WW51 January 17, 2018: Calling a Spade a Spade… Or the Importance of Naming a Traumatic Event: The origins of Human Service Response™, Part 1

Wednesday Wisdom Series: Calling a Spade a Spade…Or the Importance of Naming a Traumatic Event
Wednesday Wisdom Header
Here is your bi-monthly Wednesday Wisdom series from the Family Assistance
Foundation, reminding you that a fully-integrated approach for assisting survivors of
traumatic loss involves a balance of head and heart. Wednesday Wisdom is written
and copyrighted by Carolyn V. Coarsey, Ph.D. and distributed by the Family
Assistance Education & Research Foundation Inc., fafonline.org. Reprint is available
with written permission from the Foundation. 

Calling a Spade a Spade… Or the Importance of
Naming a Traumatic Event: The origins of Human Service
Response™, Part 1

Wednesday Wisdom Heart 

"The conflict between the will to deny horrible events and the will to proclaim
them aloud is the central dialectic (clash) of psychological trauma."

                                                    ― Judith Lewis Herman,
                                                    Trauma and Recovery: The Aftermath of Violence
                                                    From Domestic Abuse to Political Terror

              In 2018, the Foundation is placing major emphasis on providing more training
and assistance to airports and ports of call and other ‘touch points’ where survivors
and employees interact within the first few moments of a crisis. Through the
Wednesday Wisdom™ series, we will provide information and review terms and
definitions that underlie the Human Service Response™ (HSR™) model for assisting
survivors in the immediate aftermath of a traumatic event.
            While the concepts of HSR™ are also useful when supporting survivors of
natural disasters, the origin of the model came about when crises occurred in the
workplace and employees had no clear understanding of their role, and no training
on how to help survivors. Left on their own, employees often made mistakes that
increased the traumatic experiences of the survivors.
             Interviews with survivors over the past thirty years since HSR™ started,
show that Care Teams also known as Special Assistance Teams, who provide
longer-term support for victims and families, are having a positive effect on the
experience of the survivors. However, Care Teams are not at the airports or ports of
call, and typically do not meet the survivors for several hours. Sometimes due to the
geographical location of the crisis, they may not be able to meet the survivors until
a day or two later. While survivors give these employees high marks for their
support and service, these teams cannot reverse the harm done during the first
several hours of a mishandled crisis.


The origins of the model: Human Services Response™
            Interviews with survivors of air, rail, military and other disasters from the late
seventies and early eighties provided much of the information used to develop the
HSR™ models. Today, for airline tragedies, the National Transportation Safety Board
(NTSB) serves as the liaison between survivors and the airline, and other agencies
which assist them. Similarly, other programs have evolved to help survivors of
military and other transportation crises. Yet, each year, there continues to be
examples where untrained employee responders make the same mistakes that were
identified in the earliest interviews. Mobilizing Care Teams and other resources is
further delayed when there is hesitation on a company’s part to acknowledge the
magnitude of a crisis.
            The following example from the Foundation’s early research shows the critical
importance of naming a trauma accurately. A jet crashed into water on takeoff. The
aircraft broke apart upon impact, instantly killing two passengers who were seated at
the fracture. The company waited until the day following the crash to activate their
employee responders. They believed that the harmful effects of the trauma had been
contained by the first responders who rescued those unable to evacuate on their own
and other medical personnel who attended those survivors who were admitted to
the hospital.
            Surviving passengers who were hospitalized overnight had a significantly
different post-accident experience than the ‘walking wounded’. Following are excerpts
of interviews with two of the surviving passengers.
[1] One was severely
traumatized by the crash, and the other felt that the experience had improved her life.

Bryon
            The overhead rack came down on me. The seat collapsed. I was in row 20.
The section between 20 and 21 broke apart. That is where the two women were
sitting who were killed on impact.

            That part of the plane separated right in front of me. The seat in front was
pushing against me. I could not get out. I kept struggling doing everything I could. I
don’t know how long it was. I could hear the helicopter overhead and the firemen on
the bank with their loudspeakers and there was a boat with men rescuing people.
The water was between my stomach and my waist, and it was getting fairly high. I
felt I would drown and all this time I did not know I was in water. All I could smell
was diesel fuel. I had no way of knowing we had crashed into the bay; I just thought
the tanks had ruptured and I would go up in flames.

