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Bystander Syndrome: Healing the After-Effects of Hurricane Katrina
San Francisco, CA
Tuesday, September 06, 2005
For Those Indirectly Affected by Natural Disaster-- How to Overcome Feelings of Powerlessness
By Dr. Meg Jordan, PhD, RN, Global Medicine Hunter®
San Francisco, CA—Spe 6, 200) --- A week's worth of misery and devastation have swept over the residents of the Gulf Coast, and the rest of us have stood by, stunned by the painful images, often to the point of feeling powerless.
For those whose lives are shattered through sudden homelessness and severe loss, it will take many months, perhaps years, to recover. But for those who are only indirectly affected by Hurricane Katrina's dreadful wake, it's not always as obvious that they, too, should initiate actions for self-care and recovery right away.
Health professionals and emergency workers learned many lessons from 9/11 that can be immediately applied to this latest natural disaster. In terms of mental health, the onslaught of around-the-clock televised images of dead bodies, grief-stricken victims, and desperate people take a psychoemotional toll on viewers. If you find yourself being glued to the TV and Internet news, then here are some steps you should take now:
1. Trite as it may seem during times like these: if you don't take care of yourself, you can't take care of anyone else. Remember how flight attendants tell you to put the little air cup on yourself before your put it on children you're traveling with? If you passed out first from lack of oxygen, you'd be no good to that kid or anyone else. Make sure you turn off the TV in the late evening, and get as close to eight hours of sleep as possible. Don't skimp on good nutritious meals. And take a daily walk to reflect, clear your head and feel recharged.
2. Send a donation –any amount. Raise money through yard sales, community events if you don't have enough cash yourself. One of the best sites for deciphering what works best for your values, interests and pocketbook is www.directrelief.org. I made an immediate donation to the Red Cross, but after I saw the $650,000-plus annual salary taken by its president, I wished I had sent money to the Salvation Army, (whose leader takes only $13,000 per year).
3. Offer housing if you can. The massive web efforts undertaken by MoveOn.org and Craigslist match thousands of refugees with available housing. Both websites have simple ways to sign up. Take a moment to know your limitations and be clear with those upfront (women only, no smokers, etc). It will save time and trouble for all concerned.
4. Understand how the process of recovery and healing will unfold. Read the Survival Hierarchy list below and offer assistance as needed, along the stages of recovery. Revisit it after you've taken care of yourself, and dealt with your own fatigue, sadness and shock.
Survival Hierarchy: Safety, Water, Food, Chronic Management
5. First, safety must be secured. This means a safe environment, free from attack or further threat. Survival must always be built upon a safe and secure foundation first. Unsafe conditions include downed electrical lines, fire, combustion threat, drowning, violence, extreme heat or cold, and terror or fright. Sometimes pure, unchecked terror will lead people to fatal, irrational acts such as the world witnessed in Iraq recently on the bridge filled with pilgrims running from an imagined suicide bomber. In the case of this hurricane, the safety issue will continue to challenge relief and recovery efforts since the flood waters carry the threat of contagion from nearby chemical plants, West Nile mosquitoes, food poisoning, decaying bodies, rats, human and animal waste, toxic mold infestations, raw sewage, and jagged debris.
6. Next, clean water must be obtained either through filtration or purification tablets (usually iodine based). People can wait three days for food, but generally not more than a day for water. The hurricane victims that have gone without water in temperatures over 100-degrees are the ones that have suffered heat injury, heat stroke and fatal dehydration. Babies and young children will dehydrate sooner due to their faster metabolisms and higher fluid intake needs.
7. Then food supplies must be obtained. Shipments of prepackaged foods have proven to be the most effective. Reliable protein mixed with slow-burning whole grain carbohydrates are urgently needed for emergency situations. Food rations by relief organizations should be upgraded to no longer include dehydrated mixes that require water, since potable water sources are limited. Victims should avoid eating foods that are contaminated by toxic water, human waste, or spoilage from lack of refrigeration.
8. After safety, water, and food are secured, then assistance should be directed to triaging for chronic medical conditions can be accomplished. (Triaging by medical personnel for acute emergencies should coincide with the first step of securing safe environments.) Chronic conditions include diabetes, asthma, heart disease, and other non-acute medical states that require daily medication or lifestyle management. Assistance should then be directed toward securing reliable supplies of daily medicines or other types of medical therapies.
