emergency response command has organized and arranged 375 families of missing passengers to mourn at the scene of the accident, and carried out more than 500 psychological counseling for their families. After the accident, the Guangxi Health Commission sent a team of experts to the scene to organize emergency medical rescue work for the first time, and it is worth noting that the expert group also included more than 50 psychological experts in the first batch of psychological experts in the region.
In the view of Qian Ying, director of the Office of the Clinical Psychology Center of peking university sixth hospital, such post-disaster psychological intervention is necessary, she has participated in the psychological crisis intervention after the "6.13" Shiyan gas explosion accident, the Wuhan epidemic and other disasters, and is the person in charge of the crisis intervention course of Peking University.
At the moment of the accident, the family may be numb, panicked, closed or constantly searching, collapsing, until they accept and mourn, "all these reactions are normal." Qian Ying told the surging news reporter, "Respect him, (let him) deal with it in his way." "The most important thing at the moment is to activate the support system around them, family and friends, and spend time with them.
This is also what Ma Hong did when he participated in the psychological intervention after the "5.7" air disaster in Dalian 20 years ago. After the accident, she accompanied the families of the three flight attendants for a week, taking care of their lives and listening to them. When the child finally said goodbye to his mother, she accompanied him to put the drift bottle and asked him to put in the words he wanted to write to his mother." ”
Ma Hong is the chief physician of the Department of Psychiatry at Peking University Sixth Hospital. After the 1994 Karamay fire in Xinjiang, she became a member of China's first post-disaster psychological crisis intervention team, and has since participated in the psychological crisis intervention of almost all major domestic disasters such as the "5.7" air disaster in Dalian, SARS, the Wenchuan earthquake, and the Tianjin port explosion.
Ma Hong stressed to the surging news reporter that after a disaster, in addition to professional psychologists, "in fact, all the people involved and watching are professionals." "In this process, social support is particularly critical, on the one hand, to provide basic survival security, on the other hand, to solve the most anxious problems for families, such as the transmission of accurate and true latest search and rescue information, therefore, the media is also the main body of psychological rescue."
[The following is the dialogue between The Paper and Qian Ying and Ma Hong]
Everyone deals with grief differently
The Paper: In this air crash, which groups of people do you think may need psychological crisis intervention?
Qian Ying: There are 4 kinds of exposure to general disasters, the first of which is directly exposed to people who experience this event. The second category is the disabled relatives, (that is) the relatives of the staff and passengers on the flight. The third type of indirect exposure, we all count the third type, through pictures, news by various influences. The fourth category is the crowd that often encounters these things. In this air disaster, it is rescue workers, firefighters, police and other workers. Flight attendants are actually a high-risk group.
The Paper: Relatives of the crew, what kind of psychological support do they need?
Qian Ying: Let's first understand his psychological state, they usually have 4 psychological states. First of all, you may still be numb, don't know what to do, and if this is the case, be sure to assist him. For example, some people are so panicked that they can't eat and drink, so they get him food and drink; he can't do anything now, let him find his relatives and friends around him, and accompany him to spend time.
But there are also people who are numb on the contrary, he seems to be very cold-blooded, should go to work, there is no reaction at all, but in fact, these two categories belong to the state of numbness.
Let's not criticize him, why are you so cold-blooded, it is actually a reaction, but also a kind of self-protection, the people around him to understand him, let him accept his own reaction, do not blame himself.
The second state is that they will not admit it and keep looking for it. I once intervened with one (family member) and half a year later, she called her husband's phone and thought he was alive. This is called denial and may require professional intervention.
In the period of the first and second states, don't always mention this to him, he can't accept it, at that time, he may be more broken.
The third state is that if you accept it slowly, you will be frustrated. Especially in the family, there are no important roles, such as the old people's home, the young people die, there will be a feeling of collapse. If you enter this state, you will have more support. But if you are persuaded, he may not like to listen, and will feel that you stand and talk without waist pain, it has not happened to you, how do you know how much pain I have? Just accompany him.
Usually, most people can come out in 3-6 months, enter the reorganization period, mourn, say goodbye, and complete unfulfilled wishes. Through various mourning activities, a sense of ceremony, and a farewell, many of the methods of our traditional Chinese culture still work.
A person in a period of depression, we can accompany him to mourn, because he has accepted this fact. But if the person in the denial period, do not remind him of the mourning too early, this is different (time) period is not the same.
In the final state, he accepts reality and returns to life. This period is also quite critical. I used to have a patient, and he ended up saying, I can't wear brightly colored clothes, and for a year, he thinks I'm wearing it, and he's sorry for the deceased. Respect for him at this time (others need) is a kind of remembrance of him. Don't go and say, it's been a year, how do you do it. He may take a little longer than anyone else. But it also encouraged him to return to real life.
After 4 stages, there is a specific intervention. All of these reactions are normal, not to feel ashamed.
The Paper: In this way, psychological intervention is actually a long process.
