September 12, 2005
Trauma and Mass Victimology - A Psychologist's Views the Aftermath of Katrina
I received this first hand account of the aftermath of Katrina (I assume it is written from Houston) in an email from a colleague.
Anne Gervasi is a licensed psychologist. She donated her time and her talent working with Katrina refuges at first, Reunion Arena and then, the Civic Center.This is her first hand account and reaction to what she had to deal with. If you blog, please put this outthere. We want everyone in the country to read this first-hand account of the horror that is Dallas. If you have an extensive mailing list like I do, please forward it, too.
First-hand reaction to Katrina refugees
There are so many words that come to mind. As a scholar I am thinking Diaspora, social displacement, systemic disruption, mass trauma, pandemic and unbelievable chaos. As a clinician, I am looking at something that we have never been trained to handle in this country—a level of victimization and its resultant psycho-social ripples that mandate a whole new field of clinical practice-mass victimology. Katrina kicked the top off of a racist and social termite's nest that has been growing beneath the ground since Reconstruction. These were deeply religious people who have lost God and for that matter, faith and hope. Hope has been replaced by magical thinking that augurs a second and more terrible level of social disruption and anger not far down the road.
Over and over, I kept hearing a framing of self that puzzled me until I realized that this is how it must have been for blacks after Reconstruction. Over and over, people said, "everyone has been so wonderful, thank you, thank you." When I said, "there is no need to thank us, you are our fellow citizens and we want to help you—American to American," there would be a long pause as if the idea of being the same never struck them before.
They are angry and it is growing. The system failed them. For that matter, there is no system because all the safeguards and preparations that we thought were in place aren't there. I have been begging anyone who would listen over the past two years for a program in mass victimology to prepare for the next tragedy after 9/11. Now it is here and the lack of organization, science, and preparation are going to result in terrible consequences for us as a nation.
Imagine sending people who have been assimilated into the most stable demographic population in America into cities and towns all over the US who are as unprepared as the victims to understand their sense of dislocation and their support needs. The lower Gulf States have a language, a history, a social dynamic, a faith, a societal structure, and a ritual system unlike any other in America. These people have lived in and been acculturated to this system for generations. When the dust settles and the mud dries, we are going to see all over America, a nation that will lose patience with the needs of a foreign refugee population. Abandoned once again, the fury and the trauma that have been momentarily quieted by the outpouring of empathy and support post-crisis, will arise larger and more terrible than we have been equipped as a nation to handle. I hear it now, over and over, in the survivor stories, in the loss of self, and the need to reclaim dignity and power.
Right now, numbness is being replaced by magical thinking. "People want me here—here is better. I think I'll stay here." What is going to happen when reality sets in? The bulk of people who are planning to stay don't understand the system here. Even though we abut borders, we are a vastly different nation. At least we are southerners. What is going to happen to the thousands being sent to Connecticut or Illinois or New Jersey? They are being offered free apartments, furniture etc., by generous and well meaning people who haven't thought the long term consequences through very well. A lot of the apartments are in areas where they won't have transportation or jobs. What is going to happen six months down the road when the magic wears off and the help slowly fades? How about the holidays for a people who thrive on ritual, tradition, and celebration?
The trauma they are experiencing is so profound that we have no cultural term or machinery set up for it. The dead and nameless bodies by the thousands rotting in the water, arriving dead on the buses with them, or dying next to them in the shelters are a huge festering wound that no one dares mention. This is a true Diaspora the likes of which we haven't seen since Reconstruction. The immediate needs that are being addressed ignore the greater traumas yet to be spoken. No governmental system can survive the number of wounded and disillusioned people that we are going to see sprouting up all over America. Something far greater and more organized has to be done.
Then to the helpers and what is happening there. Turf wars have already sprung up. In the name of "I know better than you do," chaos and wasted energy are multiplying. The Red Cross was initially in charge of certifying the credentials of the helping therapists. After Oklahoma City and the pretenders who arrived there, this seemed like a wonderful clearing house. Everyone who wanted to help had to go through a brief orientation and a thorough checking of credentials. Only licensed professionals were allowed. Driver's licenses were checked for criminal records. This seemed to be a common sense excellent approach to the question of rapists, pedophiles, and other thugs being denied access to a vulnerable population. Actually, things ran better than I expected at the beginning. Then in came the physicians who I guess felt that their non-existent coursework in this area qualified them to better run things. Immediate chaos, disorganization, and all sorts of ersatz "helpers" began running around. They grabbed our current Red Cross badges and then stopped us from going back on the floor to finish seeing our patients without the new badges, which they just happened to be out of. We had an optometrist with prescriptive lenses but no glasses or readers and no idea when he'd ever see any. We had a deaf booth but no deaf helpers. In the midst of all this chaos, thousands and thousands of the walking wounded mixing with the powerless well-intentioned came the whispered word, pandemic. Lots of people are suddenly getting sick, and we have to have precautions. Don't eat or drink or touch the patients. We only have one bottle of disinfectant in the mental health section, so come back here—the length of the Convention Center—after each patient. "What of the people who are being cycled out of here?" "What are we sending into the population?" If people are sick and contagious, where are the precautions to separate the vulnerable? What of precautions such as masks and gloves to keep the medical professionals and first responders safe? All the here and now is suspended in the hope that maybe tomorrow will take care of itself and the worst won't happen. Those are the question we asked on the first day. NO ONE IS IN CHARGE.
Therefore, there is no consistent answer or approach or forethought. I am no infection guru but as soon as I heard on day one that people with no water were forced to drink water with bloated bodies, feces, and rats in it, the thought of cholera, typhoid, and delayed disease immediately occurred to me. What if the fears of disease are correct? People are fanning out throughout America. Where is the CDC?
