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Learning From The Past and Planning For The Future
MENTAL HEALTH MOMENT March 19, 2004 "Four things come not back: the spoken word, the spent arrow, the past, the neglected opportunity." - Omar Idn Al-Halif
Short Subjects
LINKS Rocky Mountain Region
Disaster Mental Health Institute
CONFERENCES AND WORKSHOPS:
CRISES IN RURAL AMERICA
Crisis Interventions And
Critical Incident Stress Management:
Current Status and Future Directions
April 21-24, 2004
Casper, Wyoming
Registration: 1-800-442-2963 ext 2212
Society of Australasian
Social Psychologists 33rd Annual Meeting
April 15 - 18, 2004
Location: Auckland, NEW ZEALAND
27th National AACBT Conference
(Australian Association for
Cognitive and Behavior Therapy)
May 15 - 19, 2004
Location: Perth, Western Australia
AUSTRALIA
Society of Australasian Social Psychologists
33rd Annual Meeting
April 15 - 18, 2004
Location: Auckland, NEW ZEALAND
Contact: SASP@auckland.ac.nz
Deadline for submissions: 1 February 2004WFPHA 10th International Congress on
Public Health: Sustaining Public Health
in a Changing World: Vision to Action
April 19-22, 2004
Location: Brighton, ENGLAND
Contact: Allen K. Jones, PhD
Secretary General World Federation of
Public Health Associations
Email: stacey.succop@apha.orgXIV. IFTA World Family Therapy Congress
March 24 - 27, 2004
Location: Istanbul, TURKEY
14th Biennial Meeting of the Society
for Research in Human Development
(formerly the Southwestern Society for
Research in Human Development -- SWSRHD)
April 1 - 3, 2004
Location: Park City, Utah, USA
7th European Conference on Psychological Assessment
April 1 - 4, 2004
Location: Malaga, SPAIN
Contact: Antonio Godoy
Facultad de Psicologia
Universidad de Malaga
29071 Malaga.( SPAIN)
Tel. (34) 952 13 25 32
Fax (34) 95213 11 00
Email: godoy@uma.esAnnual Conference Society for
Industrial/Organizational Psychology (SIOP)
April 2 - 4, 2004 Location: Chicago, Illinois, USA
Email: lhakel@siop.bgsu.edu3rd Annual Hawaii
International Conference on Social Sciences
June 16 - 19, 2004
Location: Honolulu Hawaii, USA
Contact: social@hicsocial.orgSociety for the Psychological Study of
Social Issues (SPSSI) Convention
June 25 - 27, 2004
Location: Washington, DC, USA
17th Congress of the International Association
of Cross-Cultural Psychology (IACCP)
August 2 - 6, 2004
Location: Xi'an, CHINA
Contact: Zheng Gang
Institute of Psychology
Chinese Academy of Sciences
100101 Beijing, China
Email: iaccp2004@psych.ac.cn
Florida State University Trauma Researcher Reports From KuwaitCharles R. Figley, Ph.D., Florida State University School of Social Work professor and expert in traumatology, is spending several months as a Fulbright Fellow in Kuwait, studying the recovery and resilience of the Kuwaiti people in the wake of the Iraqi occupation of 1990. His account of a recent experience in that country is located at: http://fsu.com/pages/2004/03/12/trauma_research_kuwait.html
National Fire Academy Trains Nation's Firefighters
The National Fire Academy (NFA) is the training arm of the United States Fire Administration (USFA). Since 1975, NFA has had more than 1.4 million students go through its courses. Countless lives have been saved and property losses prevented as a direct result of this training and education. For the Full Story, Go To: http://www.usfa.fema.gov/fire-service/nfa/nfa-abt.shtm
Disaster Recovery Summary Update: PAGO PAGO, American Samoa
The Federal Emergency Management Agency (FEMA) provides the following update of federal disaster recovery assistance given to date in American Samoa in the wake of Cyclone Heta:
Nearly 9,000 American Samoa residents and business owners have registered with FEMA to apply for aid. Most who are eligible have already registered, but the deadline to do so was Saturday, March 20, 2004. FEMA has issued approximately $10.7 million in temporary disaster housing grants to people whose homes have been severely damaged and to those repairing their primary residences to make them safe, sanitary and functional. The agency has provided more than $13.2 million for other serious needs directly related to Heta. The U.S. Small Business Administration (SBA) has approved approximately $4.2 million in low-interest disaster loans to homeowners, renters and business owners. The loans cover costs for the long-term repair or rebuilding of cyclone-damaged private property owned by individuals and businesses.
