The Canterbury earthquake and the effect it may have on families: Part two

Yesterday, I posted about some of the short-term effects that emergency events like earthquakes and the cumulative stress of aftershocks can have. Today, I’ll continue to describe some the medium to long-term effects, helpful things to do, and some indicators as to when you might need to find help.

Medium term effects

Some families cope well with the crisis and immediate aftermath. Changes which are not obviously related to the crisis may occur some weeks or months after the incident.

  • Routine and work patterns, ambition or motivation in the affected member or others in the family may change; work efficiency and concentration may be reduced.
  • Spouses/parents may be short tempered, irritable or intolerant, leading to friction in relationships and misunderstanding between themselves and their children.
  • Children or teenagers can be clingy, attention seeking or disobedient – this usually indicates they are anxious or fearful.
  • Teenagers may become more rebellious or demanding, or through other behaviour, demonstrate a need to have a sense of control over their lives.
  • Child or adult family members may be overly concerned to help. They may try hard not to do anything wrong and postpone their own needs to support the affected member.
  • Family members’ feelings for each other may change by becoming more detached, uninvolved or preoccupied with personal problems as each member tries to cope with their own reactions.
  • Spouses may experience changes in their sexual relationship.
  • Children and teenagers’ school performance and concentration may be lowered; they may lose former interests.
  • Family members may lose interest in leisure, recreation, sport or social activities.
  • Teenagers may turn outside the family for emotional support from peers or other adults.

Immediate post crisis responses may persist or sometimes begin to appear for the first time.

Long term effects

Sometimes problems become evident for the first time, months or years after the event.

  • The memories of the traumatic event may come back for family members involved in another crisis, although it was dealt with at the time.
  • Family members, including children, often need to go over the events again when they grow into new stages of maturity and develop a capacity for greater understanding.
  • People may find future crises harder to handle, particularly when similar feelings are aroused, even if for different reasons.
  • Family members may cover up or cope with difficult feelings until all the fuss is over and things have returned to normal, and only then show their distress.
  • Any of the immediate or medium term effects may occur as delayed reactions or may become habits.
  • Problems often appear in the form of everyday frustrations. Retracing the way they have developed and examining connections to the crisis often makes the cause clearer. It is wise to assume that a major change or problem in family members in the next few years has some relationship to the crisis.

These problems are all normal reactions to an abnormal event that has touched the lives of the whole family. It is important not to blame each other. Try to understand how members affect each other. It is part of a changed pattern of family life arising from the crisis.

Helpful things to do

A few simple things will help families recover from crisis.

  • Keep communicating: Talk about what is happening, how members feel, what they need from each other. This avoids feeling alone, isolated and not understood. Don’t leave communication to chance, make opportunities for it to happen.
  • Share information: Communicate with children, teenagers and toddlers. They know something is going on and a painful reality is easier to deal with than the unknown worry of fear.
  • Do things together: Ensure time is reserved for recreation, enjoyment and rewarding experiences. Shared pleasure carries a family through many difficulties.
  • Keep family roles clear: Don’t allow children to take too much responsibility for too long, even if they want to care for a distressed parent. Help members preserve their role and position in the family and support them. Don’t overprotect children or adults. Be understanding if a member cannot fulfil their role for a time and talk about how they will resume when they are ready and able.
  • Be active: Tackle problems, seek help, seek information and don’t let small issues build up. Whatever the cause, stress leads to further problems. Stress factors don’t add up, they multiply and make everything feel worse than it is.
  • Look back: From time to time take stock of how each member has changed since the crisis. Look for the ways the crisis has influenced everyone for better or worse.
  • Allow expressions of emotions: Support distressed family members and allow them time to find their way through their feelings. They may express distress many times before it diminishes. Suppressing emotions places them outside control and therefore outside recovery.
  • Use other people: Keep in contact with support groups, other family, friends, neighbours, and workmates. Make sure the family doesn’t become isolated and too involved with itself. Share the experience with those you trust. Most families have the ability to grow through crisis. But understanding its effects and actively dealing with them is necessary.