9. Provide assistance for re-establishing social connections. Once the basics are secured, victims need to know the status of their families, loved ones, and social ties. This could include family pets and neighbors. Being stripped of material comforts, familiar items and their homes, victims are most concerned about the people in their lives. Not knowing what has happened to loved ones keeps victims in a prolonged state of agitation and hyper-vigilance. Behavioral medicine specialists report that this emotional grief is often what "locks in" the trauma to the hind brain, and replays the images and terror in the victim's mind. This can be short-circuited by simply establishing bulletin boards in shelters, finding people online, or enlisting the help of emergency agencies and news crews.
10. Provide assistance for victims to receive counseling for extreme stress, agitation, grief, loss, despondency, loneliness and isolation. These needs have been underestimated in past disasters, but are now placed foremost in the triage lists of emergency agencies. Mental health workers are now brought in to shelters during earlier stages than pre-9/11. This stage of requiring support for grief and isolation can last for many months to several years. Some helpful therapies include EMDR (eye movement desensitization retraining), talk therapy, guided imagery, anti-depressant drug treatment, support group counseling,
Bystander Syndrome is the name given to the non-victims of trauma and natural disasters. The steps for recovery and healing differ significantly since the basic foundational requirements of safety, water, food, and chronic medical management are usually not threatened.
But Bystander Syndrome requires a pro-active course of self-care attention: rest, nutrition, de-stressing exercise, social belonging, spiritual connection and psychological resiliency. Overcoming the feelings of powerlessness in the face of unimaginable human pain and loss is an undertaking that requires a practice that the Dalai Lama recommends:
Breathe in the pain of the world.
Breathe out compassion and love.
Allow your human heart to be a transformer of agonies.
With that fortifying your spirit, you can think more creatively and respond with more vigor. Start again at the top of the list, and offer small actions on a daily basis—but only after making sure you have a renewed, physical and spiritual temple to draw from.
- - - - -
- Dr. Meg Jordan is a medical anthropologist and health journalist, and President of Global Medicine Enterprises, Inc.
By Dr. Meg Jordan, PhD, RN, Global Medicine Hunter®
San Francisco, CA—Spe 6, 200) --- A week's worth of misery and devastation have swept over the residents of the Gulf Coast, and the rest of us have stood by, stunned by the painful images, often to the point of feeling powerless.
For those whose lives are shattered through sudden homelessness and severe loss, it will take many months, perhaps years, to recover. But for those who are only indirectly affected by Hurricane Katrina's dreadful wake, it's not always as obvious that they, too, should initiate actions for self-care and recovery right away.
Health professionals and emergency workers learned many lessons from 9/11 that can be immediately applied to this latest natural disaster. In terms of mental health, the onslaught of around-the-clock televised images of dead bodies, grief-stricken victims, and desperate people take a psychoemotional toll on viewers. If you find yourself being glued to the TV and Internet news, then here are some steps you should take now:
1. Trite as it may seem during times like these: if you don't take care of yourself, you can't take care of anyone else. Remember how flight attendants tell you to put the little air cup on yourself before your put it on children you're traveling with? If you passed out first from lack of oxygen, you'd be no good to that kid or anyone else. Make sure you turn off the TV in the late evening, and get as close to eight hours of sleep as possible. Don't skimp on good nutritious meals. And take a daily walk to reflect, clear your head and feel recharged.
2. Send a donation –any amount. Raise money through yard sales, community events if you don't have enough cash yourself. One of the best sites for deciphering what works best for your values, interests and pocketbook is www.directrelief.org. I made an immediate donation to the Red Cross, but after I saw the $650,000-plus annual salary taken by its president, I wished I had sent money to the Salvation Army, (whose leader takes only $13,000 per year).
3. Offer housing if you can. The massive web efforts undertaken by MoveOn.org and Craigslist match thousands of refugees with available housing. Both websites have simple ways to sign up. Take a moment to know your limitations and be clear with those upfront (women only, no smokers, etc). It will save time and trouble for all concerned.
