Trauma fears cloud upbeat picture of Thai boys rescued from cave

CHIANG RAI, Thailand, July 11, 2018 (AFP) : The dramatic rescue of a
dozen boys from a flooded Thai cave ended a harrowing two-week ordeal that
most seem to have weathered with astonishing mental and physical resilience –
– at least for the moment.

Despite days trapped in the gloom of a cramped, part-submerged chamber the
youngsters’ psychological state is “very good”, Thongchai
Lertwilairatanapong, Inspector General of the Public Health Ministry, told
reporters on Wednesday, adding that they were now “free from stress”.

The upbeat assessments were surprising given that the boys and their
football coach initially survived for more than a week in pitch darkness on a
narrow ledge — with the passing days marked by hunger and fear that they
might never be found.

When they eventually were rescued it involved an extremely hazardous
extraction — guided one-by-one, using underwater breathing equipment, though
a series of long, flooded sections of narrow tunnel.

Despite the positive health assessments so far experts said they would all
need to be monitored closely for signs of psychological distress that could
take months to manifest itself.

“Their journey is not over yet,” said Jennifer Wild, a clinical
psychologist at the Oxford Centre for Anxiety Disorders and Trauma.

“It’s possible after an ordeal such as this that similar cues will bring
back feelings or memories from the trauma … being in the dark, being in
rooms when the doors are closed, having a scan such as an MRI and possibly
swimming,” Wild said via the expert database Science Media Centre.

“In the weeks after such an ordeal, it is common for people to have
unwanted memories, feelings and flashbacks,” Wild said, adding that while
such symptoms usually clear up after a month, any longer could indicate post-
traumatic stress disorder (PTSD).

The boys are expected to spend a week in hospital in Chiang Rai and six
months of psychological monitoring.

Doctors said the weeklong quarantine period was necessary to ensure they
had not contracted any infections from inside the cave, but parents were
allowed to visit the first group wearing protective gear on Tuesday.

But even after they are fully reunited with their families and discharged,
their recovery will remain an ongoing process — especially in the short
term.

“They may become fearful, clingy, or jumpy,” said Andrea Danese, a
psychologist at king’ College London.

“They may fear for their safety; they may become very moody or easily upset
— or, in contrast, become detached or numb,” she added.

The boys — all members of the same football team — may have been helped
during their ordeal by the fact that they were already a unit rather than a
group of strangers.

“The important things will be helping each other, returning to school and
getting back into their community,” said Boonruang Triruangworawat, director-
general of the Thai Heath Ministry’s Mental Health Department.

Wild stressed that the boy’s youth and collective spirit could also play to
their advantage in terms of processing what they had been through.

“If they can view the ordeal as an unusual adventure rather than dwelling
on how the event could have cost their lives, they will be more likely to
have a good emotional outcome,” Wild said.

“If they focus and dwell on what could have happened, they’ll have a harder
time,” she added.