Will Katrina survivors need brigades of grief counsellors?

In the Houston Astrodome. Photo courtesy of Gene Dailey/American Red Cross What does it feel like to lose your home, job, community and city, all
in one hit? What if the same disaster that swept those things away also
took the lives of family members or friends, perhaps as you looked on
helplessly? What if you are living in emergency accommodation with
thousands of other refugees and have no idea when or how you will have
anything like a normal life again?

These are the questions that strain the imagination and tug at the
heart as our television screens nightly confront us with the refugees
and survivors of hurricane Katrina. Above all, what can be done to
comfort these people—particularly those who, like a black family who
spent days shut in their marooned house with their dead mother, have
suffered the worst experiences?

While most of us ponder these questions with awe, others already have
their answers and are marshalling psychological support for the
victims. Trauma experts, death educators and grief counsellors are
responding in force to a great tide of human need that will continue to
rise even as the floods recede. Or so it seems. A Google search on
"trauma counselling" linked with Katrina yielded 43,000 results. They
included a downloadable journal "for processing and recording your
trauma experience" and a podcast discussing how to respond to survivors.

These efforts and many others more substantial are, of course,
well-intentioned. But how useful are they? Are the displaced and
bereaved souls sheltering in superdomes at risk of prolonged trauma and
lasting psychological damage if they do not have immediate, expert help
to "release" their experiences?

Photo courtesy of Gene Dailey/American Red Cross Maybe not. A psychiatrist writing in the New
England Journal of Medicine
after the recent London bombings notes:
"There have now been more than a dozen controlled trials in which
people who have been involved in accidents and other traumatic events
have been randomly assigned to receive or not to receive such
counselling. The results have shown conclusively that such immediate
psychological debriefing does not work. Those who received it were no
better off emotionally than those who did not. Worse, the better
studies with the longer follow-up periods showed that receiving such
counselling actually increased the likelihood of later psychological

In fact, says the writer, Professor Simon Wessely of Kings College
London, "the people who seemed to be harmed by this intervention were
those who had been especially upset at the time—precisely those who one
might think ought to be treated. So whereas immediate post-trauma
counselling may reassure the rest of us that something is being done,
it does not actually help those who receive it."

This point of view is supported by what happened -- or didn't happen -- after 9/11. As the New York Times pointed out, "
There were more psychotherapists and mental health agencies per square
mile than anywhere else in the country" -- or in the world, for that
matter. But few people went knocking on their doors after the disaster.
New York Academy of Medicine researchers found only a very slight increase
in the number of New Yorkers who had seen a mental health
professional. "But the increase was not clinically significant," said researcher Joseph A.
Boscarino. ''We expected higher use

A few moments' reflection on our own experiences of emotional shock, or
the experience of others, reveals why. The first thing we have to do
when confronted with a sudden death, diagnosis of illness, financial
disaster or the like, is "take it in", not spit it out. The harder the
blow the longer it will take to recover from initial numbness and get
the feel of it. It is natural, in the face of adversity, to suffer a
bit in silence.

The idea that we need to talk about everything all the time seems to be
dictated more by the theories of certain professionals and needs of the
media ("Don't move the camera until you see the lip quiver and the
tears start to roll!") than the needs of the traumatised.

Some of us may spill the beans quickly, but whenever we do talk it is
unlikely that we will want to confide in a stranger, however expert. We
naturally turn to family members, friends, colleagues, our priest or
pastor—or, in the case of an event like Katrina, to those we have
shared the disaster with and who are a bit stronger emotionally than

In the Houston Astrodome -- Photo courtesy of Gene Dailey/American Red Cross What the people uprooted by Katrina need most from those outside their
community, and what will boost their mental health, is the practical
assistance that is now pouring into the region and that ranges from
tents and stretchers to scholarships and "hurricane buddies" for
students affected by Katrina who are enrolling at colleges.

Eventually they will return to their wrecked homes or settle in new
communities and rebuild their lives. For most of them, the demands of
daily life will push grief into the back ground, and healing will come
with the help of factors like religious faith, or simply the passage of

Others, less resilient, may need expert help. In England, according to
Wessely, those directly affected by the July bombings were to be
followed up by mental health services after six weeks, screened for
signs of stress disorders and offered therapy. This timing, he says,
was found effective in the aftermath of the 1998 bombing in Omagh,
Northern Ireland.

In a world that is never long without some kind of disaster, and where
robustness of character, family support and faith all seem to be in
decline, there is clearly a place for professional counsellors who can
make up to some degree for these deficiencies. But their tendency to
appear at the scene of every tragedy, even everyday ones like workplace
accidents and the death of a schoolmate, suggests a confusion about
their role and about human nature.

Ocean Springs, Mississippi.Photo courtesy of Gene Dailey/American Red Cross Like September 11 and July 7, Katrina is teaching us that people are
generally more resilient than they are given credit for, and that
families and ordinary support systems do work for them. This is evident
as last week's stories of anger and desperation over the handling of
the emergency give way to stories of bravery, generosity, ingenuity,
humour, faith, stoicism or just plain resignation.

All these qualities are at least dormant in the average citizen,
although it may take a disaster to drag them out of some of us. Indeed,
there are signs that people even relish the opportunity to rise to the
occasion. It would be too bad if that process was forestalled by
someone bent on turning us into victims.

Carolyn Moynihan is deputy editor of MercatorNet


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  • Sheila Liaugminas