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.

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Helping adolescents through the Canterbury earthquake and aftershocks: Part One

One week on from the initial earthquake, and hundreds of aftershocks later, it is the weekend. A chance to take stock of what will be remembered as an unforgettable week for a generation of New Zealanders, with considerable uncertainty about what may be yet to come.

But much of the Christchurch CBD is accessible again. All over the region, people will be out and around, surveying their surroundings. Some will take the opportunity to re-connect with others, while others will perhaps take a moment to consider their journey so far, and what they might do next.

One group that can often suffer a little from the lock-down that tends to happen during emergency events are adolescents. All sorts of stuff going on in the life of a modern adolescent – family competes for attention with peer groups, cellphones, games consoles, and generally being out and around and exploring the world. However, under the threat of earthquakes and the aftershocks, people are sometimes enforced to spend a lot of time indoors and in cramped spaces. This weekend might provide a bit of release.

Adolescents involved in crisis and emergency events, may not always show their distress outwardly. As a result, adults may misunderstand their needs or find them unwilling to accept help. Adolescents frequently lose the self-assurance they had when younger, but often gain other types of confidence and abilities. Parents, and adolescents themselves, are confused by their inconsistent behaviour. They can think rationally, but have unstable emotions and may not apply logical thinking to real situations. They need support and independence to learn this. They want to be both close to others and time to be alone as they find new ways of relating to people. To communicate with adolescents, these contradictions have to be understood. Moodiness, depression and insecurity commonly alternate with excitement, happiness and adventurousness.

Whereas children are dependent on parents and live within the family, adolescents are usually proud that they could survive on their own. School, peers, other adults and social or sporting groups are a large part of their support network. They often do not feel the family is the life support system it was in childhood. Parents may feel sidelined, but their importance is no less than before, just different.

Adolescents usually don’t understand these changes although they feel the frustration of them. They need their family to be a trusted home base for their adjustment to painful events, but how much they rely on their family to come to grips with what has happened varies greatly from one person to another.

Adolescents are often more involved in doing things than understanding emotions and may lack words to express important feelings. They handle painful events by distracting themselves. They may be immersed in their own feelings and point of view and not recognize adults’ reactions. They may feel threatened when adults try to be logical about painful experiences and not fully understand what is said until later. But their behaviour often shows they have taken notice even when they don’t acknowledge it. It is important to allow time for them to work things out and not demand immediate feedback. Parents’ own anxiety may make adolescents confused and guilty or cause them to reject the parent’s emotions to protect themselves.

Jump down to Part Two of Helping Adolescents for more.

Supporting children through the earthquake and aftershocks

The effects of emergency threat on children often worry parents and adults. However, children take their lead from how they see adults managing. They are often just as able to cope with the crisis as adults, although they do it in their own way. It is important to trust your children’s common sense, knowledge and emotional strength and your own knowledge of them. They need you to have faith in them. The majority of people (children included) behave sensibly and reasonably in a crisis, given their understanding of the situation and their knowledge. Therefore equip them with accurate factual information about the threat and give them accurate advice about what to do. Children show their courage by what they do, even if they express fear. If they are afraid; they need the chance to express it and for you to support and encourage them without losing confidence in their ability to cope. Children have untapped strength and are very resilient; with adult support they recover well from emergency stress.

Helping children under threat

  • Remain calm; it may be very difficult but try to avoid displaying unnecessary distress.
  • Be real, explain what adults are feeling and doing – they usually already can see for themselves.
  • Keep updating them and explaining what is happening in simple words so they can understand it.
  • Explain what you are doing to keep them safe, show how your knowledge helps meet the threat.
  • Get them to talk about what they think might happen and correct any wrong ideas.
  • Give them things to do to help however you can so they feel useful, even if just to keep watch.
  • Reassure them that they are brave, will manage well and you are confident in them. Remind them that many people are trying to help and will come when they can.
  • Show affection and comfort them when they are upset, then encourage them to meet the threat.

There is also some great information here from the Ministry of Education, and another great information sheet that has been put together by the employee assistance people at Telecom NZ.

Taking care of yourself when you’re trying to help others

If you’re in Canterbury, or elsewhere in New Zealand and are trying to look after the needs of those affected by the Canterbury Earthquake, there are a few pointers to bear in mind to help you you and others well, and safe from potential harm.

