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Recovery - What Happens After a Disaster Strikes
The Psychology of Recovery

Recovery from a natural disaster includes more than finding a place to stay and acquiring new belongings. It means understanding the rules concerning when and how you can clean up your home, coping with television cameras and sightseers who drive by and stare and processing the anger and disappointment of finding looters stealing your remaining possessions. It can also mean learning to discriminate the hucksters from the helpers, the good guys from the bad, at a time when you are vulnerable.

Recovery also means negotiating with insurance companies and contractors, filling out seemingly endless forms and moving from one temporary home to another. It also means coping with life's everyday problems while in a very unsettled position. As one survivor who had spent four months in several different locations put it, "As a displaced person, I felt I didn't belong anywhere. I was constantly in limbo and couldn't seem to get even the basic things done".

Recovery also encompasses the re-establishment of an emotional equilibrium. All survivors, regardless of age, are affected. And, when a small community is struck by calamity, a significant number of persons become hidden victims. While many survive ostensibly appearing unscathed, friends, neighbors and family may not have been so lucky. However, as the reverberation continues, it leaves a rupture in community life and many become secondarily affected by another's tragedy. Nearly everyone is emotionally affected to some degree.

Usually following disaster, a community is awash with professional caregivers eager to help people begin re-assembling their lives. While most are good intentioned, not all are trained in outreach, crisis counseling and debriefing techniques so essential to the recovery process. As survivors struggle to cope with terror and loss, they can benefit greatly by counseling from persons skilled in disaster response caregiving.

The debriefing process is not a technical critique, nor is it a form of psychotherapy. It is a group interaction in which survivors are lead through a series of steps that enables them to talk about their experience of a disaster. Once people start to talk about personal responses to trauma, they begin to realize that their stress reactions are normal. Through continued communication, the long term effects of trauma are lessened.

Aggressive outreach strategies become key components as many survivors do not call and make appointments for help. Frequently, they do not even realize that their emotional struggles are disaster related. Many may have limited mobility and/or access to transportation. If relocated, they may not be as visible as those who remain in close proximity to the disaster site.

Disaster relief requires non-traditional paths in order to effectively reach many victims. Typically, people's reactions during a disaster are quite similar. Many experience terror as the danger approaches and their fate remains uncertain. Yet, with some natural calamities such as tornadoes, there can be a mesmerizing affect. Many have reported becoming almost hypnotically fascinated by this awesome act of nature.

As the ominous circumstances escalate, the experience can become so intense and detailed that people perceive time and motion distortions. They may mistakenly believe that they have more time to react than in reality exists. Moreover, in panic, they may experience their reactions as unusually slowed. The latter reaction can be even more heightened for those who due to age or disability do not normally move with facility.

Immediately after the disaster comes a state of shock and denial. As one survivor put it, "Everything just shut down". During this phase, survivors will often appear dazed. Bewilderment, moving about aimlessly, or operating on "auto-pilot" might also be apt descriptions as people attempt to bring order to their lives.

Since natural disasters bring many people closer to death than at any other time in their life, the stage is set for a cataclysm of emotions. Shock is usually followed by anxiety and fear as one re-awakens to the gravity of the event. Subsequently, anger, frustration, confusion and grief often emerge. The rage can be misdirected toward others, including God, causing problems at work or in relationships. However, when those emotions appear, the cause of the feelings is usually gone. Failing to make the connection, an individual may misinterpret his/her reactions as an indication of insanity. It is critical that people realize that they are not going crazy, but rather, they are experiencing normal and very powerful feelings in response to an abnormal event.

Nightmares, flashbacks, self-doubt and fatigue are not uncommon experiences. Jumpiness is often reported as people begin to emit startled responses to noises. All of the aforementioned can be further exacerbated when the disaster is protracted, as with floods, or repeated re-traumatization occurs, as with aftershocks.

As survivors continue to grapple with their feelings, guilt and depression often emerge. Guilt can originate from at least two sources. Survivor guilt may result when one individual has suffered comparatively less than others. Self-criticism may result from the mistaken belief that a person had sufficient time to act more heroically. The guilt, "If only I would have . . .", can deter a person from coping with traumatization, thereby keeping him/her immobilized in the recovery process.