In the age of computers, we are doing worse than the pencil squibs and the rolls of paper to log in the displaced after World War II. Literacy and computer access seems to be considered as a given for people who have lost it all. Accessing FEMA is through a website. People are in shelters waiting for FEMA to come "in a few days." "Be patient." The Lieutenant Governor of Louisiana pumped my hand and replied to my desperate queries about how to help people find their parents and babies, "Be patient—give us a few days."
The mothers who have lost their children, and there are many, and the children who have lost their parents, have had it with the "be patient" response. The shelters are surprisingly silent. It is hard to find the traumatized mothers because they cry silently. One mother asked how patient I would be if my five-month-old was somewhere unknown for over a week. Over and over, others would ask, "Do you think my baby has milk and diapers?" "Do you think they are being kind to my baby?" And then, so softly that I would have to ask them to repeat, "Do you think my baby is okay?" My response—the convenient lie. Every time I said, "of course," I prayed to God that it was true.
I am sure that there is a special ring of hell for the media: The survivor stories end-on-end for the titillation of the public. I heard Soledad O'Brien say something about the still unrecognized need to address the psychological trauma. I sent a response to the CNN tip-line that there were hordes of every manner of mental health professional working 24/7. CNN's response? Dr. Phil and the stories of the survivors" on Larry King. They went to the guy who lost his clinical license for serious professional infractions to tell the stories? I could see the "entertainer" down there gathering tales of the already exploited so that he and Larry could both pimp their ratings. The real unsung mental health heroes, the counselors, psychologists, social workers and psychiatrists dealing with un-medicated sychosis and severe traumatic responses were represented by Dr. "Keep-It-Real"? We don't need tabloid help from the media. Scream about accountability and point fingers for those who can't. Where is the real help from the media? Help us find those babies and parents and missing family. We have a man in one of the shelters who is caring for four kids. They call him uncle. He is actually the cousin of the fiancé of the mother who is probably dead. The children are silent. They sit and play and weep with open mouths that can't scream. Where is the media to scream for them?
Finally, to hell with this "no blame game." The stories that I know to be true are enough to make me boil. The compassionate foreign doctors who can't find anyone to validate their credentials, the expensive mobile hospital still sitting parked waiting for federal paperwork to move into Louisiana, the five C130s sitting on the Tarmac in San Diego since the night of Katrina, still waiting for orders to move. Where the hell are the beds? We have some old people sleeping on hot plastic pool floats with no sheets. They are still no showers for people who have walked for hours through fetid waters. Their skin is breaking out in rashes. Still no showers. Where the hell are the DeCon showers bought with Homeland Security money that can shower 30 people at a time. The convention centers have no bathing facilities so the filth and skin reactions are getting worse. What of lice? There are no clothes for the really heavy and large. I was reduced to writing the women I knew who went to Weight Watchers to comb their attics for "before" outfits. When I arrived with the sack of my gatherings, I had to engage in a full scale battle and puff myself up to all my red-headed doctor fury to get them distributed to the women still sitting there in their stinking clothes.
The survivors are like the Mayor of New Orleans who apologized to George Bush for his anger. "If we tell the way we feel, maybe help will stop." All the apologists on the air distancing George and his co-vacationers and idiot appointees should be impeached. I liked Nagin when he called it all bullshit. He was right. How about Haley Barbour complaining about the lack of support for his state? Did he so soon forget his past life and what he did to set up this government of spin artists? If they had acted like a government the body count would be less. The aid would be better managed. The days of filth, and feces, and death would have been ended sooner. God help all of the poseurs in charge when these folks finally get in touch with their justifiable rage. Did you see the White House's logo for the hurricane? George and some asshole in a ball cap against a background of Katrina waving the flag. They had the energy and time for a nice logo but no time to get the elements of help in gear?
The tragedy is leavened by some moments of farce, the guy who arrived with a case of Gucci shoes in various sizes that he "saved" from his closet. The man wearing twelve expensive watches up his arm. I guess he is a punctual sort. There are the too-poignant-for-words vignettes. I saw a lady sitting on a blanket holding a photo of two children that she had pulled from the water. She kept crying and looking at it. I thought they were her children. She didn't know whose they were. They were just losses and she mourned them.
Of course there were the criminals, thugs, and mobsters. One of the greatest indictments of the "spin machine" that is going to come from this situation will be the repeated characterizations of the victims as lawless and criminal. Over and over I heard people tell me about how ashamed they were to be portrayed that way. Ninety-nine percent of these people never were characterized as anything but lawful and good citizens. In their most desperate hours to be reduced to taking food and water to survive and then to be lumped with the television thieves and the shooters is too shameful for most of them to bear. I heard from hospital employees that survived on a cup of watered grits so that the patients could make it. And then I heard had they had to hide the ones that didn't in closets to keep up the morale of the others.
The people that survived this tragedy and the people who help them all know one truth. The help and the love and the care that has been extended to them have been on a citizen-to-citizen basis. The churches, doctors, therapists, and ordinary citizens who are giving all they can in time and resources are managing to band-aid at the most elementary level-neighbor to neighbor. The government has failed. We are more vulnerable now than before 9/11 because faith in the system is gone. No system can sustain itself as a viable entity when the citizenry are the walking wounded. Victims implode a system from within and expose its decay. This is the beginning of the end unless we can get a drastic change of philosophy and restore the government to a system "by the people for the people." Right now nobody down here believes we have that.
Ann Gervasi
September 11, 2005
Photo note: Repercussions and waves, or sunrise on a plexiglass window with venetian blinds
Posted by Dakota at September 12, 2005 05:41 AM