THE HAITIAN EARTHQUAKE

The people of Haiti have suffered multiple losses – of family and friends who have died, homes that have been destroyed, possessions lost, and neighbourhoods devastated. In addition they may have physical injuries.  It is to be hoped that food and water supplies, shelter and the resources on which we all rely will be restored before long, thanks to the aid that is now pouring into the country, but the psychological and social damage will take much longer to heal.

The people of Haiti, individually and collectively, will be suffering traumatic loss - a loss that is unexpected, untimely and associated with horrific or frightening circumstances.
This may lead to:

• Trauma
• Grief
• Anger and blame
• Change

TRAUMA

“I can’t believe it’s true”

“I just can't take it in” 

Losses for which we are quite unprepared, particularly if we are unable to be present or to hold or touch lost persons, are difficult to make real, to accept, to understand.  We feel, and are, lost in a world that is beyond our comprehension.  This makes it hard to make decisions, act, feel, or respond to the many demands that we face. 

What helps?
It can take a long time to take in what has happened. It may help to spend time talking it through with others.  Don’t worry that you are being a burden to them; that’s what friends are for.  Many people find it helpful to visit the place where the disaster took place.  This will not be possible at present for those who have relatives and friends in Haiti.  Instead, it may help to talk to others who are in a similar position to you, place a wreath in a significant place, or attend memorial services or other rituals of remembrance.  You may never know what has happened to your relative or friend, so you need to be prepared to live with the uncertainty of not knowing.

“I can’t get it out of my head.”

“I keep seeing what happened as if it was happening all over again.”

Many people are haunted by pictures in their minds of the traumatic event.  While this is most likely to become a problem if you witnessed the event, yourself, it can also arise from television or other pictures that bring home the awfulness of the way a person might have died.  Such images may occur without warning or in distorted form, as recurrent nightmares, or they may be triggered by any reminder of the loss, such as sudden,loud noises, cries or shouts.

Some people go to great lengths to avoid any such reminders, because of the pain they cause.  They may shut themselves away, avoid talking of the loss and how they feel, and distract themselves with hectic activity.  This kind of reaction is not uncommon in the early days and should improve with time, but if it continues and you are concerned you should talk to your doctor.

What helps?
Haunting images can sometimes be reduced by talking to others and possibly going over the events again and again.  The images will not disappear but they should become less painful and less distressing to live with.  If this is not enough to make them tolerable, or if the images are stopping you from grieving or getting on with your life, then you should again talk to your doctor.

GRIEF

“I feel numb”

“I can’t cry!”

Numbness is our mind’s way of protecting itself from mental pain that threatens to overwhelm us.  Sometimes it may be so pronounced that we are unable to think clearly, become confused and lose our bearings.  At other times we may be unable to express feelings of any kind.  In an emergency this numbness can help us to keep going.  It is only if it continues that it becomes a problem.  Usually this reflects a fear that, if we do not keep our feelings firmly under control, they will take control of us, we will cry or become helpless.

What helps?
Grief is the natural response to the loss of a loved person.  It is more likely to give rise to problems if it is bottled up than if it is expressed.  At times of loss it is normal and appropriate to express grief in any way that feels natural.  Some people need to cry, others will rage and others just talk endlessly about what has happened.  Try to find someone you can trust who will be a good listener and don’t worry if, for a while, you look or feel helpless;  that will normally pass.  In grieving, we do not forget the people we love; we gradually find new ways to remember them.  Memories of the past are sometimes painful but they are our treasure.  It is best not to bury them for too long.  If we allow ourselves to lose control of our feelings for a while, we will find ourselves better able to live with and to control them.

“I can’t stop crying”

Grief goes on much longer than most people expect.  We need to recognise that fact and not expect too much of ourselves.  It is possible to get stuck in grief.  Sometimes this reflects our need to punish ourselves:  “Why should I be happy now that he or she is dead?”  This is most likely to arise if it is a child who has died, if we blame ourselves for their death or for not being there for them when needed.  At other times it reflects long-standing feelings of depression or helplessness, which are easily triggered by a traumatic life event.

What helps?
Grief is not like the measles; we do not go back to being the person we were before our loss.  We have changed.  We learn to live with it and, little by little, the pain will diminish.  Grief is not a duty to the dead.  Those we love would not want us to suffer.  Again, talking it through with a friend, seeking support from Cruse Bereavement Care or another organisation that offers bereavement support or counselling will help.  If that is not enough, or we feel permanently depressed or suicidal, seek specialist help.  Cognitive therapies, psychotherapies and anti-depressant medications may be of help and it is worth discussing with your doctor which of these are available and appropriate to meet your needs.  Do not give up.

