Paul
T. P. Wong, Ph.D., C. Psych.
President, International Network on Personal Meaning
Coquitlam, B.C., Canada
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The Asian tsunami trauma is a different category
of natural disaster in terms of scale and impact. Unlike most natural
disasters, which tend to be one-time blows at a specific geographic
location, the Asian tsunami catastrophe is almost worldwide in its
scale; and its devastating impact on poor and highly populated nations
may last for a generation. It is a prolonged natural disaster that
will affect the ecology, economy, health and livelihood of millions
of people for a long, long time. Traditional ways of providing therapy
may not be adequate without being accompanied by massive international
aid and government interventions in many areas, such as medicine,
public health, infrastructure rebuilding, community involvement,
and the infusion of economic capital, etc.
The path to healing will be long and difficult,
but ultimately the key to the restoration of positive mental health
is to cultivate a unique, personalized blend of strengths and vulnerabilities,
which balance despair with hope, doubt with faith, death with rebirth,
and loss with gain.
Whenever possible, seek professional help. Within
the secure confines of a clinic or counseling office, and with the
help of a competent therapist, a traumatized victim has the best
prospect to recover. The present guide is primarily intended for
those who have no access to professional help at the moment.
My approach is existential-humanistic, because
it acknowledges that suffering is an inevitable part of the human
condition, and that affirmation of meaning is the foundation for
hope and recovery. The present paper offers the following 12-step
trauma recovery guide:
1. Stay alive to allow time for healing.
Unbearable pain can drive you to the brink of self-destruction or
to the state of dissociation. You may feel very frightened, disturbed,
demoralized, or disoriented. Whatever your emotional, mental state,
just don't do anything to harm yourself. Try to seek whatever help
available so that your basic needs for food, water, shelter, security,
and medicine are met. Learn to monitor and regulate your own emotions
so that you can exercise some self-control. Seek social support
and re-establish personal relationships. Try to take care of yourself
and give yourself sufficient time to recover. Live one day at a
time. Do whatever you can to contain the injury and stay alive in
order to give hope and healing a chance.
2. Accept the horror of the loss. It
may be hard to believe what has happened to your family and your
community. It may take time to realize the full extent of your loss.
Avoidance is a natural response, but you cannot spend the rest of
your life running away from bad memories. Eventually, you need to
recognize the devastating reality and confront your own feelings
of shock, anger, fear, panic, pain, loneliness, helplessness and
hopelessness. Accepting the loss is a necessary step towards self-acceptance
and recovery.
3. Surrender yourself and let go of what
cannot be controlled. Resign yourself to the fact that you may
never recover or identify the bodies of your loved ones; that the
life you knew will never return. Surrender yourself to the overwhelming
tragedy, to forces beyond human control or to your God, if you are
a believer. Imagine yourself a broken glass - no longer able to
hold the water within it. Give up your pride, your defenses, and
your biases. Give up your desperate but futile attempt to put the
broken glass back together again. Accept the fact that all that
you have cherished has been washed away, and can never be reclaimed.
At this point, life may feel like a dream…a nightmare…a vanishing
cloud. By letting go of yourself, and relinquishing control of what
cannot be controlled, you begin to feel some release from guilt,
fear, anxiety and the need for blaming. When you are willing to
reduce life to nothingness, to ground zero, then you are ready to
start the process of rebuilding.
4. Affirm the inherent meaning and value
of life. The first building block in the process of restoration
is affirmation. The fact that you have not given up on life indicates
that you are implicitly affirming that life has meaning and purpose,
and that life is worth living in spite of the pain. You may still
feel confused, overwhelmed and fearful, but you have the inner conviction
that your ordeal will be over, and that you can start afresh. You
begin to focus on the positive aspects of life and on the promises
of tomorrows. Once you have affirmed your faith in the meaning of
life and in a hopeful future, your life begins to rise above the
debris and ashes.
5. Have the courage to endure and observe
your painful feelings. The next step is to learn to endure the
pain rather than run away from it. It takes courage, endurance,
and the defiant human spirit to continue the bumpy journey of healing.
