All 132 people on FLIGHT MU5735 were killed, and "the psychological reconstruction of the families is a very long process."

At the scene of the "3.21" China Eastern Airlines flight accident search, the families of passengers used clay pots to bring dirt home from the scene. (CCTV News Video Screenshot/Photo)

After the crash of China Eastern's MU5735 passenger plane, the search and rescue of survivors continued until the sixth day. Wearing protective suits and ropes tied around their waists, search and rescue personnel rummaged through the dirt after the rain to find the wreckage of the plane, the remains of passengers, and some of the remains. The identification of victims and the comparison of DNA tests are carried out simultaneously.

On March 21, 2022, China Eastern Airlines flight MU5735 crashed in Teng County, Wuzhou City, Guangxi Province, while on a mission from Kunming to Guangzhou.

On the evening of March 26, Hu Zhenjiang, deputy director of the Civil Aviation Administration, said at a press conference: "3.21" China Eastern Airlines MU5735 aircraft flight accident National Emergency Response Command confirmed that all 123 passengers and 9 crew members on Flight MU5735 of China Eastern Airlines have been killed. At the press conference, all stood up in silence for the victims on the plane.

Previously, some family members entered the core area of the plane crash to worship. Toward the valley, some family members shouted, "We will come and pick you up!" Remember to go home with us! Yin Ping, head of the psychological rescue expert group of the accident, said that they prepared small clay pots for the families of passengers who wanted to bring mud home from the crash site, so that they could connect with their relatives in this way and have a memorial.

"What is death?" Afraid of being forgotten. We lose, but we don't forget, and not forgetting is together. Yin Ping said.

Since the Wenchuan earthquake in 2008, a psychological assistance mechanism for emergencies in China has been gradually established. After the flight accident of China Eastern Airlines, the first batch of psychological experts more than 50 people rushed to the scene of the accident, and Wuzhou organized 70 psychologists to be on standby.

Zhu Tao, aviation safety inspector and director of the Aviation Safety Office of the Civil Aviation Administration, introduced at the press conference that as of 12:00 on the 26th, a total of 478 family members had been arranged to pay condolences at the scene, 3,800 family members had been visited to comfort their families, 747 people had carried out psychological assessments, and 1,182 people had carried out psychological counseling.

"Psychological assistance [to the families of the accident] lasts for 10 or 20 years. Some individuals or families with severe stress, their psychological reconstruction is a very long process. Zhu Zhuohong, a professor at the Institute of Psychology of the Chinese Academy of Sciences and secretary general of the Social Psychological Service Committee of the China Disaster Defense Association, told Southern Weekend that the air crash involved accident investigation, insurance compensation and other matters, and the family will need more long-term support and companionship.

It is important to confirm the end of the shipwreck and the search and rescue

Southern Weekend: What are the characteristics of the psychological condition of the families of air accidents compared to other disasters?

Zhu Zhuohong: Air disasters are a special kind of disaster, which is not the same as earthquakes, floods, and car accidents. Earthquakes and floods are natural disasters, and the causes are very clear, while the causes and responsibilities of general car accidents can be judged in a short period of time through monitoring.

The investigation and disposal of air disasters is often more complicated, some air disasters require a long investigation cycle, and even some have not been able to clarify the causes, and the determination of air disaster liability and airline compensation and insurance compensation are also more complicated processes.

This will lead to the psychological condition of the family is also very complicated, and the psychological trauma of the sudden death of the relative will be repeatedly mentioned, touched and reported, which requires lasting psychosocial assistance and support from relatives and friends.

Southern Weekend: What psychological journey will the families of the air crash go through? What help do I need?

Zhu Zhuohong: The psychological performance of family members after the air crash is very complicated, and different people have different reactions, and they should be specifically analyzed and specifically responded to. However, in general, it can be divided into five stages according to time and psychological changes: acute stress response period, anger or guilt period, bargaining period, depression period, and acceptance recovery period.

The first phase lasts about a week and is the sudden news of the death of a loved one, which is prone to acute stress reactions. In this emergency stage, different people react differently, and we are mainly divided into three categories: one is the release and catharsis of grief and sorrow, which can cry out loud and appropriately express the thoughts of relatives and inner pain. This is a normal expression of grief, and people who can express it in this way can basically walk through the stress response stage very well.

The second type of situation is that the emotions are more depressed, more rational, and the emotions are deliberately controlled, because there are old people and children, who dare not show emotions, or have to deal with various affairs related to them, and do not allow too much emotional catharsis. Families in such situations need to be properly guided to express their grief in an appropriate manner.

There is also a category of severe blows, such as fainting, collapse, or stiffness, numbness, no language and no crying, the whole person is very confused, and the consciousness is obstructed. This situation needs to be dealt with urgently by a psychiatrist.

Generally speaking, this part of the population that can acknowledge the reality of the death of a loved one can fully express grief, while some people, who are reluctant to acknowledge the reality of the death of a loved one, will look for all kinds of evidentiary evidence to prove that he (the person on board) may still be alive and hopeful.

