Summary and Incorporation: A Reference Frame for Community Recovery and Restoration
It is many, many months after the start of this book that the coeditors have sat down together to review the wealth of information and insights offered by the chapter authors. The cause of the crash of TWA Flight 800, an immense tragedy which had just occurred as we began the introductory chapter, has only recently been determined; family and friends of the victims of that flight have already acknowledged the first-year anniversary of that disaster with private and public ceremony. If we have learned anything over the last decade, it is how to mourn together our separate tragedies. This was demonstrated in the collective demonstrations of grief and public condolences for mourners following the Oklahoma City bombing, the TWA 800 downing, and, most recently, the very distinct deaths of Princess Diana and Mother Theresa. Worldwide, it has become more acceptable and more common to talk about and show grief in the public arena.
Such acceptance should encourage grief and trauma professionals to guide this growing public willingness in ways that promote individual and community recovery following crisis and loss. This book was designed to be a series of real life examples, presented and assessed by professionals, which would ultimately yield a model or template to serve as a guide for intervenors and trained community leaders during a future community ordeal. At the end of the introductory chapter, a list of questions was laid out for readers to reflect upon as they examined each chapter because the “secrets to group recovery” would be there for all to discover and decipher.
Despite the highly readable and intrinsically interesting nature of these case studies, and perhaps because of their diversity over time, place, and type of crisis, a neat model held together with arrows and dotted lines eludes us for a number of reasons. The first of these is that each of the case studies lacks some degree of scientific validity in the views presented, despite the good attempts by some authors (e.g., Nurmi, Watts, & Wilson) to examine certain aspects of the postcrisis situation more quantitatively. This is not to condemn the authors but to acknowledge that questions of what helps or what hurts a community confronted by crisis and loss have rarely if ever been assessed adequately. We simply haven’t been in the position to take advantage of our investigative abilities to do quantitative or qualitative research regarding victims’ or responders’ views of the efficacy of interventions either in a short- or long-term perspective. What is offered here, primarily, are viewpoints, albeit from impressive and knowledgeable professionals, that may (or may not) give strong hints as to what factors may propel a group toward more rapid or more satisfactory recovery. (Even the clarity of that outcome point is hard to establish.)
It is interesting to note the personal involvement of these narrators of the case studies. There are as many ways to perceive and conceptualize these events as there are reporters. In most of the crises presented, the authors were part of the response to and part of the effect of the trauma. Their personal experiences and emotional responses, in fact, color the data they offer. The impact of crisis intervention on intervenors, whether professionally trained or ad hoc, is well known. It may be called vicarious traumatization, compassion fatigue, or event countertransference. Ron Watts and Marise Wilson, in their chapter on the bus crash in Kempsey, New South Wales, aptly call it the “ripple effect of trauma.”
The factors involved in understanding the phenomenon of community trauma are, additionally, too numerous, too subtle, and too time-linked to put together into one circumscribed model. Chapters here have described, variously, both micro- and macro-level interventions ranging from accounts of the death overload of rescue workers handling bodies on the military island of Uto, Finland, to the nationally televised funeral of U.S. shuttle crew members; from the Compassion Center for family survivors in Oklahoma City to the community-wide vigils at the War Memorial in Enniskillen, Northern Ireland. The significance of time posttrauma is also apparent as authors recount the initial attempts of communities, groups, and nations to regain safety and restore basic needs, in contrast to later efforts to memorialize and signify the dead and/or event(s). These activities are not distinct phases but, rather, are linked aspects of the crisis response; actions taken in the first stage actually may produce additional survivor groups, spreading the breadth of the disaster, or may reduce tensions, hastening a return to more normal functioning.
David Bolton raises the question of whose disaster is it? While this book focuses on the impact of a crisis on the community, any loss involving destruction and death is, without doubt, a profoundly significant event for the immediate survivors. While both the community and immediate survivors share the tragedy, they do so with differing levels of intensity and needs. The community needs to restore order and move on using a different timetable than the timetable utilized by individuals most closely affected by the trauma. In this attempt to restore order, the physical, political, and social implications of disaster which are of central importance to the group may conflict with the highly personal needs of any one person or family or neighborhood. Interventions that may serve one side may not support the other.