It is not uncommon for persons to move back and forth between emotions and shock as they recover. Eventually though, people begin to "test themselves" by re-establishing old relationships or developing new ones. They begin to change in some facet, whether it be in the development of a "buddy system" to prepare for future danger, reaching out to others, enjoying each day more, or redefining or reinvesting in their relationships with God. Ultimately, recovery is signaled by constructive changes that demonstrate acceptance and adaptation. Survivors can not go back to the way they were before the catastrophe. After all, as commonly expressed by survivors, "Nothing will ever be the same".

Recovery efforts need to be structured in order to account for more than an initial intervention. Often overlooked, it is important to plan for "anniversary reactions". Anniversary reactions are periods wherein survivors experience a re-emergence of the cataclysm of emotions that originally occurred after the initial shock phase. The most typical times for anniversary reactions are six months and one year post-disaster. For many, however, the yearly anniversary date can prove difficult for upward to five years.

Many communities have found it beneficial to organize a formal activity to help survivors move through these difficult times. Activities such as ceremonial tree planting, balloon launches and picnics are a few examples of the aforementioned. The activities serve as a cathartic experience allowing survivors to place the disaster behind them as well as to embrace and celebrate life.

Older Americans can experience any or all the previously described reactions. As with any age group, trauma may be expressed directly through emotional reactions or be less readily identified by physical reactions such sleep difficulties, poor appetite, general physical ailments, a deterioration of functioning or a worsening of an already existent disease process. The difference, however, is that many older adults may not possess the same degree of resilience as their youthful counterparts.

Older persons can also experience particular reactions to trauma as a unique function of their stage in the life cycle. Faced with the potential losses of loved ones as well as their own abilities, older individuals can experience such feelings as increased insecurity even during normal, everyday living. After encountering the devastation wrought by a disaster, some older adults can find their natural feelings of insecurity and vulnerability magnified by the destructive, out-of-control nature of the disaster. They may react with feelings of increased hopelessness since they do not know if they will live long enough to rebuild their lives.

The impact can also trigger memories of other traumas, thus adding to an increasing sense of being overwhelmed. Many of the anchors to the past such as their home of many years, photographs and treasured keepsakes - so much a part of their identity - are gone. Poor health and social isolation can only add to the ordeal.

In the process of recovery, it is important for older people to reaffirm attachments and relationships. While they need to have access to familiar faces such as old friends and neighbors, often these supports no longer exist. If older people do not have significant others available, it is critical that contact be made via assertive outreach programs such as support groups. It is important that older Americans feel as though they still belong in the community.

Older adults need a sense of control and predictability. Re-establishing routines and having a permanent place to live can help increase a sense of security, stability and control. Relocation and emergency sheltering may be unavoidable. However, re-traumatization can be minimized by helping survivors remain as close to familiar surroundings as possible.

Older individuals also need to restore feelings of confidence and self-worth. Self-worth can be enhanced by talking about past successes. Confidence may be nurtured via guidance in setting manageable goals. Self-direction is essential to one's sense of integrity.

Because so much has been lost, older individuals also need to restore feelings of connectedness. Many will be left with little more than memories. Activities as simple as remembering and talking about their life can be a starting point that helps them reconnect with their unique perspective as a part of the history of mankind.

Each person recovers at a rate unique to that individual. The ease and speed of that recovery is affected by many factors. One important factor is the survivor's emotional state and experiences prior to the trauma. Other factors include the ability to understand what happened and the availability of a supportive environment. Recovery, then, can vary in degree from serene acceptance to a protracted and conflicted struggle.

While professional counseling is not always necessary, supportive relationships are essential. Most people find the needed support through family, friends, ministers or other systems already in place. Friends and family can help survivors by listening to them and accepting their feelings without judgment. Whether with the help of a friend or a professional, the recovery process begins in a helping, supportive context.

In summary, the recovery process for seniors is quite similar to that of other age groups but with a few unique features. Talking about the experience frees one to move forward. Discussing reactions within supportive relationships enables one to feel connected to others. Individual reactions to trauma are quite normal and similar. Recovery takes time, usually months and sometimes years. Each person moves at his or her own pace. Some, due to experience, age and/or frailty, are more disrupted by trauma. Social isolation make one more vulnerable to devastation. Finally, memories, rather than tangible property, can become the connective link to one's place in the world.

* courtesy of the Administration on Aging