When to seek help

There are a number of signs that recovery may not be proceeding in a helpful way:

  • Communication in the family is breaking down
  • Parents do not understand their children’s (or each other’s) behaviour
  • Things are not improving over time in the family
  • There is evidence of deteriorating physical or emotional health in any family member
  • Family members are not able to enjoy being together.

If you are concerned about yourself, your spouse, children or parents do not hesitate to contact someone trained to assess the situation and advise you. A little early help from a trained person can avoid long-term difficulty and give family members back confidence in themselves and each other.

I have adapted this from information issued by Queensland Health: Fact Sheets for Psychosocial Disaster Management. I have also compiled a version that you can download here.

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The Canterbury earthquake and the effect it may have on families: Part one

People are usually surprised by how much an event like the Canterbury earthquake affects them. It frequently changes the way they think, their values, habits, feelings and behaviour. It influences most aspects of their life. Usually people do not expect their families to be affected as much as they are, but a major event or crisis in the life of one member always influences the family.

People usually underestimate the time it takes to recover from an event like this. Although it is made up of individuals, a family is a unit. What changes one member, changes the others. This also means there is a lot that family members can do to help each other in a time of crisis.

A crisis can also bring benefits to a family in the form of greater understanding, closeness or a new appreciation of each other. It can help to sharpen the focus on what is important in life. Sometimes a crisis can bring difficulties or misunderstanding within families. Family members may not understand each others reactions. They may have to adapt their behaviour to cope with these reactions. It may not always be clear how the feelings and bodily reactions are connected with what has happened, especially if they occur sometime after the event.

Most families overcome these problems when they begin to understand why they are occurring and accept that it will take time to recover. Some of the most common reactions to trauma and crisis are listed below.

Immediate effects

Some reactions may occur immediately after the crisis has passed and continue for some weeks.

  • Spouses/parents may be afraid for their partner’s/child’s safety while away from home.
  • Children and adults may have nightmares or develop fears that a fresh crisis will occur to them, or the family member involved.
  • Family members may be angry because of the fear and distress they were put through; these feelings may be directed at the family member involved, at each other or at people outside the family.
  • Family members may lose trust and confidence in themselves and other people. The world may no longer feel safe, their own welfare may seem uncertain, everything may seem too difficult to manage.
  • Children express their insecurity by naughtiness, bed-wetting, changes in eating and sleeping habits, tearfulness and irritability,  or reverting to behaviour they have grown out of.
  • Emotional turbulence, anger, guilt, sadness, unpredictable behaviour or unreasonable reactions may occur in any family member.
  • Communication may be difficult because family members do not know what to say to each other, or they do not feel like talking.

In my next post, I’ll write more about medium and long-term effects and what you can do to help.

More on supporting children through the earthquake, aftershocks and adjusting to life

Last week, I posted a quick entry to help orient you to some of the ways that children may be experiencing the earthquake, aftershocks and life after the quake. It will certainly never be the same. Even if there is potential for growth and gain through this in the medium-to-long term, it will certainly be different. And for most, the current situation is probably disorienting and confusing – as we try to make sense of what has happened, and what will happen next.

Children have their own ways of dealing with crisis according to their stage of development. Often their response is not what may be expected and may not show up for some time. Parents and others often worry and frequently are not sure of the best way to help them. Today, I’m posting more detailed information on how children tend to react to experiences like this, their likely needs, and how you can help.

The family

The family is the most important part of a child’s life (this changes for adolescents – see my advice sheet here). Parents give them their security and confidence. What trauma means to children depends to a large extent on how their parents react to it. Often this is more important than what happens to the children themselves. Parents can help their children by sorting out their own reactions and feelings. Do not be surprised if children’s reactions seem out of keeping with their experiences, they may be reacting to family members’ distress. Children (even infants and toddlers) always know more than adults give them credit for. They are aware of many things they cannot put into words for us. Children think about things a great deal even when they are not talking about them, but they can only put them in perspective with adults’ help.

