Per reporter: Zhang Shoulin Per editor: Liao Dan
After the crash of China Eastern Airlines MU5735, on March 31, the Standing Committee of the Political Bureau of the CPC Central Committee held a meeting to demand that the aftermath be handled in depth and meticulously, and that the deceased be dignified and comforted.
The National Emergency Response Command confirmed that all 132 people on the flight had been killed. The command immediately guided the "one-on-one" docking of the families of the victims to deal with the aftermath. As of March 30, a total of 695 family members of the victims had been resettled, 7,926 psychological assessments and 2,917 psychological counseling had been carried out.
Wang Jian is the leader of the psychological rescue support working group for the families of missing passengers of Malaysia Airlines MH370, "When the incident meets three characteristics: the impact is particularly bad, sudden, and the event itself is significant, all three appear at the same time, the brain neural network can suddenly stop working, and the person behaves as a wooden ne." This is the first stage of the psychological crisis, the emergency period. Recently, Wang Jian reminded in an exclusive interview with a daily economic news reporter that the crisis event can have a greater impact on the psychology of the family, which is divided into three categories: psychological symptoms, physiological symptoms and abnormal symptoms. Psychological crisis intervention for family members should be intervened in 48 to 72 hours.
In addition to organizing the psychological rescue of the Malaysia Airlines 370 missing incident, Wang Jian also participated in the psychological rescue of major crisis events such as SARS, Wenchuan earthquake, Yushu earthquake, Malaysia Airlines missing contact, Qingdao explosion, Kunshan explosion, etc., served as the leader of the psychological rescue team for many times, and in January 2020, as the first batch of members of the national traditional Chinese medicine medical team, he went to Wuhan to participate in the medical treatment against the epidemic.
Who will be the target of psychological rescue?
During the SARS period 19 years ago, Wang Jian, as a psychiatrist, was sent to You'an Hospital and stayed in the SARS ward of the Infectious Disease Hospital for more than a month.
What does it mean to go to an infectious disease room? Wang Jian frankly said that he absolutely did not dare to think, "Once infected, it is very dangerous." ”
In the fight against SARS, SARS patients need to be treated not only physically, but also psychologically. Some patients spit on others, attack others, and show certain psychological symptoms. Wang Jian's job is to go to the infectious disease room to adjust their mental and psychological state.
This is a psychological rescue outside the disease, behind too many injuries on the scene, all needed.
In the 2008 Wenchuan earthquake, a woman ran to the staircase during the earthquake, but the stairs collapsed, everyone else lost her life, she was supported in the corner, she was rescued a few days later, but because she stayed with the corpses around her for dozens of hours, she was already stiff after coming out.
In 2014, at the scene of an oil pipeline explosion accident, the female boss of the commissary watched several old people play chess at the door, and another old man also came to watch the game, she turned to find a stool, just entered the house, it was impacted by the strong explosion outside, the explosion of the oil pipeline led to the death of the old man outside the house, and the door was full of corpses. She was a witness to the accident and became the object of psychological assistance in the disaster.
These psychological rescues, Wang Jian is involved in. He said that psychological assistance is not only for the parties, the victim's families, and relatives, but also for witnesses at the scene, such as firefighters, volunteers, and on-site medical personnel who participated in the search and rescue of the China Eastern Airlines crash.
Of course, not all of the above-mentioned persons need psychological assistance. Wang Jian summed up several major "high-risk factors": the original mental disorder, personality defects, loss of relatives, loss of friends, colleagues, classmates, etc., loss of property, disaster scene witnessing, serious psychological feelings, and impaired social functions. If you have the above two points or more at the same time, you will be the focus of the rescue object.
During the 2010 Yushu earthquake in Qinghai, Wang Jian provided psychological rescue for the injured at the scene
Three types of symptoms can occur after a disaster
This time, the crash of China Eastern Airlines occurred suddenly, and the relatives of the victims could not accept it for a while.
Wang Jian concluded that when disasters occur and relatives die, psychological symptoms, physical symptoms, and abnormal symptoms may occur for family members.
Psychological symptoms are mostly sadness, manifested by depression, low mood, and loss of interest in things. It may also be accompanied by anxiety, worrying all day long, manifesting as generalized anxiety.
"At the same time it's denial." Wang Jian said that Malaysia Airlines has not been missing for 8 years and has not found the plane, and some family members insist on not acknowledging that the person on the flight has died, and as long as the black box is not found, they will not admit that the family has passed away.
"This kind of stubbornness is denial, and there are many people in this kind of situation."
