Shattered Lives
Victims of Katrina lost everything, especially their sense of security and well-being. Can they bounce back?
And images of the chaos were seen by millions of others, some of whom were grappling with their own reactions and agonies. Elizabeth Robison, a 37-year-old mother of two girls, grew up in New Orleans. Her house in Baton Rouge became a shelter for nine family members and friends. One evening, as they sat outside eating the red beans and rice her husband had prepared on a camp stove--there was no power--they all began to relax. Then came the news over the radio that a policeman had been shot in New Orleans and that there were looters and dead bodies in the Superdome. "No one wanted to go to sleep that night," she recalls. "Our world as we knew it was just melting away, and every day it seemed to get worse."
The dual horrors--one from nature and the other man made--conspired to deprive rescue workers and evacuees alike of that crucial component of resilience, what psychologists call "active coping." A number of studies have demonstrated that psychological outcomes are vastly improved when victims are able to do something involving their treatment, rather than being passive recipients of services.
Dwelling on circumstances while being treated like a commodity triggers another psychological mechanism known as "learned helplessness," in which negative, uncontrollable external events create a profound and debilitating sense of fatalism. Victims of child abuse and other traumas often suffer learned helplessness, which can in turn cause serious mental disorders, including anxiety and depression. "The problem is that what people most need is what they don't have," says Allen. "And that is a sense of security."
The sense of security so elusive in the chaos of New Orleans was offered in Houston. "We saw people with acute stress reactions, with anxiety and depression, even people who were psychotic," says Stuart Yudofsky, chair of the department of psychiatry at Baylor College of Medicine in Houston. "People had lost everything and had very little confidence that things could be well organized because of all their frustrations in New Orleans. They were under enormous stress and pressure."
Some victims received immediate counseling, as just having the opportunity to talk about what they had gone through was valuable. A number of the evacuees suffered from serious mental illnesses like schizophrenia or bipolar disorder and had run out of their medicines, so physicians could prescribe them and get them stabilized. Others were former addicts, deprived of methadone. Responding to the physical needs of those who were there "all served to help reduce the stress," says Yudofsky. "When they first came in, they were dazed and overwhelmed, then in four or five days of relative stability, they began to look a bit happier, more confident."
Among the most vulnerable victims, of course, are the children. Some were separated from their families, while others witnessed the ordeals and despair of their parents. John Krystal, professor of psychiatry at Yale University School of Medicine, says that studies of children who had been emotionally abused or who had faced traumatic situations revealed that the major differences in outcomes were dependent on how much support they received later on. "Even if faced with horrible maltreatment, those who were more resilient experienced at some point a supportive environment," says Krystal.
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