Annan strongly condemns Israeli assassination of Hamas leader
United Nations officials today strongly condemned Israel's killing of Hamas leader Sheikh Ahmad Yassin in a move which also resulted in the deaths of eight others, with Secretary-General Kofi Annan warning that intensified clashes could ensue. For the Full Story, Go To: http://www.un.org/apps/news/story.asp?NewsID=10155&Cr=middle&Cr1=east
World grows richer, but poor still face massive nutritional deficiencies - UN report
Despite some progress in improving nutrition among the world's poor, improvements have failed to keep pace with the overall climate of global economic growth, according to a new United Nations report. For Full Story, Go To: http://www.un.org/apps/news/story.asp?NewsID=10166&Cr=nutrition&Cr1=
Anti-poverty goals at risk if reproductive health care not funded - UN official
The lack of donor support for reproductive health services is jeopardizing progress towards meeting global anti-poverty goals, the Executive Director of the United Nations Population Fund (UNFPA) warned. At the 1994 International Conference on Population and Development, held in Cairo, Egypt, developed countries agreed to provide an annual $6.1 billion by 2005 for reproductive health, including family planning. But they have fallen short by about $3 billion, according to UNFPA. For the Full Story, Go To: http://www.un.org/apps/news/story.asp?NewsID=10161&Cr=population&Cr1=
UN envoy urges more funds to help Afghanistan's schoolchildren
As Afghanistan opened its new school year, the senior United Nations envoy there urged international support for education in the war-ravaged nation. "At a time when the number of children returning to school is surging, more resources are needed to keep up the momentum," Jean Arnault told a ceremony at the Amani school. "A huge funding gap of some $173 million exists for this year alone." For Full Story, Go To: http://www.un.org/apps/news/story.asp?NewsID=10150&Cr=Afghanistan&Cr1=
School enrolment rates surging in Afghanistan, UNICEF reports
More Afghan children than ever before are enrolling in the country's schools, with up to 5.5 million expected to return next week when classes resume after the holiday break, the United Nations Children's Fund (UNICEF) has announced. Just over two years since the fall of the Taliban regime, which severely restricted women's education rights, girls comprise 30 per cent of all students and the number of girls attending class has leapt by more than 30 per cent. For the Full Story, Go To: http://www.un.org/apps/news/story.asp?NewsID=10141&Cr=afghanistan&Cr1=
UN expert calls for 'red alert' on resurgent global racism
A United Nations expert called for a red alert to warn the world about racism and xenophobia as the alarming resurgence and vitality of the traditional forms of discrimination are joined by new forms of discrimination affecting the non-national, the refugee and the immigrant. "The new ideological landscape is structured both by the excessive emphasis placed on combating terrorism and the inclusion of cultural and religious elements, which create cultural conflicts and new discriminatory practices aimed at many different groups," said Doudou Diene, UN Special Rapporteur on contemporary forms of racism, racial discrimination, xenophobia and related intolerance. For the Full Story, Go To: http://www.un.org/apps/news/story.asp?NewsID=10156&Cr=racism&Cr1=
Poor sanitation a huge killer of children, UNICEF says on World Water Day
More than 5,000 children die every day from diarrhoeal diseases, often in areas hit by man-made or natural disasters, the head of the United Nations Children's Fund (UNICEF) says in a message to mark World Water Day, whose theme this year is water and disasters. Carol Bellamy, UNICEF's Executive Director, says children suffering from poor diets and the effects of other diseases are the first to get sick when a major disaster strikes a community and its clean-water and sanitation systems. For the Full Story, Go To: http://www.un.org/apps/news/story.asp?NewsID=10157&Cr=water&Cr1=
TRIP TO SPAIN A LIFE-CHANGING EVENT FOR PENN STATERS