Children need to make sense of things that happen. Children often don’t have all the facts and their thinking is not yet mature so they use imagination to fill the gaps. Often this results in misunderstandings, which they may keep to themselves, especially if they are frightening. What they imagine is usually more frightening than what really happened.

The child’s experience

Don’t assume that you know what the child understands about the earthquake or aftershocks, but find it out by talking and listening to the child and observing their behaviour. According to their stage of development, children may only take in some aspects of the situation. Their understanding is often limited, fragmentary or even distorted.

Reassurance is important, but does not help until the child has an accurate idea of the event and its causes, and their misconceptions have been corrected. Parents also need to find out what reassurance the child needs. This is not always what children ask about at first.

When someone they know is involved in a crisis, children may be distressed and imagine how it would have been for them to be involved in the crisis, but they usually express these feelings indirectly. They may feel their own security is threatened and that it could happen to them, however unlikely this may be. Sometimes, the crisis makes it harder to deal with other ordinary problems. Children don’t usually tell adults about these things because they may feel too self-conscious, are afraid or can’t put them into words. This can lead to misunderstanding or conflict between adults and children.

Children’s reactions may appear at the time of crisis or later. Sometimes they manage very well when the trauma is in everyone’s mind and only later start to worry, become difficult or feel as though they cannot handle their responsibilities. It can take months for things to build up to the point where parents or teachers realise a child may be having problems or needs extra help. By this time the event may seem less significant to adults. It is common for children to hold back their own needs and difficulties until they sense their parents are over the worst, and it feels safe for them to relax and start reacting.

Children’s reactions

These are some of the changes that can be seen in infants and children under stress:

  • sleep problems, nightmares, reluctance to go to bed or get up
  • changes in dressing, eating and toilet habits
  • irritability, uncooperative, listless or bored
  • clinging to family or familiar things, needing objects for security
  • unable to cope with change or ordinary problems
  • reverting to immature behaviour or habits they had previously grown out of
  • changes in relationships with parents, becoming more demanding, possessive, withdrawn, or uncommunicative
  • relationships with brothers, sisters and peers become more difficult. Often there is an increase in conflict, competition, aggression or withdrawal within these relationships
  • preoccupation with the trauma; wanting to talk about it, playing it out, wanting to see where it happened
  • excessive concern for others; holding back their needs to protect adults and anxiety about loved ones
  • reduced school performance, concentration or ability to play constructively
  • overactive behaviour, restlessness or dissatisfaction
  • small ailments or injuries are exaggerated or used to get comfort and security
  • transitions such as from preschool to school may be more difficult. Often there are problems at the start or end of daily activities
  • exaggerated reactions to small crises. This may be an expression of their distress about the incident which often they don’t fully understand.

How to help

  • It is better to tell children what has happened. Giving them the facts (but without unnecessary detail) helps prevent their imagination taking over.
  • Encourage them to express emotions. Fear and sadness are their way of coming to terms with what has happened. Hold them or stay with them, offer support while they are upset and then talk about it afterwards.
  • Keep communication open by asking questions to find out what they are thinking or imagining. Tell them how adults feel and what the actions of adults under stress mean. This will prevent children blaming themselves.
  • Reassure them about the future, especially the small details of life which are such an important part of their world.
  • Encourage them to continue to be children, to play, explore and laugh when they want to, even though the adults may not feel like it. Children are often able to take their minds off the crisis and its effects better than adults.
  • Maintain routine and familiarity to help children see that life is secure and predictable.
  • Reduce change of any type to a minimum. When change is necessary, take time to prepare children for it.
  • Keep them informed of how their recovery is going and what to expect.
  • Don’t make this the time to correct bad habits, don’t overreact to unusual misdeeds or bad behaviour. Talk about the behaviour with the child; they may need to let their tension out somehow.
  • Give children time to sort themselves out with your support, don’t expect it to be over quickly.
  • Keep track of the child; remember what she or he does and says, try not to let lasting changes in temperament and behaviour creep up without noticing.
  • Make time for just being together. Take time out and reestablish recreational activities and outings as soon as you can. Pleasure is an important part of healing.
  • Re-involve the child in chores and responsibilities as soon as they are ready to cope with them again.
  • Take seriously all their concerns, complaints and questions. They may be trying to express something important which they don’t have the right words for.
  • Parents need to get support to work through their own reactions, so they can help their child.

