26 august 2018
Never say this to a
victim of terrorism and the best ways to help
Do not give them any
advice, hug them. This is one of the main tips that the psychologist Sara Bosch, with 25 years of
experience attending victims of terrorism, has shared with Salam Plan.
Perhaps you can also contribute to make each day more bearable for the victims
of a terrorist attack. Or maybe you are a victim yourself and you do not even
know it.
Bosch is head of the
Attention and Assessment Unit for People Affected by Terrorism (UAVAT) in Spain, which includes
psychologists, psychiatrists and lawyers. Since it its foundation last
February, they have treated around 170 people affected by the attacks in Catalonia (Spain),
which occurred one year ago. All of them Spanish victims, but there were also
many victims of other countries. 16 people died, more than 100 were injured and
many more were hurt psychologically, according to Sara Bosch. 90% of victims
are survivors and 80% of all the victims still suffer a psychological injury,
she says.
On the ‘International Day of Remembrance of and Tribute to the
Victims of Terrorism’ this 19thof August her advice may be
useful to all of the victims of terrorists around the world and people around
those who suffer.
Are there victims of the attacks in Catalonia
one year ago starting to ask you for help now?
Sure! Of course, of
course. (When we started contacting last February) all the people who had gone
to the emergency services of the attacks, there were people who had not yet
received psychological attention. They had been holding themselves, struggling
to cope with a psychological situation and waiting for time to heal them. But
we are seeing people who still have a lot of psychological affectation, who
have not received any treatment yet.
What needs do victims have or what problems do
they face?
In the first place,
when we think of victims, we all think first of the ones who were murdered, and
therefore we quickly connect with the relatives of the deceased. After that,
the physical wounded. Later, we began to think that there were many people
there who might not have had an impact on the body, but that it is a traumatic
experience and it is very likely that these people are emotionally affected.
At the beginning, we
also understand that there is a lot of psychological affectation in a large
number of people, but that somehow that will later heal on it own. A bit like
when we get a punch. The bad thing is that sometimes we don’t recover as
expected, and than we start considering: “what if there is something broken in
me?”
People who receive that
psychological punch, at first cannot sleep, they see the images continuously
(on their minds), the sounds of the sirens, they are hypersensitive, they are
afraid, have anxiety crises, they cry, they are disconnected from their day to
day, they behave very strange … The (initial) psychological affectation is a
chemical reaction: there is an explosion of neurotransmitters at the cerebral
level, which are the ones that generate those symptoms. Therefore, it is
something physical too.
That chemical explosion
has to calm down, but there are people where that doesn’t happen. There is a
percentage of those people, which can be perfectly 60%, that will break down (,
like a sportsman). They are going to suffer some psychological injury, which is
when those reactions remain: they cannot sleep -insomnia is very
characteristic-, they are still very afraid, they still have a state of anxiety
that doesn’t go away, they have not sit down in a terrace again to have a beer,
they have not gone back to the cinema, they do not want to enter a supermarket,
they have not taken the tube again…
What does the first anniversary of the attack
mean to them?
They know that there is
a lot of media attention and that there is also a social memory, it is a call
to their memory. It is something that they are getting through with the help of
professionals, trying not to be harmed more from the outside. But it still
means getting through an experience that is very slow and very painful to
digest and suddenly there are reminders, images … especially in the media, with
that nightmare. They do not remember, they experience it (again).
Therapeutically we are
always going to recommend facing that memory, so that it becomes something that
can be emotionally tolerated and that instead of reviving it, it may remain a
painful memory.
There
are people who have done that process and are relatively capable of being
exposed now to that homage and there are people who are still in a very early
process and avoid seeing those images, because it would be an overdose for
them. It’s each person the one who chooses
What practical advice do you give to the
victims at this point, bearing in mind that each person and each circumstance
is different
Basically, we make them
aware that they can choose, that they do not feel obliged to anything.
Sometimes, it’s a bit of giving them permission to do those things that can
make them feel better.
Without that permission, do they feel guilty?
Yes, they feel guilty.
Especially towards their relatives, because there are many who, when time has
passed, don’t understand why you are not feeling well: “nothing happened to you,
you were not injured, you are alive” (, they would tell the psychological
victims, the survivors). It’s not that they do not want to forget, it’s that
they cannot. They feel misunderstood.