A spring break trip to Spain for 46 students, faculty and alumni of Penn State New Kensington turned out to be "a life-changing event," according to William Hamilton, one of its sponsors. Hamilton, a biology professor and coordinator of the campus honors program, said the group was less than 200 miles away in Seville when Madrid's commuter train system was hit by a series of bomb attacks last Thursday. "Although we were fairly removed from the actual location of the attacks, we were following the developing story on the Spanish language BBC news network," he said. "The shock that went through the Spanish people was definitely palpable." Read the full story at http://live.psu.edu/story/6002
TMI BOOK COINCIDES WITH 25TH ANNIVERSARY OF MELTDOWN
Three Mile Island (TMI) burst into the nation's headlines 25 years ago, forever changing our view of nuclear power. The worst nuclear accident in U.S. history, which happened near Harrisburg, Pa., marked a turning point in our policies, our perceptions and our national identity. "TMI 25 Years Later," published by Penn State Press this month, presents a balanced and factual account of the accident, the cleanup effort and the many facets of its legacy. The book's authors, all affiliated with Penn State, bring extensive research and writing experience to the project. After the accident and the cleanup, Penn State University Libraries became a repository for housing a significant collection of videotapes, photographs and reports devoted to the accident. For more information on this book, visit http://www.psupress.org/books/titles/0-271-02383-X.html
Comprehensive Management of Behavioral Disturbances in Dementia
The rate of dementia has been dramatically increasing as the population ages. In order to address the multifaceted needs and demands of the individual with dementia, a broad-based comprehensive treatment approach must be implemented. Fo the Article, Go To: http://www.medscape.com/viewprogram/2896
Disparities in Cognitive Functioning by Race/Ethnicity in the Baltimore Memory Study
The impending retirement of the baby-boom cohort, along with geometric growth in the relative size of the older population, will dramatically alter the public health challenges of the 21st century. Environ Health Perspect 112(3) 2004 For the Article, Go To: http://www.medscape.com/viewarticle/471146?mpid=25957
THE MEDICAL MINUTE: NO QUICK FIXES FOR OBESITY
Chances are you are on a diet -- or you were on one in the last year. Tens of millions of Americans are dieting at any given time. Despite the attention we pay to dieting, one-third of us are obese and another third of us are overweight. According to the latest edition of the Medical Minute, a service of Penn State Milton S. Hershey Medical Center, obesity is such a big problem it may soon pass heart disease as the nation's number one killer. For attaining and maintaining a healthy weight, the simple math is: to lose weight, you must eat less than you burn off. Most of us can cut back for a couple days, but most diets fail due to inconsistency. It's important to remember that there are no quick fixes or rapid weight loss schemes that give long lasting results. Read the full story at http://live.psu.edu/story/6035
DELAYED STRESS
There have been some dramatic events in the news over the past few years. Tragedies such as earthquakes, floods, hurricanes, tornadoes, bombings, etc., while certainly not new or even uncommon, are beyond our abilities to control or, in some cases, even difficult to fully comprehend.
In Oklahoma City, rescue workers tried to help survivors and non-survivors following the bombing of a Federal building.
We all have seen scenes on the evening news and elsewhere of the aftermaths of the bombings of the U.S. Embassies in Nairobi and Dar Es Salaam, Baghdad, Afghanistan and the tragedy of September 11 in New York.
Following their return from the Viet Nam War, many Veterans experienced symptoms of what we call Post Traumatic Stress Disorder (PTSD). Veterans of the Gulf War seem to be dealing with a similar related problem which has been called Gulf War Syndrome.
What do all of the above have in common? Studies of PTSD and how to treat it and/or how to prevent it and many of its symptoms was the result of a lot of work with Veterans.
Today, we know more about PTSD and how to alert those at risk (e.g. resuce workers, victims of physical and sexual abuse, victims of natural and man-made disasters) so that they can be better prepared to deal with some of the inevitable feelings and thoughts as well as other symptoms.
