ABSTRACT
This chapter describes the day, informal consultations and staff reactions, and reflects on the principles and the stressors of disaster psychiatry. Psychological negative effects are described variously as burnout, secondary traumatic stress, compassion fatigue, or vicarious traumatization. All of these terms are borrowed from work with victims of violence, rape or sexual abuse, and the severely mentally ill and may be applicable to disaster psychiatry. Vicarious traumatization describes a permanently transformative change in the mental health worker that detrimentally affects existential aspects of the worker, such as his or her relationship to meaning and self-capacities Burnout was described by H. Freudenberger and A. Robbins and refers to cumulative psychological strain that results in being emotionally drained, depressed, cynical, losing the ability for compassion, and having an overwhelming sense of discouragement. The practical hierarchy of securing safety, addressing medical injury, and securing connection to the patient’s social supports before offering reassurance or psychiatric intervention are typical principles of disaster work.