The issue of community or group healing raises a thorny dilemma of how to assess community devastation and recovery without becoming anthropomorphic, projecting upon a community a life and identity of its own. A community consists of individuals. Buildings may crumble, laws may be broken, but it is individuals alone who feel the weight of these assaults. Group survivorship has meaning only if we accept the premise that the feelings and behaviors of individuals are influenced, positively or negatively, by the recognition and acceptance of shared meaning. The power of mental health professionals, of group leaders, and of the conveyors of mass communication lies in how those individuals and groups affect the way a community gains that meaning and copes with the crisis at hand. In this manner, the process of responding to any disaster becomes part of the story of the disaster. Indeed, salutogenic interventions coupled with responsible journalism may dilute the horror of the disaster by providing uplifting, heroic chapters for the community to share.
The broad goal of crisis intervention with any group of individuals is to offer immediate help to establish a sense of control and safety, with an eye to how each move, each aspect, each activity contributes to the later trauma narrative. If we, as traumatologists and grief professionals, are able to make the story “good,” then we will have done the work we need to do.
While we concede our inability to present an all-encompassing model that would show what percentage of intervention at what point of time would lead to what outcome, we do believe that these case studies yield insights into and direction for facilitating group survivorship that can be extended to new disasters and events. Harvesting these insights across the nine case studies has led to the development of a Reference Frame for Community Recovery and Restoration (see Table 12.1). This framework for contextual analysis of nodal traumatic events identifies, along a trauma timeline, the multiple issues and sensitizing concepts that influence communal reactions to trauma. The reference frame alerts crisis responders and leaders to important aspects of assistance across time. In addition, these issues and concepts describe the factors that ultimately lead groups toward recovery and resilience or toward prolonged personal and social grief and weakened community ties. While many will agree with the significance of the variables listed, still others may add important additional sensitizing concepts to help guide intervenors. Ultimately, however, the value of this reference frame will be evident when researchers in the field of trauma and grief demonstrate the power of these factors through postevent investigations.
What follows this rather lengthy apologia is a discussion of the issues and sensitizing concepts identified by chapter authors in their case studies and organized in the Reference Frame for Community Recovery and Restoration.
Table 12.1 Summary and Synthesis of Group Survivorship Approaches: A Reference Frame for Community Recovery and Restoration
Sociocultural History of Community/Group
Trauma does not occur against a blank slate but to individuals and groups who bring their own histories of assumptions and self-beliefs to that crisis. Anie Kalayjian addresses this directly in her proposal to put any disaster within its cultural context. She outlines how religion, language, and a history of genocide and survival contributed greatly to the coping skills of many Armenians after the devastating 1988 earthquake. Conversely, the delicate balance between religious groups in Ireland, as described by David Bolton, had much to do with the explosive posttrauma situation in Enniskillen following a terrorist bombing. We can also ask whether the relatively nondramatic death of a young woman in her sleep would have had as much effect as it did in Kibbutz Gilgal were it not for its group history in time and place. Thus the cultural narrative, the life story of a group before a disaster strikes, plays heavily into the drama of response and adjustment.
The cultural narrative is also relevant to the endpoint of the reference frame as well. Ultimately, how well a group copes with adversity will be measured and passed on, accurately or not, in how the story of the trauma is told in the months and years following its occurrence. Beyond the impact of individual lives lost and mourned by immediate survivors is the group’s incorporation of the trauma episode into its history and cultural view.
Connectivity of the Group
Bolton, in his chapter on a divided Enniskillen, poignantly depicts the issue of belongingness as one that characterizes and influences a community’s response to tragedy and that ultimately becomes the goal or measure of positive recovery. Indeed, for Bolton, the essence of community lies in the shared belief that a group of people “belong.” A cohesive community affords “a certain, safe, and wholesome environment in which individuals can lead effective, enriching and safe lives.”
The power of this preexisting sense of belonging is more enduring in united communities than in communities in which divergent values and norms present a weaker front in the face of challenging events. It is clear, for example, that in the crisis generated by the sudden death of a kibbutz member, the bonds within this tightly knit community strengthened. However, the lack of shared perspective on the meaning and consequence of events, especially with regard to community crises, is common in estranged communities where differing interpretations of the same event are almost inevitable. Bolton predicted that, in Enniskillen, Northern Ireland, with its history of divided groups, a community tragedy was more likely to lead to retrenchment than to cooperation and increased integration across groups. Echoes of this conclusion also appear in the description offered by Kalayjian of the politically tense climate of Armenia following the earthquake. Writes Bolton, “in determining our response to disasters, our approach should be aimed at minimizing the risks to people’s sense of belonging, rebuilding a sense of belonging that has been impaired, and, in extreme circumstances, helping to create a new sense of belonging.”
