American Hikers Face Enormous Psychological Challenges
Men may have to deal with PTSD and other mental illnesses.
Sept. 23, 2011— -- After 26 months of imprisonment in a notorious Iranian prison, American hikers Shane Bauer and Josh Fattal face a psychologically daunting readjustment to freedom.
"What these two guys experienced over the past two years is an ongoing exposure to captivity, which is one of the most harmful and traumatic experiences that a human being can endure," said Yuval Neria, director of the Trauma and PTSD Program at the New York State Psychiatric Institute.
Being in prison, he said, often involves traumatic experiences, including isolation, a lack of privacy, a lack of social support and, in some cases, torture. People in foreign prisons may not understand the language or the culture.
Sarah Shourd, Bauer's fiancee who was also held in the same prison after all three were arrested by Iranian authorities, told ABC News in July that Bauer and Fattal were blindfolded when outside their cells, isolated and rarely allowed phone calls. Shourd was released from prison on a $500,000 bond for medical reasons last September.
She also revealed she suffers from post-traumatic stress disorder (PTSD) and has had to deal with the anxiety of moving from an environment where she was isolated in solitary confinement to sudden celebrity.
The experience was so traumatizing, she told the Huffington Post in May, she couldn't return to Iran to face criminal sanctions alongside Bauer and Fattal.
"There's a part of me that would like to be with them and be able to stand by them and defend our innocence in court, but I'm afraid that it would be too traumatic for me after what I've already been through," she said.
PTSD, anxiety, depression, severe psychotic breaks and reliving abuse are among the conditions experts worry the hikers may face in the coming weeks and months.
"Initially, there is great excitement, happiness and relief for them and their families, but studies have shown in numerous populations that the emotional impact can be quite severe," Neria said.
While their families and other loved ones can provide the support and comfort the men need, the attention could potentially become overwhelming.
"Their family and friends may want a lot of their attention, but the men may not be able to respond to that," said Dr. Paul Ragan, associate professor of psychiatry at Vanderbilt University School of Medicine in Nashville. "It takes time to get back to normal. They need a minimum amount of demands place on them.
"In prison, you learn to be hypervigilant, aloof and want to become invisible so you're not a target," Ragan added. "You don't show emotions and you follow the regimen, and it can be dehumanizing. These men may need help making the transition."
Mental health professionals urge anyone who has been in such a traumatizing situation to try and talk about their experiences and get psychologically assessed regularly to make sure their emotional issues are under control.
They should also focus on reconnecting with their friends and relatives and learning to trust people again, but pay careful attention to any PTSD symptoms that may arise.
"If there are flashbacks or nightmares, those should be addressed immediately," said Neria.
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