Guest post by GTF faculty member Dr. Ann-Marie Neale, Karen Horney Professor of Counseling and Psychology
(Read part 1 of this post by clicking here.)
“Counseling Survivors of Disasters and Community Trauma” is an E-Tutorial offered by Dr. Neale through the GTF. This E-Tutorial is designed to help familiarize the student with types of disasters, phases of disasters, the victims, and appropriate intervention and collaboration efforts for clergy, chaplains, and mental health counselors.
What do we know about disasters and community trauma? There are typically four or five phases of a disaster. If it is known ahead of time that a hazard could potentially strike a community, this is known as the Pre-disaster Phase. For example, prior to Hurricane Sandy, the weather forecasters predicted that this storm had the potential of causing significant damage to the New York and New Jersey coastline areas. The second phase is known as the Heroic Phase which is when all the first responders, volunteers, and community members rally to help the victims and survivors. This is sometimes known as the rescue phase. During the Honeymoon Phase which can last from one week to three months post disaster, there is extensive media coverage, the community rallies with support and there is often a sense of relief that the worst is over. This is followed by or even co-exists with the Disillusionment Phase which can begin days after the event and last several years. During this time, survivors are frustrated by delays or lack of reconstruction and recovery. Finally, the Reconstruction Phase occurs when survivors and communities begin to re-establish normal physical, emotional and spiritual wellbeing.
Most mental health treatment or counseling during and immediately after a disaster is a form of crisis intervention. The majority of survivors are part of what the disaster research literature characterizes as the “normal” population- people who would likely never seek traditional mental health intervention but are now experiencing a normal reaction to an abnormal event. If we are ever asked to provide or volunteer our services during a disaster, we will be seeing survivors at the site of the disaster, in their neighborhoods, in shelters and even perhaps in their homes. Crisis intervention usually challenges the mental health team to avoid “traditional psychotherapy” and instead offer support, suggestions for proactive activities, and even ways to relax and take a break from reality. Local clergy and other volunteers often provide comfort and compassion to the survivors, their families and the responders. It is also important to help survivors tap into their own creative gifts and talents as they reach out to others and their community.
For almost ten years, I was privileged to be a Mental Health Specialist for the Red Cross. I was also on the North Carolina Disaster Response Team. Although I learned many important things about the effects of disasters, community trauma and terrorism on individuals, families and communities, since I lived in the Midwest and South during that time, the majority of my Red Cross experience dealt with the aftermath of floods and other natural disasters.
During that time I participated in a conference entitled “After Everyone Leaves” which looked at the long term effects of natural and technological disasters on the survivors. What can church members, pastors, chaplains, community volunteers and others do once the heroic and honeymoon phases are over and the rest of the world gets on with their lives? How can therapists and other mental health specialists help those who need counseling months after the disaster has ended? I remember interviewing a victim of the Midwest Floods in preparation for my talk at this conference. I chose to speak with her in what I though was a neutral location: a hotel lobby in Des Moines, Iowa. As she was sharing about how she was coping over one year after the flood waters engulfed her home (she escaped minutes before the house was completely submerged,) I noticed that she began to tremble. I thought this was due to the conversation; however, this particular hotel lobby had an indoor waterfall. Although we were sitting on the other side of the room out of sight of this waterfall, she could hear the sound of the cascading water. She told me that it was reminding her of the sound of the rushing water that flowed around her house and filled up the basement minutes before she was able to open the door and evacuate. Her beloved dog, however, did not survive. She also said that when she and other victims look at televised footage of the flood waters, they all smell the sewage and other foul odors that flood waters bring. It is as if they were back in the flood once again.
Whether we are members of an organization such as the Red Cross, are chaplains, pastors of a church, community volunteers or mental health providers, it is so important to think outside the box when determining what is necessary and helpful for victims of disasters and community trauma. Our intervention can be something quite simple yet profoundly beneficial and life-affirming.
