The emotional damage of a hurricane: how one therapist is stepping in

The two hurricanes that recently hit within weeks of each other on the U.S. Mainland have caused record-level destruction. Both Hurricanes Harvey and Irma made landfall as Category 4 hurricanes in Texas, Louisiana, and Florida.

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The resulting flood waters, storm surges, and sustained winds of up to 185 miles per hour in the affected areas caused a combined estimate of $290 billion in damage, leaving a combined estimate of 240,000 people in shelters, an estimated 16 million without power in Florida, and 82 dead in affected U.S. areas. As the flood waters recede, survivors face the realities of lost jobs, family possessions, homes, and pets. The storms’ aftermath, says Houston-based licensed therapist Bill Prasad, lies in the emotional damage left in their wake. “People have lost their homes, their communities, and their sense of safety,” Prasad says. “In many disasters, the emotional damage is not just about the incident, it is also about the aftermath.” Prasad, a 59-year-old Houston resident and certified trauma counselor, counts himself and his wife lucky. They had “go bags” ready in the event they'd need to evacuate, but the flood waters stopped just 120-feet short of the front door of his home, situated in “The Heights”, named for the elevation that likely spared the area from catastrophic flooding. He split his time after Harvey between working at Contemporary Medicine Associates, a family medicine clinic in Bellaire, Texas, and volunteering mental health services to shelter residents at Joel Osteen’s Lakewood Church, while it was open. The medical team on which Prasad worked focused on assessing and doing Critical Incident Stress Management (CISM). All who perform CISM work have received specialized training.

The goal of CISM, says Prasad, is to provide stabilization, education, and normalization, to those who have survived a critical incident, such as a workplace shooting, large-scale layoffs, and in this instance, natural disaster. CISM also lists helping survivors with resilience building and provision building among its goals. “CISM is not psychotherapy, nor does it take the place of psychotherapy,” Prasad explained, adding that he generally sees people a day or two after an event. “At this early stage, people are still in shock.” As a result of that shock, he says, CISM teams cannot provide therapy to those they work with. “Can you imagine someone trying to do therapy with you hours after you heard of the death [of a loved one]? This would be unethical and poor practice.” CISM response is crucial after a natural disaster, Prasad says, as many survivors are cut off from their support networks of friends and family. As such, CISM can help send the message that a person is safe, and validate their emotions, and help them through the initial onslaught of symptoms, which can include survivor’s guilt, higher rates of anxiety, disrupted sleep patterns, and auditory hallucinations. “Many people don't know they are having a normal reaction to an abnormal situation,” Prasad says. “They need education as to what psychological effects they might have in the future and education as to how to take care of themselves. I need to assess as best I can as to what they may need in the future, and I need to supply them with resources.” But, he says, it is not his job to erase the pain. “No one can do that. It is my job to help them get through the day and plan for the days to come.” Prasad adds: “Their world is frozen in pain, frustration, and anger. This period could last for several months to more than a year. [The survivors] will be digging out for a long time.”

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