ABSTRACT

Direct trauma victims and their families, and those who have experienced profound injury and loss as a by-product of the traumatic event, are often the main focus of early interventions. The "ripple effect" of psychological trauma is often seriously underappreciated. This chapter focuses on the human toll taken on those individuals and groups who, by virtue of their proximity to or distance from traumatic events, constitute a psychologically vulnerable population in the aftermath of terrorist acts or natural disasters of catastrophic proportion. By increasing awareness in the mental health community of the multiplicity of subtle and glaring forms trauma responses can take, more appropriate and timely therapeutic interventions can be employed to assist all trauma survivors. The poignant and dramatic ways that direct and indirect trauma has shown itself is vividly illustrated in the words and stories of people whose voices express the profound impact terrorism and disaster has had on their lives.