            Byron eventually broke free of the debris and made his way out the window
exit where he was rescued, but his emotional and psychological trauma continued
when met by untrained employees. His interview continues in his own words.
            They moved us several times and finally put us on a bus and told one of the
people to move us out of there and they did. They took us to the airline VIP lounge.
It was getting late. I asked them if I could have a sandwich and a scotch and they
said, “No, we are closed.”

            Byron was taken to the hospital due to high blood pressure. At the hospital,
he changed into a hospital gown. He was released later the same day and
transported back to the airport. Byron lost his glasses in the crash and was having
trouble with his vision. He asked an employee at the airport if there was a way to
get replacement glasses. He was told to get new glasses when he returned home.
             After arriving at the airport, Byron boarded the first available flight to his
home. His wet clothing had been placed in Macy's shopping bags, which he
carried through the terminal and on the flight with him. Seated in first class, Byron
was wearing the hospital gown he was given earlier. He felt humiliated over the
way he appeared and smelled. When he arrived at the airport in the city where he
lived, the emotional trauma continued.
            When we arrived in Charlotte, I told them that I lost my luggage in the crash.
“Tell me what to do. Do I go down here to the baggage department right now and tell
them that I lost it? I don’t have claim checks. They are in the river in New York. Tell
me what to do.” They just laughed at me. I did not have any idea what to do.

 
Ann
            I felt the plane vibrate…I could hear the brakes being applied, but we were
not stopping—finally, we stopped. I was alert and awake, my head was resting on
my knees, and my hands were dangling beside me. I was unable to speak, but I
heard what was going on around me. I think I was trapped in the airplane for 90
minutes. I heard the rescue people saying, "We've got three DOA's (dead on arrival)."
I could tell that the two people in front of me were probably who they were talking
about—and me. I could not speak up to tell them that I was alive. It became very
warm in the airplane, although I do not remember being afraid.

            Although Ann could not talk, she could hear and comprehend all that was
going on around her. Fortunately, one of the responders decided to check her pulse,
before leaving the cabin. He shouted to the others that she was alive. Due to the
crash conditions, it was not easy to extricate her from the wreckage. While the
rescue took place, Ann remembered the responders speaking gently to her and
calling her sweet names. The airplane sank about five minutes after she was
rescued.
            Ann was hospitalized overnight. Employees were dispersed to the hospital
the following morning and provided fresh, dry clothing for her and helped her obtain
other items that she needed. When she was released from the hospital, she was
driven home in a limousine. Asked later if she could think of anything positive that
came from the accident, she answered, "Yes, I bought a new house, financially I am
better off, and I've made new friends." Ann went on to explain that her life had been
improved by the crash.


[1] 2004, Coarsey, C.V., 2004.Human Services Response: A practical approach to
helping people

 
Wednesday Wisdom Head

"There are wounds that never show on the body that are deeper and more
harmful than anything that bleeds.
"

                                                                                        -Laurel K. Hamilton,
                                                                                        Contemporary American Author

                By the caring and humanitarian response provided to survivor Ann, it is
easy to see that the company had the best of intentions for assisting survivors who
survived an accident. However, because the leadership team failed to acknowledge
the catastrophic nature of the crash as soon as they knew of the basic details,
additional, life-long harm resulted for Byron and other survivors. The leadership
team's failure to call this disaster what it was, left employees in the airport, baggage
claim, and every point of interaction between survivors and company representatives
to respond with the ‘business as usual' attitude, thereby extending and adding to the
harmful effects of the original trauma.
            Company responders are led by decisions made by leadership in the first few
moments when a trauma is known about. These decisions trigger how appropriate
the company’s emergency response addresses the true circumstances of the
accident. Upcoming articles will provide additional insight into the ‘why’ behind the
approach advocated by the Foundation and examples of effective and ineffective
responses. Part Two of this article will detail the theory and supportive details of the
power employee responders possess, to help or harm survivors of a crisis in
their workplace. 
                                                                   
© 2018 Higher Resources, Inc./Aviem International, Inc.
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