ADVICE | After the Floods: Dealing with Post-Traumatic Stress Disorder

By: Maria Cristina F. Samaco

InterAksyon.com
The online news portal of TV5

It feels like we've seen all this before. Nearly three years ago, to be precise. On September 26, 2009, Typhoon Ondoy dumped rains and caused floods that trapped in their homes. Ondoy's victims struggled to save whatever they could.  Families were marooned, starved. Children, women and men drowned and were buried in landslides. 

Years after the Ondoy, victims report that it has been never the same for them again. They have nightmares about drowning and dying in flood waters. Even when awake, they are bothered by thoughts and images related with Ondoy.

Some avoid things that remind them of the tragedy. They don't go back to their old house, they don't wear the same clothes they wore when Ondoy struck, and they refuse to eat the food they now associate with having been stranded.

Victims also report feeling anxious whenever it rains. They are unable to sleep; tirelessly, they are on guard for the rise of flood waters. Victims are easily startled by the sound of thunder and downpour.  Some survivors who lost their property and/or family in the Ondoy were numbed by the experience. They became distant from other people, and had become unable to experience positive emotions such as happiness and excitement.  

The behaviors mentioned above are characteristics of Post-Traumatic Stress Disorder (PTSD), as described by the American Psychiatric Association, and they will surely be experienced by countless Filipinos in the wake of the recent rains and floods. 

PTSD develops as an extreme response to a severe stressor or a traumatic event that involves actual or threatened death or injury. This trauma leads to intense fear or helplessness which is manifest for more than one month.

When cues such as rain and thunderstorm result in calamities, victims begin to associate these cues with tragedy. Even the sound of raindrops may strike fear in their hearts.

If left untreated, PTSD can persist throughout a victim's lifetime. It can also come with other psychological disorders such as depression, substance abuse and anxiety disorders. When cues related with the Ondoy calamity can no longer be avoided, such as the relentless raining brought about by the monsoon, this leads to extreme anxiety and possibly panic attack in the victims.    

Filipino families have yet to recover from the wrath of Ondoy, yet here we are again. Filipinos pride themselves in being resilient. We have the uncanny ability to bounce back from tragedy.

Moreover, social support may alleviate the long-term psychological damage of trauma.  Knowing that there are people who are worried about you and are ready to take care of your immediate needs may provide a sense of relief and security that you are not alone to face the challenges. Talking about the crisis may likewise hasten the recovery of victims.                      

If you have family or friends who are victims of the current calamity, or if you simply want to help out, what can you do? Other than addressing their physical needs, it is important to know that victims have psychological needs as well.

The so-called SAFE-R model of crisis intervention may be useful. (Rando, T.A. 1998. When a community weeps, Case studies in group survivorship.) It outlines the following steps for intervention:

Stimulus Reduction. Ensure that the victim is in a safe environment, away from the threat of floods.  Get them into warm clothing and give them something to eat and drink. This will give them psychological distance from the components of the crisis. 

Acknowledgement of the Crisis is the next step, which involves encouraging the person to talk about what has happened and how they are doing. Allow them to process their experiences and thoughts. This will help them feel safe and cared for.

Facilitation of Understanding is the third step of the model. Help the victim understand that their reactions are normal and provide them with psychoeducation to help them make peace with what happened to them. 

Encourage Effective Coping through teaching and reinforcing effective coping and stress management techniques. 

Restoration of Independent Functioning. Despite administering the first four steps of the SAFE-R model, there are some victims who may still struggle with psychological and behavioral functioning.  For these individuals, there may be a need to obtain more intensive psychotherapy, to hold back the development of PTSD. 

The author is a PhD. Candidate in Clinical Psychology at the Ateneo de Manila University. She is a member of the Psychological Association of the Philippines.