Community Resiliency
Aligned with this sense of belongingness are a number of other pretrauma variables that might suggest how and how successfully a group manages a crisis. These variables might be subsumed under the general heading of community resiliency. Bolton defines resilience as the degree to which a community can absorb tragedy and the challenge to its practical and emotional resources.
The preexisting group functioning level yields abundant clues to the general resiliency of a community. Watts and Wilson speak of the helpfulness of natural support systems already in place prior to a tragedy. Indeed, intervention by external intervenors may undermine the power and confidence of natural systems of support and do damage in the long run to the community’s perspective of self-reliance. Such uninvited help is of more danger in today’s world where the number of outside experts, organized in numerous groups or individually, are ready and willing to descend upon a besieged community. For instance, an overabundance of helpers was known to have occurred in Oklahoma City following the bombing, and some of these so-called helpers argued over their “right” to be working at the scene.
The extent to which natural support systems have exercised preplanning for an emergency dictates, in part, what outside help, if any, will be needed. Watts and Wilson describe two forms of preparation. Passive preparedness describes the resources, economic and human, that a community has to draw upon; active preparedness illustrates the conscious planning and specific arrangements set up for anticipated emergencies. International and national intervention organizations, such as the Red Cross and the National Organization for Victim Assistance (NOVA); national professional organizations, such as the International Society for Traumatic Stress Studies, the Green Cross, the Association of Traumatic Stress Specialists, and the Association for Death Education and Counseling; and government agencies on the national and local level, through training offered and responses provided to disasters, make it more likely that communities will be involved in active crisis preparation. On the other hand, even readied communities may find themselves faced with unanticipated emergencies. The latter situation is well illustrated by Lassi Nurmi in his description of the travails of the Disaster Victim Identification Team’s response to the totally unexpected sinking of the Estonia.
Community resiliency is also related to a general competency in coping. The flexibility and openness of a community, especially among its leadership, determines how well the unpredictability of trauma can be met. Communities that are historically resistant to change and cautious of assistance from outside of known channels find adaptation more difficult. Competency in coping can be overwhelmed and weakened in groups that have experienced an accumulation of losses and are still dealing with unresolved past traumas. Bereavement overload, often observed in individuals who have suffered many losses within a circumscribed period of time, can numb a community and interfere with efforts to respond to a current crisis.
Magnifying/Minimizing Factors
Grief professionals continue to debate what constitutes the concept of complicated bereavement (a.k.a. prolonged bereavement, abnormal bereavement, atypical bereavement) as a pattern of unusual, nonstandard grief. They question if complicated bereavement occurs because of the character of the griever or because of a situation of loss that is extreme in its number, mode, or circumstance of death. Groups or communities of survivors present factors that contribute to more serious consequences of and challenges to coping with trauma. We have already noted, above, the significance of the character of the group. Additionally, there are numerous risk factors directly related to the nature of the crisis that may maximize or minimize a group’s ability to endure.
Long talked about in the field of traumatology is the differential impact of human versus natural disasters. Those events which are often called “acts of God”—hurricanes, earthquakes, volcanic eruptions, etc.—prove to be more readily accepted; human caused traumatic events bring with them the disturbing sense of intentionality of harm and preventability. Contrast the focus of anger among the Armenian earthquake survivors described by Kalayjian with the shock and fury of family survivors of the Oklahoma City bombing tragedy depicted by Karen Sitterle and Robin Gurwitch. Ellen Zinner’s description of public reaction to the Challenger’s failing emphasizes widespread concern over human error. Even Lynda Harrell’s account of the public reaction to baseball hero Mickey Mantle’s transplant and subsequent death includes the ire of those who felt that his death due to kidney failure was self-induced.
Other risk factors that complicate or intensify the nature of a tragedy include the number of deaths involved, the mode of death (murder/suicide/accidental/disease), the breadth of physical destruction, and the degree of physical mutilation to both the dead and survivors. These and similar factors might be subsumed under the heading of degree of social offensiveness. The impact of terrorism, particularly, goes beyond the body count of any single act to a broader assault upon the safety and security of the community itself. Nurmi’s account of the effects of the circumstances of rescue for responders and Watts and Wilson’s research on the rescuers involved in the Kempsey bus crash illustrate also the issue of dose response, the degree of personal exposure to trauma, as a corollary to the social offensiveness of an event. Sitterle and Gurwitch assert that dose response is closely related to who, among survivors and rescuers, is most likely to be negatively affected in the long term by a crisis.
