Friday, August 27, 2010

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Trapped Chilean Miners Face a Tough Psychological Ordeal

 
Relatives of the miners trapped underground in a copper and gold mine, gather around a screen that shows the miners inside the mine at Copiapo Reuters – Relatives of the miners trapped underground in a copper and gold mine, gather around a screen that shows …
There's almost nothing about the plight of the Chilean miners trapped beneath nearly half a mile of rock in the Atacama Desert that doesn't horrify us. There's the crowding - 33 men confined in a 600-sq.-ft. safety chamber smaller than a one-bedroom apartment. There's the heat - a stagnant 90°F relieved only by a thin trickle of fresh air that makes it down through a narrow ventilation pipe. There's the gloom - a near total blackness relieved only by the flashlights on the men's helmets. Worst of all, there's the calendar: the miners face up to four more months of such confinement before a rescue tunnel can be drilled and they can be pulled to safety. That kind of ordeal, we say, would drive any of us nuts - and we're right; it probably would.
Live entombment holds a particular terror for all human beings, and miners are no exception. They may habituate themselves to darkness and heat and very tight spaces, but when the system breaks down - when there's no prospect of re-emerging into the light after a 10-hour shift - their minds can break too. And the longer they're below, the worse the damage may be. (See how the miners survived the first 17 days of their ordeal.)
"Miners train for a lot of things, but it's hard to prepare for something like this," says Dennis O'Dell, director of occupational safety and health for the United Mine Workers of America and a veteran of 20 years in the mines himself. "They're taught first to have a route of escape. It's only when that fails that you have to think of taking shelter." (See photos of rescuers making contact with the Chilean miners.)
Chilean officials are being roundly criticized for the shabby state of the mine and the poor safety record that led to the Aug. 5 collapse - but they're also getting a lot of kudos for the way they've responded since, particularly the attention they've paid to the emotional welfare of the imprisoned men and their families. Ever since the miners were located after a 17-day search of the maze of subterranean shafts, officials have been reaching out to psychologists, family counselors and even NASA doctors, who know better than most about how people endure long periods of confinement far away from loved ones.
"Our doctors are already working with their doctors on this," says NASA spokesman Bill Jeffs. "We have a lot of experience in protecting people in enclosed environments for extended periods." (See a Q&A with a U.S. official on how the miners survived those extended periods.)
The biggest challenge the men face while waiting for rescue is the utter breakdown of structure in their new, exceedingly limited world. There's no day-night cycle, there's no work to do, there are no formal mealtimes. There's also no social hierarchy - though that, at least, will be rectified quickly, if it hasn't been already.
"Leaders will emerge," says O'Dell. "Miners tend to be like a family when they're below, so the younger ones will defer to the older ones in an almost son-to-father way. There will also be brotherly bonds that form, with everyone looking out for everyone else." That will be especially important when fights break out - and they will. "I was stuck in a mine elevator for just a few hours once, and people quickly started getting panicky," says O'Dell. Panic sets tempers on edge and tempers can blow easily. When this happens, the graybeards among the 33 will be especially needed to contain the hotheads.
Despite the dark, most of the men will have some sense of what time it is on the outside world - and those who have watches certainly will. But they'll probably stop paying attention since it simply won't be relevant in more than an academic way. Though lights are being threaded down the ventilation pipe - along with food and water - it's unlikely that any kind of predictable sleep-wake or morning-evening schedule will be established. Thirty-three men will have 33 different circadian cycles and in an already high-stress situation, it would not do to try to enforce an artificial one. "That works in the military," says O'Dell. "It wouldn't work in this situation."
See TIME's top 10 miraculous rescues.
See photos of Chile's massive March 2010 earthquake.

Whichever hours the men are awake should be as active as possible. Space-station astronauts, who may stay aloft for a year at a time, almost universally say that it's the nearly nonstop schedule of experiments and maintenance work that keeps them sane. That's hardly possible in a mine shaft, but rescue workers have done what they can to enrich the miners' environment, sending down dominoes and playing cards and passing notes back and forth. Reading material and direct communication lines will follow. The men are also being encouraged to exercise, for the mental and physical benefits, as well as to keep them from gaining weight - which could be a problem when the time comes to pull them up through a 26-in. wide rescue shaft.
"You have to normalize the situation as much as you can," says John Fairbank, a professor of psychology at Duke University and an expert in traumatic stress. "People need a routine; they need to know what to expect in their day and to have something to do with all the time they have." See a photo gallery of how the Army is treating soldier stress.
Little symbols of civilized living can help too. It's not a surprise - at least to psychologists - that one of the first things the miners asked for when rescuers made contact with them was toothbrushes. That's hardly a staple of survival, but it is one of the staples of domestic life - a humanizing totem in a dehumanizing situation. With no toilets down below, the men have similarly taken care to use a small adjacent tunnel instead, which keeps things more sanitary - and more decorous too. Other kinds of personal space are not terribly likely when so many people are crammed in so small an enclosure, but it's nonetheless wise if they all try to remain mindful of at least a rudimentary sense of territoriality - where any one person prefers to sleep, for example. "You can probably carve out a little personal space," says Fairbank, "but not much."
Far and away the most important thing the rescuers can do for the miners is to make sure they remain in contact with their families. This includes regular exchanges of letters, as well as phone calls and even video conversations when the proper equipment is set up. They need to know too that the mine officials are looking after their families while they're trapped - which relieves a paradoxical sense of guilt the men may feel at being away for so long. "It's similar to what's done with combat soldiers," says Fairbank. "The level of social support they receive is a good predictor of how well they'll do emotionally when they're at last rescued." (See photos of April 2010's West Virginia mining tragedy.)
The miners have not yet been told that that rescue could take until Christmas - and there is at least a chance it could come much sooner. But psychologists and people with experience in confinement are all but unanimous that honesty is critical and that they must be told both the worst-case scenario and the best-case possibility. Australian miner Todd Russell spent 14 days trapped in an underground tunnel with one fellow miner in 2006, and found the changing projections of when he'd be freed the worst part of the ordeal.
"After six days they're telling us, 'We should have you guys out in 48 hours, 48 hours, 48 hours,'" he told the Canadian Press this week. But that goal post kept moving and every time one 48-hour stretch would elapse the clock would be reset. That can't be allowed to happen this time.
"It's not an option not to tell them," says O'Dell. "The rescuers have already dropped some hints. But as soon as some stability is established, the miners must be told everything. Not knowing is worse than knowing."
Even when rescue does occur, the men could be dealing with the emotional blowback of their experiences for a long time. Russell says he suffered nightmares for over a year after his ordeal and the stress affected his family as well. All of the Chilean miners will be screened for posttraumatic stress disorder (PTSD) when they emerge, and it will be a surprise if many - indeed most - of them don't show symptoms. Still, if there's one good thing about PTSD, it's the post- part of it. Once the men see the sun again, the immediate crisis will be over and their healing can at last begin.
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