Letters to the editor - David Blore's
2000 paper
Received from Tessa Prattos, Athens, Greece (24/02/00)
with David Blores' response
"I would like to ask some questions concerning the protocol you have developed
for the miners. Do you differentiate it with people trapped under buildings? I've
read your paper quite carefully and I know you mention it does, but I was wondering
about the air flow. That part is not very clear to me. What is it that happens
with the air when a building collapses? Do you mean that it feels different, or
that the air flow changes direction at the exact time that the collapse begins?
In other words that the air one used to breath before the collapse feels different
than after the collapse? Also why is the amount of fluid consumption important?
Does it have to do with whether they had drunk water or coffee before the collapse
or if they were given fluids by the rescue teams? I guess it has to do with establishing
the feeling of thirst under the rubble or dehydration? My questions might sound
silly but I do have them. I'd appreciate your feedback on this. I do have in mind
the stories I've heard from the survivors. Horrendous experiences that I'm concerned
of where I start from. Their personal experiences, the loss of their friends,
the impact it had on their company. There are so many issues involved here."
Response from David Blore 29.2.00....
Thankyou for your email Tessa, your questions are perfectly valid. To answer your
questions, I should first explain that the Underground Trauma Protocol (UTP) was
designed around the use of EMDR with miners, but following the Turkish earthquakes
in 1999 it was suggested that the UTP could have its uses with these victims.
The assumption being that if you are trapped there is really little difference
whether you are on the surface or 1000 metres beneath it.
To anyone who has been down a mine it is immediately obvious that air supply,
and hence airflow, is important. Clearly air supply is important to anyone who
is trapped no matter what the circumstance. So in one way there is no difference
between those trapped in a collapsed building and those in a mine. On the other
hand, a collapsed house will likely trap individuals in a small confined space
which is likely to heat up quickly unless there is a continual fresh supply of
air, whilst a mine consists of a labyrinth of passages and can trap (in some cases)
many hundreds. In each case what soon happens is that the air temperature increases.
In the case of people trapped in a house it is immediately obvious what has caused
the temperature increase. With trapped miners, if the cause of the disaster was
massive (such as a roof-fall), air temperature will rise rapidly (some times very
rapidly and to a very high temperature). But because the underground environment
can extend for many miles it is quite possible to not be aware that a disaster
has occurred. The first thing the miner notices is a dramatic rise in temperature.
Hence the 'news' of a disaster is 'communicated' by an increase in the ambient
temperature. Of course if the temperature rises then perspiration (in an already
warm working environment) can increase rapidly to the extent that it is possible
to become dehydrated - something that miners do their best to avoid anyway by
daily taking litres of water underground each shift. Add the increase in temperature
to the increase in active rescue behaviours and an obvious increase in worry,
and fluid consumption soon becomes very important.
Research (Blore 1997) has shown that EMDR applied to traumatised miners has to
tackle all manner of memories generating flashbacks, nightmares along with numerous
'trigger situations'. In the case of mining accidents a lot of these memories
are associated with strong tactile associations of heat. It seems that victims
trapped in collapsed buildings also have memories that can be associated with
heat although it is not clear whether this is for the same reason as the miners.
I hope these points address your questions. If any reader has experience of using
EMDR with either earthquake victims or traumatised miners please
contact me.
References
Blore D.C. (1997) 'Reflections on a day when the whole
world seemed to be darkened', Changes International Journal of Psychology and
Psychotherapy, 15(2):89-95.
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