Qian Ying: Everyone is different, some people are very fast, some people may be suppressed back, serious is very long. But most people we have to trust, to trust that they all have resilience, and that's also important.
The Paper: Like after an air crash, is it better to intervene psychologically as early as possible?
Qian Ying: The sooner this sense of security and stabilization, the better. But as we said, professional grief counseling must be voluntary. Some people are willing to deal with it themselves, he doesn't want to tell people, (that) respect him, (let him) deal with it in his way, we provide him with some scientific methods, provide some platforms. But don't say, "Let's talk for a while," and expose his scars, which are likely to cause secondary trauma.
The scene of the crash. Photo by Xinhua News Agency reporter Wu Sisi
The Paper: If you arrive at the scene, how to provide psychological intervention services to your family?
Qian Ying: In the acute period, we must first ensure that everyone has a sense of security, connection, and efficacy. Let them all be surrounded by people, don't face them alone, activate the support system around him, have family members get together, have friends and friends, have a care for each other, have a support.
Some popular science lectures may be arranged to tell them that the country is still searching and rescuing and has not given up. Then also tell them that some of the reactions to this situation may have some relatively serious problems, such as long-term sleep, which is very common, under stress, there is anxiety, often nervousness, fidgeting, more intense panic, and depressive reactions, such as not wanting to live.
The Paper: How long is the acute phase?
Qian Ying: Some people are three days, and three days is a stage. After a week or two, it is necessary to evaluate again, to see what the situation of these people is, to what extent, and how they are handled differently.
Recognize the effectiveness of search and rescue personnel and flight attendants
The Paper: How to carry out psychological intervention for search and rescue personnel?
Qian Ying: Giving them lectures, on the one hand, empowering them and increasing their sense of effectiveness, they are very heroic and want to be commended. At the same time, tell him how to protect yourself in this situation and prevent yourself from being traumatized twice, because you are also an exposed person, don't exhaust yourself. Third, tell him what reactions you have, maybe you have been traumatized twice, what should you do.
On the one hand, we can let him play a role, but also to guide him, in this case, what we can do is actually limited, let him not blame himself or lose because he can't do anything, but also to ensure his safety, so that he and the people around him have a team in contact.
The Paper: For flight attendants, what psychological impacts may have on them when such an air disaster occurs?
Qian Ying: Three days before the crisis, everyone reacted differently. Some people will run away, such as the flight attendants, he does not do it, (think) too dangerous; some people are combat reactions, I want to find a way to make the aviation industry better, stay up late and not sleep; and some are numb, stupid, can't go to class, don't know what to do; and some may ask for help, very panicked, uncertain, have to feedback with the leader, ask for help, this is the reaction of the acute period of the first three days.
By a month, there may be anxiety, worry, there will be air disasters, as well as the epidemic, this matter can not be done, and later out of the house may worry about whether there will be problems. There is excessive panic, (will) not be able to sleep, and there will be all kinds of negative emotions. Even if he had a particularly good relationship with this (air crash) flight attendant, he might have thought of some of the images of that person before he died.
For example, I intervened in a car accident, and I was particularly good with the person who died, saying, "I now think of him every night in my dreams, and as soon as I eat, I think of the way we talk." ”
There are also good reactions, such as going to maintenance, cherishing the current life, caring for the family, and having a positive reaction.
These are normal and everyone will have them.
The Paper: What are your suggestions for psychological intervention for flight attendants and indirectly exposed people?
Qian Ying: Flight attendants, the focus is to recognize his sense of efficacy, and at the same time, do not over-consume themselves in terms of efficacy, so that they can protect themselves and accumulate some knowledge in advance.
For those of us who are indirectly exposed, the main thing is to restore a sense of security and let everyone stabilize. Empty photos or lists on the flight, these have to be careful, because some people who see these pictures will not be able to stand it, and it will arouse some reactions or fears from him. For such people, it is necessary to guide them positively.
Psychological rescue began with media coverage
The Paper: You mentioned earlier, "Psychological rescue does not start with professionals in place, but should start with media reports." ”
Ma Hong: I think from the perspective of emergency or post-disaster psychological rescue and psychosocial support, the media is actually one of the protagonists. There are 4 core areas of (post-disaster psychosocial support), in addition to psychologists, (there are also) health, education, community, and media, but the media does not seem to have regarded themselves as the main body of psychological rescue.
All the operations of the media, all the reports actually directly affect everyone's psychological condition, affect the mood - whether the treatment is good or not, whether the way of reception is considerate of others, respect for others, or the way of handling is very simple, let the wound sprinkle salt.
The Paper: The four roles you mentioned are all participants and workers in psychological crisis intervention.
Ma Hong: This concept must be repeated, in the face of disaster, all the people involved are either supporters or bystanders, are professionals.