After the Crash of China Eastern Airlines, the official announcement was made on March 26 that all 132 people on the flight had been killed, followed by a silent whistle.
This creates a sense of ceremony. Wang Jian said, "The ceremony is very important, the official does not announce, there are family members may not put it down." ”
Among the family members of the Malaysia Airlines incident that Wang Jian contacted, some people still watched their relatives QQ from time to time after a few years, and even told him that QQ was occasionally online.
This sounds very abnormal, and it is actually a defense mechanism of denial.
"There's also fear, and the slightest movement reacts strongly."
When he was in Wenchuan, Wang Jian met a young man, who was close to one meter and eight meters tall, but asked the head nurse not to arrange for him to live in the ward, but to support a bed in the hospital. Because I was scared in the ward, I always felt an aftershock.
Wang Jian said that this hypersensitivity is also a symptom of fear.
Anger can also occur in catastrophic events, i.e., irritability, some toward others and some towards oneself.
Self-blame, for example, some family members may wonder why he died and I live?" This is excessive internal attribution leading to guilt and self-blame. Wang Jian said.
Physiological reactions may manifest as poor food and insomnia. For example, Wang Jian may not be able to sleep in the middle of the night, nausea, vomiting, palpitation, shortness of breath, chest tightness, sweating and so on.
Abnormal reactions are psychotic symptoms, and some people can hallucinate after a disaster, saying that their loved ones are not dead, "He is at home, and he is still talking to me." ”
There are also people who can appear delirium, that is, the time and place of the person identification of the disorientation disorder, do not know where this is, acquaintances in front of him do not recognize.
"He really forgot, there was a consciousness disorder." Wang Jian said that there are also people who may be forced, or even stiff, that is, do not eat, drink, do not move, and are in a state of silence.
"Everyone reacts differently because of different personalities." Wang Jian stressed.
Psychological symptoms do not appear immediately
It is not that after the disaster occurred and the death of a loved one, the various psychological performances of the family members have been maintained, but a process that shows a stage.
The first stage is the acute phase and occurs within 72 hours. After a catastrophic event occurs, after the human nervous system instantly absorbs information, the brain network may temporarily strike, and the person appears wooden and unable to speak. It is that the mental blow is too great, but the duration varies from person to person.
The second stage is the symptom phase. Various psychophysiological reactions may occur gradually, but there are individual differences in manifestations. Someone with a strong nervous system and a strong body may have a slightly milder response and a shorter duration.
Phase III recovery period. Wang Jian said that the most important sign is to accept the facts and start to gradually consider future life. In his view, if the family starts to talk about claims, it indicates that they have entered the rehabilitation stage.
"If you're still saying, don't talk to me about losing money, I don't want money, I want our family, this is not yet in the third stage." 」 Wang Jian said that from the perspective of psychological crisis intervention, it is a good thing that the family members have made reasonable compensation claims, indicating that they have accepted the fact of the disaster.
The China Banking and Insurance Regulatory Commission recently disclosed that as of March 29, in terms of property insurance in the crash of China Eastern Airlines, PICC Property Insurance, CPIC Property Insurance, Ping An Property Insurance and China Life Property Insurance that underwrote the fuselage of the aircraft had paid a total of 116 million yuan in advance insurance compensation to China Eastern Airlines. In terms of life insurance, the relevant insurance companies have actively carried out insurance claims according to the customer's report, and 11 companies have paid 14 compensation to the families of the victims, totaling 14.85 million yuan.
The CBRC said that the next step will be to coordinate the insurance industry to further refine the claim settlement plan, optimize the claim settlement process, grasp the key links, pay attention to methods and methods, and properly do a good job in follow-up insurance claims services.
From the perspective of psychological crisis intervention, Wang Jian said that it is not necessary to provide indiscriminate psychological assistance to every family member or witness, and the WHO (World Health Organization) Psychological First Aid Manual puts forward 7 principles, one of which is informed consent.
"You feel like he needs comfort, but he probably doesn't feel it, at least not now." Wang Jian said that this requires observation and conversation. Psychological assistance should not be imposed on others, but to assess needs, key rescue targets should receive timely and effective psychological assistance.
In Wang Jian's view, the work of psychological assistance experts in disasters is a combination of psychological counseling and social work, both psychological intervention and on-site practical help to meet their basic needs such as disaster information communication and contact with family.
