The images play over and over in Jasmin Hasic's mind.
He is in a bungalow on a Thai beach (search) with his wife Nadja. A towering wave crashes over them. He holds out his hand, but a wall collapses on her back and she's pulled out to sea. She clings to a palm tree in the sea. He calls out her name. She doesn't respond.
"This is in my head. .... Every day, every day," Hasic says.
His wife survived, but the memories still make Hasic cry and keep him awake at night.
Thousands of survivors like Hasic are haunted by horrific memories of the tsunamis that devoured coastlines in Asia and Africa. Health professionals say physical wounds heal quickly, but it may take years for people to recover emotionally.
"They will need ... very, very robust counseling," said Cesar Vargas, an emergency room doctor who was helping victims in this island resort where Hasic, an Austrian, had been vacationing.
Some parents are in denial, believing their missing children survived and are living in the mountains.
Among relief volunteers there are survivors who can't force themselves to leave the area because they feel guilty they're alive, said Jason Young, a British psychotherapist who set up a makeshift clinic at Phuket (search) City Hall.
Others are afraid of the dark, the water or being alone.
"People are here with their loved ones on holiday ... it's just the day after Christmas (search) and the next minute their loved ones are gone," Young said. "There's two issues there — a natural disaster, which is traumatic in itself, and the loss of a loved one."
Thai survivors now live amid the rubble of destroyed bungalows, cars and capsized boats, as well as thousands of bodies, most of them stored at Buddhist temples.
"A big problem after this is the psychological (troubles)," said Thai Health Minister Sudarat Keyuraphan. "In some villages, almost all families have encountered a great loss. We have found that people are still terrified and trembling although the incident happened several days ago."
Many Thais believe in ghosts, and the number of dead in the area — nearly 5,000 — could cause paranoia. Some people already are saying they want to move away, Young said.
In Banda Aceh, on the Indonesian island of Sumatra where tens of thousands died, some experts said they hadn't yet seen psychological problems.
"You see a lot more smiling and laughing than in the other countries five days after a disaster," said Matthew Huei-Ming Ma, a Taiwanese medical professor leading an emergency team.
But experts expect patients throughout stricken regions to require counseling and question whether enough is available.
Several groups, including the Red Cross (search) and Salvation Army, have sent teams to India to counsel traumatized survivors.
Untreated, they can experience post-traumatic stress disorder (search), said David Sattler, an associate professor of psychology at Western Washington University in the United States who has done research on natural disaster survivors.
The treatment needs to happen soon or problems can go on for years, experts say.
"These are normal reactions and people need to be reassured of that," said Margaret Miles, a professor at the University of North Carolina-Chapel Hill who has worked with disaster survivors.
"It is when they continue to occur years later and impact on one's ability to get on with life that they become difficult," she said in an e-mail interview.
One of those who has already sought treatment in Thailand is Swede Torbjorn Kalm, whose wife and son were seriously wounded and were only recently found in a Bangkok hospital.
Two of his daughters escaped unharmed but his youngest child, Saga, a 3-year-old girl with blond pigtails, is still missing.
Kalm said he can't sleep, cries often and had a vision of Saga on Wednesday.
"Suddenly, it was like she was running to me," he said, crying outside the Phuket town of Wachira, where he was posting flyers with her picture.
When the family gets home to Alingsas, Sweden, Kalm said they'll seek professional help.
"I'm sure that every day of the rest of my life I will have this with me."