Advice from the experts: Surviving a disaster: Controlling our fears

Q&A with Amanda Ripley, author of The Unthinkable: Who Survives When Disaster Strikes — and Why

As we go about our day-to-day lives, disasters are far from the minds of most people. But 90 percent of Americans live and work in places where there are significant risks for earthquakes, tornadoes, floods, hurricanes, terrorism or other natural and human-made disasters. When a life-or-death situation occurs, some people do better than others. In the midst of a disaster, many people panic, while others assume leadership roles. Some people emerge as heroes while others simply freeze.

APHA’s Get Ready campaign recently interviewed award-winning Time magazine writer Amanda Ripley, who has criss-crossed the globe to cover some of the most devastating disasters of our time. In her recent book, The Unthinkable: Who Survives When Disaster Strikes — and Why, Ripley offers insight into how our brains work during disasters and tells us how we can increase our odds of surviving. — TDJ

What happens to us in the midst of a disaster and why do some of us do better than others?
We literally use different parts of our brains instantly in a disaster. Everything changes. As one Sept. 11 survivor said to me, “You don’t ever want to have to think in a disaster.” He knew that because he had experienced the complete change that occurs when you are in a life or death situation. So literally you lose peripheral vision, your heart rate increases, your blood pressure goes up, you get an injection of stress hormones which help you perform physically, but actually make it much harder to perform cognitively, so you have a lot of trouble making decisions —  even simple decisions — or processing new information. So the reason some of us often do better than others in a disaster usually has to do with what was in our brains before everything went wrong, because you won’t be able to really progress much from where you were once things go bad. So it really depends on what you had in your head as far as what to do, how to do it, when to do it, before everything went wrong.

How can we overcome weaknesses and boost our odds of surviving in a disaster?
The more familiarity you have beforehand with any of your major risks and how to get out of them, the better you will do. For example, if you know that you live in place that is at high risk for flooding, which is true of many millions of Americans, then the more thinking you have done about what you would take with you, how you would evacuate, when you would evacuate, how you would deal with your elderly mother — all of those things are not going to go very well if you wait until you are under stress — you are not going to make great decisions. So the more you can feed your brain with plans and thoughts and even execute some of those plans in advance, the better you are going to do.

In general, we have certain weaknesses when it comes to assessing risk and performing well under stress. We also have a lot of strength, but if we can understand what the weaknesses are in advance, then we can do a lot better. One of the biggest weaknesses is that we tend to move very slowly under extreme duress, and the more we have done in advance the more quickly we will push through that phase and perform appropriately.

Why do so many of us shut down or freeze in the midst of a disaster?
This is so common, so pervasive across every kind of high-stress event. I have talked to firefighters who have many tales of people freezing up, all the way to stockbrokers who have seen it on the trading floor during a stock market crash. You see it across all kinds of contexts, and you actually see it in every animal that has ever been tested in a laboratory setting. This tendency to shut down or freeze is, in my mind, an evolved defense mechanism. It is so powerful and so common that I don’t think we would have evolved to this state unless it served a purpose. In many particularly ancient kinds of threats, shutting down in a life or death situation, where your body goes numb, you stop moving, you look like you’re dead, could be an appropriate response if you’re getting attacked by a saber-toothed tiger, for example. But in more modern situations it isnot as appropriate. We need to understand this better because it’s the kind of thing you can overcome, and it’s very, very dangerous in events like fires or plane crashes. We’ve seen this many times, we know that this is a bigger risk than almost any other behavior — certainly much more likely than panic — so we should start planning for it in advance.

In your book you talk about the “survival arc” that we all must travel to get from danger to safety. Can you explain a bit about that?

Across all different kinds of disasters, from sinking ships to burning buildings, people tend to go through three phases. The first phase is a powerful kind of denial, where your brain works quite aggressively to normalize what is happening, to downplay the threat and make sense of what’s happened based on everything that your brain has seen before. It is a perfectly normal response, but it can take up precious time. The second phase after denial is deliberation. Most people become extremely social in disasters. They look to each other for cues and advice and information, and that is also a really important phase, but again, it can take up a lot of time if you don’t push through that phase efficiently. The third phase is the decisive moment, where people take action based directly on what’s happened in the denial and deliberation phases. Sometimes it’s the appropriate action and sometimes it’s not, but often we only know that in retrospect.

Are there any specific traits that might predict how well we will do in a disaster?