Another risk domain is controllability, not in preventing the trauma but in preparing for its imminent coming and in effectively responding to the emergency situation it creates. In none of the case studies presented in this book, save in Mantle’s death, was there any public warning of events to come; in the latter case, some argued that the public should have been informed sooner of Mantle’s pending death. But in situations where there is some knowledge of impending destruction from hurricanes, tornadoes, and such, both physical and psychological steeling is possible. Controllability also speaks to the degree of effective response that is mustered following trauma and the minimizing of a sense of social chaos. Geographic and political factors limited the immediacy of response in Armenia and maximized it in Oklahoma City. On the other hand, the limited “success” in finding survivors in the rubble of the Murrah Building in Oklahoma City seemed to diminish the distinction of the rescue efforts, at least in the minds of the first responders involved.
The extent of dislocation of the community also contributes to general trauma impact. The greater the number of social support systems, both community and individual, left intact following a crisis, the more resources exist for rescue and respite to move the group forward beyond the crisis. Kalayjian describes the difficulties in Armenia that resulted, not only from the widespread destruction sustained, but by the relocation of family units and the resulting breakdown of local neighborhood support. Mary Beth Williams, Robert Baker, and Tom Williams describe similar responses in Kobe, Japan, particularly among the elderly who were most frequently relocated away from their home environments. However, for many tragedies, the destruction is symbolic, not physical, and dislocation occurs only in terms of changed political circumstances and social assumptions, as was the case for NASA after the Challenger explosion.
Addressed only circumspectly in the chapter on the bombing in Oklahoma City and in Eliezer Witztum and Ruth Malkinson’s account of the assassination of Yitzhak Rabin was the public controllability realized through the criminal or civil justice systems. The positive impact of those systems to identify and punish those responsible for community tragedies and to create a public perception of lawfulness and social order can be great. Responsibility for the rupture of the shuttle Challenger, for example, was a major concern for both the public and NASA, though for different reasons. The public wanted and needed some sense of accountability. Responsibility for an emergency event or for the unsatisfactory response to an emergency event is often sought to bring about some sense of justice following loss.
Duration of Trauma
It stands to reason that the prolongation of a trauma results in greater emotional cost to individuals and groups. Bolton describes the benefits of having only a minimal time period between the bombing and rescue efforts in Enniskillen, whereas Watts and Wilson describe the torturously long efforts throughout the night to cut away victims and survivors from the frames of collided buses. Longer still were the futile rescue efforts in Oklahoma City. Some emergencies, like the Mississippi and Missouri River flooding of the summer of 1994, continued for weeks, testing the usual definition of an emergency situation. To continue to endure within a life-and-property-threatening situation magnifies vulnerability and helplessness. Moreover, when the process of recovery is also prolonged, communities enter an emotional limbo that increases the extent of victimization and delays the initiation of the grieving and recovery process.
Crises that occur over a prolonged time frame or are repetitive emergencies hamper any possibility of establishing an interim homeostasis, a symbolic but crucial breathing period when groups can take stock of the situation and direct efforts toward restoration of a genuine homeostasis. Bolton introduces the concept of rolling disaster to describe one event followed by another, creating a fearful expectancy of continued threats to community order and safety.
Significance of Trauma
Some events become markers in the history of a community or nation. Members easily recall where they were when the event took place or when they first learned about its occurrence. Community history may be conceptualized in terms of before and after a particularly norm-changing trauma. Such nodal events reflect the significance with which the group defines that particular situation. What makes an event so “earthshaking” in the life of a group is the combination and interplay of all the characteristics of the trauma period described in this section of the summary. Thus, the preexisting cultural narrative of a group merged with the particular nature of the trauma, its duration, and the degree of group dislocation contribute to the significance of an event. It is in this vein that Watts and Wilson describe the designation of a “bus crash person” for those responders who are distinguished and set apart from others by their involvement in a particular trauma.
Of overarching importance is the communal perception of the stressor and its characteristics. Communal perception is more than the total sum of all risk factors and prior history; it includes the additional interpretation of moment placed by the group at every point in the trauma and posttrauma recovery periods. For all of the staggering implications of the disasters encountered in the bombing in Oklahoma City, the earthquake in Armenia, and the sinking of the Estonia, shock and pain is also echoed in the survivors’ reactions to Mali’s singular death, as described by Amia Lieblich in her chapter on Kibbutz Gilgal. Zinner’s description of the nodality of the Challenger disaster for the American public also portrays an event of great cultural weight despite its circumscribed consequences.
