WATCH THIS VIDEO TO LEARN MORE ABOUT THE IMPORTANCE OF MAKING SENSE OF DISASTER
When the distress associated with the experience of disaster is too frequent, too intense or lasts for too long
When the disaster impacted individual finds themselves constantly ruminating on the disaster experience, or being preoccupied with the possibility of future threatening situations
When the distress associated with the event does not begin to subside over a matter of weeks
When distress escalates and begins to interfere with everyday life
Provide psychoeducation about the concept of ‘processing’ and the importance of making sense of what happens to us.
Provide psychoeducation about the importance of gradually moving away from avoidant coping styles.
Encourage disaster-impacted individuals to take naturalistic opportunities to talk about the event, or encouraging more structured attempts to writing about the disaster experience.
Provide psychoeducation about the importance of coming to terms with disaster?
Describe the relationship between intrusive, unwanted memories of the disaster and avoidant coping?
Elicit common posttraumatic attributions?
Support disaster-impacted individuals to gently engage with their memories of disaster events, either through conversation or by writing?
Determine if you are personally in the position to listen to stories of disaster if asked to?
Many people feel distress in the aftermath of disaster. For most, the distress will settle in the days, weeks and months after the disaster, and the recovery process is facilitated by their use of adaptive coping strategies and by engaging with family, friends and local support networks. The strategies people employ to support their recovery varies from person to person, as does the time taken to recover, and it is important that health practitioners do not interfere with naturalistic recovery processes. However, health practitioners should be alert to circumstances in which disaster-impacted individuals report that their distress remains intense, or becomes worse with time. Listen also for indications that individuals are thinking about the disaster (or its aftermath) in snap shots, often focusing only on the most distressing or upsetting aspects of the disaster. Focusing on snapshots instead of the whole experience contributes to feeling “stuck”, and prevents distress from fading. Also be alert to the possibility of the development of frank mental health disorders, and either employ routine clinical assessment strategies and treat appropriately, or refer to a general practitioner or specialist mental health practitioner for assessment and ongoing support.
Encourage understanding of the importance of making sense of disaster experiences. Terms such as “processing”, “sorting through”, “organising” and “coming to terms with” can be employed. There are two goals. The first is to reduce reliance on avoidant coping by encouraging opportunities to engage with the memory and to sit with associated thoughts and feelings. The second goal is to reduce focus on the most distressing “snap shots” of the disaster by putting all of the pieces or fragments of memory relating to the event together and in sequence. Both often occur naturalistically during everyday conversations and moments of personal reflection. By better organising memory fragments, thoughts, feelings and reactions to the disaster, or other troubling events/situations, the overall memory becomes clearer and more structured, and interpretations of the event can become more balanced, or less distressing or frightening. Making sense of disaster in this way can support a broader recovery process.
Where individuals find the process of recalling disaster events overwhelming and respond with a persistent pattern of avoidance, more structured opportunities for engagement can be encouraged, and taking opportunities to write about the disaster experience is often helpful. It is important that disaster-impacted individuals understand that starting the process of writing about their experience in detail can temporarily increase distress. The steps below provide guidance about how to approach a writing task step by step.
Commence the writing task
Encourage the individual to choose a distressing memory, troubling or upsetting issue to write about. This might relate to the disaster itself (e.g., seeing the house burn down; trying to find the kids when it was time to go), or it could be something that has happened subsequent to the disaster (e.g., engaging with contractors to rebuild house; negotiating with work to return to work; losing livelihood as result of fires) or something else that is troubling them (e.g., dealing with a neighbour).
In writing about their experiences, there are a number of aspects to the process that may be helpful to consider:
‘Processing’ disaster events takes time. Changes in meaning and reductions in distress do not occur quickly, and evidence of those changes can be difficult to recognise. Writing about disaster events may also prompt individuals to talk more about their experiences, thoughts, feelings and reactions. Health practitioners may themselves be sounding boards for that process, or they may encourage individuals to engage with others during this time. It is helpful to remember that social connectedness is an important predictor of outcome. Health practitioners should also be alert to the possibility of worsening mental states, and be prepared to refer to general practitioners or specialist mental health providers as necessary.
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