▎ WuXi AppTec content team editor
It has been 1 month since the "3.21" air disaster.
On April 20, a preliminary report of the investigation was released, but the specific reasons still need to be further investigated.
And this sudden disaster, the shadows, fears and pain left in people's hearts, still linger.
What kind of psychological trauma will survivors or families of those who survived the air crash experience? How can it be treated to calm down?
Today, I bring you the story of a survivor of an aircraft accident.
"The pilots had difficulties"
On August 24, 2001, at 5:45 a.m. GMT.
Margaret McKinnon's flight was crossing the mid-Atlantic, flying at an altitude of 12,000 meters.
She went into the bathroom of the plane and turned on the faucet, only to find that she couldn't get any water.
Image credit: 123RF
Also flying along with her husband, John Baljkas, was asleep in his seat in the middle of economy class.
They are from Toronto, Canada, less than a week into their wedding and on their way to Portugal for their honeymoon.
We have less than 2 hours to go before landing. Margaret had planned to go back to her seat for a nap before landing, but she competed with the faucet for half a day and finally had to give up.
What she didn't know was that the aircraft bathroom pipes were water produced by the air pressure generated by jet engines — seemingly just faucet problems, but suggesting that there might be a deeper fault behind it.
As she walked down the dark aisle to her position next to John, the passengers suddenly began to stir.
The small television in the aisle had been running for a few minutes before the movie suddenly stopped, and the lights in the cabin kept flashing.
She sat down next to John, who had just woken up, only to hear a notice on the radio: "The pilot is having trouble."
For a moment, the passengers began to panic and even cry loudly.
The crew was seen scattered on all sides, instructing passengers to pull out their life jackets and shoes from under their seats.
A flight attendant began to speak, but before she could finish speaking, she was in tears. Another flight attendant said: "We will land in the water. ”
Only to hear a noise from the middle of the cabin, as if something had been turned off, the roar of the engine also stopped, and suddenly felt a stream of air whistling around the fuselage. There was a dead silence.
At 6:26 a.m., someone said, "The engine went out."
Now, the 150-ton plane has lost all power, like a kite with a broken line, floating and sinking from an altitude of 10,000 meters.
Image credit: 123RF
"We're going to die!" A passenger cried.
Darkness before dawn
Fortunately, Margaret grew up listening to sirens and fire detectors — her dad was the deputy captain of the fire brigade, and her mom was a nurse.
She often hears them talk about car accidents, people trapped in their homes, or escaping from a fire.
It is these stories that are still strong in the face of pain, which makes her unable to extricate herself and dream of becoming a writer when she grows up.
But after going to college, she had a new interest, majoring in psychology. When she was engaged to her husband, she was already a PhD candidate at the University of Toronto in the field of memory and brain pathways.
"It'll be all right," John said to her.
On the plane, a couple struggled to put life jackets on their young children. There are people around crying, some people whispering softly, some people praying for heaven's blessings, some people saying goodbye to their children and relatives...
Margaret, who had had asthma for years, took a few hard breaths. Oxygen masks fell from above, but some face shields no longer worked.
At that moment, Margaret still remembered the thoughts in her heart: "My life is already very happy now, and I am satisfied." My husband, I love him too. ”
But then she became more and more distraught and frightened, and the plane descended faster and faster. Since the end is inevitable, no matter how optimistic and strong it is, it can only surrender.
She recalled a video she had seen before— the hijacking of an Ethiopian Airlines flight in 1996. After running out of fuel, the pilots tried to make a forced landing in the Indian Ocean, and in the blurred picture, the plane quickly disintegrated as soon as it hit the water.
She knew in her heart that the plane had crashed into the water and that her chances of surviving were still slim.
By this time, Margaret had accepted the ending, but John couldn't accept it at all—he believed that they would survive anyway.
He also planned an escape: After following the plane into the sea, they climbed out of the exit of the plane and swam to the shore.
He said they were both swimmers and theorized that there would be no hypothermia in the warm Atlantic waters.
"Our shoes may be useful for a while," he told his wife, "and it will be all right." She squeezed his hand.
At this point, the plane was continuing to descend, and the disaster had lasted 30 minutes. But for those who know they are going to die, it's like ten thousand years have passed.
Suddenly, the co-pilot informed everyone that in the next 5 to 7 minutes, they would try to land on a small island in the Azores called Terceira.
The pilots began to control the plane's spirals and glides—spinning like a red wine corkscrew, in an unbearably intense range, and everyone was thrown to the side. Then, the plane finally began to fly smoothly and accelerate.
Margaret's mind kept jumping, thinking about what it was like to land in the water, and then thinking about what to do if she crashed on land.
Aftermath
Outside the window was the pre-dawn darkness, barely visible, but she caught a glimpse of a little land, and then the surface of the water.
Finally, the plane's landing gear hit a hard surface. Her body rushed forward with inertia, and there was a scraping sound in her ears until the plane came to a complete stop.
Image credit: 123RF
The passengers began to cheer and applaud, but the crew quickly organized everyone to rush to the exit slide, fearing that the plane would explode on the ground.
When everyone got off the plane, several buses arrived and took the shivering, injured survivors to a small terminal.
In this moment of relief, the fire of curiosity about science in Margaret's heart burned brightly—how would all those who experienced this accident remember it in the future?
She looked around as if everyone were walking ghosts—
They were also wearing life jackets, lying and sitting on the ground, and the smell of vomit was everywhere. "It's terrible, it's cruel."
