Thai Cave Rescue: Psychology of Survival
The whole world have been focused past two weeks on the very high risk rescue of twelve schoolboys trapped some 800 metres in the darkness of the Thai Caves. In The Daily Telegraph yesterday I read of the altruistic intervention of the US billionaire and enterpreneur Elon Musk who sent his engineers from his companies,Space X and The Boring Company to Thailand to help rescue the schoolboys and their football coach. They have been trapped for over two weeks in the Tham Luang caves of northern Chiang Rai Province.
Mr Musk dispatched his highly skilled engineers as a result from twitter users who were savvy in their use of social media to exert social influence in the context of such a highly dangerous rescue, where a Navy Seal for the Thai navy has already died in an effort to save the children and their coach. Such is the extremely high risk of death for both rescuers and children aged between 12 and 16 years old.
This has been also a profound rescue where these kids will have been severely psychologically traumatized for so long in the most horrific imprisonment that would test their mental functioning, and a plethora of other brain functions which I shall discuss in the next few paragraphs. This rescue has demanded a broad range of international rescue skills by divers, engineers, army and navy and many others to get the boys out as quickly as possible. This is the ultimate test of human psychological sills and decision making. One slip or error in thinking could cost the lives of the coach and the schoolboys.
As I type the breaking news informs me that eight schoolboys and their coach are still underground as the Thai rescue is paused. Peter Faulding from The Specialist Group International said that the boys seem to be in very good shape, they managed to walk out -that’s a really good sign. Experts report that this is “ one of the greatest rescues in history”. Psychologically the incredible and high level of risk in going into the caves and utilizing a range of international skills, is another story in and of itself. The route down into the rugged darkness would have tested all of the navigational scientific and technological skills of every rescue team experts. There were the skills of getting the heavy duty pumps into the caves to pump much of the water out….without that ..the boys would have had to swim 4 Km through the dark narrow channels 800 metres underground. Even though much of the caves have now been exposed, its enough to further traumatize the young developing minds and mental functions of the schoolboys. It is not a normal brain function for teenagers like these to undergo such trauma in the worst hell like state they could ever have imagined. They would have had to utilize all their range of human cognitive functions to learn how to dive, use breathing apparatus, and have faith in the diver team in order to survive one of the world’s greatest rescues.
We could easily stretch our imagination to visualize the cold dark narrow rugged jagged caves scratching our skin without a glimmer of light, the hypothermia, the thoughts of their parents and loved ones, this in itself would induce devasting fear and stress with thoughts of death. Remarkably they were able to maintain relatively high spirits once they knew the rescue operation was under way. The fears of flooding and drowning in itself would cause panic and would demand logic, calmness and the human ability to maintain a sense of humour.
Tragically one of the divers Mr Kuman was on his way out of the cave complex when he died after delivering air tanks to different locations along the very treacherous route. He gave his life that the schoolboys could live. His job was to deliver the oxygen, but he did not have enough on his way back confirmed Passakorn Boonyalak, the deputy Governor of the province.
This highly unique rescue and the human tragedy that took the life of a very fit and experienced navy seal, Mr Kuman, signifies the intense danger rescuers undergo in order that the teenagers will live. Reports from the scene shows that highly skilled divers with years of rescue operations behind them, have had to use all their knowledge training and skill to dive through dark winding passages. They would have to swim carefully for five hours with four oxygen tanks through very strong currents, as reported by the Daily Telegraph7th July.
Rob Spray, a sea search diver told Sky News that this has been a” remarkable” rescue. Because some of the kids cold not swim, it added to the complications as they had to learn the psychological preparation of how to swim through the dark. This would have put normal teenagers under immense pressure at the best of times but they endured so much fear and trauma, its incomprehensible how they managed to become survivors of such tragic magnitude. The team operated quickly and very efficiently.
The psychological effects of survival in such a cave rescue requires a group conformity effects besides compliance to and with the leader. This is where leadership skills and team cohesion becomes a success story. The job and function of the coach and leader is to use his or her sills to tap into the boys psychological skills and get their mindset focused on survival techniques.
Like the Chilean miners trapped in a copper mine for ten weeks in 2010, the young boys in Thailand have a history of working together and a hierarchy of roles that allow survival tasks to be divided and shared. The human brain has the capacity to work and function effectively when kids use a series of step by step cognitive functions that they know will lead them to safety. The psychology of survival means that decisions must be made to remain active and not to enter into passive mode. The leadership function is to employ active skills that involve each schoolboy so that they feel a collective responsibility to self and to each other for survival.
A vital human skill is as I have previously mentioned , the boys use of humour. Their mental capacity to tell each other jokes will strengthen the survival logic and strategy and keep them from falling into a downward spiral of low self efficacy and depression. Ina recent tabloid article I read some very interesting and important survival insights.
As medics and rescue divers map out the plans to extract the boys through flooded tunnels, psychologists and child development specialists will be called upon to ameliorate the fallout from this life-altering trauma. Although the most harrowing portion of the trapped footballer’s ordeal is likely past, managing the ongoing mental breakdowns and psychological scars is another maze that must be navigated. “Sometimes the treatment can be worse than non-treatment,” says Peter Levine, author of Waking the Tiger, Healing Trauma. “Some treatment has the person re-live all of the pain and the depression and agony. That doesn’t work. What you need to do is help the person come back into their body, and to come back into present time. Sometimes you revisit memories. But just the re-living of memory is by and large, in my opinion, often harmful. I would say some therapy might be helpful, but not talk therapy, that’s quite, quite limited. Nor what’s called ‘exposure therapy’ where you get the person to re-live the trauma.”