Response of Leadership
Timely support during crises is offered best by those who are able to provide a sense of control by reducing both physical and cognitive uncertainty. These people become the event “leaders”; it is the pretrauma leadership to whom we look first to bring the community back to its feet following shared loss. Ronald Reagan’s response to the Challenger disaster and his eulogy at the funeral for the astronauts both identified and directed the grief of the U.S. citizenry. The Governor of Oklahoma gracefully represented his state to the survivors and families of those lost in the federal building bombing. Bolton identified, in the aftermath of the terrorist bombing in Ireland, the enormous significance of key public leaders stimulating positive transformation by conveying accurate and up-to-date information, dispelling rumors, acknowledging loss, and modeling rationality. Grief leadership is important because recognized authority figures, whose influence in the community is enhanced during times of communal vulnerability and need, can so readily and appropriately guide members in ways of coping, even when the immediate effects of the disaster are still occurring and the ground is still shaking. Leaders have the opportunity to be symbolic representations of control. Writes Kalayjian, “exposure to a common threat can, with the right leadership, pull people together, and the recollection of cooperation and support can also promote individual and group maturity.”
Why would leaders not respond effectively, when to do so is so important to group recovery? Lack of knowledge and experience are perhaps the greatest restraints to adaptive response by those in authority. Training leaders to be prepared in the event of disaster means more than simply ensuring that sufficient emergency supplies are on hand. It means providing leaders with a full understanding and appreciation of the psychological impact of loss and threat of loss on individuals and on the community as a whole. Many of today’s leaders are being trained vicariously by well-publicized examples of executive action such as that shown in Oklahoma City. At the same time, the general public has come to expect direction and understanding from their leaders. This was clearly demonstrated in the public frustration directed toward the monarchy following Princess Diana’s death. Today’s public may be disappointed and angry when salutary grief leadership is not forthcoming.
Leaders may fail to respond appropriately because the dimensions of the tragedy have left them genuinely without the physical resources to respond in an adequate way. Some leaders may become personally incapacitated by the crisis, just as some responders do, while still others may choose to minimize the extent of group loss either for self-serving reasons or as part of general group denial. Although denial may allow the group time to get its bearing, ultimately, denial will not and cannot lead to recovery. Finally, some leaders may simply lack the personal philosophic perspective to find or create meaning in adversity that is sufficient to guide, support, and sustain community members in time of loss.
Bolton acknowledges Beverly Raphael’s pioneering work and her conceptualization of the role of emergent leaders who may arise in the absence of any authorized management. This was the role of Mr. Wilson, the father of one of the slain Irish in Enniskillen, who served as a model of recovery for others caught up in the confusion following the bombing. Emergent leaders who themselves are direct survivors of the crisis bring with them their own cachet of authority.
Response of Intervenors
Traumatology as a profession has grown significantly over the last decade. Various national and international organizations, including the International Society for Traumatic Stress Studies, now exist wherein traumatologists may share their experiences, research, insights, and training models. Certification responding to set standards of education and experience now exists for trauma counselors, emergency workers, and agencies offering response and training in crisis intervention through the Association of Traumatic Stress Specialists. The ability to carry out appropriate trauma assessment as quickly as possible and continuously over the various phases of a community crisis is becoming more defined and refined as traumatologists expand and elevate their profession. Nurmi adds to this need for accurate situational assessment the importance of having preexisting relationships and experiences among team members; of having broader resources of trained professionals available; and of having training specifically for the challenges of death notification.
The very presence of a crisis team is an important statement to first responders of the emotional and physical difficulty they may have faced, without making the statement that they are impaired. Critical incident stress debriefing, critical incident stress management, and other stress management interventions aimed at crisis responders have become accepted and widely used in the growing professional world of traumatologists. The well-executed research of Watts and Wilson on the long-term emotional consequences for responders of the Kempsey bus crash demonstrates what has long been recognized by those in the trauma field: first responders often become disaster victims of the very trauma that they manage.
This is one of the dimensions of the ripple effect of trauma, expanding the impact of tragedies to those not touched by the first blow. Rescuers are an often forgotten survivor group whose need to be acknowledged, both for their heroic acts and for their suffering, parallel those of other groups more readily identified by those using Zinner’s model of group survivorship. Baker, who created “bearapy” after the San Francisco earthquake, reports that his visits to Kobe significantly affected him by bringing him back to scenes of early combat experiences in Vietnam. Watts and Wilson detail the distressing intrusive phenomena experienced by intervention team members in Kempsey. Nurmi points out the feeling of death overload, of being overwhelmed and mentally engulfed by the experience, as expressed by himself and responders to the Estonia sinking. These feelings were exacerbated, he notes, by the enormity of the loss, the numbers of victims, extreme rescue conditions, faulty rescue equipment, and time pressure for rescue. Moreover, the impact of confronting trauma for the intervenors may well be underestimated in research and anecdotal reports due to the need for trained intervenors to appear strong and invulnerable. Not all rescue efforts are or can be handled by trained professionals. Individuals who come upon the scene or who have been caught in the crisis itself often become first responders. These incidental rescuers may be overlooked when outreach efforts to intervenors are offered.
