Spiritual approach to addressing trauma

Spiritual approach to addressing trauma

Andayani, Canada

The World Health Organization (WHO) estimates that 10 percent
of tsunami survivors are suffering severe psychiatric problems
and as many as 50 percent, less acute psychological disturbances
(The Jakarta Post, Jan. 28).

This is hardly surprising considering the nature of the
catastrophe. Indeed, following the 1993 Latur earthquake in
India, the Voluntary Health Association reported that 89 percent
of survivors suffered depression.

For many tsunami survivors, life may seem futile and
meaninglessness as they start to internalize the reality of the
disaster. They have experienced multiple losses, including the
deaths of loved ones; loss of jobs, property, social network and
status; cultural and symbolic losses. This is a complete sense of
loss in that survivors are in the position of coming to terms
with the losses of the present day as well as setting aside their
ambitions for the future.

As newspapers and other broadcasting media have related, many
of the survivors continue to suffer nightmares and flashbacks,
often triggered by colors, sounds etc. The survivors may exhibit
phobic symptoms, be afraid of waves, the sea, tremors, and other
reminders, and thus react in an "irrational" manner.

Profound self-blame is also evident among the population, as
many individuals feel guilty for their inability to save their
loved ones. For people with missing family members, the situation
is worse since this status generates ambiguous loss.

This manifests when the individual is physically absent but
psychologically exists. The family may become preoccupied with
the victims, secretly developing and maintaining a hope that they
are safe. The survivors may only be satisfied if clear-cut
information is given, in the absence of such information the loss
remains ongoing and for many, completely consuming.

The responses of excessive crying, lack of concentration, loss
of appetite, angry outbursts, sleeplessness and a sense of
alienation are not considered pathological if they cease within
three months after the event. Those whose symptoms persist after
three months, however, are vulnerable to post-traumatic stress
disorder (PTSD). If post-traumatic stress disorder surfaces, it
should be assessed and treated by trained professionals.

It should be noted that the trauma is likely to be unresolved
if the proper therapy is not sought by the survivors. Research
has shown that trauma can be repressed only to resurface months
or years later. Signs of this would include depression or
disruptive behavior, such as substance abuse, violent behavior,
suicidal tendencies, and so on. Thus, the trauma becomes more
complex, long-lived and even multi-generational. The next
generation of survivors would view disruptive behavior as an
acceptable form of problem-solving.

WHO recently announced that it would initiate the re-
establishment of mental health services with the Indonesian
government. The number of psychiatric patients is staggering; on
average, following the tsunami, 30 people have sought services on
a daily basis in Aceh.

Mental health professionals require culturally sensitive
approaches in working with the survivors. Without overlooking the
compassion as well as the professionalism of the United Nations
and other multilateral agencies, we should be mindful of the
sociocultural needs and natural healing systems of local people
otherwise we are imposing a western-style of intervention that
could even be detrimental to the residents.

In this case, spiritually sensitive intervention is
recommended.

In order to move on, survivors must integrate and accept the
tragedy as a reality. Spiritualism encourages people to accept
the tsunami as God's will, and gives them greater resilience.

Failing to recognize spiritualism as the Acehnese people's
natural healing system, therefore, would cause the victims to
feel more alienated and disengaged with the approach itself, and
thus the outcome of therapy would be affected.

International relief workers should work side-by-side with
local professionals and community leaders in order to provide
appropriate psychiatric services. They need to explore this
natural coping mechanism and integrate it into problem
resolution. Prayer, rituals, ceremonies, traditional modes of
healing and the like could also be accommodated in psychiatric
services.

Decision makers must take into account the spirituality and
religions of the Acehnese in the rehabilitation phase so that the
mental health services offered are suited to the population in
need.

The writer is a lecturer at the Sunan Kalijaga State Islamic
University (UIN). She is pursuing her Masters of Social Work at
McGill University, Canada and can be reached at
andayani_safwan@yahoo.ca.