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Disaster
Assistance
Disaster Preparedness Manual for the Aging Network
X. Disaster Advocacy and Outreach Program
B. The Psychology of Recovery
Recovery from a natural disaster includes more than finding a
place to stay and acquiring new belongings. It means understanding
the rules concerning when and how you can clean up your home,
coping with television cameras and sightseers who drive by
and stare and processing the anger and disappointment of finding
looters stealing your remaining possessions. It can also mean
learning to discriminate the hucksters from the helpers, the
good guys from the bad, at a time when you are vulnerable.
Recovery also means negotiating with
insurance companies and contractors, filling out seemingly
endless forms and moving from
one temporary home to another. It also means coping with life's
everyday problems while in a very unsettled position. As one
survivor who had spent four months in several different locations
put it, "As a displaced person, I felt I didn't belong anywhere.
I was constantly in limbo and couldn't seem to get even the basic
things done".
Recovery also encompasses the re-establishment of an emotional
equilibrium. All survivors, regardless of age, are affected.
And, when a small community is struck by calamity, a significant
number of persons become hidden victims. While many survive ostensibly
appearing unscathed, friends, neighbors and family may not have
been so lucky. However, as the reverberation continues, it leaves
a rupture in community life and many become secondarily affected
by another's tragedy. Nearly everyone is emotionally affected
to some degree.
Usually following disaster, a community is
awash with professional caregivers eager to help people begin
re-assembling their lives.
While most are good intentioned, not all are trained in outreach,
crisis counseling and debriefing techniques so essential to the
recovery process. As survivors struggle to cope with terror and
loss, they can benefit greatly by counseling from persons skilled
in disaster response caregiving.
The debriefing process is not a technical critique, nor is it
a form of psychotherapy. It is a group interaction in which survivors
are lead through a series of steps that enables them to talk
about their experience of a disaster. Once people start to talk
about personal responses to trauma, they begin to realize that
their stress reactions are normal. Through continued communication,
the long-term effects of trauma are lessened.
Aggressive outreach strategies become key components as many
survivors do not call and make appointments for help. Frequently,
they do not even realize that their emotional struggles are disaster
related. Many may have limited mobility and/or access to transportation.
If relocated, they may not be as visible as those who remain
in close proximity to the disaster site.
Disaster relief requires non-traditional paths in order to effectively
reach many victims. Typically, people's reactions during a disaster
are quite similar. Many experience terror as the danger approaches
and their fate remains uncertain. Yet, with some natural calamities
such as tornadoes, there can be a mesmerizing affect. Many have
reported becoming almost hypnotically fascinated by this awesome
act of nature.
As the ominous circumstances escalate, the experience can become
so intense and detailed that people perceive time and motion
distortions. They may mistakenly believe that they have more
time to react than in reality exists. Moreover, in panic, they
may experience their reactions as unusually slowed. The latter
reaction can be even more heightened for those who due to age
or disability do not normally move with facility.
Immediately after the disaster comes a state of shock and denial.
As one survivor put it, "Everything just shut down".
During this phase, survivors will often appear dazed. Bewilderment,
moving about aimlessly, or operating on "auto-pilot" might
also be apt descriptions as people attempt to bring order to
their lives.
Since natural disasters bring many people closer to death than
at any other time in their life, the stage is set for a cataclysm
of emotions. Shock is usually followed by anxiety and fear
as one re-awakens to the gravity of the event. Subsequently,
anger, frustration, confusion and grief often emerge. The
rage can be misdirected toward others, including God, causing
problems
at work or in relationships. However, when those emotions
appear, the cause of the feelings is usually gone. Failing
to make
the connection, an individual may misinterpret his/her reactions
as an indication of insanity. It is critical that people
realize that they are not going crazy, but rather, they are
experiencing
normal and very powerful feelings in response to an abnormal
event. Nightmares, flashbacks, self-doubt and fatigue are not uncommon
experiences. Jumpiness is often reported as people begin to emit
startled responses to noises. All of the aforementioned can be
further exacerbated when the disaster is protracted, as with
floods, or repeated re-traumatization occurs, as with after-shocks.
As survivors continue to grapple with
their feelings, guilt and depression often emerge. Guilt can
originate from at least
two sources. Survivor guilt may result when one individual has
suffered comparatively less than others. Self-criticism may result
from the mistaken belief that a person had sufficient time to
act more heroically. The guilt, "If only I would have .
