Chernobyl Liquidators' Health
as a Psycho-Social Trauma

4.4.2. What is psychological trauma?

       Description of psychological trauma (Herman 1997: 33; emphasis added) is opened with a statement which might be considered as a key to understanding its origin, development and ways of mitigation:

       Psychological trauma is an affliction of powerless

which is expanded further:
       At the moment of trauma, the victim is rendered helpless by overwhelming force. When the force is that of nature, we speak of disasters. When the force is that of other human beings, we speak of atrocities...
       Interestingly, from this point of view, the Chernobyl Disaster, for the majority of its (at least military) liquidators is both a disaster and an atrocity, or rather the sum of the both (below R denotes radiation, nR — non-radiation):

(Chernobyl Disaster for the liquidators) =
= (natural) disaster [with its R and nR-factors] +
+ (social) atrocity [nR-factors]

       In dealing with psychological trauma and its long-lasting impact, it is necessary to understand that (Herman 1997: 33, emphases added)
       Traumatic events are extraordinary not... because they overwhelm the ordinary human adaptations to life. Unlike commonplace misfortunes, traumatic events generally involve threats to life or bodily integrity, or a close personal encounter with violence and death.... According to Comprehensive Textbook of Psychiatry, the common denominator of psychological trauma is a feeling of “intense fear, helplessness, loss of control, and threat of annihilation.”
       McFarlane and de Girolamo (1996: 136, emphasis added) define central experiences of the PTSD in a similar way: as “helplessness, powerlessness, and threat to one's life”.
       It is considered that trauma cannot be measured quantitatively. However, certain identifiable experiences are believed to increase the likelihood of harm, among them:
— being taken by surprise,
— trapped,
— exposed to a point of exhaustion.
       (All three notions seems to be relevant to Chernobyl: many experiences were absolutely unexpected for the liquidators, the liquidators (especially military) were, in fact, prisoners of the social system, their human rights in the zone were severely violated; and prolonged work and stay in the zone did result in the exhaustion.)
       The most powerful determinant of psychological harm is the character of the traumatic event itself. Individual personality characteristics count for little in the face of overwhelming events.
       There is a simple, direct relationship between the severity of the trauma and its psychological impact, whether the impact is measured in terms of the number of people affected, or the intensity and duration of the harm. Studies of war and natural disasters have documented a “dose-response curve”: whereby the greater the exposure to traumatic events, the greater the percentage of the population with symptoms of PTSD. For example, 15 years after the end of the Vietnam War,
— 36% of the veterans who had been exposed to heavy combat experience still qualified for a diagnosis of PTSD; by contrast, the PTSD-diagnosed constituted only
— 9% of the veterans with low or moderate combat exposure,
— 4% of veterans who have not been sent to Vietnam, and
— 1% of the civilians.
       With severe enough traumatic exposure, no person is immune. However, the impact of traumatic events also depends to some degree on the resilience of the affected person. In this issue the ideas of the PTSD framework coincide with those of extreme/unusual environments impact.
       Though highly resilient people have the best chance of surviving relatively unscathed, no personal attribute of the victim is sufficient in itself to offer reliable protection. The most important factor universally cited by survivors is good luck.
       While a few resourceful may be particularly resistant to the malignant psychological effects of trauma, individuals at the other end of the spectrum may be particularly vulnerable. Predictably, those who are already disempowered or disconnected from others (e.g., those younger, less educated, having pre-existing psychological disorder) are most at risk.
       Though the likelihood that a person will develop PTSD depends primarily on the nature of the traumatic event, and, secondarily, on the individual's resilience, individual differences do play an important role in determining the form that the disorder will take. For example, in a study of combat veterans with PTSD, each man's predominant symptom pattern was related to his individual childhood history, emotional conflicts, and adaptive style. Men that had been prone to antisocial behaviour before going to war were likely to have predominant symptoms of irritability and anger, while men who had had high moral expectations of themselves and strong compassion for others were more likely to have predominant symptoms of depression.

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Studio ARWIS  Kharkov, 2001