After hurricane, psychologists help



“I was there to offer a compassionate presence,” says Karen Postal, Ph.D., ABPP, a neuropsychologist in Andover, Mass., who volunteered at Camp Edwards to assist people displaced by Hurricane Katrina. (photo by Tom Croke)

By Phyllis Hanlon

Hurricane Katrina, one of the most devastating natural disasters in U.S. history, caused not only widespread physical and structural damage, but also emotional harm. Thousands of people displaced by this catastrophe were shuttled to other locations, in some cases, thousands of miles from their hometowns. Several New England spots were designated as evacuation sites where support personnel, including mental health professionals, are helping these individuals to rebuild their lives.

Eager to assist but unsure of what she'd find, Karen Postal, Ph.D., ABPP, a neuropsychologist in private practice in Andover, Mass., volunteered through her local Red Cross office. She was sent to Otis Air National Guard Base/Camp Edwards on Cape Cod where she witnessed a scene she'll not soon forget. "These people had literally been taken off rooftops and out of shelters. They couldn't shower or change their clothes," she says. "They were bewildered and had an increased sense of powerlessness."

One of the most surprising aspects of this situation involved the role Postal played. "I'm used to helping people with words. This time, I helped by giving out clean socks and underwear. I was there to offer a compassionate presence." She did not directly ask questions but listened when individuals felt compelled to tell their stories.

The desperateness of the situation hit home when Postal produced a bag of children's toys. "It never occurred to me that the adults would find comfort in these stuffed animals," she says. "One woman had lost her home, her neighborhood. She had no family and didn't know anyone else there. She needed the comfort of that bear."

In collaboration with the Massachusetts Department of Mental Health (DMH), Steven Gross, MSW, director of the Children's Trauma Recovery Foundation (CTRF), and his staff are aiding efforts at Camp Edwards with an emphasis on the importance of providing safety and stability. "Don't look at yourself as clinicians, but allow your clinical experience and knowledge to guide your humanity," he says. "We need to be an informed and compassionate presence. Good crisis response allows for sustainability."

According to Gross, children affected by Katrina need what all children need: healthy relationships, an opportunity to have fun and play with others and structure. "Our goal is not to provide mental health counseling for children," he says. "We want to tap into their resiliency, empower them and meet their basic needs. This has therapeutic value."

Echoing these sentiments, Liza Suárez, Ph.D., associate project director at the Adolescent Traumatic Stress and Substance Abuse Treatment Center and clinical assistant professor at the Center for Anxiety and Related Disorders at Boston University, says, "Now is not the time to determine a longer term reaction."

Anticipating the integration of children from the Gulf States into the local educational system, clinicians at the center are working with the Boston school system to raise awareness of the impact of trauma and the best ways to provide support. "Our agency has offered free mental health care to families and children relocated to Massachusetts," Suárez says. "Students from Tulane are here in Boston and we are offering them crisis counseling."

In Rhode Island, James L. Campbell, Ph.D., director of the counseling center at the University of Rhode Island (URI), serves as a member of the disaster planning committee and reports that statewide drills that tested ideas and strategies have led to the systemization of efforts. "Our response to the hurricane helped point out gaps in the planning strategy," he says. The disaster plan was activated at a military complex in Middletown that housed approximately 110 Hurricane Katrina evacuees. Campbell notes that the facilities and infrastructure available at URI would also be a major resource during a disaster.

Having worked in New York after the 9/11 terrorist attacks, Essex, Vermont child psychologist Mark Banks, Ph.D., traveled to the Gulf area to aid victims. He found the situation "over the top." Relative normalcy prevailed in Montgomery, Ala., but the closer he got to the coast, the more "wholesale destruction" he witnessed. In Gulfport, Miss., Banks tended to community members, first responders and other Red Cross workers at a local shelter. He describes a devastating picture. "There was no water, no electricity, no toilets and the food of the day was MREs (meals ready to eat)," he says. Even 25 miles inland the scene was grim. Although the events of 9/11 produced "nationwide cultural shock," Katrina caused more physical damage, Banks says. "However, the emotional damage is less palpable."

Banks recalls a corner lot littered with broken trees, rags, plastic remnants, rubble and the remains of a house overlooking a calm ocean at dusk, while an American flag waved gently in the breeze. "It was very poignant to see this ghostlike [scene] with the flag in the foreground. It was a sobering reminder that so much had been lost," says Banks.

While victims of natural disasters desperately need support, mental health professionals who provide counseling and other types of assistance may also require emotional sustenance. Bette Lewicki, Ph.D., a neuropsychologist at Crotched Mountain Rehabilitation Center in N.H., lent technical support in the Worcester Red Cross service center. "We help chapters be prepared with a plan of support. A number of workers are coming back from working at different sites. We need to be ready to meet their emotional needs and give information about the effects of stress to these psychologists," she says.

Susy Sanders, Ph.D., CTS (certified trauma specialist), private practitioner in Phillips, Maine, cites the growing problem of compassion fatigue, also called secondary posttraumatic stress disorder (PTSD), in mental health professionals. In a disaster of this scope, incredible stories emerge, she says. "There is no way you can sit with [victims] and not feel emotionally charged. It's important to know that you'll experience a certain level of compassion fatigue." Psychologists trained prior to deployment reportedly fare better. Also, Red Cross guidelines restrict mental health professionals to a two-week, on-site shift in any disaster situation.

Sanders encourages good self-care and awareness of emotions or affect, cognitions or thought, behavior and physiology that might indicate the onset of compassion fatigue. If these factors are ignored, she suggests that a collective effect could result in overwhelming illness. "Psychologists are better able to help clients after they get help themselves."

After hurricane, psychologists help (November 2005 Issue)

After hurricane, psychologists help
(November 2005 Issue)