The Psychological Aftermath of Katrina

Articles are starting to appear about how some Katrina refugees are being arrested for public intoxication and disorderly conduct in the Astrodome and in various shelters. The articles mention this fact as if it were happening in a vacuum, as if the last horrible days were not an inextricable backdrop to this behavior.

Of course order needs to prevail to keep people safe. And yes, there are a few folks who were no doubt engaged in disorderly conduct before the winds and the water of Katrina came. But the vast majority of them were not. And in the aftermath of Katrina, these folks might find themselves feeling things and thinking things and doing things that are ‘off.’ Things that they, themselves, do not understand. When this happens, what they need is competent psychological understanding and, if need be, intervention. Yes, such intervention can include caring, respectful containment when necessary. But what it definitely does not include is a jail cell.

Imagine it. You’ve weathered a huge, horrific hurricane in which your very life was threatened. The residents of your beloved city were forced to flee in a dramatic mass exodus. That, in and of itself, is traumatizing enough. But then in the aftermath, if you were lucky enough to have a house or apartment left, you are now faced with no electricity or any running water and no prospect of any. As you are scrounging for potable water, you watch in amazement as your home with all of your worldly possessions you can’t afford to replace, your precious memorabilia and your memories get swallowed up in a fast rising flood of water you are helpless to stop. Many of you are elderly or sick or frail. You watch as one by one you begin to succumb to the rising water, the heat, the lack of food or essential medicines. If you haven’t watched your family die, perhaps you can’t find them. Maybe they were whisked away by a helicopter to who knows where.

As you sit grief-stricken at the loss of beloved pets and family members, you watch in horror as the bloated bodies of your friends and neighbors float down your street that is now a rubble-choked river. You feel ill and weak from little decent food and water for days upon days. You are filthy. Everything, including you, stinks. You feel betrayed and abandoned as the promised help never came, and never came, and never came. You feel helpless, always helpless. When you are finally rescued, you perhaps are separated from your six month old child, your husband or your grandmother with nothing but the clothes on your back, or a garbage bag filled with hastily gathered, soaking belongings. You are then transported tens, hundreds, or even thousands of miles away to a totally unfamiliar place. If you are one of the few lucky ones, you are taken in by a family of strangers. If not, you are either put in another huge warehouse-like situation or in a shelter where you are under armed, curfewed watch and told blithely that “you are not under arrest.” But it sure feels like it. You have been subject to such surreal and stupefying trauma upon trauma upon trauma that nobody could ever possibly understand but you and those who have also gone through it. And then with your mind still reeling and your body in shock, you are expected to behave as if you are at a big tea party on the 50 yard line with thousands of others. And if you “misbehave” because you are beyond your breaking point, you may be arrested.

Tea party manners in the Astrodome and the shelters would be lovely, but our brains and our bodies just don’t work that way after such incredible trauma. Sure, some folks may internalize the stress of it all and shut down and look somewhat worse for wear but ‘fine’ on the outside ­ at least for now. But for most people, something is going to give.

After a trauma, you first help people feel as safe as is humanly possible and then you educate them about their reaction and let them know it’s normal. You help them tolerate their seemingly ‘crazy’ reactions and find ways to mitigate their impact. If need be, you help them contain themselves. In the long term, you help them integrate their experience so they can regain a semblance of normalcy in their lives. But never, ever do you punish them. It is a wrongheaded, uninformed response that will only add trauma to trauma and increase the very behaviors you are trying to stop.

“If they are safe now, what’s the problem?” you might be tempted to ask. The problem is that now is when the psychological aftermath begins. Once you are no longer in life or death, minute-to-minute survival mode, your brain and your body now have room to begin processing, feeling, reliving, and remembering all that’s happened, whether you want to or not. And try as folks might to keep it together, often times they can’t. These are not people misbehaving ­ they are having a perfectly human response to a stress none of us should ever find ourselves pretending we can possibly imagine.

A traumatic response has nothing to do with being poor or having no formal education. It is not about skin color. It is not about having a ‘weak character,’ as is the prevailing attitude in the military when men and women in combat zones get ‘shell shocked.’ Traumatized soldiers are expected to have a very brief respite, if they’re lucky, and then ‘suck it up’ and get back to the front lines. That is as absurd and ignorant of how human beings are hardwired as it is adding insult to injury. While people bring their own personal and family histories and cultures to every situation, so everyone’s response will be somewhat different, trauma affects everyone to one degree or another.