"At the reception site of Malaysia Airlines, we set up a reception desk in the corner, and someone took the initiative to find us. Probably not now, but one day the emotions get out of control and we follow. Therefore, psychological assistance is first and foremost observation and companionship. ”
But help don't add to the mess. Wang Jian mentioned that in the Wenchuan earthquake, some volunteers took the initiative to help out of kindness, but they cried to the other party.
During the Wenchuan earthquake in 2008, Wang Jian did psychological rescue for the injured at the scene
Avoid secondary injuries
Psychological rescue should also avoid secondary injuries.
What is secondary injury? "You pat your chest and say that the doctor will be able to cure you all, or you say that the official must be able to lose a lot of money, and finally can't cash in, it is a secondary injury." Wang Jian said not to give unrealistic expectations to aid recipients.
In the face of disaster, everyone is deeply hurt. In the China Eastern Airlines incident, 4 women talked about their friends who died on Flight MU5735. The 39-year-old single mother, married from Guangdong to Yunnan in 2006, has only returned to her mother's home once in the past 16 years, and needs to work three jobs in Yunnan to barely maintain family expenses, this time taking China Eastern Airlines MU3753 to Guangzhou to work, planning to pay off 60,000 yuan of debt.
"Sitting there, the news [of the plane accident] came one after another, and everyone started crying."
"During this time, our family members have communicated, have the family members dreamed of coming, did not dream because they did not leave?"
"Friends can't sleep, often wash their faces with tears at night, these days who see whoever sees them is wearing big circles like brass bells, sometimes turn out her photos to see, tears can't be stopped." 」
Friends can get involved, but psychological helpers can't get overly involved. "Accompanying his sad heart can be felt empathy, but not overly involved." Because you are all involved, crying with him every day, and in the end he does not feel the strength from you. Wang Jian said that the helpers should have strength and accompany him out of the psychological crisis as a strong backing.
In addition to the accompaniment of not being overly involved, there is also leadership. Wang Jian said that he was holding his hand out of the difficulties instead of carrying him on his back and holding him. Because the accompaniment is finally over, it is necessary to exert his own effectiveness, as an adult's sense of efficacy, to deal with and cope with everything, rather than making decisions for him in a big package. Otherwise, when the helper leaves, it is a second injury.
Make fewer mistakes in the details, which requires rigorous training. Earlier, when assisting in Kunshan, Wang Jian found that some medical personnel told the injured: You must hold on, you see that we are all rescuing.
"What is rescue! Let him hear, all rescue me, that's how nervous. Wang Jian suggested that it is better to replace it with "treatment or help". Therefore, the aid pays attention to the cautious words and fully considers the feelings of the other party.
Psychological rescue medications are available
Although it has been nearly 20 days since the incident, Wang Jian said that in the 2020 Wuhan outbreak, he provided psychological assistance on the spot for 67 days, Malaysia Airlines lost contact for 53 days, and Wenchuan earthquake assistance for 3 weeks.
Wang Jian pointed out that in fact, most of the psychological assistance lasts for two weeks, and then the work is handed over to the local mental health agency, which may be a long work in the later stage.
"In the Kunshan explosion, some patients were seriously burned or even disabled, and the patients needed a long recovery process physically and psychologically, which required local psychological and medical workers to do it." Wang Jian gave an example.
Psychological intervention is a technical activity, during which various techniques are used. But Wang Jian pointed out that the first thing is to accompany, soothe and empathize, and use various technologies as the work is carried out.
For emotions, if the ups and downs are large, Wang Jianhui instructs the subject to use breathing relaxation, muscle relaxation, and mindfulness.
For cognition, if there is a cognitive bias, cognitive reconstruction is done through cognitive behavioral therapy (CBT).
For flashbacks, as well as post-traumatic stress disorder, eye movement desensitization techniques can be used to help eliminate them.
Of course, it also includes group counseling, which is mainly aimed at on-site witnesses such as firefighters, medical staff, volunteers, etc., and psychological stress reduction is implemented in group counseling, which can be completed in one or two weeks.
Wang Jian also mentioned that drugs are sometimes used. "For acute psychiatric symptoms or depression, anxiety, insomnia, etc., drugs are a very good means to help the subject stabilize emotions and control the mental symptoms quickly." Drugs are also often used in psychological rescue. ”
In the China Eastern Airlines incident, some family members encountered online violence, and all kinds of false information were temporarily rampant, and even led some family members to publicly apologize under the attack of the network, hoping that they would no longer be attacked.