. .", can deter a person from coping with traumatization,
thereby keeping him/her immobilized in the recovery process.
It is not uncommon for persons to move
back and forth between emotions and shock as they recover.
Eventually though, people
begin to "test themselves" by re-establishing old relationships
or developing new ones. They begin to change in some facet, whether
it be in the development of a "buddy system" to prepare
for future danger, reaching out to others, enjoying each day
more, or redefining or reinvesting in their relationships with
God. Ultimately, recovery is signaled by constructive changes
that demonstrate acceptance and adaptation. Survivors can not
go back to the way they were before the catastrophe. After all,
as commonly expressed by survivors, "Nothing will ever be
the same".
Recovery efforts need to be structured
in order to account for more than an initial intervention.
Often overlooked, it is important
to plan for "anniversary reactions". Anniversary reactions
are periods wherein survivors experience a re-emergence of the
cataclysm of emotions that originally occurred after the initial
shock phase. The most typical times for anniversary reactions
are six months and one year post-disaster. For many, however,
the yearly anniversary date can prove difficult for upward to
five years.
Many communities have found it beneficial to organize a formal
activity to help survivors move through these difficult times.
Activities such as ceremonial tree planting, balloon launches
and picnics are a few examples of the aforementioned. The activities
serve as a cathartic experience allowing survivors to place the
disaster behind them as well as to embrace and celebrate life.
Older Americans can experience any or all the previously described
reactions. As with any age group, trauma may be expressed directly
through emotional reactions or be less readily identified by
physical reactions such sleep difficulties, poor appetite, general
physical ailments, a deterioration of functioning or a worsening
of an already existent disease process. The difference, however,
is that many elderly may not possess the same degree of resilience
as their youthful counterparts.
Elderly persons can also experience particular
reactions to trauma as a unique function of their stage in the
life cycle.
Faced with the potential losses of loved ones as well as their
own abilities, older individuals can experience such feelings
as increased insecurity even during normal, everyday living.
After encountering the devastation wrought by a disaster, some
older adults can find their natural feelings of insecurity and
vulnerability magnified by the destructive, out-of-control nature
of the disaster. They may react with feelings of increased hopelessness
since they do not know if they will live long enough to rebuild
their lives.
The impact can also trigger memories of other
traumas, thus adding to an increasing sense of being overwhelmed.
Many
of the
anchors to the past such as their home of many years, photographs
and treasured keepsakes - so much a part of their identity
- are gone. Poor health and social isolation can only add to
the
ordeal. In the process of recovery, it is important for older people
to reaffirm attachments and relationships. While they need to
have access to familiar faces such as old friends and neighbors,
often these supports no longer exist. If older people do not
have significant others available, it is critical that contact
be made via assertive outreach programs such as support groups.
It is important that older Americans feel as though they still
belong in the community.
Older adults need a sense of control and predictability. Re-establishing
routines and having a permanent place to live can help increase
a sense of security, stability and control. Relocation and emergency
sheltering may be unavoidable. However, re-traumatization can
be minimized by helping survivors remain as close to familiar
surroundings as possible.
Older individuals also need to restore feelings of confidence
and self-worth. Self-worth can be enhanced by talking about past
successes. Confidence may be nurtured via guidance in setting
manageable goals. Self-direction is essential to one's sense
of integrity.
Because so much has been lost, older individuals also need to
restore feelings of connectedness. Many will be left with little
more than memories. Activities as simple as remembering and talking
about their life can be a starting point that helps them reconnect
with their unique perspective as a part of the history of mankind.
Each person recovers at a rate unique to that individual. The
ease and speed of that recovery is affected by many factors.
One important factor is the survivor's emotional state and experiences
prior to the trauma. Other factors include the ability to understand
what happened and the availability of a supportive environment.
Recovery, then, can vary in degree from serene acceptance to
a protracted and conflicted struggle.
While professional counseling is not
always necessary, supportive relationships are essential. Most
people find the needed support
through family, friends, ministers or other systems already in
place. Friends and family can help survivors by listening to
them and accepting their feelings without judgement. Whether
with the help of a friend or a professional, the recovery process
begins in a helping, supportive context.
| Last Modified: 7/16/2009 9:05:49 AM |
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