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An Emergency Psychologist Explains What She's Doing for Italy's Earthquake Victims

Emergency psychologists are at the scene of the devastating earthquake to help victims with their first steps towards processing trauma.

Photo by Fabrizio Di Nucci/VICE News

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This article originally appeared on VICE Italy

Early Wednesday morning, a 6.2-magnitude earthquake hit central Italy, destroying municipalities on the border between Umbria, Lazio, Marche, and Molise. The tremors were felt from Rimini to Naples and, at the time of writing, the death toll has risen to 241.

Along with the Fire Services, the Red Cross, and Civil Protection, the first units of emergency psychological services are also on site. These include volunteers from the SIPEM SoS Federazione (SIPEM standing for Italian Society of Emergency Psychology), which, for years, has dealt with bringing the first psychological aid to victims of disasters in Italy. SIPEM was there after the devastating 2009 earthquake in Aquila and after last June's train crash in Puglia in the South of Italy; 308 and 23 people lost their lives in those disasters, respectively.

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We spoke to SIPEM's president, Dr. Cristiana Dentone, over the phone to learn what can happen psychologically to victims during and soon after a disaster, and what the volunteers—all psychologists and social workers—do to help.

VICE: Your people are on site now. When something like this happens, what's the first psychological relief you can give to victims?
Dr. Dentone: Right now we're in the impact phase, where we provide assistance to people gathering in medical centers, field hospitals, and other facilities. Our people are in the streets, too, offering support to anyone who might need it. In this phase it's very important not to forget to spend time supporting the rescuers, too —they're experiencing their own kind of trauma. In circumstances like this, rescuers are often also just locals—victims who, despite maybe having suffered some loss themselves, go out to help and save others.

What kind of trauma do victims of destructive earthquakes usually experience, in this phase?
Well, people are confronted with something they couldn't have imagined before. The experience of an earthquake is terrifying and it deeply undermines a sense of personal, inner security. That can lead to despair and fear, but there are also many people who can sustain themselves in some way—enough to help with the rescue. After that initial stage, other types of emotional reactions surface—anger, fear of going back home, or the fear of never getting your house back. That can affect direct victims, but also people who didn't lose anyone and don't have any injured friends or family.

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Given that everyone in an event like this has their own story and their own individual loss, how do you relate to those individual needs?
For now, we just do what's needed in this emergency. We help to reunite people, and if someone has lost a loved one we support them when they go to identify the body. Of course, it's only later that we can provide a kind of personalized care and ensure that people have the tools and support to process the trauma, and to prevent that trauma leading to chronic mental illness.

What could be the long-term psychological effects of an event like this?
The most notable long-term effects are linked to post traumatic stress disorder. The field of emergency psychology emerged from research done with Vietnam veterans, and with victims after the Oklahoma City bombing. The research shows that the failure to process certain experiences can lead to continued emotional imbalance. That can happen very early after the initial trauma, and our immediate intervention is aimed specifically at preventing that.

You have worked following many different catastrophes, the latest being the train crash in Puglia. How does your work change depending on the situation?
Of course the type and number of people is different, and how many people from vulnerable groups have been affected—elderly people, chronically ill people, orphaned children. And generally the scale is bigger in the case of an earthquake than after an accident, so an initial problem to solve in an event like this is the managing of our resources.

How long do you work in an area that has been hit by a disaster?
Emergency psychology is named precisely that because it deals with emergencies. The main objective is to normalize the experience and make sure the communities are reactivated—which includes psychological health centers in the area. We come in to help at the most difficult time, because local psychological professionals can also be victims. How long we stay really depends on the scale of the disaster, and it's decided on together with healthcare facilities.

I can imagine that knowing that other Italian places hit by an earthquake are relatively quickly forgotten by the authorities—Aquila's old town, for example, is still in shambles after the 2009 earthquake—can have some psychological impact on the victims of this latest earthquake.
Seeing what is still going on in Aquila has a very, very negative impact on new victims, who know that this could happen here too. Of course, we're all professionals, but we're volunteers—we try to do everything we can to be useful after this disaster. But for the rest, we can only hope for the best, just like everyone else.