4. Understand how the process of recovery and healing will unfold. Read the Survival Hierarchy list below and offer assistance as needed, along the stages of recovery. Revisit it after you've taken care of yourself, and dealt with your own fatigue, sadness and shock.
Survival Hierarchy: Safety, Water, Food, Chronic Management
5. First, safety must be secured. This means a safe environment, free from attack or further threat. Survival must always be built upon a safe and secure foundation first. Unsafe conditions include downed electrical lines, fire, combustion threat, drowning, violence, extreme heat or cold, and terror or fright. Sometimes pure, unchecked terror will lead people to fatal, irrational acts such as the world witnessed in Iraq recently on the bridge filled with pilgrims running from an imagined suicide bomber. In the case of this hurricane, the safety issue will continue to challenge relief and recovery efforts since the flood waters carry the threat of contagion from nearby chemical plants, West Nile mosquitoes, food poisoning, decaying bodies, rats, human and animal waste, toxic mold infestations, raw sewage, and jagged debris.
6. Next, clean water must be obtained either through filtration or purification tablets (usually iodine based). People can wait three days for food, but generally not more than a day for water. The hurricane victims that have gone without water in temperatures over 100-degrees are the ones that have suffered heat injury, heat stroke and fatal dehydration. Babies and young children will dehydrate sooner due to their faster metabolisms and higher fluid intake needs.
7. Then food supplies must be obtained. Shipments of prepackaged foods have proven to be the most effective. Reliable protein mixed with slow-burning whole grain carbohydrates are urgently needed for emergency situations. Food rations by relief organizations should be upgraded to no longer include dehydrated mixes that require water, since potable water sources are limited. Victims should avoid eating foods that are contaminated by toxic water, human waste, or spoilage from lack of refrigeration.
8. After safety, water, and food are secured, then assistance should be directed to triaging for chronic medical conditions can be accomplished. (Triaging by medical personnel for acute emergencies should coincide with the first step of securing safe environments.) Chronic conditions include diabetes, asthma, heart disease, and other non-acute medical states that require daily medication or lifestyle management. Assistance should then be directed toward securing reliable supplies of daily medicines or other types of medical therapies.
9. Provide assistance for re-establishing social connections. Once the basics are secured, victims need to know the status of their families, loved ones, and social ties. This could include family pets and neighbors. Being stripped of material comforts, familiar items and their homes, victims are most concerned about the people in their lives. Not knowing what has happened to loved ones keeps victims in a prolonged state of agitation and hyper-vigilance. Behavioral medicine specialists report that this emotional grief is often what "locks in" the trauma to the hind brain, and replays the images and terror in the victim's mind. This can be short-circuited by simply establishing bulletin boards in shelters, finding people online, or enlisting the help of emergency agencies and news crews.
10. Provide assistance for victims to receive counseling for extreme stress, agitation, grief, loss, despondency, loneliness and isolation. These needs have been underestimated in past disasters, but are now placed foremost in the triage lists of emergency agencies. Mental health workers are now brought in to shelters during earlier stages than pre-9/11. This stage of requiring support for grief and isolation can last for many months to several years. Some helpful therapies include EMDR (eye movement desensitization retraining), talk therapy, guided imagery, anti-depressant drug treatment, support group counseling,
Bystander Syndrome is the name given to the non-victims of trauma and natural disasters. The steps for recovery and healing differ significantly since the basic foundational requirements of safety, water, food, and chronic medical management are usually not threatened.
But Bystander Syndrome requires a pro-active course of self-care attention: rest, nutrition, de-stressing exercise, social belonging, spiritual connection and psychological resiliency. Overcoming the feelings of powerlessness in the face of unimaginable human pain and loss is an undertaking that requires a practice that the Dalai Lama recommends:
Breathe in the pain of the world.
Breathe out compassion and love.
Allow your human heart to be a transformer of agonies.
With that fortifying your spirit, you can think more creatively and respond with more vigor. Start again at the top of the list, and offer small actions on a daily basis—but only after making sure you have a renewed, physical and spiritual temple to draw from.
- - - - -
- Dr. Meg Jordan is a medical anthropologist and health journalist, and President of Global Medicine Enterprises, Inc.
St. John Group
San Francisco, CA
415-454-2243
415-4593165
