Personal Impressions Of The Federal Building Bombing In Oklahoma City
By John Tassey, Ph.D.
NCP Clinical Quarterly 5(4): Fall 1995
When discussing the events following the bombing of the Alfred P. Murrah Federal Building on April 19, 1995, in Oklahoma City, I am flooded with impressions, both visual and visceral, regarding my experience. It is my desire that the following will illuminate some of the personal challenges faced without being too idiosyncratic for more general appreciation.
In Oklahoma City, disaster mental health is a "niche" filled by only a few psychologists and social workers. By way of rotation and interest, on April 19th I was the Chair of Disaster Mental Health at the Oklahoma County Red Cross Chapter, Co-Chair of the Oklahoma State Critical Incident Stress Management Team (OCISMT), and Coordinator of the American Psychological Association Disaster Response Network (APA DRN). A positive aspect of this disaster in our community is more psychiatrists, psychologists and clinical social workers have expressed an interest in disaster and trauma training and so the delegation of responsibility should become more broad based.
Immediate and relatively unlimited access to the various disaster sites was assured by a pre-existing relationship with the command structure of the emergency response and law enforcement community. American Red Cross and Oklahoma State Critical Incident Stress Management Team (OCISMT) affiliations afforded me the authority to not only deploy mental health providers but also to petition for their use across a variety of settings. By responding to the smaller local and state "disasters" across the years, a good reputation has been established with the emergency services personnel, and our faces and procedures are familiar to them.
Arriving at the Federal Building about thirty minutes after the explosion, I was accompanied by four Catholic Social Ministries social workers. They were assigned in teams to the triage areas being established at the four corners of the Federal Building. They had no disaster or trauma response training or experience and wanted to know what "to do." Considering the number and nature of casualties, very little immediate crisis intervention was indicated. I also wanted "to do" something, so I assisted with carrying the wounded to triage areas. I do not believe it is disparaging to report that our presence within the first hour, on site, was a placebo effect. In fact, I think the value of an early mental health presence can not be overstated. A number of fire, EMS and Red Cross personnel mentioned how reassured they were to see me on-site, although they, as well as I, would have a hard time identifying what I "did."
The surviving unhurt children were first taken to the Red Cross Chapter two miles away. I received a call from the Family Services Coordinator that "mental health" was needed at the chapter for the children and the parents. With one telephone call (an important issue during a disaster when all lines and cells are overloaded), VAMC Psychology Service assured me that highly-qualified mental health professionals would be dispatched to the chapter. Across the afternoon and into the night these psychologists and psychiatrists were faced with the heart-wrenching task of consoling parents unable to find their children at the chapter or in area hospitals, and to others as they began to realize their loved ones were still in the building.
The incident command structure was established downtown within minutes of the blast due to the close proximity of the Federal Building to the police and fire headquarters. OCISMT members began establishing a presence at the rescuer rest and rehabilitation sites. Efforts to define one rehabilitation site for critical incident stress debriefing (CISD) were thwarted as the rest areas were moved eight times during the afternoon because of threats of another bomb, removal of potentially explosive ordinance, fear the building would collapse and the needs of preserving areas of the crime scene. Before dark, a site for CISD was permanently established in the incident command center and briefings and defusings began for every shift by order of the Oklahoma City Fire Chief.
The influence of the Oklahoma City Fire Chief's mandate for all personnel to be debriefed presented problems and advantages. The initial problem was recruiting peer counselors for CISD that were not exposed during the initial rescue efforts or ongoing search and retrieval activity. The value of our newly organized state-wide network was realized as out-of-town peer CISD counselors were recruited. An advantage of the mandate for debriefing was that other rescuers, not only OKC Fire Department, arrived at the end of their shift for debriefings. Within the first week, personnel from the Federal Emergency Management Agency (FEMA), local and federal law enforcement and most mutual aide fire departments were part of the debriefings. By the end of the initial operation, active duty and National Guard personnel were also "ordered" to report for debriefings before leaving their on-site posts. As the days turned into weeks, we were surprised to discover that many debriefing participants wished to address previous critical incidents as well -- in some cases, these were events that had occurred on other assignments, but there were also instances when individuals brought up distressing military experiences.
The intensity of the destruction, and the perceived motivation of the bombing, created a heightened security around the Federal Building/Incident Command perimeter and at all the major service sites. Security clearances were issued and revoked and volunteers, including some out-of-town mental health workers, were escorted out of the perimeter due to inadequate identification. But with the appropriate identification, nobody questioned why mental health providers were present or what they would be doing. Everyone understood and facilitated our activities and expressed appreciation at our presence.