In my own clinic where I work weekly with teenagers who suffer trauma depression and anxiety disorders, normally following tragedy, there is value in what Peter Levine has just claimed. Like many psychologists who work in health and clinical work with trauma, its not a case of “One treatment fits all” each case is not only highly complex but highly unique.I have to dismantle each teenager emotionally and rebuild them together again. This is highly complex work and can take years. Each schoolboy will have changed very substantially and psychologically. He will never be the same every again. Whilst his mind will be rewired and his endless sessions with psychologists, child psychiatrists, trauma specialists and many other health professionals, the world he knows and his social perceptions of that world before he went don into the cave, will be changed .Teenagers I work with have experienced traumas during the troubles in Northern Ireland, seeing fathers murdered on their doorstep, being out shopping when a car bomb explodes nearby, killing their family and loved ones, years of therapy healing does come but at a price.
The Will to Live
John Leach has written extensively about some survival strategies we employ when faced with a life threatening and highly dangerous environment. He argues’….
Cognition underlies all our behaviour including survival behaviour. Yet, when life is threatened, cognitive function becomes impaired. This article examines current research into the role of working memory and executive function in survival situations and attempts to shed light on why so many people in survival situations perish unnecessarily. It also seeks to remove the term ‘will-to-live’ as an outdated concept that hampers our further understanding of human behaviour in extremis.
Tales of human survival in extremis have always held a public fascination: think of climber Joe Simpson, frostbitten and starving, dragging his broken leg for four days to reach his mountain camp in Touching the Void (Simpson, 1988). Or the Uruguayan rugby team who survived an airliner crash in the Andean mountains by eating the flesh of their dead friends before a small team left to seek help in Alive. Add to these the numerous accounts of survivorship in brutal prisoner-of-war and concentration camps as well as more contemporary accounts of escape from sinking ships, crashed aircraft and collapsing buildings.
There exists a natural admiration, a mix of respect and incredulity, for people who have endured life-threatening duress; who have faced death and come through alive whilst others around them have perished. We tend to view such survivors as possessing a quality above the ordinary; a strength of character, a purposefulness or drive to overcome the crushing physical and psychological duresses they encounter: a so-called, ‘will-to-live’. Indeed, in 1945 the Admiralty established a committee under Rear-Admiral A.G. Talbot to study naval lifesaving. One of its findings was that, ‘Evidence indicated that it was essential for survivors to have the will-to-live’ (Talbot, 1946).
Attempts have been made to pinpoint this ‘will-to-live’ by identifying a survivor personality. These approaches have tended to be either popular (Siebert, 2001), psychiatric (Bennet, 1983) or autobiographical (e.g. Richards & McEwan, 1989). Yet personality constructs have proven inadequate, and I would argue that this is because we have been asking the wrong question. The tractable research question is not, Why did this person survive when all around perished? Instead, we should ask why so many people die when there is no need. In other words, it is not the ‘will-to-live’, but the ‘won’t-to-live’ that matters.
NHS Treatment for Trauma
The main treatments for post-traumatic stress disorder (PTSD) are psychotherapy and medication.
Traumatic events can be very difficult to come to terms with, but confronting your feelings and seeking professional help is often the only way of effectively treating PTSD.
It’s possible for PTSD to be successfully treated many years after the traumatic event occurred, which means it’s never too late to seek help.
Before having treatment for PTSD, a detailed assessment of your symptoms will be carried out to ensure treatment is tailored to your individual needs.
Your GP will often carry out an initial assessment, but you’ll be referred to a mental health specialist for further assessment and treatment if you’ve had symptoms of PTSD for more than four weeks or your symptoms are severe.
There are a number of mental health specialists you may see if you have PTSD, such as a psychologist, a community psychiatric nurse or a psychiatrist
If you have mild symptoms of PTSD, or you’ve had symptoms for less than four weeks, an approach called watchful waiting may be recommended.
Watchful waiting involves carefully monitoring your symptoms to see whether they improve or get worse. It’s sometimes recommended because 2 in every 3 people who develop problems after a traumatic experience get better within a few weeks without treatment.
If watchful waiting is recommended, you should have a follow-up appointment within one month.
If you have PTSD that requires treatment, psychotherapy is usually recommended first. A combination of psychotherapy and medication may be recommended if you have severe or persistent PTSD.
Psychotherapy is a type of therapy often used to treat emotional problems and mental health conditions such as PTSD, depression, anxiety and obsessive compulsive disorder.
The treatment is carried out by trained mental health professionals who listen to you and help you come up with effective strategies to resolve your traumatic episodes.
There are three main types of psychotherapy used to treat people with PTSD.
Cognitive behavioural therapy (CBT)
Cognitive behavioural therapy (CBT) is a type of therapy that aims to help you manage your problems by changing how you think and act.
Trauma-focused CBT uses a range of psychological treatment techniques to help you come to terms with the traumatic event.
For example, your therapist may ask you to confront your traumatic memories by thinking about your experience in detail. During this process your therapist helps you cope with any distress you feel, while identifying any unhelpful thoughts or misrepresentations you have about the experience.
Your therapist can help you gain control of your fear and distress by changing the negative way you think about your experience. For example, feeling you’re to blame for what happened or fear that it may happen again.
You may also be encouraged to gradually restart any activities you’ve avoided since your experience, such as driving a car if you had an accident.
You’ll usually have 8-12 weekly sessions of trauma-focused CBT, although fewer may be needed. Sessions usually last for around 60-90 minutes.
Eye movement desensitisation and reprocessing (EMDR)
Eye movement desensitisation and reprocessing (EMDR) is a relatively new treatment which has been found to reduce the symptoms of PTSD.
It involves making side-to-side eye movements, usually by following the movement of your therapist’s finger, while recalling the traumatic incident. Other methods may include the therapist tapping their finger or playing a tone.