The symptoms are many and won’t be fully delineated here. But for example, some people may get depressed or suicidal when they’ve never remotely felt that way before. People may start having serious panic attacks. Some may become unable to go outside or come inside. Others may be startled extremely easily. They may have difficulty concentrating to the point of not being able to have a simple conversation. Day to day life may seem superficial and intolerable. Sleep may be severely disturbed. Nightmares are common. Interpersonal interactions can become painfully difficult, and long standing relationships may suffer. Kids often regress and show much younger behaviors than is usual for their age ­ thumb sucking, bedwetting, etc. They may be very clingy, or attach to nobody, or both. The ability to contain emotions, including anger, may be more pronounced. Fights might be more apt to break out, particularly when people are being forced to live in such close quarters with so many where autonomy and privacy is all but non-existent. It’s more tolerable for many to feel angry than it is to feel sad or scared. Children and adolescents, particularly, often act out their trauma through “behavioral problems.”

To cope with such intolerable feelings and thoughts, people often resort to alcohol and drugs, as we do when we try to numb ourselves in other situations we have difficulty wrapping our heads around. Such numbing is common whether it is through substance abuse, children refusing to talk, or feeling like everything around you is a dream, to name but a few ways.

However the collective trauma manifests, I fear the response to these emerging and very predictable symptoms will cause people who don’t understand to heap appalling, unfair stereotypes on the refugees who are mostly poor and people of color ­ “they don’t know how to be behave” “they are ‘conduct problems,'” “they should be quiet and appreciate what has been done for them,” etc. Such mislabeling and gross misinterpretation of the situation would be its own disaster.

Expecting refugees to take a small amount of financial assistance and ‘get on with’ it is extremely unrealistic. It’s a set up for the refugees and it’s a set up for the people of our country. Those who suffered through Katrina need to be educated about the effects of trauma, as do the loved ones and communities that are welcoming them, as does our government. Dismiss this if you will. But just like the socio-political subtext of this disaster, if we pay no heed to it, you can be assured we’ll all live with greater consequences later.

If we’re serious about helping the refugees of such a tragedy in the long term, we must make mental health care a priority. Significant impairment in occupational functioning is very common in those who have suffered major trauma. Looking at it from a stark dollars and cents standpoint, if we start helping folks deal with their trauma now and in the ensuing weeks and months (and, yes, maybe years) ahead, the likelihood that they can create productive, fulfilling lives for themselves will increase. If not, some children may not be able to sustain their efforts in school and drop out. Those same kids as well as the adult survivors of Katrina may show up in psychiatric hospitals, community mental health settings and the like. Such reactive forms of treatment are vital but are much costlier interventions for tax payers than preventative care. And they certainly are more psychologically and emotionally costly for those finding themselves with such severe symptoms that they need major interventions or inpatient stays. This is true for mental health services in general.

If you are concerned that you or someone you know is suffering from trauma, regardless of the cause, talk to a mental health professional in your community, or go to http://www.sidran.org/survivor.html for some good resources. But in general, remember a ‘crazy’ stress response is really a perfectly normal response to a ‘crazy’ situation. There is no shame in being human. Our psyches can only take so much, no matter who we are. In the very unlikely event they were ever to find themselves in the same situation, privileged white presidents and their cabinet members and their family members would manifest dramatic trauma symptoms, too.

CAROL NORRIS is a psychotherapist who has worked with many trauma survivors. She is a freelance writer and a member of and the former national organizer for CodePink. Contact her at www.carolnorris.blogs.com

 

 

CLARIFICATION

ALEXANDER COCKBURN, JEFFREY ST CLAIR, BECKY GRANT AND THE INSTITUTE FOR THE ADVANCEMENT OF JOURNALISTIC CLARITY, COUNTERPUNCH

We published an article entitled “A Saudiless Arabia” by Wayne Madsen dated October 22, 2002 (the “Article”), on the website of the Institute for the Advancement of Journalistic Clarity, CounterPunch, www.counterpunch.org (the “Website”).

Although it was not our intention, counsel for Mohammed Hussein Al Amoudi has advised us the Article suggests, or could be read as suggesting, that Mr Al Amoudi has funded, supported, or is in some way associated with, the terrorist activities of Osama bin Laden and the Al Qaeda terrorist network.

We do not have any evidence connecting Mr Al Amoudi with terrorism.

As a result of an exchange of communications with Mr Al Amoudi’s lawyers, we have removed the Article from the Website.

We are pleased to clarify the position.

August 17, 2005

 

Carol Norris is a psychotherapist, freelance writer, and longtime political activist.