According to Cyberspace China, the Cyberspace Administration of China has instructed the website platform to strengthen the traceability and disposal of online rumors related to the crash of a passenger plane of China Eastern Airlines. As of March 26, a total of more than 279,000 pieces of illegal information had been cleaned up, including more than 167,000 pieces of rumor information, 2,713 accounts disposed of, and 1,295 topics of dissolution.
Wang Jian believes that it is understandable for the families of the deceased to express their grief and thoughts through the Internet, which is understandable. He suggested that netizens be merciful, because at this time, the family members are fragile inside, and their hearts are easy to be further hurt and may even collapse. It is hoped that the online society will have good intentions and call on the regulatory authorities to seriously deal with online violence.
Practice mindfulness to calm the mood
Su Dongpo, a lyricist with a broad heart, said that "the boat has passed away since then, and the river and the sea have lived the rest of their lives", and also said that "this peace of mind is my hometown". But the death of his loved ones still makes him sad, he said, "ten years of life and death are two vague, do not think, unforgettable." Thousands of miles of lonely graves, nowhere to say bleakness."
We often say that we don't know which tomorrow or accident will come first. Life and death, calamity, calamity... They are all compulsory courses in life.
In response to the disaster, Wang Jian specially put forward professional opinions on self-care psychology and prevention of psychological crises.
Human beings are very weak and weak, and disasters can occur at any time. First, a strong nervous system rather than a fragile heart needs to be cultivated from an early age in the family and environment. Avoiding disasters is ultimately unrealistic, just as there is the title of Owen Yalong's book "Looking Straight at the Sun", people cannot avoid it, they can only face it.
Second, in the face of misfortune, although emotionally troubled, we must still try to remain rational. The more you fall into disaster, the more emotions prevail, but in the end, reason needs to dominate this brain. Only reason tells us how to deal with things, and emotions will bother us more. Therefore, what is important is how to stay rational.
"Actually, you can choose to do something with a very sad feeling." Wang Jian stressed.
Third, a good man three gangs. To make full use of the social support system, when family, friends, and colleagues lend a helping hand, we must not refuse it. We may lose our minds because of our emotions, but the people around us are calm and can help us get out of trouble.
Finally, remind yourself that disasters are in the balance, and don't make extreme decisions such as divorce, suicide, dropping out of school, giving up your career, etc.
"The decisions you make are basically wrong, because in a disaster, you are not making decisions intellectually." Wang Jian said that you can slow down, in addition to getting rid of the current situation, major choices can not be made first.
From the perspective of informed consent, Wang Jian proposed that one of them to get rid of the current situation is to deal with emotional problems. The best way is to relax your breathing and scan your body. About 10 minutes at a time, you can better calm the mood. There are dedicated mindfulness-guided audios for this area that can be followed by exercises.
In addition to regulating emotions, you can also regulate your thinking. At present, the thinking is chaotic and prone to cognitive bias. Wang Jian suggested that for thinking and concepts, you can ask yourself a three-step question, that is, CBT asking: First, what evidence proves that this idea is correct. People usually think automatically and cannot be questioned. For example, if you feel that you can't live, you can ask yourself what the evidence of "not being able to live" is.
Second, what is the evidence against this notion. That is, what is the evidence that negates my "inability to live"?
Third, what are the worst results and the best results that positive and negative thinking has caused to me, and what are the most realistic results for me?
Wang Jian said that when people are in the most pain, they need to do self-brainstorming, let the thinking space open, see another possibility, rather than being wrapped up in emotions.
In addition to emotions and thoughts, it can also regulate willpower. From a behavioral point of view, Wang Jian proposed that you can take the initiative to make healthier behaviors, such as trying to restrain yourself, taking care of your own diet, sleep, and family. Eat and sleep on time to help your family. If possible, show kindness to others and reflect personal efficacy.
Starting with simple behaviors, this is optional.
【Interviewee Profile】
Wang Jian is the director of the Department of Psychology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, chief physician and doctoral supervisor. Graduated from Peking University School of Medicine.
President of the Professional Committee of Traditional Chinese Medicine Psychology of the World Federation of Chinese Medicine Societies, Vice Chairman of the Beijing Mental Health Association, Editorial Board Member of the Chinese Journal of Internal Medicine.
He has participated in the psychological rescue of major crisis events such as SARS, Wenchuan earthquake, Yushu earthquake, Malaysia Airlines missing contact, Qingdao explosion, Kunshan explosion, etc., served as the leader of the psychological rescue team for many times, and in January 2020, as the first batch of members of the national traditional Chinese medicine medical team, he rushed to Wuhan to participate in the medical treatment work against the epidemic.
Daily economic news