Therefore, no matter what the situation, the first few days will always insist on search and rescue, looking for possible survivors, but also to give the family a hope. However, at some point in time (usually a week), a clear statement will be given to confirm the death of the passenger and the search and rescue will be completed. Malaysia Airlines' situation is special and lasts a long time.

Southern Weekend: Is declaring the end of search and rescue an important milestone?

Zhu Zhuohong: Yes, it is important to confirm the death and the end of the search and rescue, which can make the family have psychological expectations and truly accept the reality of the death of their loved ones. It is generally determined whether or not to die around the seventh day, and according to the funeral culture, the first seven sacrifices are the more important mourning ceremonies. Soon after, the Qingming Festival is also a heartbreaking day, requiring emotional support from psychological assistance volunteers to their families.

The duration of the next stage is uncertain, generally until the end of the cause investigation, this stage of the family's psychological changes are more complicated, if not handled properly, there may be some anger or guilt and self-blame.

Expressions of anger are also diverse. Sometimes anger will be directed at oneself, such as the family will be upset and blamed, if you did not let him take this flight, or should not let him come to see me, should not let him attend this meeting, etc., showing a sense of self-attack or guilt.

If the anger is directed externally, it will express dissatisfaction with improper media reports, netizen messages, organizational measures, investigation progress, relic claims, the attitude of the airline receptionist, insurance company claims, etc. The process is more complicated, there are more influencing factors, at least the results of the investigation are clear before it is over. Psychological assistance at this stage is very important and can play a role in psychological counseling and communication.

The third stage is the process of "bargaining" between liability determination and payment by airlines and insurance companies. If the payment process involves the determination of multiple relationships and responsibilities, if the payment process needs to continuously fill in various forms and repeatedly involve the information of the deceased passenger, the psychological trauma of the family will continue to be touched and the trauma will continue. Psychological assistance at this stage is also very important.

In this process, in fact, the real role of psychological assistance is often not our experts, nor doctors, but the companions and friends of immediate family members. Relatives and friends accompanied him and went with him to deal with and deal with this matter. Therefore, it is necessary to do some guidance and training for relatives and friends.

There should be a ceremony of mourning and remembrance.

Southern Weekend: How can relatives and friends better accompany each other?

Zhu Zhuohong: This applies the three principles of psychological first aid, the first is to closely observe the family, his physical state and mood, sleep, diet. The basic safety of life should be guaranteed, whether he has some suicidal thoughts, say some extreme words, and if so, communicate with the professional psychological rescue team in time.

At the same time, let relatives and friends know that it is normal to have a lot of phenomena in this process. For example, crying, flashbacks, and insomnia, many of them are normal.

The second is to listen more and persuade less. Don't stop him from expressing it and saying "don't think that, don't say that". It's about empathizing with him and listening patiently.

The third is connectivity. It is necessary to connect with the information of search and rescue personnel and the outside world of airline personnel, because the social function of the passenger's immediate family members is often declining, and the relatives and friends who are really reliable are very important.

This is what we call psychological first aid, psychological first aid by relatives and friends to do the best, because the real 24-hour accompaniment of family members, is familiar relatives and friends, they can do it after simple training. This is especially true when the negotiation and bargaining stages are involved later.

Southern Weekend: Are there any high-risk situations that require special attention?

Zhu Zhuohong: What needs to be paid close attention to is the occurrence of severe stress reactions, such as syncope, or scattered eyes and confusion, such as not being able to answer questions accurately, and not being able to identify people and places. Others can always hear the voice of the deceased and can see the appearance of the deceased, which is an acute disorder. Psychological assistance specialists are needed to provide some medication as soon as possible to help him stabilize his condition and ensure safety.

Southern Weekend: Do accompanying relatives and friends need to pay attention to self-protection?

Zhu Zhuohong: It is best to accompany relatives and friends with more than two people, and take turns to change shifts. It is necessary to eat when it is time to eat, and to rest when it is time to rest, which is what we must do for people who do psychological assistance, otherwise it is easy to dry up, which is a relatively long process.

Southern Weekend: Sounds like some very basic work.

Zhu Zhuohong: Psychological first aid is not so advanced, its essence is humanitarian social support, and each of us can be trained to learn. In fact, we all have a strong relationship around us to protect, and in the face of disaster, strong relationships will be warmed together, you can imagine that everyone is like this. When you encounter this kind of thing, who do you call and who can accompany you. The social support of relatives and friends is an important part of psychological first aid.

Of course, psychological assistance and trauma treatment can only be done by trained professionals.

Southern Weekend: The passenger's family mentioned in the interview that they did not know how to tell the elderly and children the news of the crash and crash. Especially if your child has noticed an abnormality, how do you tell them?

Zhu Zhuohong: When telling the elderly, pay attention to his physical and mental condition, and be particularly careful if you have underlying diseases. You can't say it all at once, you need to let him have psychological expectations and psychological preparations.