If there is a (psychological) professional, he may be able to discover what is affecting everyone on the spot. If he can get into the headquarters, he also gives advice, or he knows professionally in companionship; and if there are other (if any) high-risk people, such as someone who wants to commit suicide, or someone who is crying and faints, can't sleep at all, or is very angry, he may have more skills and methods than others, even drugs, that can help these people. The rest is long-term treatment, and if it really turns into trauma and stress disorder, it needs a professional.
But at the scene, the most important thing is acute rescue. In the earliest stage of emergency rescue and disaster relief, the main (focus) is social support. This is not a (psychological) professional problem, no psychologist can have it, and if the rescue is done well, there is no (psychological) problem at all.
How to do a good job of leadership, how to formulate a plan, how to find volunteers, how to have food and water to drink. Basically, children can go to school as soon as possible, and the media provides them with effective resources. The health piece can be done to make them smoke less and drink less, and all sick people have medicine to eat. These are psychological relief after disasters. You solved his most anxious problem at the moment, and he felt better.
Now the most anxious to find someone, you tell him the news of the search for someone; he is anxious to find a black box, you now tell him to find a black box, he is better. He's anxious about what you do. Because of the mood problems caused by this incident, whether it is anxious, numb, or aimed at his loss, the person does not have "what should I do behind?" What do I do now? What happens next? "In fact, it is all related to the formulation of policies.
Wuhan is the best example, (about) social support. Don't have masks? Supermarkets are sealed, communities are sealed, no food to eat? No one to deliver food? No, you can't. Without social support, you say I don't care about your food, I don't care about your water, I don't care about anything, I send a group of psychologists over, then there is no use. So basic survival, safety, want to drink water, want to eat, want to find people, want to know information, I now have no place to charge my mobile phone, all these problems are solved, looking for someone I am looking for, you say he is still in a hurry? He may not be in much of a hurry.
So the media is particularly critical, and now the media is the first time to the scene, and the most anxious thing for everyone is almost all exposed by the media. At this time, the media is the most professional, if the media report is particularly in place, everyone will be much less anxious.
The Paper: What can and cannot be done by the media, can we talk about this in detail?
Ma Hong: Tell the facts, see what you see, don't guess, don't say how to estimate.
There is also information, where I want to go, how to go, or where there is a reception room, what is the hotline. Now we often report it, but I have observed that it does not appear very frequently. (Also) some useful information, such as the small site now, it is not recommended for civil volunteers or unorganized volunteers to come. There is also a situation that the media wants to report, the progress, arrangement, and status of the rescue.
Don't report too much, publicize people's pain and misery. Do not report these in prime time, if children must watch, under the guidance of adults to see, especially tragic these.
After 9/11, there was discussion and reflection. The impact of the picture of the newspaper is too much, repeatedly put, people who are not in Manhattan also see (frightened) sick, this kind of crying, sadness is contagious. There can be some, mainly to report the powerful things, the things you are looking for. Because of the post-disaster psychology, if he has fallen into the pit, you just accompany him in the pit (it is not OK), you have to slowly lead him to the outside of the pit, although it is very tragic, but life has to go on, I accompany you slowly to hope.
The Paper: Now the function and role of the media are becoming more prominent and obvious, right?
Ma Hong: Yes, because now everyone has a mobile phone, check the messages anytime and anywhere, and at that time they had to watch in the newspaper or on TV. So the role of the media is more important than before.
Psychological first aid is to accompany, listen, and communicate
The Paper: The last time you intervened in the psychological crisis after the air disaster was the "5.7" air disaster in Dalian in 2002.
Ma Hong: It was Beihang that found our hospital, and he had employees on top of the plane. We are volunteers.
The Paper: What were the main forms of psychological intervention at that time?
Ma Hong: It is to accompany the three families of the company, the family members of the flight attendant, (for example, how to face) the problem of the children at home, and not to tell his mother that he was killed.
The Paper: Did you interact with your family at that time?
Ma Hong: I accompany them every day, we go every morning, and then I get to know them very well.
Later, when it came to saying goodbye, some of them fished up some relics, and some did not find anything. There was a family who had a child, and his mother didn't find anything, so we ended up putting a drift bottle with him and asking him to put in it the words he wanted to write to his mother.
The Paper: How long did your company last?
Ma Hong: For almost a week, the union of Beihang Company has been serving.
The Paper: What do you do when you are accompanied?
Ma Hong: Nothing to do, psychological first aid is companionship, companionship is the three elements, listening, companionship, communication, mainly you listen to him, what they want, we help them to communicate, take care of their lives, because they are not good at eating, in addition to thinking of some ways to express (emotions) for children.
The company was going to have a meeting, and in the evening a group intervention was given to the people of the company to ensure that the meeting had to continue.
The company also held a ceremony for them, and everyone flew a lot of kites on the beach and wrote a lot of words to comfort their loved ones.
The Paper: Today, some family members went to the scene to worship and immerse themselves in grief. What can you do as a psychologist at this time?
Ma Hong: Same. Companionship, taking care of life, if there are children (help) to take care of children, we will accompany them for whatever they want to do.