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Disaster and Psychological Responses

On Sunday, October 25, 2009, Dr. Peter Lin gave a talk in both English and Chinese on “Disaster and Psychological Responses” to address the increasing numbers of disasters around the world, and most recently the typhoon that affected Taiwan in August 2009.

Dr. Lin began his talk by referring to Master Sheng Yen, who taught that we should not only pray to Guanyin, but learn from the bodhisattva’s example, be bodhisattvas ourselves and take compassionate action. While people who help others are bodhisattvas, those you who suffer are great bodhisattvas. Practice is not to just sit on the cushion, but help others in times of trouble.

Dr. Lin focused his talk on the effects of major natural, man-made, and individual disasters on mental health, how to help others, and the psychological effects disaster have on those who help others. It is important not only to have compassion for others, but to act with wisdom. “Good intentions are not enough. If you are going to help someone, it is important to understand that whatever you do can either contribute to help people get better or traumatize people.”

When people face disasters, most people are resilient, can recover on their own, and experience normal psychological reactions. Common initial responses include numbing, arousal, anxiety, inability to relax, survivor’s guilt, disinterest in receiving help, and attitudes of ambivalence about the death of family members, while a small group of people may display heroism.

These psychological responses will gradually disappear, except for 20-50% of the population who may still experience some of these symptoms. Ongoing emotional responses include depression and grief, dissociative experiences (the feeling of being disconnected to reality), psychosomatic disorders, anxiety, worry, re-experiencing (such as flashbacks), nightmares, loss of memory, interpersonal difficulties, and spiritual discontent.

Before an imminent disaster, people may respond in two ways—denial or hypersensitivity. After a disaster, most people will go into shock, then act by helping themselves and others, have feelings of hope as disaster relief arrives, depression as resources are withdrawn, and then slow recovery. People may have “anniversary reactions” or trigger events where people re-experience disaster responses.

For every one victim who suffers from physical injuries, there may be an additional four who suffer from psychological injuries. While physical injuries may be relatively straightforward and simpler to “fix”, psychological injuries may take years to treat. People who are more at risk are children, the elderly, the physically impaired, drug users, first responders, and people who suffer from mental disorders and psychological trauma. People whose responses worsen after a month should seek a professional for help. It is the job of helpers to make correct mental health referrals.

If people are interested in learning about how to help others during a disaster, Dr. Lin recommended that people take courses in Psychological First Aid.

According to Dr. Lin, these are five things we could do to help people who are facing disaster:

· Provide safety: help people get what they need, such as water, food, shelter, warmth
(Physical needs precede psychological needs)
· Promote calmness: listen to people, try to understand them if they are difficult to deal with, be compassionate and kind, provide accurate information
· Promote connection: help people be with their loved ones, especially children
· Promote hope: give hopeful information; don’t criticize. Find out the types of services that are available. Remind people that help is on the way.
· Promote self-efficacy: help people to transform themselves from being victims to being survivors. Ask people to engage in the help process. Encourage people to help themselves.

Dr. Lin suggested that we NOT do the following:

· Don’t force people to share their stories with you.
· Don’t give people simple assurances. Don’t say, “At least you survived.”
· Don’t tell people how they should feel and think.
· Don’t tell people why they feel a certain way.
· Don’t make promises you can’t keep.
· Don’t criticize.

Additional things we can do are:
· Politely observe.
· Ask simple, respectful questions.
· Provide practical help.
· Speak firmly.
· Be a good role model.
· Give age-appropriate information.
· Be patient.
· Be responsive.
· Be visible and available.
· Keep confidentiality.

In addition, Dr. Lin stated that we should know when to refer people to professional help and call for help if there is anyone who is suicidal, if there is abuse, criminal activity, medical emergency, if someone is socially isolated, hallucinating, or abusing alcohol or drugs.

Helpers need self-care because they are part of the high-risk population. Helpers tend to believe that their feelings are less important than the victims. In reality, helpers’ well-being is as important as the victims, because if helpers are not feeling well, they are not able to help others.

For helpers, there are 3 major stressors – preparing to go to the disaster site (rushing, not having enough information), at arrival (dealing with the sights and smells) and conflicts between co-workers and helpers. Common responses are sadness, anger, not wanting to leave, not paying attention to feelings, and denial of the need to rest and sleep. Without self-care, helpers may experience Secondary Traumatic Stress Disorder, feeling traumatized, and may even experience symptoms that are the same as those who experienced trauma first-hand. The may experience Compassion Fatigue, where they may first feel compassion and empathy, and then become tired and burn-out.

Dr. Lin said that we should take care of ourselves by knowing as much as much as possible before entering the disaster site. Once at the disaster site, eat, drink enough fluids, get plenty of sleep, and practice relaxation techniques. When helpers return home, they should go back to their normal routines, and be prepared to know that not everyone will be interested in their experiences.

Dr. Lin concluded his talk by saying that as helpers and victims, we can deal with any circumstances and situations if we understand the meaning and purpose of life.

(Report by Chang Jie)

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