The following is based on a piece I wrote for the Opinion Page of CNN.com upon the release of the 33 trapped miners in Chile (Photos from Chile government)
It is only human nature to be concerned about the psychological welfare of the 33 miners who are emerging from their prolonged stay trapped underground. Those of us who work in the specialty of mental health especially as it applies to disasters and posttraumatic stress have pondered the differential list of possibilities that we know can happen to survivors of individual and mass traumatic events.
Possible Psychological Problems
The range of psychological sequelae includes symptoms of posttraumatic stress such as nightmares and flashbacks of being trapped in small tight living quarters with the possibility that they would never get back. There could be reoccurrences of the memories, thoughts and feelings which they had at the moment that the mine collapsed when they realized that they could be facing immediate death. The miners may find that despite their freedom, after being rescued, that they have become claustrophobic and fear and avoid any type of closed spaces. Their nervous systems may be reset in a manner, which makes them high strung and easily aroused. A sudden noise may cause them to be very jumpy.
The newly rescued miners may have significant problems in sleeping as their biological clock may be quite altered. It is possible that the radical changes in nutrition and the diminished hydration which they have experienced has effected their medical health which could further impact on their mental health. It is been suggested that they could be candidates for kidney disease which could lead to them being sluggish in their ability to concentrate as well as the other serious effects of such a medical condition.
There may have been some interpersonal conflicts which festered with the close proximity and could preoccupy the miners even after they are rescued. Then there is the issue of reestablishing relationships with family, friends and workers, which were abruptly suspended since the accident. There may be expectations that will not be met by spouses, lovers, children and others. Similarly those awaiting the rescue on the outside, may be disappointed if the miners do not respond as they anticipated. The pressures and overall experience with the media may be overwhelming for some of the men. Those miners who may have had a problem or a tendency to use alcohol and drugs may turn to these substances to try to relieve anxiety and other feeling which they have in the aftermath of being rescued. This could easily spiral out of control leading to serious problems.
Resiliency Expected to be The Default
Having said all this, I believe that the majority, if not all of the rescued miners will psychologically do very well. I base this view on the fact that although we know there are many post traumatic problems that people do have who have suffered individual and mass trauma, most people show resiliency and get through these events without long lasting psychological damage. In addition the factors, which appear to contribute to enduring psychological issues either were, not present or seemed to have a short lived effect.
For example there was not death or any serious injury to the miners. While there may have been initial moments where the miners feared for their lives, this appeared to have been mitigated once they found the safe area in the mine. They also understood that a rescue effort was being undertaken and was expected to be successful. Just as important, they had communication (which included video and audio) with their families so their isolation was far from complete. In fact, they knew that their entire country and people around the world were following their ordeal and were rooting for them. While such enormous expectations can sometimes create pressure on a person, in this case there were no actions, which they had to perform but rather they could just appreciate the support that they had from other people
While I do not know the details, it has been reported that while they were trapped they also had access to mental health counselors via their communication channel and could also be given tranquilizers or other psychotropic medication if needed along with any other medical supplies. They were given miniaturized video players as well as games to divert and exercise their minds during their confinement. I also assume that in the aftermath, when they are out of the mine, they and their families will have some meeting with sensitive and knowledgeable counselors who will address any symptoms which they may have. These professionals will be alert for potential substance abuse problems, as well.
This Will Change Their Lives Forever
In the end this experience will change their lives forever. People who have had a brush with death often are able to reevaluate their life trajectory and make positive decisions for themselves that they might not otherwise have done.
While the miners were trapped below the ground a Uruguayan rugby player who survived more than two months of isolation in the Andes with 15 others after a 1971-plane crash brought a message of hope for them. This survivor,Jose Luis Inciarte said, “They are in the process of discovering the joy of being alive and the will to survive.” I hope that this message and the good wishes for the miners from people around the world will allow them to triumph over this traumatic experience.