Nice, Ten Years Later: What Research Tells Us About the Victims’ Recovery

Your research on the Utøya survivors is based on a multi-year follow-up study. What does this type of study tell us about how trauma evolves over time? And what can we expect for the victims of the July 14 attacks, who are about to mark the ten-year anniversary?

What we generally observe after this type of trauma is that, in the first few days and weeks, people who were directly affected or who lost a loved one experience intense reactions: flashbacks, agitation or hypervigilance, and difficulty sleeping. For many, these reactions gradually subside. But for some survivors or relatives of victims, these reactions may remain intense over a long period, or even manifest later, worsening over time.

People’s experiences therefore vary greatly. Several factors come into play: what the person experienced before and during the attack, but also everything that happens afterward. It is precisely during this latter period that we can take action. Our priority, as healthcare providers and researchers, is first to prevent the onset of long-term disorders, and then to identify those who have developed them and need treatment.

Over time, a particular phenomenon can be observed: during the acute phase, public attention is very intense, but it then fades. For those who continue to suffer, this gradual silence can become painful in and of itself. Added to this is the feeling of having been permanently changed, of no longer functioning as before—whether professionally, academically, or socially. Festive events can become triggers for painful memories, which can lead to gradual isolation and further weaken social ties. It’s a vicious cycle.

For the victims of the July 14 attacks, the commemorations have a particularly ambivalent dimension: they represent a form of collective recognition—confirmation that the event has not been forgotten—which can bring real relief. But they also reawaken painful memories. And the fact that it coincides with the national holiday adds a specific challenge: every July 14 will be both a moment of collective jubilation and a reminder. Over time, people learn to live with this duality, but it does not disappear completely.

It’s also important to note that not all experiences are marked by suffering. Many people recover, and some experience a form of positive transformation: a reordering of their priorities, a greater appreciation for life’s precious moments. This is something we’ve also observed in our studies.

The attack on the Promenade des Anglais struck a crowd gathered for a national holiday, in an open space, during a moment of collective joy. How do these characteristics influence trauma and care needs?

The festive context plays an important role in how the trauma is imprinted in memory. Flashbacks—those memories that surface involuntarily—can be triggered not only by July 14 itself, but by any festive social gathering. Over time and with appropriate care, these reactions tend to diminish for most people. But for those whose reactions are very intense, avoidance of such situations can set in and become a problem in itself.

There is, however, one aspect that is less often discussed: the fact that this attack occurred in a very public, highly publicized setting can also facilitate social support. When everyone knows what happened, it is easier for those around the person to understand why they are struggling and to offer help. This is very different from more private traumas (domestic violence, sexual abuse), where silence and sometimes shame make it harder to access support. The collective nature of the trauma can thus, paradoxically, serve as a resource.

The flip side of this visibility is that excessive media coverage can weigh heavily on those seeking to regain some inner peace. In Norway, after the July 22 attacks, the perpetrator’s face and name were ubiquitous in the media, to the point that a movement was organized to turn newspapers over so as not to see him. I think France has been more cautious in this regard following the Nice attack, and that’s a healthy approach: we must not let the perpetrators of attacks dictate the media narrative.

You’re collaborating with French and European teams to compare psychosocial care systems following the attacks. What differences have you observed between the Norwegian and French responses?

In the immediate aftermath, the two countries take fairly similar approaches: they set up reception centers where victims and their loved ones can gather and receive initial support. The difference lies more in who provides this care and for how long.

In France, the response during the acute phase relies on specialized care—psychiatrists, psychologists, and psychiatric nurses—organized within medical-psychological emergency units (CUMP), which remain active for the first month. At the end of this period, individuals are referred based on their needs: specialized care, a primary care physician, or no specific follow-up if they are doing well.