PTSD, sometimes also referred to as Delayed Stress, is identified by certain common signs, including the following:
Depression
Depression is a common response to a traumatic event. It can be present in a number of forms which may include sleep disturbance (e.g. difficulties sleeping, intrusive or disturbing dreams, or even too much sleep). Other signs may include general feelings of worthlessness or helplessness or difficulties concentrating. Some may experience feelings that no one will understand how they feel. They may find little support among friends, acquaintances and/or relatives. Some may try to alleviate their feelings through attempts at "self-medication" involving alcohol and/or drugs.
Isolation
There are times when those involved isolate themselves from others or will have few friends. They may feel isolated and distant from peers. For example, they may feel that their peers or friends and family would rather not hear what their experiences were like. They may feel rejected.
Rage
Rage is also a common response. Feelings of irritation, touchiness, easily striking out at others who happen to be near (usually verbally, but some- times physically). Some may experience frequent rage reactions while others may sublimate or repress their rage by breaking inanimate objects or putting fists through walls. There are many reasons for the rage - a rage at not being able to control or change the events that occurred.
Avoidance of Feelings
Some may talk about episodes in which they did not feel anything when they witnessed or experienced the death of a buddy or friend or the more recent death of a close family member. Often troubled by their responses to tragedy, on the whole, they would rather deal with tragedy in their own detached way. Especially problematic is an inability to experience the joys of life. They may describe themselves as being emotionally dead.
This "Defense Mechanism" dulls one's awareness of the death and/or destruction surrounding him/her. It is a survival mechanism which does help one to pass through a period of trauma without becoming caught up in its tendrils. This numbing only becomes nonproductive when the period of trauma has passed, and the individual is still numb to the affect or emotions around him/her. They may feel that, should they let themselves release the numbness, they may never stop crying or may completely lose control of themselves.
Survival Guilt
When others have died and some have not or are rescuers, they may ask "How is it that I survived when others more worthy than I did not?" or "What could I have done to get here sooner and save this life?"
Survival guilt is an especially guilt-provoking symptom. It is not based on anything hypothetical. Rather, it is based on the harshest of realities - the actual death of a human being and the struggle of the survivor or rescuer to live. In some cases, the survivor or rescuer has had to compromise him/herself or the life of someone else in order to deal with this. The guilt that results may eventually lead to self-destructive behaviors. Feelings of helplessness may develop over the inability to change the outcome of events. Guilt may develop over "maybe if I had been there sooner or had done more, etc...."
In some cases (e.g. War, earthquakes, other disasters) those who suffer the most painful symptoms are primarily those who have served as corpsmen, medica, EMTs, etc. They save many lives. However, some of those they try to save die. Many casualties are beyond medical help, yet many emergency response workers suffer extremely painful memories for long periods thereafter - some for the remainder of their lives. Some tend to blame themselves for these deaths.
Anxiety Reactions
Many workers describe themselves as very vigilant human beings. Their autonomic senses are tuned to anything out of the ordinary.
Fear is a normal reaction to disaster, frequently expressed through continuing anxieties about recurrence of the disaster, injury, death, separation and loss. Because children's fears and anxieties after a disaster often seem strange and unconnected to anything specific in their lives, their relationship to the disaster may be difficult to determine. In dealing with children's fears and anxieties, it is generally best to accept them as being very real to the children. For example, children's fears of returning to the room or school they were in when the disaster struck should be accepted at face value. Treatment efforts should begin with talking about those experiences and reactions.
Before the family can help, however, the children's needs must be understood. This requires an understanding of the family's needs. Families have their own shared beliefs, values, fears and anxieties. Frequently, the children's malfunctioning is a mirror of something wrong in the family. Dissuading them of their fears will not prove effective if their families have the same fears and continue to reinforce them. A family interview should be conducted in which the interviewer can observe the relationship of the children and their families, conceptualize the dynamics of the child-family interactions, and involve the family in a self-help system.
The parents' or adults' reactions to the children make a great difference in their recovery. The intensity and duration of the children's symptoms decrease more rapidly when the families are able to indicate that they understand their feelings. When the children feel that their parents do not understand their fears, they feel ashamed, rejected, and unloved. Tolerance of temporary regressive behavior allows the children to re-develop anew those coping patterns which had been functioning before. Praise offered for positive behavior produces positive change. Routine rules need to be relaxed to allow time for regressive behaviors to run their course and the re-integration process to take place.
