Managing trauma ... minding the Mind

The psychological response to the report on London Bombings 

The ordinary, anonymous, predictability of a tube ride was shattered on July 7th by 4 bombers. The trauma, violence and horror that followed was made more powerful by the apparent normality of travelling in London. Everyday thousands of people travelled through London without a second thought. Journeys were planned, organised, and (usually) successful. However, the ordinariness and security of our transport network suddenly became dangerous and fragile.

This article comments on aspects of psychological trauma weaving through the details, and behaviour of people affected by the London Bombings. Every weave and turn could be commented on for its psychological component however, we have selected a few pertinent aspects for comment. The context of July 7th is important to mention in relation to the psychology of group behaviour.

In the days prior to July 7th there had been 3 large group gatherings. Campaigners in Edinburgh were marching in protest to the G8 summit; music lovers were gathered in force for the Live 8 concert; and sports supporters were packed into Trafalgar Square to hear the result of the Olympic committees decision. Looking at press coverage of these large groups one might imagine that the whole country was enjoying the Live 8 concert, or the whole country was behind the London Olympic bid. In fact where there are large groups, there will always be descent, there will always be factions, there will always be those excluded, and those who chose to exclude themselves. The groups of excluded may choose to be silent during such demonstrations, and allow others to naively assume that they are all part of the unified group. This is how the bombers presented themselves to the travelling public on the morning of July 7th. They weren't dressed in remarkable clothes, they had no markings of evil, violence or death. They were viewed in the way that every other unknown, anonymous face is responded to on the tube that morning.

For the people getting the trains however, their story is different. Some pushed to get on the trains, others chose to wait, but for the fated trains that morning, those conscious decisions were life or death decisions. For those who chose not get on the train, the survivor guilt can be incredibly powerful.

Survivor guilt is a type of remorse felt by people who survived an event where others were killed or seriously injured. If the deaths and injury had more do with luck and co-incidence rather than choice the guilt is often stronger. Survivor guilt is not logically, but represents a swing between feeling grateful for being alive and intense sorrow for those who died. For the community of London however, the capital had suddenly become a very dangerous place. When disruption ensues, everyone wants information, there is a desperation to get safe and stay safe. We are very used to our world being a safe and predictable place, and we know ourselves steering successfully through the predictable world we inhabit.

We have very little experience of ourselves as anxious, frightened, panicky people. After a crises, people will often say "I never knew I had those feelings within me", or "I never imagined myself in this state before". The anxious, frightened feelings of people in a crisis can be calmed by contact with family and friends.

On the morning of July 7th, the mobile phone networks went down for a short time, and for those people alone in London, this added to their isolation. This period of time without contact may have added weight to the task of personal recovery (see later). In addition, when we are plunged into this state of fear and anxiety, we are often wanting a higher authority to take control, to execute the authority that will stabilise the situation. On July 7th, the Government carried this function. At 11am, on July 7th, the Home Secretary Charles Clarke quotes "The situation has been very confused but is now coming under control". At 5.30pm, the Prime Minister promised the "most intense police and security service action to make sure we bring those responsible to justice", and at 23.40, the highest authority in the country, the Queen states that she has "sympathy for the relatives and friends of those who lost their lives and despite these brutal acts, she will not be changing her way of life".

Psychologically, these words of calm, control and common-sense from our senior figures are hugely important. Evidence suggest that the longer we feel vulnerable and out of control, the longer it can take us to recover.  Immediate reassurance of some-one close can go a long way to helping people feel safe and recover. In the absence of close family members and friends, this job is down to the public and emergency services.

Four days after the bombings, Tony Blair informed the nation that transport schedules were, are as far as possible back to normal, millions were returning to work, and there was a steely determination that was genuinely remarkable. These words of course designed to encourage people to get resilient and get back to familiar routines. So did it work?

A study carried out 11 days after the bombings, (Rubin et al 2005) interviewed 1000 Londoners to assess their levels of stress after the bombings, and their intention to travel around London. The study found that 31% of Londoners reported substantial stress as a result of the bombings, and 32% reported an intention to travel less since the bombings. Also, those who found it difficult to contact their friends and family on the day were significantly more likely to experience substantial stress.

A further interesting finding from this study was that Muslims in London suffered disproportionately greater levels of stress than respondents from other faiths. This may have been accounted for by their anxieties in attempting to distance themselves from the bombers, or their anxiety about being falsely accused. The psychological ramifications of the London bombings are still being felt across many groups in London, whether it is the bereaved friends and relatives experiencing a traumatic bereavement, or the injured passengers attempting to overcome post traumatic stress disorder.

There are of course other less obvious groups of traumatised people such as the families of the bombers, some of whom were shocked and horrified to learn that their son, brother, or husband was partly responsible for this tragedy. A final comment about psychological responses to trauma is that we often spend a lot of time discussing psychological wounds and injuries resulting from trauma, but in the study quoted above those people who had had previous exposure to terrorism had a much lower likelihood of stress after July 7th. Hence providing evidence for the resilience factor and the opportunity for growth and strength after such a crises.

References: Ochberg F.M . Bound by a trauma called Columbine. The Washington Post. (2000) Rubin G.J, Brewin C.R, Greenberg N, Simpson J, Wessely S. Psychological and behavioural reactions to the bombings in London on 7th July. British Medical Journal 2005;331:606. Continuity Forum Sara McKenna 020 8993 1599

The Continuity Forum will be further address this topic with a special event focused on the human aspects of BCM, Crisis and Incident Management For more details on this event and the general activities of the Continuity Forum please contact us directly.