Spiders and PTSD: the ordeal facing boys trapped in a cave


Spiders and PTSD: the ordeal facing boys trapped in a cave

As divers prepare to rescue a Thai soccer team, experts warn their turmoil may have a huge and lasting effect

Sarah Knapton

A group of trapped Thai schoolboys and their soccer coach may have appeared elated and calm after British divers discovered them on Monday, but their ordeal will take a huge physical and mental toll, according to experts.
Rescuers were giving the 12 boys and their 25-year-old coach crash courses in swimming and diving on Wednesday as they prepared to extract the soccer squad and end their 11-day ordeal.
They reportedly became lost in the Tham Luang caves in Chiang Rai province when a post-practice outing went awry. About 4km of tight, fluid conditions and uncertain weather separate them from the mouth of the cave.
Trauma experts said the boys, who are between 11 and 16 years old, will have gone through a range of emotions, including denial, anger, despair, acceptance and bargaining, during the nine days when they were unsure if help was coming.
Cut off from sunlight, their circadian rhythms may also have shifted to a 25-hour cycle, leading them to be confused as to how long they had been trapped. One of the first questions their rescuers was asked was what day is it?
And although they appear to have access to air and water, poor sanitation in the small cave could leave them in danger of infections. The lack of space could also make moving around difficult, meaning their bones may start to atrophy from lack of use, making an escape plan more difficult.
And, to make the nightmare all the greater, large cave spiders scuttle along the cave floor.
Professor Mike Tipton, of the Extreme Environments Laboratory at the University of Portsmouth, said: “In terms of a survival hierarchy they are doing okay. They appear to have air, water, warmth and now a source of food, so they could theoretically last for a long time down there.
“But a particular problem is the lack of space which will stop them moving about, which is essentially for cardiovascular function and bone health. In that sense they are like astronauts in microgravity. That could prove difficult if they need to dive a long way to get out.
“Lack of sanitation could also cause problems, and experiments have shown that when people are in environments where there is no day and night, their body clock shifts, a condition called free-timing.”
Experts said that the fact the group was a football team, who were used to relying on each other, could help their survival but warned that recovering from the trauma would take many weeks after leaving the cave.
Dr Jon Goldin, vice-chairperson of the Child and Adolescent Faculty, at the Royal College of Psychiatrists, said: “People have different levels of resilience, but it is good that they are a football team as they will be used to working together and supporting each other, so they are in a far better position than someone stuck on their own.
“They seemed to be relatively calm when they were found, but it could be demoralising now to find out that they may be weeks or months from being rescued. It will be important to manage their expectations.
“Afterwards they will need a lot of support from friends and family, rather than immediate psychological input. There is a high risk of (post-traumatic stress disorder) and they are likely to have trouble sleeping, experience nightmares and have flashbacks.
“They may start behaving like younger children, needing more reassurance and becoming hyper-vigilant. If these symptoms persist beyond a month or two then professional support would be indicated.”
Silver lining
However, some experts said the experience could end up having a positive effect on the youngsters.
Neil Greenberg, professor of defence mental health at King’s College London, who has visited the cave system, said: “It is very large, with a sandy floor, and what I remember are the cave spiders which scuttle around, which is very unusual for a cave.
“There are a wide range of factors which might influence how (the children) cope prior to them being ultimately rescued, including team spirit, their health and the approach that the rescuers take to getting them to safety.
“It may well be that many of the group will find it challenging to ‘return to normal’ when they are initially freed; however chances are most will be fine, perhaps even psychologically stronger in the longer term.
“We have to hope that if any of them do stay distressed for an extended period when released, that they will be able to access good support and professional care to ensure that they are returned to a good state of health.”
Tipton added: “It is said that what doesn’t kill you makes you stronger, and we know that people in very traumatic situations often re-evaluate their lives and start to appreciate things like family and the sunrise, so in the long run it could have a psychologically beneficial effect.”
– © The Daily Telegraph

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