When the children show excessive clinging and unwillingness to let their parents out of their sight, they are actually expressing and handling their fears and anxieties of separation or loss most appropriately. They have detected the harmful effects of being separated from their parents and, in their clinging, are trying to prevent a possible recurrence. Generally, the children's fears dissolve when the threat of danger has dissipated and they feel secure once more under the parents' protection.
Children are most fearful when they do not understand what is happening around them. Every effort should be made to keep them accurately informed, thereby alleviating their anxieties. Adults, frequently failing to realize the capacity of children to absorb factual information, do not share what they know, and children receive only partial or erroneous information. Children are developing storehouses of all kinds of information and respond to scientific facts and figures, new language, technical terms, and predictions. Following the 1971 earthquake, the children in Los Angeles were observed to become instant experts. The language used by them in a daycare setting was enriched by technical terms, such as Richter Scale, aftershock, temblor, etc. The children learned these new words from the media and incorporated them readily, using them in play and in talking with each other.
The family should make an effort to remain together as much as possible, for a disaster is a time when the children need their significant adults around them. In addition, the model the adults present at this time can be growth enhancing. For example, when the parents act with strength and calmness, maintaining control at the same time they share feelings of being afraid, they serve the purpose of letting the children see that it is possible to act courageously even in times of stress and fear.
Sleep Disturbances and Nightmares
Some may find the hours before sleep very comfortable. As a result, they will stay awake as long as possible.
Sleep disturbances are among the most common problems for children following a disaster. Their behavior is likely to take the form of resistance to bedtime, wakefulness, unwillingness to sleep in their own rooms or beds, refusal to sleep by themselves, desire to be in a parent's bed or to sleep with a light, insistence that the parent stay in the room until they fall asleep, and excessively early rising. Such behaviors are disruptive to a child's well-being. They also increase stress for the parents, who may themselves be experiencing some adult counterpart of their child's disturbed sleep behavior. More persistent bedtime problems, such as night terrors, nightmares, continued awakening at night, and refusal to fall asleep may point to deep-seated fears and anxieties which may require professional intervention.
It is helpful to explore the family's sleep arrangements. The family may need to develop a familiar bedtime routine, such as reinstating a specific time for going to bed. They may find it helpful to plan calming, pre-bedtime activities to reduce chaos in the evening. Teenagers may need to have special consideration for bedtime privacy. Developing a quiet recreation in which the total family participates is also helpful.
Other bedtime problems of the children, such as refusing to go to their rooms or to sleep by themselves, frequent awakening at night, or nightmares can be met by greater understanding and flexibility on the part of the parents. The child may be allowed to sleep in the parents' bedroom on a mattress or in a crib, or may be moved into another child's room. A time limit on how long the change will continue should be agreed upon by both parents and child, and it should be adhered to firmly. Some children are satisfied if the parents spend a little extra time in the bedroom with them. If they come out of bad at night, they should be returned to it gently, with the reassurance of a nearby adult presence. Having a night light or leaving the door ajar are both helpful. Getting angry, punishing, spanking, or shouting at the child rarely helps and more frequently makes the situation worse. Sometimes, it becomes clear that it is actually the parent who is fearful of leaving the child alone.
Parents from middle-class families have been educated to believe that allowing their child to sleep in the parents' room has long-lasting deleterious effects on the child. Families accustomed to overcrowded and shared sleeping space have less trouble in allowing children to be close to them. Closeness between parents and children at bedtime reduces the children's and adults' fears.
Providing families with information on how to handle bedtime fears can best be done in the family setting or with groups of families meeting together. The families feel reassured upon learning that what they are experiencing is a normal, natural response, and that time and comfort are great healers. Learning that the sleep disturbance behavior is a problem shared with other families is reassuring.
Intrusive Thoughts
Some workers frequently report replaying especially problematic experiences over and over again. They may search for alternatives to what actually happened. They may castigate themselves for what they might have done to change the situation, suffering subsequent guilt feelings today because they were unable to do so in the situation. Most report that these thoughts are very uncomfortable, yet they are unable to put them to rest.
