An eleven-year-old Dutch boy, the sole survivor of a plane crash, reportedly smiled at his aunt and uncle who flew to his bedside when they recognized him from television pictures. He hasn’t been told yet that his parents and brother died in the crash.
The boy, identified as Ruben van Assouw, suffered multiple fractures in his lower limbs when the Afriqiyah Airways Airbus A330-200 crashed Tuesday at Tripoli International Airport killing 92 passengers and a crew of 11. Ruben is the sole survivor.
So, what lies ahead for the young victim? The good news is that his body is projected to have a complete recovery, however, his psychological injuries may persist for the rest of his life.
The most obvious danger is persistent Post Traumatic Stress Disorder (PTSD) when one is witness to death or potential death that can cause lifelong feelings of anxiety, depression, detachment, distressing dreams or “flashbacks”. In children repetitive play may involve acting out the trauma over and over.
One major symptom of PTSD is “Survivor’s Guilt” and it adds symptoms of depression and low-self esteem that follow the belief that somehow their survival caused the death of the others. The sad thing about survivor’s guilt, as seen in the families of Holocaust survivors, is that is can be a multi-generational disorder.
Finally, Ruben may suffer painful Attachment Injuries because his primary attachment figures were suddenly eliminated. The child can grow up to have a powerful mistrust of love and relationships, or in a very anxious way, cling to new attachment figures even when they don’t provide a healthy return.
The road back to mental health is long, though very possible. Intensive grief counseling might be combined with family systems therapy to help him bond and attach to his new caregivers. Once Ruben is able to view himself as a sufferer, not one who caused suffering, he can mourn and continue with life.
The most amazing thing about the human psyche is it’s ability to heal after trauma. His biological predisposition to anxiety, depression, and feelings of abandonment will be a major determinant of his future mental health. Some people recover from horrific events very well, while others can become dysfunctional by even minor emotional trauma. That’s the fascinating thing about psychology — it happens at the intersection of biology and environment. Our prayers go out to Ruben.