But she thought again, "[people's memories of disasters] may really need to be studied."
Shortly after returning to Canada, 9/11 happened in the same year, and the whole world was enraged.
She found herself strongly sympathetic to the passengers on the plane hijacked in the terrorist attack — she also had a nightmare in which the plane crashed into a skyscraper. But John didn't feel the same way.
In April 2002, details of the plane crash were broadcast on television. Margaret and her husband watched the special at home. At this time, her life and career were deeply changed by this experience.
She remains a young, ambitious scientist pursuing postdoctoral studies at the Rotman Research Institute in Toronto. Surprisingly, although she is highly alert to danger, she can still fly to all parts of the world.
Image credit: 123RF
But she suffered from nightmares and anxiety, dreaming again and again of the plane, that seat, unable to escape.
Her research direction has also changed, and she is becoming more interested in memory and post-traumatic stress disorder, which is exactly what she herself is experiencing.
Why do you have anxiety and nightmares that other survivors of the co-affliction do not?
For example, her husband John did not have nightmares, nor was he changed or troubled by this accident, but he was very happy that he could survive.
Unexpected findings from the study
So she decided to work on the subject with her colleagues.
It took them years to find enough surviving crash passengers willing to come to the study — and 19 people arrived.
Like Margaret, half of them had symptoms of post-traumatic stress disorder (PTSD); the other half, like John, did not.
The study consisted of two main parts: brain scans, interviews with survivors, and analysis of the results.
Psychologists have long distinguished between two long-term memories of their own experiences, which are stored in different parts of the brain.
One is called episodic memory: it is related to first-person perspective, emotion, and specific ideas (such as the memory of Margaret struggling to breathe in her seat);
The other is called non-episodic memory: it's mostly objective facts that have nothing to do with a person's subjective experience (such as her memory of the flight number).
In this study, they wanted to see how many memories the survivors kept and see if they were accurate.
In 2004, Margaret also did a subject in her own study—when she first began to relive the video of the accident, the fear of death returned like a tidal wave.
She didn't think her emotional burden would be so heavy, and reading the interviews of other survivors would make her feel tired.
They remembered details she didn't remember—the smell of something burning, the dark environment, the shaking sound of the flight attendant, the countdown before the pilot landed; others remembered the pilot's sudden shout, "We have a runway!" We have a runway!
Image credit: 123RF
In 2014-2015, two studies of survivors of the crash were published in the journal Clinical Psychological Science.
The researchers found that the emotional memory centers of the crash survivors' brains — the amygdala, hippocampus, midline frontal lobe and posterior region — increased blood flow when viewing footage of the crash video at the time.
When the researchers showed the 9/11 news footage to the crash survivors, many had very similar enhancement activity in their brains, while the control group of subjects (those who did not experience the accident) responded more neutrally to both disasters.
But the most surprising thing is that all survivors, whether with or without PTSD, exhibited a "powerful memory-enhancing effect" —
That is to say, the memories of both types of people about this event contain an unusually rich plot and the details of the first-person perspective.
PTSD has long been associated with "vivid traumatic memories."
But apparently, this study found that if a person only retains lucid traumatic memories, it doesn't mean that those memories have invasive effects.
This suggests that PTSD is not necessarily triggered by the storage of emotional memories, but may be influenced by other factors.
Moreover, 30% of people with PTSD experience a "numbing effect," becoming numb and shutting down all their senses when reliving memories.
But whether it's "overstimulation" or "out of sight," neither is a healthy response.
Popular science time
1. Why do different people react differently to trauma?
The incidence of PTSD is 5% to 10% in the population, and the incidence in women is twice that of men.
"We know there are some risk factors," Margaret said, "but there's no way to predict exactly whether a person will develop PTSD." ”
She said people with a history of trauma may be more susceptible to impact, as well as those who have been marginalized by society — such as those who have been bullied, humiliated, discriminated against, or raised in toxic stressful environments.
Image credit: 123RF
For example, she herself had a history of depression before that flight, and depression can also be a risk factor for post-traumatic stress disorder.
2. How is PTSD treated?
For many years, the main therapies for post-traumatic stress have been basically talk therapy: exposure therapy, which allows patients to relive memories of fear and gradually desensitize; and cognitive behavioral therapy.
But Margaret and her colleagues agree that healing trauma isn't just about identifying or erasing bad memories, but also about trying to tell your own story in a third-person perspective, as if you were telling someone else's story.
In recent years, there has been an emerging technology called "eye movement desensitization reprocessing therapy" (EMDR). During treatment, patients need to recall traumatic memories in their minds while being guided by a therapist to rhythmically swing their gaze back and forth from side to side.
This method sounds strange, but it is still relatively effective, and it is increasingly recognized in the mainstream medical community.
But further research remains to be done on why it works — the technique, some argue, mimicking the way the brain integrates and processes memories during rapid eye movement (REM) sleep.
In short, patients who tend to have first-person horrors about memory can often become simply "remembering" the experience after EMDR treatment.
Today, Margaret McKinnon is an associate professor of psychiatry at McMaster University and a senior professor at the Homewood Research Institute in Ontario.
After years of treatment and more than 20 years of research, she said, now let her recall the accident, remember a lot of details, but not afraid at all.
She had played those memories back and forth in her mind, like watching someone else's story.
In the future, she will continue to explore to benefit more patients.