Center for the Study of Traumatic Stress
The Center for the Study of Traumatic Stress (CSTS) is part of the Department of Psychiatry, Uniformed Services University of the Health Sciences

Emotional Reactions to Human Remains
in Mass Death
In disaster relief operations,■■ Talking with others while working
relief workers can ultimately becomeand during down time is very
In disaster relief operations,involved in recovering the remains ofimportant. This helps prevent
reliefworkers
canultimatelyvictims. If this occurs, you are likely togetting lost in your own thoughts
become involved in recovering thesee, smell, and handle the remains ofor emotions.
men women and children of all ages.
■■ Help others in distress by being
remains of victims.
Working with or around them maya good listener. Don’t mistake
arouse strong feelings of pity, horror,
expression of feelings forrepulsion, disgust, and anger at the senselessness of thisweakness. Remind others thattragedy. You may feel guilty for not helping enough. Thesestrong emotions are normal andreactions are normal and a part of being human. You may
honorable.
feel emotionally numb, or you may even use “graveyard■■ Humor is a good stress release. Even graveyard humorhumor” to make the suffering and death seem less terrible.
privately among friends may be helpful but this will be
These are also normal responses. Strong emotions oroffensive to some. Do not be disrespectful toward thereactions may be most painful when a victim is a child, orremains.
reminds you of someone you love, or of yourself. Even if
you’ve worked in disaster environments before you may■■ Limit your exposure to remains as much as possible.
react differently here than you have in the past. Remember■■ Limit the exposure of others, also, by using screens,strong emotions are honorable and they confirm yourponcho curtains, partitions, covers, body bags, andhumanity.
barriers whenever possible.
Here are lessons learned by other people who have■■ Since perfumes or aftershaves used to mask odors
worked with remains in disaster environments. Although
may trigger later memories, it may be better to breathe
these tips cannot make a horrible event easy they will help
through your mouth than to use these items to cover up
you continue to work, and to live with your experiences andunpleasant smells.
memories without being haunted by them: Remember the■■ Be compassionate, but avoid focusing on any individual
larger purpose of your work.
victim—especially those with whom you may identify.
■■ By recovering remains for identification and respectfulburial you are showing care, giving hope, and preventing ■■ Personal effects found near remains may be importantfor identification. They may also become importantdisease for the living. Your supervisor must be aware
reminders for surviving family members or loved onesof all body recovery work that you do and coordinate
so they should not be taken as souvenirs.
with the local authorities requesting assistance in this■■ Do not focus on personal effects more than necessary as
important effort.
this can be particularly distressing.
■■ It may be difficult to prepare yourself mentally for■■ Remind yourself that remains are not people anymore
what you will see and do. Specific information about— just the remains.
job requirements and the experience of others can behelpful.
■■ It’s OK to say silent prayers, but let local religious leaders
conduct memorial services or more public ceremonies.
■■ While on the job wear protective gloves and coveralls
to reduce your risk of disease, take frequent breaks,■■ Be respectful of local cultures and religious beliefs thatmaintain hygiene, drink plenty of fluids, and eat good
may be very different from your own.
food. Rest (off of your feet) when not working. Facilities■■ As time allows, have your team get together for mutual
for rest, washing hands and face, for showers and fresh
support and encouragement.
clothes should be available.
Continued■■ 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 jobchange may be helpful.
■■ Afterwards, do not feel guilty about having distanced
yourself mentally from the suffering or tragic deathsof individuals.
■■ Some people find debriefings with trained counselors
helpful but others do not. Participation should bevoluntary. Any group debriefings should be withpeople 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 StressUniformed Services University of the Health Sciences
4301 Jones Bridge Road, Bethesda, MD 20814-4799
www.CSTSonline.org | cstsinfo@usuhs.mil