Rescuers look for meaning, too, in the event and in the outcome of their professional interventions. Sitterle and Gurwitch poignantly describe the spontaneous acknowledgments of the efforts of rescue workers in Oklahoma City and how helpful it was for rescue team members to interact with families of the victims at the Compassion Center and, later, to visit surviving children at relocated daycare centers. Nurmi notes the positive effect that rituals designed for the family and communities of victims had for many of the Estonia rescue team members and, conversely, the missed opportunity for support for rescuers who were not able to participate in the debriefings that took place at other locations. At the same time, Nurmi openly describes some of the negative changes in personal life perspective that the sinking and subsequent rescue efforts had on him.
Intra- and Intercommunity Communications
Communication is an essential aspect of community; it is within the shared view of life and living that the foundation of belongingness and community are to be found. We have already noted how important the leadership is in providing factual information and supportive direction to members. Survivors themselves, given the ability to share experiences and assistance, will form spontaneous support groups for one another that help in the process of psychological recovery. The media have also come to play an especially important role in disseminating information and in offering an instant analysis of the significance and/or meaning of the event, both within and outside the community in crisis. This is demonstrated in the immediate and extensive press coverage of Rabin’s assassination and in the Estonia disaster, where information on what had occurred helped to dispel rumors. Conversely, the delay in obtaining and reporting facts about the Challenger explosion led to questions about the veracity of the government agency in charge of the space project. In the Oklahoma City bombing, Sitterle and Gurwitch write that description of rescue efforts broadcasted by the media provided a sense of order and proactivity that supported waiting families. In cooperation with mental health professionals and volunteers, press reporting of emotional consequences to be anticipated in survivors and in children exposed to crises helps to lay the groundwork for mental health interventions. The media also provided the stage for the expression of loss by survivors and of concern by outsiders. Individual stories of death, escape, bravery, and good fortune all become part of the narrative of the event. A community tragedy is less about buildings falling than it is about the people of the community. How the people tell the story of the event colors recovery, and communal events today are more widely shared via the media, shaping and reshaping a shared perspective.
In taking a broad view perspective, the chapters in this text are less anecdotal in focus. However, it is the individual story or single photo that brings an event down to understandable proportions and symbolically represents the larger crisis. Such is the impact of the now-famous photograph of the fireman carrying the limp body of a dead child in his arms in Oklahoma City. In Israel, the photos and TV coverage of the children’s parade and candlelighting symbolized the mourning of a nation. Conversely, Bolton points out that the press can overlook or choose to ignore the experiences of some individuals and groups and thereby reinforce their sense of vulnerability and victimization.
The coverage of funerals and memorial ceremonies by the press invites a broader audience to these events today, and newspeople themselves often become the surrogate grief processing group. Thus, we were all invited to the funeral of the Challenger astronauts when Reagan spoke on behalf of the American nation. We all took part in the funeral of Mickey Mantle and heard the moving eulogy by Bob Costas. Often shown is the moment on television when Walter Cronkite, the premier news anchorman of his day, announced to the public the death of John Kennedy in 1963 and paused to wipe a tear from his eye—a moment remembered over the intervening 35 years.
Intermediate Intervention Approaches
Multilevel assessment, repeated over time, is the hallmark of professional intervention during a community crisis. The unexpectedness of a traumatic event often necessitates an immediate response more directed by necessity than by plan. However, subsequent interventions following the initial crisis should reflect the changing needs of both individuals and groups of individuals within the community. Kalayjian writes that “expeditious, careful, and comprehensive assessment of several layers of the community is essential to diagnose and meet the bereaved community’s needs.” She cautions, however, that it is more difficult to assess the needs of a community, given the complexity of membership, deficiencies, and expectations, than it is of individual survivors.