But it also takes stills. Learn to observe all the unpleasant and
terrifying feelings until you can name and articulate them. At the
same time, learn to recall positive moments and discover positive
meanings of negative moments. This exercise of cultivating positive
emotions will help cushion the blow of tragic reality. Be careful
not to re-traumatize yourself. Make sure to give yourself breaks
by taking a walk or talking to a friend, when you feel overwhelmed
by torrents of painful emotions. Give yourself permission to express
your anguish, grief and fear. More importantly, learn to observe
and listen to your feelings with mindfulness and attentiveness,
no matter how unpleasant and threatening. By learning to "mentalize"
your painful feelings in a nonjudgmental, honest manner, eventually
your feelings become your teacher and your guide.
6. Revisit and reconstruct the tragedy.
Initially, you may be obsessed with only the negative and painful
aspects of the tragedy. But do enquire about the calamity. Read
about it. Talk about it. Write about it. Share it with someone.
Eventually, you will be able to give a more complete account of
the larger picture. Once you are able to place your loss in a global
perspective, your unbearable pain becomes more bearable. More importantly,
it will help you make sense of the trauma by creating a coherent
story about it.
7. Make sense of the loss. You may never
fully understand the cause or the reason for the catastrophe, but
you need to make some sense of what has happened to you. You have
already affirmed the meaning of life. It enables you to begin the
process of rebuilding your shattered assumptions about the world,
about God, and about yourself, in order to accommodate past and
future tragedies. Through managing your personal meanings, beliefs
and life goals, you learn not to ask why bad things happen to you,
but how you can make the best of your loss. You are able to make
sense of the loss through a creating a personal narrative that includes
the past, the present, and a hopeful future.
8. Restore your faith. Meaning and faith
are the two pillars of an enduring hope. Regardless of whether your
faith is in God, Buddha, Allah, or Higher Power, it would be difficult
for you to beat the odds without faith. Often, faith is the only
light glimmering in an otherwise dark tunnel. Yes, you may be very
angry with God and question his benevolence, but deep down you realize
that you are in no position to judge God. Human suffering will be
forever shrouded in mystery. But you can experience God's grace
and comfort, when you pray for courage and help. Faith enables you
to see beyond the tragedy and transcend your present circumstances.
Faith provides an unshakable foundation for hope.
9. Participate in acts of compassion.
Faith and meaning always express themselves in concrete actions
of compassion. You reach out to fellow sufferers, and try to bring
hope and comfort to their lives. By being reconnected with others,
you become more grounded to reality and experience more social support
yourself.
10. Adapt to the new reality. Now you
are ready to make the necessary adjustments to adapt to the new
circumstances. You start from the ground floor up, one step at a
time. You begin to make new friends and seek new opportunities for
work. By developing a new routine of daily activities, life gradually
returns to "normalcy".
11. Transform the loss. You still feel
the pain and grieve the loss. Sometimes, you find yourself sinking
into a black void, not knowing how to extricate yourself. But as
you refurbish your inner space, cultivate positive meanings, your
life is elevated and enriched. In the process, your loss is gradually
transformed and integrated into your tapestry of personal meaning.
12. Build a new future. You continue
to work toward rebuilding your life, with a new found purpose and
renewed passion for living. You have developed a new appreciation
of life and relationships. Every day becomes a precious gift to
be enjoyed, valued and used for the betterment of humanity. You
have more than survived the tsunami -- you have flourished!
Bibliography:
Allen, J. G. (2005). Coping with trauma:
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Psychiatric Publishing.
Herman, J. (1997). Trauma and recovery. New
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Levine, P.A., & Frederick, A. (1997). Walking
the tiger: Healing trauma: The innate capacity to transform overwhelming
experiences. New York: North Atlantic Books.
Schiraldi, G. R. (2000). Post-traumatic stress
disorder sourcebook. New York: McCraw-Hill.
Van Der Kolk, B. A., McFarlane, A. C., & Weisaeth,
L. (1996). Traumatic stress: The effects of overwhelming experience
on mind, body, and society. New York: Guilford Press.
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