... typhoon ondoy, post-traumatic stress disorder (ptsd), and disaster counseling ... (philippines, psychotherapist, psychologist, psychiatrist)

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Dealing with trauma after 'Ondoy'

(article excerpt)
ABS-CBN - Wednesday, September 30

MANILA - The damage brought by tropical storm Ondoy (international code name Ketsana) ruined the lives and homes of thousands of Filipinos in Metro Manila and surrounding provinces.

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"This time, we're dealing with trauma based on a calamity or disaster. So it's very disheartening to know the extent of the damage, not only environmentally but with regard to people's lives," said clinical psychologist Dr. Randy Dellosa in an interview on Mornings @ ANC on Tuesday.
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Trauma
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Dellosa said there are different kinds of trauma based on different emotional incidents in a person's life.
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"I've talked to a number of survivors and they have exhibited different types of emotions," he said.
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Though they have bravely stepped up to help others during the typhoon, disaster response teams or volunteer rescuers also need help themselves.
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"These 'heroes' also need our help. Because some of them may be acting out of their own fears. We call this counter-phobic helping. Just to confront their fears, they start helping people, but deep inside they have anxieties and fears," Dellosa said.
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Common reactions experienced by disaster victims are the following:
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SHOCK over the suddenness of the disaster, being unprepared for it, and feeling bewildered. Dellosa said there is also a tendency for victims to deny that things were happening to them, even if they were confronted with flood waters and scenes of death and destruction.
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ANGER that can be directed towards the disaster, God, others, or themselves. Victims question why disasters happened to them and if they had done anything wrong. They can also feel regret for choosing to live at a certain place, especially when there is great loss.
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DEPRESSION after losing property or loved ones. Dellosa said it is natural for victiims to cry profusely, even if they don't know the reason, or to feel an overwhelming sense of sadness. "That's part of the grief of losing so many things," he said.
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SURVIVAL GUILT or wondering why they survived and others did not. Victims may feel that others were more worthy of living, or that they did not do enought to help others. This is sometimes accompanied by the feeling that they should have died along with their loved ones.
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Further, people surrounding a typhoon victim or survivor are also at risk for developing psychiatric disorders because the experience of dealing with others' losses can be traumatic or make them feel vulnerable.
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Telltale signs
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Victims can develop anxiety disorders like a panic disorder. Throughout a person's day, they can experience periodic symptoms like shortness of breath, palpitations, gastric disturbances, and tenseness of the body.
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Dellosa said victims can also experience anticipatory anxiety, or the fear that something traumatic will happen again. This can happen, for example, if a typhoon victim gets nervous at the first sight of rain.
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Depression can manifest in sudden changes in appetite, energy level, or sleeping patterns. Victims have difficulty focusing or concentrating, and can even have suicidal tendencies or thoughts - just to escape pain or even to reunite themselves with their loved ones. 'Sometimes they are stoic and do not show emotions. But they are delaying the manifestation of their anxiety. Everyone can experience this, from old to young," Dellosa said, adding that children and the elderly are particularly vulnerable to emotional stress.
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What to do
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He warned those who have relatives of friends who exhibit overwhelming anxiety or depression to seek professional help immediately, or to offer a sympathetic ear so that victims can unload their feelings.
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In counseling, this is called a "defusion stage" where victims release pent-up emotions and tell their stories so that healing takes place. "You have to lower the level of anxiety and terror that they feel. This takes place in the first few hours after the disaster and before they sleep. Allow them to vent and share their stories," Dellosa said.
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People should also avoid showing graphic images of calamities to victims because it reinforces their negative feelings. It would also be a good time to mobilize the victim's support system (friends, family, church) to remove feelings of helplesness or lonliness.
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