The Medical Examiner declared that death notification would occur at one center and enlisted the use of one of the large local churches three miles from the Federal Building as closer suitable facilities had been damaged in the blast (see Sitterle article, this issue). The psychological impact of this center was appreciated by all at this facility, and the mental health coordinator early on was the facility coordinator, establishing the milieu to include both civilian and military security deployment, food services, training, screening, and family and staff policy. Since none of the psychiatrists or psychologists directing the death notification was over-rehearsed in any politically correct agency agenda, the needs of the family of missing and deceased loved ones was always the central mission. It would be impossible to describe all the subtle but significant changes that evolved over the three week course at the death notification center based on family member feedback, sensitive observation and a dedication to support the families.
Mental health providers were deployed at the Medical Examiner's office, the temporary morgue, and all the Red Cross service centers, shelters, disaster headquarters and chapter. In testament to how highly esteemed the VA psychologists were held by the Red Cross Mental Health Officer, by Friday, April 21, the manpower needs for immediate mental health services were met and all mental health volunteers were referred back to the community -- except VA psychologists. Psychologists from the Oklahoma City VAMC were specifically assigned to areas requiring a depth of personal as well as professional experience, advanced organizational skills, and a respect for the confidentiality regarding material debriefed.
The civilian and military law enforcement personnel were a great asset to the overall operation but to mental health services in particular. Their presence, literally surrounding the building at the death notification center, was reassuring to the family members, staff and volunteers. They were compassionate, respectful and ever-faithful in their protection of the family members, and enthusiastically unrelenting in their isolation of the media from the family members. We modestly returned the favor by defusing/debriefing their sentries, often in traditional CISD fashion but sometimes in "Hummers" at isolated checkpoints in the early morning hours.
The media was ever-present and resourceful (cunning) during the first four weeks after the bombing. The local affiliate stations were considerate of the operation and some of the news crews first on the scene abandoned their equipment to assist with the rescue effort. The national media arrived before the first FEMA team and was most interested in exposing the gore, grief and conflict of the disaster. The international media seemed only interested in sending back something that identified that they were in Oklahoma City. Public affairs officers from local, state and federal services and agencies postured to exploit the extensive media coverage available. Since I find talking with the media a valuable public service for someone else to provide, I developed two strategies to avoid interviews. The first was to isolate myself in secure areas where media were not allowed. My backup method was to provide a boring, obviously over-rehearsed statement which was counter to the sensationalism the media was seeking. Working to my advantage in the avoidance of the media was the knowledge that they do not have the luxury of waiting for me and that their deadlines necessitate finding someone else.
I encourage those that enjoy talking with the media to consider how their media exposure influences the relationship with the populations they will be interacting with during the disaster response. My experience is that most rank and file law enforcement and firefighters as well as many disaster victims view the media as "the enemy," or at least with much suspicion regarding their motivation and sensitivity. A high profile media relationship would contaminate relationships and diminish access, both physically and psychologically. My observation is that during a disaster, first impressions are highly weighted and often an opportunity to exonerate oneself does not present itself.
During the immediate and acute phases of a disaster, we found that critical incident debriefing offers emergency personnel a vital opportunity to begin the long process of adjusting to the trauma encountered. It was also clear that emergency workers benefit from multiple debriefings and that the debriefing process should, in effect, continue for several months after deployment. More specifically, conducting post-deployment debriefings has several benefits: 1) workers are able to understand and correlate their response to normal stress syndromes, thereby giving them the opportunity to normalize and universalize their reactions; 2) by holding debriefings after a period of time, any psychic numbing that may have occurred in workers may have diminished, thereby giving workers greater flexibility to discuss emotionally-laden experience; 3) post-deployment debriefings can serve to identify and refer workers who may need individual help.
Debriefing is not psychotherapy. Regrettably, I received feedback from many law enforcement and fire service personnel about well meaning mental health providers trying to "get in my head." These are legitimate complaints by emergency personnel who see themselves as competent, having to do a difficult job, and are concerned about being labeled with a diagnosis. Though a debriefing may be obligatory, workers are not seeking, nor necessarily in need of, treatment. Rather they benefit from the opportunity for catharsis, to verbalize trauma, from group and peer support, and from information about common stress responses.
This experience has taught me a good deal about myself, various relationships and the resilience/ fragility of our human existence -- and politics. I have learned to respect people I previously could not tolerate. I am humbled by the outpouring of support. I hope this article can be a conduit to express my profound appreciation and the thanks of our community for the genuine and generous contributions extended to us during this disaster.
John Tassey is Director of the Behavioral Medicine Clinic, Department of Veterans Affairs Oklahoma Medical Center and Assistant Professor, Department of Psychiatry and Behavior, Oklahoma University Health Science Center.
|