ANGER AND BLAME

“I feel so angry”

Anger is a very natural reaction to sudden and traumatic loss.  It may be directed against  anyone who is thought to be to blame for our suffering, for example, the authorities.  Personal faiths/beliefs may be severely challenged.  In our desperation we may even find ourselves hitting out at the people we love the best.  You may even feel angry with the person who has died and feel as if they have abandoned you.

What helps?
Remember that anger can be a force for good if it is controlled and directed where it can do good rather than harm.  Try to hold back from impulsive outbursts and, if you have said or done things that have hurt others, don’t be too proud to apologise.  They will understand.

“I blame myself, I feel so guilty”

“If only I had...”

None of us is perfect and it is easy to seize on something that we did or didn’t do in our attempt to find someone to blame for the disaster that has happened.  Consequently, we end up blaming ourselves.  At the back of our minds we may even cling to the idea that, if we punish ourselves, we will make things right again and get back the person we have lost.  

What helps?
Sooner or later we have to accept that what has happened cannot be changed and that blaming yourself can also change nothing.  But we do not choose the way we feel.   Guilt and anger are not feelings that can be switched on and off at will. Be gentle with yourself and accept that it will take time for these feelings to reduce.

CHANGE

“I feel so frightened”

We all know that disasters happen, but we don’t expect them to happen to us.  Most of the time we go through life feeling safe, protected from harm and immune from disaster.  Therefore when disaster strikes, all in a moment the world has become a dangerous place, we can take nothing for granted, we are waiting for the next disaster.  Our world has been turned upside down.  Fear causes physical symptoms - tense muscles, racing heart, sweating, breathlessness, sleeplessness.

What helps?
The first and most important thing is to recognise that the symptoms of fear are normal.   Headaches, backaches, indigestion, even feelings of panic are natural reactions that will decline as time passes;  they are not symptoms that will lead to something worse.  In addition you are not as helpless as you feel.  Talking about your feelings, listening to peaceful music, prayer, meditation techniques, aromatherapy or whatever helps to relax you helps put you back in control.  If you remain worried contact your doctor.  

“Life has lost its meaning”

Each person’s sense of purpose and direction in life arises from a hundred and one habits of thought, assumptions about the world that we take for granted:  “I know where I’m going, and I know who’s going with me.”  Then, all of a sudden, we can take nothing for granted any more.  Perhaps the person who died is the one we would have turned to at times of  trouble - and now, when we face the biggest trouble in our lives, they are not there or, if they are, they are so overwhelmed by their own grief that we cannot burden them with ours. 

What helps?
It is important to recognise that it will take time and hard work to adjust.  It is rather like learning to cope with the loss of a limb.  For a while we will feel as if a part of ourselves is missing.  Hopelessness and despair are understandable reactions when someone who has been a central part of your life dies.  It is important to talk to people you trust about these thoughts, and to remember that life does go on.  While there will always be someone missing in your life, there are things worth living for.  It may be helpful to talk through these feelings with someone experienced in bereavement support or bereavement counselling or if you have a faith, someone who shares these beliefs.         

When people say  “He or she lives on in my memory”, this is literally true.  In the long run the most important thing about the people who have died is not how they died, but how they lived.

For those who speak English:
Services available from Cruse Bereavement Care

• On-line access to information here on the Cruse website
• Confidential Day-by-Day Helpline 0844 477 9400
• Free leaflets online here and more are available through the helpline, or from Cruse Central Office, PO Box 800, Richmond, TW9 1RG
• For young people: on-line access to information and support through their own special website, RD4U
• For young people: a freephone helpline 0808 808 1677
• The international journal, Bereavement Care, exists for professionals who support bereaved people 

For those who speak French or Creole:

Colin Murray Parkes' book ‘Le Deuil’, Frison-Roche, Paris (2000).

Amurt-Haiti started operations in Haiti in 1988, when it first opened a school under a tree in Port-au-Prince.  Those years still mark the philosophy of the NGO, which heavily relies on volunteers from all over the world, and on a very close relationship with the local communities it seeks to serve.  Since then Amurt has grown to include approximately 80 full-time employees forming five teams and working in areas as diverse as community health, environmental restoration, infrastructure, education, and more. See the website | email to info@amurthaiti.org

SUNY Downstate Medical Center provides telephone support, staffed with Creole-speaking mental health professionals.  See the website | Call (718) 270-1000 (718) 270-1000.

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Cruse Bereavement Care, January 2010

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