THURSDAY, Jan. 14, 2010 (Health.com) — The earthquake that hit Haiti on Tuesday has caused untold physical devastation, flattening much of the capital of Port-au-Prince and leaving tens of thousands dead. The psychological effects of the disaster may be similarly devastating, and they are likely to persist long after the aftershocks have subsided, for the people in Haiti as well as for Haitians abroad who are watching the events unfold on TV.
Haitian-born clinical psychologist Guerda Nicolas, PhD, the chair of the department of educational and psychological studies at the University of Miami, has written extensively about how Haitians cope with tragedies, especially hurricanes and other natural disasters. (A study of hers appears in a new book, Mass Trauma and Emotional Healing Around the World.) Nicolas is currently coordinating counseling efforts in Miami’s large Haitian community and plans to travel to the island next week to assist with mental-health outreach.
Health.com spoke with Nicolas about the psychological impact the earthquake is likely to have on Haitians, and what can be done to support friends and family members who are suffering beyond the disaster zone.
Q: What are the immediate psychological concerns following a disaster like this?
A: There isn’t an immediate response. When an individual is in the midst of that—and I’m saying this not just as a professional, but from experience and the work I’ve done in Haiti—you’re in action mode, and you’re just thinking about what’s going to happen. The actual trauma, the psychological impact, doesn’t occur until several months after. It’s when things get quiet and there’s not much going on that you start to feel the impact and the sadness of the images that you witnessed. Having come so close to death starts to set in.
Q: Is that when post-traumatic stress begins?
A: Exactly. After the relief effort has ended, after the funerals are done—that’s when post-traumatic stress disorder (PTSD) occurs. In the event of any type of trauma, a person can have acute stress and anxiety, but PTSD doesn’t occur until six months after, after the person has been experiencing the symptoms of not being able to sleep, and the flashbacks.
Q: Are there other symptoms that accompany this kind of trauma?
A: Depression is one of them; often it’s a marker for PTSD. Anxiety is another common response. Oftentimes [PTSD] is associated with substance abuse. There’s a desire to numb the pain, so people have a tendency to drink more heavily to cope and deal with the pain. But different individuals have a different cultural response to situations, and there’s not a uniform way [to respond].
Q: Can people at a distance from the event experience shock and post-traumatic stress as well?
A: Yes, absolutely. We call that vicarious traumatization. And it can be more damaging psychologically because there’s a feeling of helplessness—watching the images, seeing the devastation, and knowing you can’t do anything about it. The people there are really trying to do something to alleviate others’ suffering, and that can be helpful.
The symptoms are very similar to PTSD. People will have nightmares; they’ll have flashbacks of the images they’ve seen on television. They may have sleeping difficulties, they may not be able to eat, they may not be able to concentrate.
Next page: Preventing vicarious traumatization