How the Chilean Miners Will Cope: Q&A with a Trauma Expert

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REUTERS/Jose Manuel de la Maza/Chilean Presidency

On Wednesday night, as the world watched, the last of the 33 trapped Chilean miners made it safely to the surface. After having spent more than two months underground in a collapsed mine, the men emerged remarkably physically healthy and robust, Chilean health officials said. One man had enough energy to literally jump around after his rescue, hugging the gathered crowd and cheering.

The miners were evaluated and treated for some health complications at Copiapo Hospital immediately after rescue. But from here on out, it will be the miners’ psychological well-being that will likely be the focus of their after care. Will they be able to handle the stress of sudden celebrity? Will they have proper social and psychological support going forward? As Mario Sepulveda, the second miner to be rescued, said: “The only thing I ask, personally, is that you please not treat us like celebrities. … I want to continue being treated like Mario Antonio Sepulveda Espinace, the worker, the miner. I love that, and I think that in some shape, way or form I want to continue working.” (More on Time.com: Photos of the rescue: all 33 miners brought to safety).

Trauma experts say a return to normal life is indeed crucial to recovery after a disaster. For more clarity on the emotional difficulties the rescued miners may face, TIME Healthland spoke with Dr. Carol Tosone, a trauma expert at NYU’s Silver School of Social Work and author of the Feel Free to Feel Better: FEMA Trauma Training manual. Tosone has provided crisis support to earthquake survivors in Indonesia and to 9/11 witnesses in New York City. It is important to note that she has not counseled the Chilean miners personally.

Q: How do you think such a large group of miners was able to succeed to this point psychologically, without any fighting or destructive antisocial behavior underground?

A: One thing that was very helpful for them was the sense of camaraderie — there was a critical mass of them, and they are all men from similar backgrounds. In this Hispanic culture, [of machismo] they could provide each other with a kind of shared bravado as well as having companionship.

I think what could have made this trauma easier was that it was a bonding experience. Studies show that even if people are competitive, when they have an external threat they no longer perceive each other that way. So having the group of them, that’s a plus.

Q: Now that they are no longer together in a group, how will they cope with re-entry to normal life?

A: First of all, it’s not just their own traumatic reaction, it’s their families’ reaction to them as well. There will be a lot of focus on them as heroes — there will be this external expectation for them to be O.K. In other words, if they are having a negative reaction, that won’t be acceptable to people. Culturally, it will be hard for them to focus on what could be perceived as weakness.

In Hispanic culture, there’s usually a very strong sense of the familia — a tight-knit group and a sense of getting through things together, and that takes over for a lot of the mental health profession. But usually, mental health considerations are still important — they may have flashbacks or other symptoms [that the family doesn't understand]. It will be interesting to see how many of them will go back to mining versus taking another profession.

But coupled with that is the pressure to move on — the community wants everything to be okay. Remember Sully, the pilot who landed safely in the Hudson? He retired right after. And when you talk with the flight attendants [onboard], there was one in particular who was significantly traumatized. She talked about how everyone else was celebrating while she still had nightmares.

Q: Can you describe the process of recovery after trauma?

A: We now know that when trauma occurs, it’s more of a right-brain activity, which provides a “fight or flight” response. It’s like the reptilian side of the brain. When you experience trauma, the left side basically shuts down, and that’s the body saying you are in survival mode. After a period of crisis, the left brain starts to kick in, functioning to understand the meaning of what’s happened. (More on Time.com: Photos: Venezuela Cracks Down on Illegal Mining)

Even if healing occurs, there will always be receptivity for trauma. For example, New Yorkers who went through 9/11, when a plane is flying low overhead, they may be the first to look up. I was there and I look up. So the miners might experience that — triggers when they see something or feel closed in.

But the key is to integrate the trauma and grow from the trauma. There’s a phenomenon called post-traumatic growth, which is the expectation that you grow after a trauma. After a traumatic event, you’ll hear people say: “It makes me realize how precious life is,” or “It made me realize how important my family is.” When something like this happens, you get the sense of limited time, which is harder to appreciate without [an event], so that’s one of the positives that comes with it.

Q: You mentioned that families will be a support system, but is there also a risk of trouble in interpersonal relationships — with spouses or children?

A: Oh, yes, absolutely. There’s the quintessential example that we all know from war [veterans]. It’s really hard to become intimate with somebody, when you’ve had to spend so much of your day totally on alert.

Similarly, here, the miners might feel uncomfortable and not really sure what to do or say. They might keep things to themselves, especially given that they were all men down there. It’s a macho culture and that’s part of the problem. So it’s kind of like, “You can handle it” — that makes it really difficult to express problems.

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