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 First Responders
on Emotional Reactions to Human
Bodies in Mass Death
In your work responding to■ Talking with others while
emergencies and disasters, you may
working and during down timeWorking with remains may arouse strong
see, smell, and handle the remains
is very important. This helps
feelings of pity, horror, repulsion, disgust,of individuals of all ages. Working
prevent getting lost in your own
with or around them may arouse
and anger. These reactions are normal.
thoughts or emotions.
strong feelings of pity, horror,■ Help others in distress by being
repulsion, disgust, and anger at thea good listener. Don’t mistake expression of feelings
senselessness of this tragedy. You may feel guilty for not
for weakness. Remind others that strong emotions are
helping enough. These reactions are normal and a part ofnormal and honorable.
being human. You may feel emotionally numb, or you may■ Humor is a good stress release. Graveyard humor, ineven use “graveyard humor” to make the suffering andprivate and limited circumstances, may be helpful but
death seem less terrible. These are also normal responses.
will likely be offensive to some. Do not be disrespectfulStrong emotions or reactions may be most painful when atoward the remains.
victim is a child, or reminds you of someone you love, or■ Limit your exposure to bodies as much as possible.
of yourself. Even if you’ve worked in disaster environments
before, you may react differently here than you have in the■ Limit the exposure of others, especially non-first
past. Remember, strong emotions are honorable and they
responders and civilians, by using screens, poncho
confirm your humanity.
curtains, partitions, covers, body bags, and barriers
Here are lessons learned by other people who havewhenever possible.
worked with bodies in disaster environments. Although■ Since perfumes or aftershaves used to mask odors
these tips cannot make a horrible event easy, they will help
may trigger later memories, it may be better to breathe
you continue to work, and to live with your experiences andthrough your mouth than to use these items to cover up
memories without being haunted by them:
unpleasant smells.
■ Remember the larger purpose of your work. By■ Be compassionate, but avoid focusing on any individual
recovering bodies for identification and respectful
victim—especially those you may identify with.
burial you are showing care, giving hope, and preventing■ Personal effects found near bodies may be importantdisease for the living. Your supervisor must be awarefor identification. They may also become importantof all body recovery work that you do and coordinate
reminders for surviving family members or loved ones
with the local authorities requesting assistance in thisso they should not be taken as souvenirs.
important effort.
■ Do not focus on personal effects more than necessary as■ Seek information about job requirements and thethis can be particularly distressing.
experience of others. It may be difficult to prepare■ Remind yourself that bodies are not people anymore —yourself mentally for what you will see and do.
just the remains.
■ While on the job, wear protective gloves and coveralls■ It’s OK to say silent prayers, but let local religious leaders
to reduce your risk of disease, take frequent breaks,
conduct memorial services or more public ceremonies.
maintain hygiene, drink plenty of fluids, and eat good
food. Rest (off of your feet) when not working. Facilities ■ Be respectful of local cultures and religious beliefs that
may be very different from your own.
for rest, washing hands and face, and showers and freshclothes should be available.
Continued■ 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