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The Stress of Trauma

Discussion in 'News, Politics & Debates' started by anthony, Aug 24, 2006.

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  1. anthony

    anthony Silently Watching Founder

    Indelible in American minds are the images of two airlines crashing, over and over again, into the World Trade Center on 9/11. Will the images of Hurricane Katrina have a similar psychological effect on survivors who see images over and over again as local and national media focus on the one-year anniversary?

    Some mental-health experts say they could be a psychological trigger.

    When Irene McIntosh saw the endlessly repeating 9/11 images, the counseling psychology professor sent faxes to all the TV networks asking them to stop for the mental-health good of the American people. She suspects others in her profession did so, and one network, ABC, did lessen the image repetition.

    McIntosh, for a year in the thick of the Mississippi Coast's recovery, is among others who worry extensive media coverage of the one-year anniversary will stress further a Coast citizenry taxed by uncertainty, slow rebuilding and massive personal losses.

    "Anniversaries trigger that event all over again," said McIntosh, a Ph.D. in counseling psychology, associate professor at University South Alabama and director of the D'Iberville Volunteers Foundation, which has orchestrated recovery for that waterfront town, one of more than a dozen on the Coast reshaped by Katrina.

    "Anniversaries are tough and I have concerns over all the events that are happening in the next week as a constant reminder that this is the anniversary. Post-traumatic stress is a worry in the sense we're seeing a level of physical and emotional exhaustion."

    It is important to note that she and some other mental-health experts are careful not to say post-traumatic stress disorder, or PTSD.

    "But post-traumatic stress, without the "D," can come from anything that overwhelms our resources, and that is Katrina," said McIntosh, who has lived in D'Iberville since the 1970s. "Any time you have a situation where you have deficits between resources and needs you have the potential for stress.

    "Individual perseverance is that piece of the picture that I think won't get the recognition on the anniversary. Across the Coast people remind me about how strong the human spirit is, how indomitable it is. The ordinary citizens who have served, who have gotten through one more day, they are the heroes."

    Ray Scurfield, one of the Coast's best-known experts on post-traumatic stress, is in the thick of post-Katrina himself. The University of Southern Mississippi associate professor of social work who is recognized nationally for his research on war traumas is having to restructure classes because warlike Katrina claimed decades of his lecture research and notes.

    "PTSD is a very specific term, a psychiatric diagnosis," said Scurfield. "Do I think PTSD is being overused in the Katrina aftermath? The answer is, What is a normal and expectable range of responses to something like Katrina?

    "I think a number of people are having normal and expected responses, and they are stressed but they are not psychiatrically disordered. One of the things I tell people is that you cannot expect to do everything to the same degree or as quickly as you could before Katrina. We're preoccupied, have too much on our plates, too many challenges.

    "I believe many are suffering post-traumatic stress. The same applies to military people coming back from war. The military calls it combat-stress reaction. I think we are having hurricane-stress reaction to Katrina, and that could go on for a while because of how extensive the damage is and how widespread the reminders are."

    Scurfield talks about the five stages of disaster recovery: Heroic, tunnel vision, honeymoon, disillusionment and reconstruction/recovery. The last two, he said, are where many people on the Coast now are at the one-year anniversary.

    The disillusionment characteristics, he said, are a strong sense of disappointment, anger, resentment and bitterness from delays, failures or unfulfilled hopes or promises of aid.

    "Obviously, that applies to a number of people in Mississippi and Louisiana," Scurfield said. "I suspect it is a substantial minority, maybe 30 percent-plus. I think there is a significant group stuck on the why did it happen to me and what we've lost, but we have no hard data to support that. All this is research yet to be done."

    USM just took a step in that direction by establishing the Katrina Research Center, and Scurfield, as director, is applying for grants to support the catastrophic-event research on health, economic development and environment impact.

    "As we come to the one-year anniversary, or any time, we must recognize hurt and trauma that has occurred but we also have to look at the other side of the coin," Scurfield said.

