Center for the Study of Traumatic Stress
CSTS | Department of Psychiatry | Uniformed Services University | 4301 Jones Bridge Road, Bethesda, MD 20814-4799 | www.CSTSonline.org

Information for Relief Workers on Emotional
Reactions to Human Bodies in Mass Death
In mass disaster relief■■ While on the job wear
operations, the role of relief workers
protective gloves and coveralls
Though personnel may begin ancan change. Though personnel
to reduce your risk of disease,
operation expecting to provide food,
may begin an operation expecting
take frequent breaks, maintainshelter and care for other basic needs,
to provide food, shelter and carehygiene, drink plenty of fluids,
for other basic needs, they canand eat good food. Rest (off ofthey can ultimately become involved
ultimately become involved inyour feet) when not working.
in recovering the remains ofrecovering the remains of disaster
Facilities for rest, washing hands
disaster victims.
victims. If this occurs, you areand face, for showers and fresh
likely to see, smell, and handle theclothes should be available.
remains of adults and children of■■ Talking with others while working and during down
all ages. Working with or around them may arouse strong
time is very important. This helps prevent getting lost in
feelings of pity, horror, repulsion, disgust, and anger at theyour own thoughts or emotions.
senselessness of this tragedy. You may feel guilty for not
helping enough. These reactions are normal and a part of■■ Help others in distress by being a good listener. Don’t
being human. You may feel emotionally numb, or you may
mistake expression of feelings for weakness. Remindeven use “graveyard humor” to make the suffering and deathothers that strong emotions are normal and honorable.
seem less terrible. These are also normal responses. Strong■■ Humor is a good stress release. Even graveyard humor
emotions or reactions may be most painful when a victim isprivately among friends may be helpful but this will bea child, or reminds you of someone you love, or of yourself.
offensive to some. Do not be disrespectful toward theEven if you’ve worked in disaster environments before
remains.
you may react differently here than you have in the past.
Remember strong emotions are honorable and they confirm ■■ Limit your exposure to remains as much as possible.
■■ Limit the exposure of others, also, by using screens,your humanity.
poncho curtains, partitions, covers, body bags, andHere are lessons learned by other people who havebarriers whenever possible.
worked with remains in disaster environments. Althoughthese tips cannot make a horrible event easy, they will help■■ Since perfumes or aftershaves used to mask odors may
you continue to work, and to live with your experiences andtrigger later memories, it may be better to breathe
memories without being haunted by them: Remember thethrough your mouth than to use these items to cover up
larger purpose of your work.
unpleasant smells.
■■ By recovering remains for identification and respectful■■ Be compassionate, but avoid focusing on any individual
burial you are showing care, giving hope, and preventing
victim—especially those with whom you may identify.
disease for the living. Your supervisor must be aware■■ Personal effects found near remains may be importantof all body recovery work that you do and coordinate
for identification. They may also become importantwith the local authorities requesting assistance in thisreminders for surviving family members or loved ones
important effort.
so they should not be taken as souvenirs.
■■ It may be difficult to prepare yourself mentally for■■ Do not focus on personal effects more than necessary as
what you will see and do. Specific information about
this can be particularly distressing.
job requirements and the experience of others can be■■ Remind yourself that remains are not people anymore
helpful.
— just the remains.
Continued■■ It’s OK to say silent prayers, but let local religious

leaders conduct memorial services or more public
ceremonies.
■■ Be respectful of local cultures and religious beliefs that
may be very different from your own.
■■ As time allows, have your team get together for mutual
support and encouragement.
■■ Acknowledge horrible aspects of the work, but do
not dwell on memories of the details. You should let
your supervisor know if an aspect of your work is
particularly difficult or stressful for you — a job change
may be helpful.
■■ Afterwards, do not feel guilty about having distanced
yourself mentally from the suffering or tragic deaths ofindividuals.

■■ Some people find debriefings with trained counselors

helpful but others do not. Participation should bevoluntary. Any group debriefings should be with people
who shared your experiences.
■■ Strange dreams or nightmares, feeling tense, or having
intrusive memories are common during or shortly after
stressful work with human remains.
■■ Sharing your emotional reactions with loved ones isoften helpful, but may be very difficult to do.
■■ If anxiety, depression, sleep difficulties or irritability
persist more than two weeks after your return home
you should seek assistance from a counselor or aphysician.

Center for the Study of Traumatic Stress
Department of Psychiatry
Uniformed Services University
4301 Jones Bridge Road, Bethesda, MD 20814-4799
www.CSTSonline.org