I hope the following true story helps illustrate this point. When I was a Red Cross volunteer during a severe flood in Louisiana, a woman showed up at the Family Service Center seeking financial aid. Her home was flooded and she was now staying with her aged father and her 30 year old severely mentally handicapped daughter whose mental ability was that of a 3 year old. This woman was disheveled and visibly trembling. As her story unfolded, the Family Service worker referred her to the mental health team as she seemed to be emotionally distraught. The woman’s tears flowed as she told me that her mentally handicapped daughter was not eating or drinking. This daughter was getting weaker and weaker and seemed to be in a state of extreme grief. This grief was due to the fact that a doll she thought of as “her baby” had been destroyed by the flood waters and thrown away. According to the mother, her daughter just kept crying for “my baby.” She loved to “feed her baby” and was inconsolable after seeing the water logged doll being tossed into the trash by her well-meaning grandfather. Since her daughter had the mental capability of a three year old child, she did not understand why “her baby” was thrown away.
As I thought about this problem, I realized that no department had money put aside to pay for a doll as this was considered a “non-essential item” and therefore not covered by the Red Cross emergency relief fund. I called the local churches and none of them had a doll that could be fed with a real water bottle in their donation boxes. I was about to give up but finally went to the nurses’ department in the Red Cross Service Center and passionately pleaded with the charge nurse to make an exception and give this victim a money voucher for Wal-Mart that could be used for a “non-essential item.” She agreed and we gave this loving mother the voucher.
Several weeks passed and one day I was approached by a family services worker who said that someone wanted to talk with me. I saw a woman whose clothes were clean and neat, and whose face was wreathed in smiles. At first I did not recognize her as the tearful, unkempt distraught woman of weeks before. She rushed over, held her arms out and gave me one of the warmest hugs I have ever received. Then this survivor told me that after she left the Service Center weeks earlier, she immediately went to Wal-Mart and found a doll that could be fed with a real bottle for her daughter. When she gave the doll to her, the daughter started laughing and singing “My baby is back, my baby is back!” She immediately began to feed her baby and to eat and drink again. The baby doll’s name was Nina. As the mother embraced me she said “Praise the Lord, Nina done ROSE from the dead!!” Then she tearfully thanked me over and over for caring enough to convince Red Cross to pay for a “non-essential item” like a doll.
Due to this and other similar incidents, the Red Cross has established a “compassionate fund” which is now used by the Mental Health teams for seemingly non-essential items like toys for children. However, it was the determination of this mother – the “Defiant Power of her Human Spirit” that is truly inspirational. Even though this survivor was still homeless, living with her aged father and had lost nearly all her possessions, she was able to see the blessings in her life. This mother reached out for help for her daughter by asking for the seemingly impossible. She then took the time to thank those who reached out to her. Often when I fear that something is impossible and can’t be done, I think, “But wait! Nina done rose from the dead, so never give up!”
It is my hope that this essay will inspire and motivate the reader to think about how each of us as individuals or through our church communities, our volunteer groups, our workplaces or our mental health practices can be of help and service following a disaster or community trauma. There is little doubt that one day we will all be challenged to give of ourselves, our talents and our support to the survivors in our own communities and families. Will we be willing and ready to answer the call?
About Dr. Neale
Dr. Neale will serve as Moderator of the Clinical Colloquium “Logotherapy and Existential Analysis in Trauma Exposure” during the Viktor Frankl Institute of Logotherapy’s 19th World Congress held this June 19-23 in Dallas, Texas.
Dr. Ann-Marie Neale is Karen Horney Professor of Counseling and Psychology at the GTF. She is a Registered Nurse and holds a Master of Arts and Doctor of Philosophy in Clinical Psychology from Michigan State University. She is an Academic Associate and Dipomate in Logotherapy from the Viktor Frankl Institute of Logotherapy in Abilene, Texas. Dr. Neale’s specialized areas of interest include Logotherapy; survivors of natural disasters; 12-step recovery programs for addicts, alcoholics & families; physical illness and mental health; aging in modern society; and gender issues in the workplace, among others. She serves as a Thesis Supervisor, Project Consultant and E-Tutorial faculty at the GTF. Read more…