For smaller children, use a relatively gentle approach. If it is a preschool child, you can first tell the child what death is through picture book stories, gradually establish psychological expectations for the child, and then clearly tell the child that his father has died, but he has been living in our hearts.

I used to deal with a few cases after car accidents, and they lied to their children for a long time that "Daddy is on a business trip." The child will think, why doesn't dad call me when he is on a business trip? Why not keep me video? He is not leaving us, not loving me anymore, etc. In fact, children can feel the change of the whole family atmosphere and the emotional changes of adults.

In principle, it should be told. However, everyone and every family has different circumstances, so it is best to inform your loved ones under the guidance of a psychologist. When telling, first let the other party have a psychological expectation and preparation, and then make it clear that the relative has passed away, not a business trip abroad. In addition, there should be a ceremony of mourning and remembrance.

Southern Weekend: How can mourning ceremonies be done?

Zhu Zhuohong: This time I saw that there is a very good form of remembrance, that is, to bring a piece of soil back. We sometimes need something tangible to mourn, and the soil itself has such a cultural meaning. During the epidemic, many family members cannot see the remains of their loved ones, and they will also replace them with clothes or photos, and they must have a farewell and be sad.

In fact, every family is different and copes differently. It is also an important principle that the families of the victims of this accident can ask a psychologist to intervene and seek assistance before informing their families.

On March 24, search and rescue personnel searched the core site of the crash of china Eastern Airlines MU5735 airliner. (Xinhua News Agency/Photo)

Family members must return home with ongoing psychological assistance

Southern Weekend: At present, the command has confirmed that all the personnel on flight MU5735 of China Eastern Airlines have been killed. What advice do you have for psychological assistance after this?

Zhu Zhuohong: Generally speaking, we say that psychological assistance is something that lasts for 10 or 20 years. Some individuals or families with severe stress, their psychological reconstruction is a very long process.

Early crisis intervention and psychological first aid can effectively prevent post-traumatic emergency disorder, which is empirically studied. However, prevention is prevention, air disaster investigation and insurance compensation last a long time, and after the first two stages, the third stage, the bargaining period, is particularly noteworthy.

I think airlines should set up a special psychological assistance program for the families of air disaster victims, and establish psychological assistance hotlines, websites and volunteer services so that families can get help at any time. Because the air crash involves many complex compensation issues, especially the cause of the air crash is not clearly investigated, it may bring lasting trauma. If the family is dissatisfied during the payment process, the trauma will continue.

Another is the insurance company, which suggests that post-disaster psychological trauma treatment insurance can be established to provide continuous financial support for subsequent treatment of post-traumatic stress disorder and depression.

After this stage, the family may return to the place of origin, at this time back to the original place of life, do relics sorting, make a real farewell, see things and think about people, may enter the fourth stage, that is, the depression stage.

Southern Weekend: Do families need to continue psychological assistance after they return home?

Zhu Zhuohong: If there is no tracking at this stage, psychological assistance will be over, which is a big problem. At this time, they should be able to get help at any time, and the hotline is a must. The second is the support network, which can be established through video and audio, etc.

If the family does not take the initiative to ask for help, do not want to see people, at this time the community should establish a social psychological assistance mechanism, community social workers or social psychological service personnel can take the initiative to visit the door, the more do not ask for help, it may be more serious, rather than the phone to need help, should be regular follow-up. Of course, most of them can smoothly get out of the shadow of the air disaster and return to the regular life under the care of all aspects of society and the support of psychological assistance, which is the fifth stage, the recovery stage.

Southern Weekend: For this air crash, the search and rescue personnel and other flight attendants at the scene will also be affected, what psychological support do they need?

Zhu Zhuohong: People within the airline who are closely related to the flight attendants of the crashed flight will definitely have to do a crisis intervention. In fact, China Eastern has already done it.

This crisis intervention also varies according to human distance and the degree of stress response. If it is close to the crew members who are killed, and the people who usually eat and live together need to be focused intervention, and even one-on-one psychological assistance is needed; if they are only in the same airline, but they have not met, collective intervention can be carried out. In the absence of an ascertained cause of the accident, it is important to ground aircraft of the same type. There is a set of methods called crisis event pressure management in the world, and there are many trained experts in China, and these experts can be invited to participate in the processing.

For search and rescue personnel, before entering the scene to carry out search and rescue tasks, they should be mobilized to tell everyone what to pay attention to and how to deal with different situations. For example, the smell of aviation kerosene at the scene is very strong, or what if you are particularly nervous to see the remains, have nightmares at night or can't eat. A team should be staffed with a psychological assistance team.

After the task is completed, psychological assistance personnel should be asked to perform group psychological interventions on them, or group interviews to help them understand which of their reactions are normal and which are abnormal, assess and screen for serious problems, and follow up according to the situation.

Southern Weekend reporter Liu Yixian