Spiritual approach to addressing trauma<\/p>\n
Andayani, Canada<\/p>\n
The World Health Organization (WHO) estimates that 10 percent
\nof tsunami survivors are suffering severe psychiatric problems
\nand as many as 50 percent, less acute psychological disturbances
\n(The Jakarta Post, Jan. 28).<\/p>\n
This is hardly surprising considering the nature of the
\ncatastrophe. Indeed, following the 1993 Latur earthquake in
\nIndia, the Voluntary Health Association reported that 89 percent
\nof survivors suffered depression.<\/p>\n
For many tsunami survivors, life may seem futile and
\nmeaninglessness as they start to internalize the reality of the
\ndisaster. They have experienced multiple losses, including the
\ndeaths of loved ones; loss of jobs, property, social network and
\nstatus; cultural and symbolic losses. This is a complete sense of
\nloss in that survivors are in the position of coming to terms
\nwith the losses of the present day as well as setting aside their
\nambitions for the future.<\/p>\n
As newspapers and other broadcasting media have related, many
\nof the survivors continue to suffer nightmares and flashbacks,
\noften triggered by colors, sounds etc. The survivors may exhibit
\nphobic symptoms, be afraid of waves, the sea, tremors, and other
\nreminders, and thus react in an \"irrational\" manner.<\/p>\n
Profound self-blame is also evident among the population, as
\nmany individuals feel guilty for their inability to save their
\nloved ones. For people with missing family members, the situation
\nis worse since this status generates ambiguous loss.<\/p>\n
This manifests when the individual is physically absent but
\npsychologically exists. The family may become preoccupied with
\nthe victims, secretly developing and maintaining a hope that they
\nare safe. The survivors may only be satisfied if clear-cut
\ninformation is given, in the absence of such information the loss
\nremains ongoing and for many, completely consuming.<\/p>\n
The responses of excessive crying, lack of concentration, loss
\nof appetite, angry outbursts, sleeplessness and a sense of
\nalienation are not considered pathological if they cease within
\nthree months after the event. Those whose symptoms persist after
\nthree months, however, are vulnerable to post-traumatic stress
\ndisorder (PTSD). If post-traumatic stress disorder surfaces, it
\nshould be assessed and treated by trained professionals.<\/p>\n
It should be noted that the trauma is likely to be unresolved
\nif the proper therapy is not sought by the survivors. Research
\nhas shown that trauma can be repressed only to resurface months
\nor years later. Signs of this would include depression or
\ndisruptive behavior, such as substance abuse, violent behavior,
\nsuicidal tendencies, and so on. Thus, the trauma becomes more
\ncomplex, long-lived and even multi-generational. The next
\ngeneration of survivors would view disruptive behavior as an
\nacceptable form of problem-solving.<\/p>\n
WHO recently announced that it would initiate the re-
\nestablishment of mental health services with the Indonesian
\ngovernment. The number of psychiatric patients is staggering; on
\naverage, following the tsunami, 30 people have sought services on
\na daily basis in Aceh.<\/p>\n
Mental health professionals require culturally sensitive
\napproaches in working with the survivors. Without overlooking the
\ncompassion as well as the professionalism of the United Nations
\nand other multilateral agencies, we should be mindful of the
\nsociocultural needs and natural healing systems of local people
\notherwise we are imposing a western-style of intervention that
\ncould even be detrimental to the residents.<\/p>\n
In this case, spiritually sensitive intervention is
\nrecommended.<\/p>\n
In order to move on, survivors must integrate and accept the
\ntragedy as a reality. Spiritualism encourages people to accept
\nthe tsunami as God's will, and gives them greater resilience.<\/p>\n
Failing to recognize spiritualism as the Acehnese people's
\nnatural healing system, therefore, would cause the victims to
\nfeel more alienated and disengaged with the approach itself, and
\nthus the outcome of therapy would be affected.<\/p>\n
International relief workers should work side-by-side with
\nlocal professionals and community leaders in order to provide
\nappropriate psychiatric services. They need to explore this
\nnatural coping mechanism and integrate it into problem
\nresolution. Prayer, rituals, ceremonies, traditional modes of
\nhealing and the like could also be accommodated in psychiatric
\nservices.<\/p>\n
Decision makers must take into account the spirituality and
\nreligions of the Acehnese in the rehabilitation phase so that the
\nmental health services offered are suited to the population in
\nneed.<\/p>\n
The writer is a lecturer at the Sunan Kalijaga State Islamic
\nUniversity (UIN). She is pursuing her Masters of Social Work at
\nMcGill University, Canada and can be reached at
\nandayani_safwan@yahoo.ca.<\/p>",
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