Dealing with Crisis 2 of 4 (Dr. Brent Lindquist)

Hello again.  This month I’m working through a series on crisis, particularly related to the crisis that is going on in the South Asian zone around the Indian Ocean as a result of the tsunami. Today is my second program and I want to talk about - what does a survivor really need?  I want to make a distinction here in that I try and use, in my own mind and my own heart, the word survivor for the victims.  Maybe that’s just playing with words, but I like to think of these people as having survived something and not necessarily merely being victimized by it.  I’m not trying to diminish they’re impact, but I’m trying to instill from the beginning, from the inside of me, the idea that there is hope and that things will get better over time hopefully.

So what does a survivor really need?  Now, as you think of ‘survivor’ you probably want to recall that in the last program I talked about people even where you live, which may be thousands of miles from the Indian Ocean , who have been experiencing symptoms.  And so on one level, they’re sort of survivors.  But what do survivors need?  Well, I think they need us to listen to them and to care for them. Now, that sounds kind of obvious, but disaster stress and grief reactions are very normal responses to abnormal events.  Sometimes particularly with people who are more mental health oriented, like me, there is a tendency to put a mental health label on that and that’s something that is definitely not needed and should not be done.  People experiencing crisis need to feel free to not be labeled as mentally ill.  Indeed, if people like me go into those things we have to be careful to make it seem like we’re not trying to diagnose everybody.  Especially in the immediate after-effects of the heroic and honeymoon phases when everybody’s working hard and probably overdoing it, we need to remember that they are experiencing normal reactions.  It’s completely normal to be afraid, to be hyper-vigilant, to be extremely grieving over things and to feel lots of stress and have difficulties sleeping or eating and all of that.  That’s all normal.  When it continues beyond the first few weeks even when there are resources around, it becomes not quite so normal.

Another point for the survivors is that they need to try to get back to a normalized kind of life and schedule as quickly as is possible.  Now in some of the places that have been hit by the tsunami, normality will not be there for months, if years, if ever.  But on the other hand, there are normal things that you can do.  For example, sleeping, eating right (if there is available food), drinking enough liquids, and stuff like that.  Those are the basic issues and part of the basic hierarchy of needs that need to be met, really, before people can begin to work on the psychological.  One of the struggles going on right now is that some of those basic needs aren’t being met and it doesn’t look likely for some of the outlying areas that those needs will be met any time soon.  Unfortunately, this can prolong the problems and prolong the recovery as well.

Most people who are survivors don’t seem themselves as a need of mental health.  They see themselves as in need of practical suggestions and that’s probably what they’re going to respond to the most.  They don’t need psychological discussions of what they’re going through.  They need ideas or thinking through decision making and stuff like that.  One of the problems that survivors have is in decision making and concentrating so sometimes a kind of a gentle questioning approach may really help somebody make sense out of what they need to do next. Even asking simple questions like: Are you warm?  Are you comfortable?  Do you have any needs?  Do you have a blanket?  Do you have a cup for water?  Do you have water?  Those kinds of things are much better than, So tell me how your depression is doing today? ...if you get my drift.

Another point that survivors need is that they need people to address them in their own contexts.  This is related to the fact that I’m a North American.  Now I can make these radio programs, for instance, and this organization can broadcast them, but that’s me talking to non-North Americans.  We have to be careful about how we present and how we provide information and we must tailor that to meet their particular needs. These needs include things like where they live.  Are they rural or urban?  Their age – are they old, young, middle aged?  Are they parents or children?  Are they grieving family members?  Is there a faith-basis to their life?  We need to take into account all of that so we can help set up systems that can help them recover.

I think it’s important that we look beyond.  What is the need, the long-term need?  Too often we end up focusing only on this particular few days of time getting people the blankets, the food, the water, getting them a structure to live in and then stuff kind of falls apart.  The long-term recovery is very important.  And that requires the work of all kinds of people and entities and agencies and governments and non-governmental organizations to help people really rebuild their community.

As I look over the next 3–5 years that we’re going to be recovering from this whole process in the South Asian context, we need to think through how we’re going to give people that kind of hope and give people the practical advice, mental health input, social health input and balance input that helps them make the best use of the physical resources and funding that they’re given.   Then we can see vibrant communities grow out of this.  That’s my hope.

As we look at the next things that survivors need, I want to go back to the fact that survivors need to tell their stories.  Sometimes the most healthy and healing thing you can do if you’re dealing with these survivors as they recover is to give them an opportunity to talk about things. Not drag it out of them, but just let them know that you’re willing to listen.  For example, I can go and talk to somebody and say, Now it’s important that you talk about your situation so I need you to really open up and tell me all the ins and outs and all the details about everything that has happened to you. Well, they’re going to feel like they’re being violated if I do that.  How much better would it sound like this, I understand that you’ve been through a lot and that you are really having some issues that are bothersome. I want you to know that I’m available to listen if you want to talk about anything.   Perhaps now isn’t a good time but I just want you to know that. That kind of respond is going to be heard by the person as giving them permission to have appropriate limits to their grieving, their experience and responses so that they can talk through things. Sometimes it’s also good to try to listen for some of the hope in their words, Maybe some people don’t have a lot of hope, but to build on that to encourage them to see that they’re talking about the next time, or next week they hope to get resettled and then they can start back on their business, and endorse that as a possible hope and a good thing to think about or plan on.  Certainly, in the disillusionment phase, some of these hopes will get squashed but that doesn’t mean we don’t keep trying to work through some of these issues.

Well that about wraps up today.  As you think about what survivors really need, I think they need to be listened to, they need to be given practical input, and they need to have a sense of control where appropriate.  Talk to you next time!