Summary: Brief Tips for Parenting after a Disaster

Be a caring parent.
Parents and guardians play a major role in ensuring the safety and well-being of their children. Although you may be under more stress after a natural disaster, it is important to continue caring for your children. Children are strongly affected by your reactions.

Keep your children safe.

You must know where your children are and who they are with at all time.

Establish routines.
Establishing new routines is especially important when normal ones are disrupted. If you are in a shelter and unable to return home, establish routines such taking a family walk, eating meals together, or reading a bedtime story.

Take a time-out.
When you feel overwhelmed, take a time-out. Take a few deep breaths, count to 10, or take a walk alone.

Ask others for help.
Ask trusted friends, family members, and other parents for help if you feel overwhelmed.

When to seek help

The best gift you can offer children is understanding. Don’t hesitate to seek advice if you do not understand any aspect of your child’s behaviour or if you have any concerns. A little help early can save a lot of heartache.

I have adapted from information issued by http://www.samhsa.gov and Queensland Health: Fact Sheets for Psychosocial Disaster Management. This information is also available on a fact-sheet I compiled for the Ministry of Health.

Checklist: Common reactions, positive coping, and when to seek help

A new week is with us. So, here’s a heads-up.

Distress is an understandable and normal response to major disasters. Common causes of distress may be related to having been directly at risk from the earthquake and aftershocks, being concerned about family and friends who may be affected, witnessing injuries and distress to others, or being caught up in the panic and confusion that often follows. In addition, feelings and memories related to previous experiences of disasters or other grief and loss may also resurface. Most people experience acute stress during emergency events and most manage with courage and strength. However, sometimes it is only later when the distressing images are recalled that some of the stressful effects start to show.

While most people will manage with the support of family and friends, there are times when extra help and support may be needed. Those who have feared losing loved ones, have been seriously injured, or are highly distressed by the aftershocks, will often need particular support and care. Our communities have a history of coping with uncertain and troubled times with courage and strength.

There are three important things you need to know:

  • normal reactions to this type of emergency
  • positive ways of coping
  • when to get extra help.

Normal reactions to a disaster like this include:

  • shock and numbness, often fear at first
  • horror and grief when the extent of loss is realised
  • frustration, anger, helplessness and even sometimes despair when it all seems too much
  • sometimes fears or old worries may resurface.

These feelings usually settle over the early weeks.

Positive ways of coping may be:

  • supporting one another, especially in the family and in your community
  • providing emotional support – comforting each other
  • carrying out practical tasks – tackling the jobs that need to be done a bit at a time and counting each success
  • sharing your experience and feelings with others – a bit at a time when it is right for you
  • looking after your own and your family’s general health – rest, exercise, food and company all help (being careful not to drink too much alcohol).

Sometimes, post disaster stress can be ongoing and affect your physical and mental health and wellbeing.

It’s time to ask for help if:

  • your sleep is badly affected
  • you feel very distressed, irritable, on edge or agitated much of the time
  • you feel hopeless, despairing, miserable or that you can’t go on
  • you have trouble concentrating, are distracted and cannot do your usual tasks
  • you feel your health is not so good
  • you have recurrent nightmares or intrusive thoughts about the earthquake
  • you have new symptoms or old problems may seem to have returned, eg. breathing, heart and stomach problems.
  • For children, withdrawal, aggressive behaviours, difficulties at school, problems separating from parents or going to sleep may indicate the need for help.