In Norway, the acute phase is primarily managed by primary care providers—general practitioners, nurses, and social workers—at the local level, as Norwegian municipalities have a high degree of autonomy. Following the July 22 attacks, a special program was implemented: proactive follow-up for at least one year, with systematic check-ups three times during the first year. It was not up to the survivors to seek help; rather, local teams reached out to them to provide practical support, monitor their health, and refer them to specialized care if necessary.

In the long term, the differences are therefore significant. But the fundamental question—which approach is most effective?—remains difficult to answer. Research in this field faces a major obstacle: attacks are unpredictable, and a rigorous and ethically sound research protocol must be deployed very quickly among potentially traumatized individuals, sometimes including children. This is a considerable challenge. Our teams are working to build a solid body of comparative data across countries to better evaluate our practices and improve them collectively.

Your research shows that the impact of a terrorist attack can be severe for children and adolescents. Ten years after Nice, what do we know about the trajectories of these young victims?

First, it’s important to note that the Nice-based team, led by Professor Florence Askenazi, has conducted the most direct research on this topic, and they are the ones to consult for precise data. What they have shown is that these issues can persist for a long time in children and may be identified late—sometimes because families take time to realize that something is wrong, and sometimes because the manifestations of trauma in very young children are difficult to interpret: they vary greatly depending on age and stage of development.

What we have observed more broadly in our research at NKVTS, particularly after Utøya, is the impact of trauma on academic performance and future prospects. Adolescents who were doing well before the attack might find themselves unable to concentrate or to finish high school. It is not only the pain of what they experienced that weighs on them, but also the feeling that the attack has permanently altered who they are and what they can hope for.

What I also want to highlight is how the team in Nice was able to transform this experience. The July 14 attack affected a particularly large number of children and families, and the care provided to them led to changes in French practices in this area. They established a center specializing in psychological trauma in children and families, which continues to serve as a model for best practices at both the national and international levels.

As the tenth anniversary approaches, commemorations, trials, and memorial sites take center stage. What role can they play in the process of recovery for the victims and society?

Commemorations serve an important function for society as a whole: they remind us that terrorism is not acceptable, and they create a moment of collective unity in the face of violence. For victims, seeing that society has not forgotten can be a valuable form of recognition. But expectations and needs vary greatly from one person to another. Some need to reconnect with others and be part of these moments. Others prefer to stay on the sidelines. It is important that society not create an implicit obligation to participate: the invitation must remain open, and the freedom not to accept it must be fully respected.

Trials represent a unique stage. They are society’s response, demonstrating that terrorism is not tolerated, and can allow some victims to move on. But they can also trigger intense emotional reactions, particularly among those who testify or follow the proceedings closely. It is important for loved ones and healthcare providers to understand that a resurgence of symptoms around the time of the trial is common and predictable; this is not a relapse, but a normal reaction. Being prepared for this period makes it easier to get through it.

The timing of the trial is also a factor to consider. In Norway, the trial took place nine months after the attacks, which fit seamlessly into the ongoing support system that had been established. In Nice, the trial took place several years later, by which time some victims had already made significant progress in their healing. Reopening this chapter after having moved forward can be particularly difficult to cope with.

What is your view on the ambition of the Museum and Memorial of Terrorism—of which you are a member of the Scientific and Cultural Council—to serve as both a place of reflection and a source of knowledge?

I believe this dual purpose is not only coherent but necessary. If we compare it to the memorial center in Oslo dedicated to the July 22 attacks, we see this same balance between reflection and learning, and that is what gives it its strength.

Reflection allows us to process grief, pain, and the reality of what human beings can inflict on one another. The educational dimension, on the other hand, looks toward the future: we learn, we understand, and we collectively affirm that we will not let terrorism weaken society. These two dimensions are not at odds with one another; they reinforce each other.

This type of place also offers something precious: it reminds us that we form a society. On many issues, we hold very different opinions. But on this point, we are in profound agreement: we do not want this violence. The Terrorism Memorial Museum can be a space where this shared conviction is expressed and shared, in all our diversity.