Surfside Condo Collapse: Trauma, Moral Injury, and Resilience in Disaster


Key Takeaways

  • The Surfside condo collapse will have profound mental health impacts for both victims’ loved ones and rescue workers, as they deal with grief and trauma.
  • Leadership and policy that make room for personalized grieving processes can help individuals build resiliency.

In the early hours of Thursday, June 24th, the Champlain Towers South condominium partially collapsed. Many of its residents were believed to be sleeping at the time.

The building, which has been fully demolished to assist search-and-rescue efforts, was a 12-story beachfront condominium in Surfside, a town in Miami-Dade County, Florida. Nearly two weeks after the collapse, rescue workers continued searching for survivors. But no one has been rescued alive. Thirty-two people have been found and 117 remain unaccounted for.

Today local officials announced that crews would shift their focus to recovery efforts, acknowledging that there remain no chances for survivors among the rubble.

When disasters like this occur, Jeffrey Holguin, PhD, a fire psychologist and veteran based in Washington State, tells Get Meds Info that the consequences are felt at multiple levels. Victims’ friends, families, and communities are grieving. And rescue workers must search around the clock, leading to exhaustion.

What Is a Fire Psychologist?

Fire psychologists, according to the Fire Service Psychology Association, have a unique understanding of the cumulative trauma firefighters face over the years. Holguin works with first responders through one-on-one therapy and health counseling.

But there’s also a fundamental trust that’s been damaged.

“There’s a bunch of values disruption here. In the United States, we can reasonably expect a building that we all live in to be safe,” Holguin says. “So our trust and our faith in people’s ability to keep us safe, that we’ve paid them to do that—that was all violated.”

How Will This Impact Victims’ Loved Ones?

Over the past two weeks, rescue workers made their way through the rubble in the hopes of finding survivors and victims. The surprise of the collapse, Holguin says, mixed with the delay in finding victims, could make it difficult for loved ones to feel like they have closure.

“This is the one thing that’s going to turn trauma stress to trauma disorder,” he says. Questions like “How could this happen? Why did this happen? And whose fault is this?” receive convoluted answers. This is compounded with the uncertainty and terror broadcast on the news each day.

“The human brain does not like traumatic occurrences without answers,” Holguin says. “So it’s going to start erroneously filling in those gaps and causing a lot of memory fractures, isolation, aggression, and distress.”

In the course of grief, many do feel better over time. However, in some cases, grief just doesn’t go away. This is called “complicated grief,” and can start to wear on an individual’s mental and physical state. And those grieving a sudden loss, such as loved ones in the Surfside condo collapse, are more likely to experience complicated grief.

The fact that many of the Surfside victims also came from various cultures adds another component to the grieving process. This emphasizes a need for translation services and cultural sensitivity, wrote historian Rebecca Shimoni-Stoil, PhD, for NBC News.

Many missing residents are Latin American, for example, and about a third are believed to be Jewish or Orthodox Jewish. For the latter specifically, Shimoni-Stoil wrote, there are body recovery and burial practices that need to be practiced.

“This is not simply a question of making life more bearable for survivors; it is about prioritizing their mental health alongside their physical health,” she wrote.

What This Means For You

If you or someone you know is grieving, connecting with community and support groups can help. Florida Blue has partnered with New Directions Behavioral Health to offer people coping with the Surfside condo collapse a free 24-hour grief-counseling helpline (with bilingual emotional support, most likely in Spanish): 833-848-1762. The Children’s Bereavement Center based in South Florida is also offering grief support groups for all families and friends affected by the collapse.

Rescue Workers Feel the Toll

As a fire psychologist, Holguin is acutely aware of the repeated trauma first responders and rescue workers experience. But it’s not always best characterized, he says, as post-traumatic stress disorder (PTSD).

“What’s unique about firefighters is they don’t have that singular [trauma], or just a couple of really massive exposures,” he says. “What they have is this sort of death by a thousand paper cuts. They have trauma and stress constantly.”

This constant trauma and stress, Holguin adds, can be exacerbated by another unique aspect of local firefighters or rescue workers: They’re working to help people they know, not complete strangers. Unlike army personnel, Holguin says, “chances are they’ll be treating people they know personally.”

