The Psychology of Confinement: Q&A With NASA Psychologist Al Holland

BY Lea Winerman  October 14, 2010 at 3:43 PM EDT

Chilean president Sebastian Piñera sings the national anthem with chief supervisor Luis Urzua, the last miner to be rescued (Flickr Creative Commons/Rescate Mineros)

NASA psychologist Al Holland has spent decades helping to prepare and support astronauts on long-term space missions. In August, he went to Chile to advise officials there on how to help the 33 miners trapped underground — a long-term confinement situation not so different from a space flight. Holland spoke to the NewsHour Thursday.

Tell me about the work you do at NASA?

The work I normally do is the psychological aspects of long-duration spaceflight. That began before the Mir mission, in the early 90s, with us going around to [study] the situations we thought were going to be similar to long-duration spaceflight. So I would go around to the submarine community, the polar Antarctic community, remote oil drilling platforms, that sort of thing, and collect information on how people adapted and what some of the problems were that they saw.

And then from there we went to do our own confinement studies. And here I led the psychological aspects of some closed life-support capsules, where we put teams in there for up to three months at a time, to understand, again, what sort of issues come up and how can we best intervene to make their life better and to support them emotionally and psychologically.

And then the international space station, the ISS program began. And so we’ve had some 24 flights there, up to six months in length. So that’s what I do. Currently, I support the astronauts that are on board, and their families. I also do selection for astronauts, and training, and in-flight support and repatriation.

How did you get involved in the Chilean mine rescue. Did NASA reach out to the Chilean government to offer support?

It was really the other way around. The Chilean government was very active, once they found these folks, in saying “Ok, we can’t get to them for several months down the road, how are we going to manage that and what sort of problems are they going to have?”

So it was a situation that was made to order for us. We felt very comfortable giving technical advice on that. So we went down on the 30th of August and stayed about a week, and talked to our counterparts down there and gave them advice. And then since that time we’ve been in touch by e-mail.

What kind of advice did you give?

One of the very first things I noticed was that they were still in the adrenaline rush, if you will, of having found the men and trying to find some way to extract them quickly. They had not yet changed to long-duration thinking — they were moving that way but hadn’t yet completed the turn. So I tried to get the miners, the families and the topside officials thinking in terms of a marathon rather than a sprint. I was telling them about self-regulaiton, how individuals need to regulate their emotions. And how to set healthy expectations among the miners and the families, rather than unrealistic expectations, of rescue. And just a wide variety of team and individual coping strategies.

Another major area we talked about were circadian rhythms, and regulating the sleep-wake cycle. When you’re in a dimly lit mine like that, for long periods of time, you can start to do what’s called “free-running.” That’s where your internal clocks tend to get out of synchrony. You can be sleeping at the wrong time and awake at the wrong time, and everyone gets on their own schedule — and it doesn’t do well for team dynamics or community health. So we got the men on a regular sleep-wake cycle and advised them on how to normalize the day, not only with regular patterns of light and dark, but also with set times to exercise, and to eat, and certain calls that they had to attend to from the topside physician each day, and various duties like tending to the resupply lines. So that established a regularity to their day and helped them to have some individual and social stability.

How does what these miners went through compare to astronauts’ experience?

There are similarities and differences.

There are a lot of similarities in all of these long-duration confinement settings. You have the confinement, you have the fact that in this mine’s case [as in spaceflight], they had the opportunity for communication and for two-way video with the families. We knew ahead of time, before they would be rescued, so we had time to train them. We had time to retrofit a support program for them. They had time to build up their knowledge so they would be able to cope down under much better. So I think a lot transferred directly over, with just some modification in that we were retrofitting a group rather than pre-fitting the group.

However there were some really strong differences in the circumstances of the miners were in versus our people. The miners had been thrust into the situation; they hadn’t wanted to be there, they hadn’t spent their lives trying to get there. And they didn’t know when they’d be getting to come out. Normally our people know “Ok, your landing date is here, give or take a week or two.” And so they can pace themselves, they can look forward to that time. And it’s much, much easier to bear versus when you don’t know when you’ll be rescued or how long you’ll be down there.

Another big difference was that 33 was a much larger number than the six people we’re used to working with. But then the space down there they had was much larger than what we’re used to working with for our six. So that kind of equaled out — their “social density,” the number of people per cubic volume, wasn’t too different.

So in short, there were differences and similarities, but a lot of it transferred over.

You mention that the men hadn’t been selected or trained ahead of time. But did it help that they were miners, and used to being underground?

That’s a good point. They were in an environment they knew. They had been working there, some of them, nearly all their lives. Some were newer to it, but certainly it was a familiar environment that they were trapped in, it wasn’t alien to them, so I think that helps a lot. And also, I think they’re a tough group too.

Another thing that helped them a lot was their leader, Urzua. He got them organized, he interceded and established a pattern down there, established roles, gave meaningful work to people, and had them working on their own behalf to either escape, or to be heard and found and rescued, which was successful. So that — taking charge of your own fate — has a really positive effect on your motivation. It has a positive effect even after you come out, on how you look back at that experience and how traumatic it was versus how good it was.

How will they look back on their experience? What kind of mental health issues might they face going forward?

They’re 33 individuals, so I think we’re going to see a range of reactions to being trapped down there. We really will find that out as their stories unfold and as time goes by. Because lots of times symptoms don’t show up right away, they show up later down the road. But I think the doctors are definitely are going to be looking for anxiety reactions, family difficulties, difficulties sleeping or concentrating. They’ll be looking for symptoms such as reliving the entrapment experience, nightmares that don’t go away or intrusive thoughts during the day. They’ll be looking for aversion to dark.

They definitely will have a counseling program and I think they’ll greatly encourage regular contact with a counselor to assess individuals as they go down the road. One thing that’s going to happen is that everyone has to go through some major adaptation with the new fame. The families, spouses, and the miners as well. And I think there are going to be some people who maintain their balance and do that very well, and there will be other people who have more difficulty.