    "What is positive and good about this? Typically the negatives have a built-in positive that people aren't recognizing. The negative is, That was my ordered life and it got shattered. The positive corollary is What have I learned about my priorities? A lot have learned or relearned it's not the material but the relationships, or our faith, or something else."

    Scurfield illustrates "personal variations" with the example of the person who goes to the waterfront and says, Look what we've lost, it'll never come back. But another will say, Wow, it's been cleaned up and I see a couple of buildings going up."

    Ed Cake, an Ocean Springs environmental consultant who has worked alongside McIntosh at the D'Iberville Volunteers Foundation, believes, as do others, that personal recovery is helped through talking, if you are a survivor, and listening if you are one of the thousands of volunteers who have come from across the country.

    "Only in the telling and retelling does it become past tense," said Cake. "It is only in the telling that we heal."

    That has been the premise of Project Recovery, which in recent weeks has stepped up efforts to be a listening ear as the one-year anniversary approaches. Project Recovery's blue-shirted outreach workers, at least 250 on the Coast, are commonplace.

    "One thing that we are encouraging people is to realize most will probably have a reaction at the one-year anniversary and knowing that in advance is helpful," said Wendy Bailey, public relations manager of Project Recovery.

    Bailey lists possible anniversary reactions as regret, sadness and frustration. This can include a return of fear or anxiety, flashbacks, depression, sleep problems or people turning to drugs, alcohol or eating disorders. Bailey and her colleagues believe that realizing these are reactions may occur will help people cope.

    "Mississippians should be proud of how far they have come," she said. "The people of the Coast are very determined and resilient, and on the anniversary should celebrate those strengths you have developed as a survivor. "

    Dr. Ray Scurfield of University of Southern Mississippi-Gulf Coast gives these tips for coping from trauma.

    Scurfield says it is important to realize that experiencing a trauma can result in your being "knocked out of your orbit" of what was a familiar, recurring life pattern. It seems as if you now are a stranger in a strange town; a lot of what you have known and have become accustomed to just does not seem to apply anymore - basic assumptions about what you have always taken for granted and what you have believed and assumed makes up your current life - and what is in store for your future.

    Here are his suggestions:
    • Start with the basics. Rest, get physical activity, eat a healthy diet, reduce or eliminate tobacco/caffeine and other artificial and unhealthy stimulants and suppressants - basic strategies crucial to strengthening yourself emotionally and physically.
    • Get back to everyday routines. Find a balance between reflection/introspection vs. routines/activities. Re-establish normal household and daily routines. You cannot feel relatively "normal" if you are not "acting" or "behaving" normally.
    • Remember what worked before the trauma occurred. There is no need to rely solely or even primarily on new strategies if things you did before the trauma were good for you to do - even though you may need to make some creative adjustments to do what you used to enjoy doing.
    • Balance. Keep up with current events and what is going on outside of your own personal sphere of existence - and yet pay attention to yourself and those important to you.
    • Find positives in the negatives. For every negative aspect there is a potential positive corollary. For example, after Sept. 11, 2001, and after Katrina, many people reported an enhanced sense of caring for others. By giving to and helping others you will reinforce your own self-esteem and energize yourself and enable yourself to move beyond being too self-absorbed with only yourself and your life challenges.
    • Talk informally with one or more people about how you are doing and feeling and how they are doing and feeling. It can be helpful to know you are not alone in your reactions and can give you a more realistic perspective of what is normal and what is not.
    • Reassess and set priorities. What lessons have you learned? Are things not as important as they used to be? Dedicate attention to what is most important to you, be it family, friends, co-workers, your physical, mental and spiritual health.
    • Be realistic about what you can accomplish and when. In our post-Katrina world, it is essential to be realistic and not be extremely self-critical; you just may not be able to do all the things you used to do before, or to do them as quickly or as well as you used to do them.
    • Playtime and humor. Are there any two things (other than relationships and your faith) that are any more therapeutic?
    Source: Sun Herald
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