Among the many survivors I have talked to, the people who have military training or even Boy Scouts training tend to perform a little better in a lot of situations. But more important is not the training but the culture, the whole outlook on life. Research shows that if you have what’s called an “internal locus of control,” so you believe that you influence your destiny, then you tend to do better and recover more fully in a lot of situations. If on the other hand you feel like you are kind of at the mercy of fate and are in a more passive victim role in your day to day life, then that could be problematic because you’ll be less likely to take action and can have trouble recovering. It’s not 100 percent for every situation, but those trends tend to play into it. So the more you feel like you’re in control of your destiny and the more confidence you have in your ability to affect change, the better you actually do. It’s very much a self-fulfilling prophecy.

Are there any simple ways that we can train our fears and thoughts to help us survive in a disaster?
There are simple things you can do that are taught to first responders and elite military units, and they basically are not that different from yoga. Anything you can do to ramp down that fear response so that it doesn’t overwhelm your ability to think will help. We know that the most effective way to influence your subconscious brain is through breathing. With controlled breathing, for example, you breathe in for four counts, hold for four counts, release for four counts, hold for four counts and you repeat, over and over and over again whenever you are under stress. It could be mild stress, but it’s something I practice all the time, in traffic and so forth. This is the kind of thing that is actually taught to swat teams and Navy Seals. It is extremely effective in helping you control the physiological response to stress.

In your book you mention who the real first responders in a disaster are. Who are they?

Talk to anyone who has actually survived a disaster and they will instantly tell you that they were the first responders. Since Sept. 11 we have become very reliant upon first responders. We spend a lot of money equipping firefighters, police and so forth and that is all well and good, but the reality is that in major disasters, those people are not there, they just can’t be everywhere at once. In big disasters, regular people do the majority of life saving, so the people you work and live with are the first responders and I really think that this is probably the most important lesson I have learned in covering disasters over the last decade. If we continue to focus on the experts and not the public, we are not going to get any better at this. We really have to focus our energy on the people who are always first at the scene in every disaster and that’s regular people, so continuing to pour billions of dollars into equipping first responders, and not equipping and training the public is, I think, a mistake.

When it comes to hurricanes and other weather-related risks, we often overestimate ourselves. Can you explain how?

The three major risks that I consider the most under-appreciated but significant risks that most Americans face are fire, floods and lightning. Those are things that, because of the way we are wired, we don’t spend a lot of time worrying about in advance. We don’t really stress about them. We stress about things that are less likely to happen, for example our kids getting kidnapped, or terrorism attacks or shark attacks. But these are things that are extremely unlikely for most people. There is only so much attention we all have to spend in preparedness, so it is important to really prioritize. What are my biggest risks? It obviously depends on where you live and how you live but certainly we know that disasters are getting more frequent and more expensive in this country, largely because of wind and water events. We live in these dense, vertical cities near water, so we really have to try to focus our minds on things like floods, and also fire, which generally kills more people every year than all other disasters combined.

In your book you talk about “group think” and you note that our best chances of survival are usually improved by sticking together. Why is that?
It seems to be an evolved reality because you see it in mammals as well. Chimpanzees, for example, when they are under a threat, will form groups and show each other affection. They also become very hierarchical and pay even more attention to the leader than normal, and this is also true of humans. The reality is that in disasters, we don’t turn into the kinds of hysterical mobs that we see in movies. We tend to actually show each other great courtesy when things are going very bad and that should be enormously reassuring to people. I can’t tell you how many times I’ve heard this from survivors — people who have been in terrorist attacks, people who have been in enormous fires — they always marvel at how well most people behaved. In general, the crowd does not really like panic, does not like people who are screaming and out of control, and the crowd will snuff that out pretty quickly, either by helping that person or minority of people or by aggressively telling them to stop. So generally, people form groups and that is helpful because you need information more than almost anything else in most disasters. Ten brains and 20 hands are better than one brain and two hands.

What is the biggest mistake made by the people in charge of protecting us?

Again and again, the people in charge of protecting us tend to underestimate the ability of the public. They think that people will panic if they are given frightening or potentially frightening information. They think people will loot or misbehave and I can’t tell you how many times this has come up. Even in my conversations with high-level emergency preparedness officials, there is among every group of experts a belief that they know better. I think this is just part of human nature, but it is very dangerous when it comes to preparedness. The reality is, usually you may know better but you’re not going to be there. The tendency to think that regular people will not perform well is often misguided. Regular people perform much better on average than we expect. So we really need to enroll regular people, engage them creatively, listen to them in advance and have them literally at the table when we are making decisions about emergency evacuation drills, about how to prepare for biological threats. They literally need to be at the table or else a natural bias will warp our planning and we will end up with emergency plans that are written for emergency responders.

— Q&A conducted, edited and condensed by Teddi Dineley Johnson, The Nation's Health, APHA

March 2009