Not all who are exposed to tragedies experience all or some symptoms. However, it is not possible to be exposed to such events and have no feelings, thoughts or responses. Being prepared for them and recognizing what effects they can have can prepare one to deal with them.
Debriefing following involvement in such experiences can help prepare one for what they may feel or think. It can provide them with support from others; methods for dealing with their feelings, thoughts and responses; and resources for future assistance if needed. It is like a vaccination which helps prevent more serious consequences.
Finally, if any of the above-described feelings, thoughts or responses occur or persist, talking with someone who can help (minister, priest, rabbi or a counselor or therapist) might help alleviate and deal with the symptoms.
When we are exposed directly to tragedy, we are affected by it and need to deal with it.
People in crisis are extremely vulnerable. They are open to hurt as much as to help. The goal of crisis counseling should be to protect them from further harm, while providing them with immediate assistance in managing themselves and the situation. Crisis counselors provide brief, clear, and gentle directions and support to distressed victims. As soon as possible, they help the victims take on responsibility for their own care. It is important to provide frequent reassurance and guidance when the situation is most threatening. The most important thing is to offer assistance to help the individual gain a sense of control of self and situation, and not to do everything for the victim.
Whenever possible, it is important to help the victim identify and focus on the problem, or the most important problem if there are several. This helps the individual gain a sense of perspective and to prioritize their recovery efforts. They need to be told what is happening and why to help reduce the sense of surprise or feeling that they are being lied to.
Provide Information Sessions
Information sessions presented jointly with the organizations involved are intended for the whole community. They consist of providing general information and dealing briefly with the current difficulties, the reactions that may be shown by the victims, services available, and the problems typically associated with returning to normal life. The activities suggested for information sessions are all optional. None are mandatory, neither for the disaster victims nor for the members of their families or witnesses of the event.
During these information sessions, the following messages are among those given with regard to physical and emotional reactions:
• the physical and emotional sympotms are part of a stress reaction and are considered normal;
• these symptoms occur in most people in a situation of stress, threat or loss. They are primitive reactions of the mind and body, and their purpose is to help the individual survive;
• stress syndromes, although normal, can, however, present health risks if they persist, since they rob people of energy and make them vulnerable to illness. In some cases, they can even have reppercussions on a person's whole life;
• there are many ways of dealing with stress reactions, such as surrounding oneself with people one feels good with and with whom it is easy to talk about what one is experiencing, doing vigorous physical exercise, or using relaxation techniques.
• the most effective way of relieving stress reaction syndrome is verbalization sessions on the event.
To search for books on disasters and disaster mental
health topics, leaders, leadership, orgainizations,
crisis intervention, leaders and crises, and related
topics and purchase them online, go to the following url:
https://www.angelfire.com/biz/odochartaigh/searchbooks.html
RECOMMENDED READING
Aftershock : Surviving the Delayed Effects of Trauma, Crisis, and Loss
by Inc. P.I.A. Specialty Press
From Publishers Weekly
Slaby, a New Jersey psychiatrist specializing in crisis therapy and prevention, here details the etiology of aftershock, i.e., delayed reaction to emotional upheaval, and illuminates the advances in treatment that can change the ways stressful events affect people. Post-traumatic shock disorder (PTSD), which may mimic or mask other conditions such as depression and anxiety, can be triggered long after the precipitating crisis, emphasizes the author in this helpful, informative guide. Aftershock (a term borrowed from geology), if undetected or untreated, can create physical as well as psychological problems, we're shown in case studies drawn from Slaby's practice. Dramatic evidence of cure through pharmaceutical and psychiatric intervention is presented, as well as self-help preventive measures. Copyright 1989 Reed Business Information, Inc.
Additional Readings at:
Also try looking here for September 11, 2001: A Simple Account for Children.
Videos on Terrorism
Other videos about terrorism
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Contact your local Mental Health Center or
check the yellow pages for counselors, psychologists,
therapists, and other Mental health Professionals in
your area for further information.
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George W. Doherty
Rocky Mountain Region
Disaster Mental Health Institute
Box 786
Laramie, WY 82073-0786
MENTAL HEALTH MOMENT Online: https://www.angelfire.com/biz3/news
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