Prediction: The Cave-Trapped Boys Will Not Be Traumatized

I usually focus on crime, the law, and trauma in victims. In this essay I want to consider the basic criteria for a diagnosis of Post-Traumatic Stress Disorder (PTSD) and argue that the Thai boys trapped in a cave will show an excellent recovery from their ordeal. I will also argue that their coach likely will have psychological challenges ahead of him and that, given the situation he faced, is at considerable risk for developing PTSD.

Here is a brief listing of the criteria for a diagnosis of post-traumatic stress disorder following a life-threatening or other highly disturbing situation: emotional distress, nightmares, flashbacks, overly negative thoughts about oneself, self-blame for causing trauma, negative emotions such as guilt or shame, and symptoms that last more than one month. These criteria are listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V).

These boys, ages 11 to 16, clearly endured a nightmarish event and could be expected to suffer long-term psychological damage as a result. They were trapped in a dark, flooded cave over two miles from the opening, without food or adequate water for nine days. They will, of course, be affected psychologically, but I believe, will not develop a mental-health disorder as a result. My argument is based on the following ameliorating factors:

1. The situation that the boys endured was clearly life-threatening and extreme by any standard, and yet, the boys were united as members of a close-knit sports team and seem to possess mature personality strengths that are predictive of resilience.
2. The team members were physically strong as athletes and used to high-risk adventures and competitions.
3. The boys were taught techniques of coping through meditation to quell their fears.
4. The coach kept panic from developing and provided guidance in surviving and sharing the limited food that was available.
5. Family members showed they had strong bonds with their children.
6. Some of these children had survived difficult challenges before as immigrants from a country in turmoil.
7. The concern that the nation of Thailand and the world has shown in this amazingly integrated rescue operation, and the universal affection given to these boys, will enhance their self-identity as survivors and heroes rather than as victims of cruel circumstance.
8. In all likelihood, the coach had shielded the children from the likelihood that they faced certain death if they were not discovered within a limited time.

The coach showed that he cared so much for his soccer team that he let the boys have all the food. Since he had led them into a precarious adventure, as their caretaker he was bound to have a sense of guilt and self-blame. Trapped in the dark, surrounded by deep, contaminated water, the coach would have foreseen a situation in which death was inevitable. He knew the caves, the likelihood that the rains would not subside, and that escape was seemingly impossible. Once he found out that one of the rescuers (a Thai Navy seal) had died during the rescue operation, his sense of guilt (survivor guilt) would have been compounded. The fact that he is a caring, empathic person is indicated in his sacrifice of much of his drinking water and his deep apology to the children’s parents upon his discovery. For these reasons, his psychological recovery probably will be difficult.

Positive developments are that the parents, instead of attacking the coach for this foolhardy mission, are grateful to him for saving their children’s lives. Nor, as indicated in reports, does the Thai government seem to be blaming the coach for the toll that this rescue mission has taken on the country and its people. In Japan, in contrast, the blame would be evident at all levels of society, and in Afghanistan as well, missionaries who had been kidnapped were shamed upon their rescue for causing such trouble. In the United States, lawsuits would be pending for negligence of the coach or the sports team that he represented. By all indications, the Thai people are more forgiving and less litigious. These national characteristics will enhance the psychological recovery of all involved—the coach, the family members, and the soccer team.