PSYCHOLOGICAL RESPONSES TO WILDERNESS ACCIDENTS - Medicine for Mountaineering and Other Wilderness Activities - page 39

Normallythecycleofprotest,despair,anddetachmenttakessixtoeighteenmonths.The
bereaved finally work through their loss, say their final good-byes, and restructure their
lives and personalities, reconciled with their loss.
Stress Imposed by an Accident
The normal emotional state of an individual involved in any sudden, unpredictable, and
overwhelming crisis is similar to an acute grief state. If the incident is traumatic, the over-
whelming emotion results from experiencing the possibility of death and fearing for one's
life. An accompanying sense of helplessness, of having lost control over survival, adds to
theimpact.Individualsoftenareawareofseekingtoescapeandofbeingweak,vulnerable,
and helpless. Their self-esteem and sense of competence have been assaulted, and they see
themselves as unable to keep out of harm's way or as having acted with poor judgment.
Hours to weeks after the incident—depending upon the individual and the nature of the
incident—the people involved are subjected to secondary stresses such as the prospect of
being immobilized and isolated without food or shelter, the prospect of being totally de-
pendentuponstrangersforrescue,orthemoredistantprospectofnotbeingabletogoback
to work or to other valued activities.
Responses of Accident Victims
Duringaccidents,one-eighthtoone-fourthofthepeopleinvolvedreacteffectively.They
areoftentoobusytoworry.Aboutthree-fourthsarestunnedandbewildered.Theyshowno
emotion, are inactive or indecisive, and are usually docile. They may be totally unrespons-
ive or behave in an automatic, robotlike manner. Manifestations of fear such as sweating,
palpitations, tunnel vision, or a dry mouth may be present. This type of reaction is known
as psychological shock but should not be considered an abnormal reaction. A final one-
eighth to one-fourth of people involved in accidents react inappropriately with incapacitat-
ing anxiety or hysteria.
Immediately after an accident, responses that are similar to the stages of the grief reac-
tion occur. During the stage of protest or denial, the person may not be able to deny that a
problem exists but refuses to admit the magnitude of the problem. The problem is under-
stood intellectually but not emotionally, and the individual is blasé and unconcerned.
Someindividualsarestunnedandconfused;othersarevigilantandcool.Someareemo-
tionally expressive, displaying anxiety, anger, sobbing, a sense of relief, or a tendency to
blame others. Others are controlled, exhibit little distress, and appear composed. Both be-
haviors reflect denial and emotional exhaustion or shock. Both reactions are normal, but
individuals need acceptance of their responses and assurance that they are normal. People
may be vulnerable to damaged self-esteem if they perceive their behavior as inadequate or
abnormal.