The Surfside rescue effort, Holguin adds, highlights this: On July 2, a Miami firefighter identified his seven-year-old daughter’s body in the debris.

In these desperately painful moments, Holguin says, workers might experience moral injury or events that “contradict deeply held moral beliefs and expectations.” Guilt, shame, disgust, and anger are common reactions.

What Is Moral Injury?

According to the U.S. Department of Veterans Affairs, in order for a moral injury to occur, “the individual must feel like a transgression occurred and that they or someone else crossed a line with respect to their moral beliefs.” Examples of situations in which moral injury could occur include:

  • Killing or harming others in a stressful situation
  • Medics or rescue workers not being able to care for all who were harmed
  • Not being able to perform a duty
  • Surviving when others did not (survivor’s guilt)

Moral injury, in addition to trauma, fatigue, and grief, could pose a big risk at Surfside, Holguin says.

“That is, if I become a firefighter first responder, I want to go into my community to make it better, right? I want to go out and help people.”

When that option is taken away, for example, due to the immensity of this catastrophe, or the shock that it actually happened, Holguin adds, “that is an existential crisis that is difficult to process.”

While the Surfside condo first responders work to recover victims from the rubble, local reporting indicated that some are working 12-hour shifts—just edging on the limit proposed by the Centers for Disease Control and Prevention (CDC) to reduce lasting trauma.

On top of it all, workers may already be exhausted by the COVID-19 global health crisis. And COVID-19 precautions—and possible outbreaks—add another source of stress. On July 3, six rescue workers tested positive for the virus.

“I’ve spent thousands and thousands of hours in the clinic with first responders, and the vast majority of the time that PTSD is mentioned, it’s not PTSD,” Holguin adds. “It’s moral injury, trauma exposure, depression, substance abuse, and sleep destruction.”

That is, the long work hours and stress often keep people from physically taking care of themselves. “The idea that we are a victim of trauma is a little bit easier of a pill to swallow than us being accountable for our own resilience.”

What Improvements Can Leaders Make?

The Surfside condo collapse, as it’s now officially being called, may be one of the largest building failures in U.S. history. But disasters like these, Holguin says, aren’t going to go away.

“When we take a step back and look at this, we know our best evidence suggests that our man-made and natural disasters are going to keep increasing in both frequency and volatility,” he says, particularly if U.S. policy doesn’t make headway on climate change and gun violence legislation.

But when crisis calls again, Holguin urges people in leadership positions to prioritize recovery and resilience.

Not all victims and rescue workers respond to traumatic events equally, and not everyone needs the same recovery activities or time. “We’ve had a tendency in the past to use one-size-fits-all interventions,” Holguin says. “And those are not evidence-based [all the time]. There’s a lot of evidence that suggests they do more harm than good.”

Jeffrey Holguin, PhD

When disaster strikes, typically we do a hell of a job coming together and helping each other out.

— Jeffrey Holguin, PhD

Instead, leaders need to make room for individualized processes of trauma and grief, Holguin explains.

“Some people need to pull back, spend time with their loved ones, hug their kids because they might have pulled a kid out of the rubble,” he says. “Some people need to go home and sleep for a few days off and they’re right back. Some people need a month off.”

Tailoring recovery periods to individuals, Holguin says, can allow them to take better physical care of themselves, which then plays into their resiliency.

“What we’re seeing in firefighters nationally now is chronic kidney failure,” Holguin adds. “They’re awake too many hours, or they’re not drinking enough water. Their nutrition is poor because they’re overstressed. We’re seeing low testosterone because they’re hyperaroused and they’re overly stressed. The biggest contributor to psychiatric illness for firefighters is sleep deprivation and metabolic issues that come with shift work.”

Preventing these cascading consequences of prolonged stress can help rescue workers be more resilient.

“We are in the middle of an identity crisis in the first responder community,” Holguin says. “That means there’s a ton of space here for improvement, doing things better, facing something that we don’t necessarily want to face about ourselves. That’s how we improve.”

However, Holguin says, despite improvements that need to be made, “when disaster strikes, typically we do a hell of a job coming together and helping each other out.”

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