Related to this is what Sitterle and Gurwitch label as “phase-appropriate mental health services.” The Compassion Center in Oklahoma City is one example of an intervention that worked well in the initial aftermath of the bombing. Bolton describes how helpful the trained volunteers from CRUSE Bereavement Care were in assisting (as opposed to supplanting) existing support mechanisms within Enniskillen following the explosion. Central to that success was consultation with those directly affected by the trauma in order to assess the best course of action.
Few of the chapters describe more formal therapeutic approaches to bereavement intervention postcrisis. Kalayjian notes, in passing, the growing acceptance of EMDR (eye movement desensitization and reprogramming) and describes more fully the theory and value of logotherapy. Frankl’s long-respected therapy model is one tool therapists may use to help trauma survivors find meaning and resolution from loss. Whether and how this can work on a large scale has yet to be demonstrated. Sociotherapists, professionals expert in analyzing and creating treatment plans for the community, are at this writing more of a concept than a reality.
Survivorship Groups
Zinner presents an extended examination and model of group survivorship. She writes that “the idea of group survivorship permits the examination of the impact of a death on aggregates of individuals beyond the family and friends of the deceased and promotes the exploration of ways to help groups respond positively to the death.” The power of the group survivorship concept lies in directing intervenors to identify all groups affected by the tragedy, to assess their level of survivorship or relationship to the loss, and to shape responses appropriately to the needs and norms of each group. Bolton refers to hierarchies of suffering in an attempt to distinguish between those who may merit our immediate and most focused support versus those who are less affected. When victims close to a crisis (for example, the children in the daycare center near the Murrah building) are helped, then other groups less directly affected by the crisis often feel supported vicariously.
Vulnerable groups, such as children, adolescents, and elderly, whose life stage makes them especially sensitive to loss and change, have often been disregarded or ignored in postcrisis disaster plans. As Williams, Baker, and Williams wrote in describing the aftermath of the Kobe earthquake, the elderly became the “lost souls” and frequently died from isolation and loneliness. Another group whose needs are less often identified are those individuals who bear responsibility for leadership and support giving during a crisis, such as government leaders, clergy, mental health personnel, and volunteers. Sitterle and Gurwitch label these “silent survivor groups” because they are so rarely heard from or attended to in otherwise exemplary intervention efforts.
Zinner’s description of the social rights and social obligation of survivor groups provides another sensitizing framework to direct and evaluate responses. The importance of acknowledgment of survivor groups cannot be underemphasized. Communal support of those who are suffering depends upon a mutual interplay of survivor groups recognizing their own connection to the disaster and those outside the group affirming the hardship that has been endured. As we have noted, Bolton raises a difficult issue when he asks the question, “whose disaster is it?” He argues that “the implications for a town or community are predominantly social, economic, political, and more dispersed. The implications for victims are much more immediate, physically and emotionally, and intensely personal. These two perspectives need to be held together with due regard for both.”
Ritualization/Memorialization
Rituals have great power and have been a part of communal interactions from time immemorial. They may be traditional and at the ready (e.g., the Catholic mass in Enniskillen); arise spontaneously out of circumstances and capture the urgency and imagination of the moment (i.e., the singing of the peace song in Jerusalem; leaving teddy bears at the fence surrounding the Murrah building; the spontaneous religious ceremony when the bodies of the Estonia victims came to the Finnish mainland); or may be planned to serve an identified need (Challenger learning centers; Mickie Mantle’s organ donor/baseball card). In each of the crises and losses described in this text, rituals play a healing role as symbolic communal responses to an event that goes beyond any one individual or family in its impact and consequence.
One function met by the use of ceremonies is that of survivor group identification. The distinguishing of those who have suffered from those who have not and who would/should serve the role of consolers reflects the very essence of group survivorship. Group identification through ritual emblems or behaviors also operationalizes the concept of hierarchies of suffering, denoting those most burdened by trauma. Families who had lost a loved one or loved ones in the Oklahoma City bombing were consistently treated with deference; they were protected from the press in the first days following the explosion and were included in the efforts to set up a memorial many months later.
The wearing of armbands or ribbons, the lowering of flags, the coming together in group demonstration of grief and loss all serve as evidence of shared mourning. Frequently, this coming together occurs literally when emotional grounds are spontaneously (e.g., the perimeter of the fence around the Murrah building) or intentionally (e.g., the Vietnam Veteran’s Memorial in DC) created. The support offered to families at the funeral of a single family member is multiplied and extended to a community when funerals are opened and broadcast to a nation. Such was true for the funerals of the astronauts as well as that of Rabin and Mantle. In many instances, funerals and later memorial ceremonies not only give evidence to communal grief but give direction in how to act out grief publicly. The children’s candlelighting vigils at the site of Rabin’s assassination, for example, provided an avenue to demonstrate grief. Rituals give people a structured opportunity to “connect when they feel disconnected.”