This is just the brief version. If you want more detail about specific topics, check out the other posts on this blog. The home page will have a list of recent posts in the right-hand column. Or you can click here for the fact-sheets at the Ministry of Health. I compiled these too.

Helping adolescents through the Canterbury earthquake and aftershocks: Part Two

Continuing on from Part One of this topic, I could talk about the influence of peer groups and all sorts of other things. But, for now, I’ll cut to the chase. Here are some of the behaviours you might see from adolescents as they come to terms with their experience of being under threat with the uncertainty this involves:

These responses are all signs of the stress of coming to terms with crisis. They are normal reactions to abnormal events and should pass with time.

  • excessive concern for others, guilt, anxiety and insecurity
  • sleeplessness or wanting to sleep all the time
  • withdrawal from family, spending increased time alone listening to music or watching TV
  • wanting to be around the family more than before or more dependent on family or other people
  • sudden need for independence expressing feelings like ‘don’t treat me like a child’ and ‘you’re only my Mother’
  • uncooperative, irritable and only concerned with what is important to them
  • bored, listless and dissatisfied unable to cope with responsibilities or duties, reverting to immature or irresponsible behaviour
  • preoccupation with the trauma, wanting to talk about it all the time – or angrily refusing to talk about it
  • more detached from life, the future or interests, and an unwillingness to set goals
  • want to do everything now: they are impatient or intolerant
  • pessimism and cynicism, loss of interest in the future
  • changed values and philosophy of life poor concentration, memory, organisation, planning skills and reduced school performance
  • restlessness, always needing to be doing something or be with peers
  • exaggerated emotional reactions to small problems
  • angry, controlling, assertive and demanding
  • exaggeration or return of previous problems.

If some of this seems contradictory, welcome to the world of adolescence.

Here’s how to help:

  • Give them accurate information about the event and its consequences.
  • Correct any misunderstandings and rumours, but do not burden them with details unnecessary to the overall understanding
  • Encourage them to express emotions and put thoughts into words—if not with you, make sure they talk to someone. Give them the opportunity, but let them go at their own pace.
  • Expressing strong emotions is a natural way to come to terms with crisis. As the emotions subside recovery starts.
  • Suppressed emotions can cause long-term problems. But there are many ways to express, not just through talking.
  • Keep communicating, if they won’t talk about emotions, ask the adolescent what they are thinking.
  • Let them know about your reactions, explain about stress and recovery. Even if they don’t admit it, they do take in what is said
  • Keep telling them you love and care about them no matter what they do or say.
  • If they object to what you are doing, don’t argue, ask them how else you can help.
  • Reassure them about the future, especially that their current distress will pass in time.
  • Make plans to reduce pressure at school or in other activities if they are having trouble coping.
  • Support them to continue their social and recreational activities, to play, explore, laugh, even though the adults themselves may not want to.
  • Maintain routine and familiar activities, ensure life is secure and predictable; minimise change.
  • Keep them informed about how their recovery is progressing and what help is available.

Don’t make this the time to have disputes about normal problems such as work, chores or defiance. Leave this for later or it will be confused with the crisis reactions. The problems usually fade as adolescents recover. If not, the problems will be more successfully worked out later.

Adolescents’ striving for independence, seeking help from peers and adults other than their parents and expressing critical attitudes are all indications of parents’ success in giving adolescents the strength and confidence to become adults. This behaviour needs to be valued and worked with rather than against.

Sometimes, adolescents have a narrower point of view and can accept the earthquake and all it entails in a matter-of-fact way. They may not need their parents as much as parents need them. When this happens parents must continue to be available, but in a different, more detached way and avoid burdening adolescents with their own distress as much as possible.

An event like this also provides adolescents with opportunities for growth and discovery about themselves. With help, adolescents can eventually mature as a result of the experience. They often show strength and resilience that has not been evident before.