ABSTRACT
The disaster psychiatrist, and all mental health personnel working in disaster response, must therefore understand these reactions and their sequelae on two levels. Something creates a separation from the stars, a negation or disturbance in the heavens. As noted disaster psychiatrist Jack Lindy has observed, the etymology of disaster reflects a disruption in the fabric of the usual, expectable order of our universe. In other words, disaster refers to a destructive event that changes our relationship to the world. It affects what psychoanalysts call external reality. To a psychiatrist, the scene was striking for several additional reasons. Like an emergency room, a disaster scene is a paramilitary situation in which an operational hierarchy is used to structure an otherwise chaotic, overwhelming environment.