Let’s start with the positives:

DO

Promote SAFETY
Help people meet basic needs such as food and medical assistance.

Promote CALM
Provide accurate information about the situation and listen to those who want to share their feelings and stories.

Promote CONNECTEDNESS
Help people to contact their loved ones and keep families together.

Promote HOPE
Acknowledge the difficulty of the situation and remind people that the responders are doing all they can to help.

Promote SELF-SUFFICIENCY
Give practical suggestion on what people can do.

Now, the things to avoid:

DON’T

Don’t force people to share their stories.

Don’t say everything will be OK.

Don’t tell people what and how they should feel.

Don’t tell people how they should have acted earlier.

Don’t make promises that cannot be kept.

Don’t criticise services in front of those who are in need of them.

Remember there is no right or wrong way to feel and react to a disaster. You also need to remember that whether you’re working or volunteering to help others, if you don’t keep yourself safe and well, you won’t  be able to do it for very long, and you may even do yourself harm. Here are some tips you might find useful to keep yourself as well as you can.

TAKING CARE OF YOUR BODY

Get enough sleep and rest. Eat healthily. Exercise as much you can – rhythmic activities like walking, running, and swimming. Avoid drugs and excessive drinking and smoking.

TAKING CARE OF YOUR MENTAL HEALTH

Learn about normal and abnormal reactions to disasters. Don’t ignore your own emotions. Know when to seek help. Do things you find relaxing.

TAKING CARE OF YOUR SPIRITUAL SELF

Make time to reflect. Meditate. If you find it helpful, pray. Find spiritual connection or community.

INCREASING YOUR RESILIENCY

Do something that will help you to regain a sense of control. Focus on your strengths and positive coping skills.

REACHING OUT

If you feel overwhelmed reach out. Do not be afraid to accept help.

REMAINING ACTIVE

Go back to your normal activities as soon as it feels comfortable to do so.

MANAGING YOUR WORKLOAD

Maintain a healthy balance between your work and rest. Take breaks and time off. Prioritise your tasks.

REDUCING YOUR STRESS

Do things you find comforting: exercise, read, listen to music. Be with people whose company you enjoy. Practice stress reducing exercises.

I’ve adapted these points from the from the New York City Department of Health and Mental Hygiene, Office of Mental Health Disaster Preparedness and Response. I hope you find them useful.

Psychosocial support resources available – videos and factsheets here

You can find many of the factsheets I prepared for the Ministry of Health and the cross-government National Welfare Recovery Group here.

You will also find a series of videos – but don’t worry, if you don’t have the time or the bandwidth to watch them, I’ll be discussing some of the content here often.

Check back to see what is new.

Psychosocial support after the Canterbury quake – Advice blog

In the hours, days and weeks ahead you may come across instances where people are worried, anxious, frightened, or just uncertain about their experiences and futures. You may be feeling like this yourself. Some will have experienced damage to their property which means that they cannot live where they normally live. Others may have experienced injury – whether to themselves, or their loved ones. And this injury could be physical or non-physical, visible or non-visible. What we know from the research is that most people will be ok, especially if they have their usual resources to draw upon – especially their social networks and experience with coping with adversity successfully before in their lives. Others will need more support.

This site provides information to help you to help yourself and others.

This blog started after doing some work over the first couple of days after the initial earthquake, having been quoted in a NZ Herald article here on helping children after the event (also also in the Star Canterbury and another article here, and here), and a Radio NZ National radio interview on Nine to Noon with Kathryn Ryan too. I also made a post on Nigel Latta’s Facebook page after being prodded by a friend on looking after children after the earthquake.

As a result of the work that I have done to develop the NZ Government’s psychosocial support response in emergency events, I’ve been inspired to set up this new blog on support after the quake – please check in regularly for bite-sized advice and tips to help you recognise some of the new and unsettling thoughts, feelings and behaviours that you and others around you might be seeing or going through, and how to help yourself and others.

I’m happy for you to share this information with whoever you think might find it useful. Just check with me through the comments function if it will be used for press or media purposes. Always happy to receive feedback too. Thanks.