Such was not the case, however, in Kobe, where mass funerals necessitated by environmental circumstances were not experienced as a way to bring the group together; instead, they were culturally unacceptable and did not allow for the spirits of the deceased to enter the afterlife in a socially acceptable manner. If the culture does not allow for mass grief or emotional outpouring, as was the case in Kobe, then mass funerals and other communal demonstration will not provide for emotional release and comfort.
Rituals and memorializations provide means to establish remembrance and bring closure. It is important to families that the dead be remembered, which is the function of tombstones and personal shrines. It is important to communities that major communal events are recalled and commemorated as significant threads in the total collective fabric or unique history of the community or group, which is the function of statues and plaques and renamed streets and buildings to honor the deceased. Remembrance and closure are different sides of the same coin. One focuses on the loss, the other on the recovery. Both are needed but may be required at different stages in the crisis. Similarly, permanent memorials and markers may be designed and used to commemorate the event, the loss, the rescue, or the recovery. It is the latter focus that provides material for myth making that interweaves the trauma into the community’s collective fabric.
Perhaps the most important aspect is that rituals are a tool for creating meaning. The impact of an event is measured more by its interpretation than its consequence. Even death, a seemingly all or nothing situation, can be judged heroic and contributory or debased and senseless. Reframing events as evidence of the strength of a community, the humanity of a nation, or the existence of divine providence through the use of rituals and memorializations does much to promote individual healing and communal recovery. This is what Sitterle and Gurwitch mean when they write about “taking an unspeakable negative and doing whatever possible to turn it into something positive.” Bolton notes that less helpful outcomes may be realized, however, when symbols are misused or suppressed or when the recovery rate of one group is at a different level than that of others. Sensitivity to timing is significant, too, as Witztum and Malkinson point out in their discussion of the possibly excessive number of memorial ceremonies held in the initial wake of the Rabin assassination which led, in the authors’ eyes, to negative outcomes for Israeli society.
Recovery and Restoration
Kalayjian writes:
Massive traumatic losses not only create a crisis in the community, they create opportunities for survivors to understand their obligations to one another and to the earth, and also help the community feel such obligation. … It may well be a paradox that traumatic disasters which disrupt the way of life of a community may lead to spiritual evolution as long as the community can learn from and find positive meaning in a communal crisis.
The existential meaning of life and death, responsibility, and human significance are challenged and sharpened in times of personal and community crisis.
Nodal events, those that are and will always be of significance as markers in the timeline of the community and as “a pivotal event in the world view of the community” (Kalayjian), must undergo a positive transformation in order to be of immediate and long-term value to the group. This is part of the task of community response to trauma. A community must respond to the immediate emergency; must restore homeostasis by regaining stability and/or establishing a new stability and “new normal state,” and, finally, must offer a renewed and strengthened community identity based on the community’s ability to transform the crisis into a triumph of survival and growth. Professional intervention and guidance can and should be a force in this transformation effort.
The posttrauma period is, theoretically, an indefinite period following the disaster because it is part of the community’s narrative record for the life of the community. Witness the 10th-anniversary commemorations of the Challenger disaster described in Zinner’s chapter. Some events (birth of nations, wars, major political events) may always be remembered by a community. Other events, of seeming importance today, may fade in the intervening decades (e.g., “Remember the Alamo”) but their importance in the tapestry of a community should not be devalued. Community lessons inform the generations to come.
How best to reduce the negative consequences of trauma and to promote individual and community recovery and health is, in essence, the quest and purpose of this book. The authors of these chapters have told the stories of particular events in such a way that the reader can understand the power and influence of the crisis on the peoples affected, often including the authors themselves. The value of bringing these historical narratives into one collection is to provide a forum in which to see the themes that reoccur and to judge the effectiveness of interventions taken and opportunities missed. The framework described in this summary chapter merely highlights what these previous chapters have brought so vividly to light. What is still needed, however, are academic autopsies, concerted focus efforts to determine not only what took place following a significant crisis but how interventions were received by those for which they were designed, both in the immediate aftermath and in the longer term.
When a community weeps symbolically, it does so for the social fabric torn by tragedy and for the suffering of its members. We deal perhaps only metaphorically when we speak of such tears at a communal level; yet the recovery of the community and its return to a renewed stability are crucial for the well-being of each and every group member. This is the goal of group survivorship.