Even they themselves do
not understand why they are not OK and consider it a sign of weakness, for
example. And it is not a sign of weakness, nor is it stubbornness of not
wanting to overcome something.
There is a lot of
incomprehension, as much as of the victims towards themselves, as of the
relatives, the close friends, the bosses … We tell them: do not force yourself
to feel well, understand if you are not OK, respect that you are not OK. This
is a slow process. Look for what can make it as easier as possible to feel calm
and, above all, if you have not yet started a treatment, go to a professional –
basically a psychologist – to help you go through this whole process, because
it is a psychological injury. It has nothing to do with being weak or not
wanting to get over it.
And what can the people who love them do to
stop messing up when they are trying to help?
Accompany them in their
feeling, the same way we tell the relatives of the deceased that we join with
them in their grief. We need to do the same with those who got injured.
Therefore, if they prefer not to talk, then we do not speak. If they feel bad,
we do not have to tell them anything, hugging them is enough.
Let us remind them that
we are there, that we are in a safe place, and we do not need any special
phrase. And try to be available to what they may need, without asking them how
they are all the time. Supporting them with empathy.
Do not question them,
do not to judge them, and do not give them advice. It is simply being there, at
their disposal, and not looking for the magic phrase, because the advice does
not help. They advise themselves.
And the media and politicians, who perhaps are
the ones who treat this issue the most in the public sphere? What can we or
they do to not make it more painful and help as much as possible?
Media, on the one hand,
have the need of giving information and therefore it is true that these images
of the van (at the attack in Barcelona) … is a repeated image. But it is true
that if we consider respecting the victims or not hurting them, we should not
issue them.
There are victims (for
whom) talking about their experience (helps them) or they have a message to
give us. I would ask media to say the full message of those affected, just as
the victim wants to express it. Because what has been happening is that many of
them do the interview, (that) has been an extra effort for them but they had
the expectation that it would serve something. And when they see it later, they
tell you: “They have not said that; I told them it was very important to me.”
Then: “They have only put my drama, they have only published the gruesome
part.”
I believe that on the
one hand it is true that it is very difficult not to give that message that
they will see as morbid, but as we talk to the victims, allow them to give
another message that they need to tell us.
And
politicians … Errrrr, wow, how much time do we have? In a terrorist attack,
unlike other crimes, a message of solidarity is generated with incredible speed
and impressive magnitude. They are continuously told by politicians and
everyone: “We are with you, for whatever you need …”. That generates both an
expectation of support, and when it is not there later, after months, or when
they begin to process their needs with the Administration… that solidarity does
not disappear, it is directly the opposite: denials, denials.
What type of refusals? Of treatment, or
information …?
Yes, right. Denial of
treatment, fundamentally, and denial of recognition as a victim. For example,
when there is an attack which has the power to grant recognition of victims of
terrorism, the Ministry of the Interior in Spain will have a list of people, which
will be collected from the wounded and deceased (…). For the Ministry all these
people are the victims of the attack, they will be able to see exercised their
rights of compensation for injuries, they can go to a psychologist if they need
it … there will be no problem.
The ones that worry us
are those that are not in that list, because many psychological wounded do not
go to the doctor. Many go to their homes and after three, four, five or six
months those people cannot take it anymore, they break.
What should we never tell a
victim of terrorism and what is most likely to help?
When
it is about someone who has lost a beloved one, I think you should especially
not give them any advice. You have to be there for what they need and offer
help in practical things.
Like solving paperwork or
buying food, if they do not feel strong enough.
Exactly.
And allow them to feel their pain, even if we do not like to see it.
And in the case of
psychological victims, the survivors?
Do
not remind them that “fortunately nothing has happened” to them. Do not ask
them to make efforts, because when a person has a psychological injury she does
many more efforts than we think.
Also,
you need to understand that they can be very fluctuating. Maybe there are days
that are worse than others. Let them know that if one day they are not feeling
well, you are there to complement them. And do not try to make them explain how
they feel or stop conferring them attributions that hurt them even more: “you
are so and so”, “you don’t do whatever”, “don’t take it that way” … Try not to
make attributions of that type, because they tend to blame themselves very
easily.
Listen
to them when they want and do not force them to talk.
I suppose that in the end these
tips for people who are psychologically wounded are equally valid for everyone,
also the physically wounded.
Sure.
And something important as well about people who have a psychological
affectation: it is important to help them to get back to a (certain) routine,
because many of them can be in a somewhat chaotic state.
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