It can happen to anyone at any time: witnessing a serious traffic accident and suddenly having to render assistance to the victims. Severe injuries, people trapped in wrecked vehicles, perhaps even fatalities. First responders at traumatic events often experience a feeling of helplessness and shock.
"Most people who experience terrible events cope relatively well," said Pastor Hanjo von Wietersheim, who is in charge of emergency pastoral care for the Lutheran Church in Bavaria. He said it was normal to have flashbacks and nightmares for up to two months after seeing a bad accident because mind and soul needed time to sort out the ordeal.
As many as four per cent of the witnesses need psychological help, von Wietersheim estimates.
Wilfried Echterhoff, head of the Cologne-based Institute for Post-Accident Psychological Care (known by its German abbreviation ipu), puts the number at 30 per cent, however. "Lifelong damage can occur: massive anxiety, permanent inability to work, depression and feelings of helplessness," Echterhoff said.
Symptoms of post-traumatic stress include nightmares, insomnia, intrusive memories of the event as well as increased use of tobacco products, alcohol or medications. Job performance can decline, too.
"It's impossible to clearly assess on the spot whether an eyewitness will later need professional help or not," von Wietersheim said.
"Eyewitnesses of serious accidents normally want to leave the scene as quickly as possible," noted Michael Steil, national coordinator for the Psychosocial Emergency Care department of the German Red Cross. "I've often heard of people who drove off and then had to stop, trembling, 20 minutes later. What they had gone through finally hit them."
Often witnesses of accidents can only give the injured words of comfort until emergency medical personnel arrive, or look on helplessly as people die. This, according to Steil, can result in lasting feelings of guilt.
"People who have helped to save a life or assist an injured person generally have less trouble getting over the event," he said.
Steil advises people who have witnessed an accident to make a conscious effort to take their mind off it in the days and weeks afterwards. "It's important to do something nice for yourself when you feel the need for it," he said, adding that physical activity could also help. "Someone having trouble sleeping should get plenty of exercise since it's easier to fall asleep if you're physically exhausted."
If none of this helps, therapy is in order.
How well, and how quickly, a person gets over an accident also depends on the people around him or her, according to Steil. "Fewer and fewer people are capable of handling such situations by themselves," he said. "For a lot of people, life consists solely of fun and career. They've never concerned themselves with death. And social networks aren't as close-knit as they used to be."
Consequently, oppressive memories of accident casualties can persist, causing post-traumatic stress.