SECTION I:Natural Disasters in the United States

This page intentionally left blank

Natural Disasters Section Introduction

Karla Vermeulen

When my fellow editors and I teach students and professional responders about how disasters’ characteristics tend to correlate with survivors’ typical psychological reactions, we talk about how people usually have an easier (though not an easy) time recovering from natural disasters compared with those who experience intentional acts of malevolence. Intuitively that should be no surprise: Unlike events where someone actively intended to cause harm, these weather- or geology-related disasters are usually seen as random acts of nature, completely uncontrollable, or as acts of God that often generate painful questioning for those who believe in an omnipotent deity. That certainly can be traumatic for those believers who are now robbed of their faith or are forced to question the benevolence of their God. Disaster mental health responders should be prepared to hear questions like "How could God have let this happen?” - unanswerable questions that may best be referred to a chaplain or spiritual care provider, but whose significance for the survivor should not be minimized.

Still, we generally see that survivors of natural events tend to have a less difficult time accepting what has occurred, largely because there is no one to blame, except God/karma/one’s higher power or deity - or just the rotten luck of being in the wrong place when a particular natural disaster happened to strike their spot on the map. There usually aren't criminal investigations or trials that prolong survivors’ exposure to the event, and natural disasters are less likely to be politicized or to become fodder for ongoing media punditry. Sometimes the impact of these disasters is limited to property damage with no human casualties or injuries. Dealing with a flooded basement or a tree through the roof might be stressful and expensive, but not necessarily traumatic. Those impacted can focus on recovering from their losses without a lot of the secondary stressors that often surround human-caused events, as the chapter introducing that section of the book will describe.

However, no one should ever claim that going through a natural disaster isn’t difficult at best and potentially traumatic at worst. These events may cause people to lose their homes and all of the precious belongings those homes contained. Sometimes they lose their communities if they choose or are forced to relocate permanently. People can die in natural disasters, as can pets, and survivors may have feared that they or their loved ones were going to die, which is an experience no one forgets. Recovery periods can be long and exhausting, and there are never enough resources to go around.

We also see that even when betrayal, blame, and anger seemingly shouldn't be present in response to natural disasters, these emotions are frequently a part of survivors’ range of reactions. And the effects of these feelings are powerful, even if they sometimes seem irrational to responders. Put yourself in the shoes of a survivor who has just lost their home to a natural disaster:

You could be blaming meteorologists, volcanologists, hurricane chasers, emergency managers, law enforcement, politicians, and everyone else who should have recognized this threat and protected their constituents - you -from it. Clearly, you think (accurately or not), someone should have done a better job of warning you, or of putting more effective protective measures into place.

You’re probably angry at your local authorities for failing to push through a federal declaration of emergency that would bring more resources to your county, and you’re definitely upset about the runaround you feel your insurance company is giving you.

You’re mad at the media for being present with their intrusive questions and cameras, and then you’re mad at the media for moving on to the next disaster and abandoning your community when there’s still so much work that needs to be done to clean up.

You might blame your pets or livestock for not sending stronger signals about the approaching earthquake. Why didn’t the horses/dogs/spiders make their premonitions clearer? That may sound silly, but people sometimes go through elaborate mental gymnastics in order to avoid being caught off guard again in the future.

Which brings us to the key point to be prepared for when trying to support survivors of natural disasters: It’s very common for them to blame themselves - not for the event itself, usually, but for ignoring a warning or otherwise acting or failing to act in some way that could have prevented or mitigated the harm they experienced. You may hear people say things like:

• • Maybe the horses/dogs/spiders did send a clear signal and 1 was too busy to recognize it! 1 won’t make that mistake again.
• • 1 should have protected my belongings better, put our valuables up high or in a safe deposit box, or bought a better home insurance policy.
• • If only 1 had followed the evacuation warning, we wouldn’t have been trapped when the flooding hit.

• 1 think God is punishing me for something 1 did before (or something

someone in my family or community did before, depending on beliefs about karma or collective responsibility and retribution).

Sometimes this self-blame is appropriate. People can be careless and let an insurance policy lapse, and they frequently disregard warnings that might have spared them from exposure to harm. In such cases survivors have to find a way to forgive themselves for real mistakes that they made. Sometimes the self-blame is exaggerated, distorted, or based on an inaccurate belief. Either way, it’s an attempt to control the situation - and to prevent it from ever happening again in the future. Rational or not, the message to oneself is that “I made a mistake this time, but that won’t happen again.” And this can lead to more productive behavior in the future like improved compliance with the next warning, but it often comes at a cost of guilt and self-blame that can increase distress for survivors of these events.

And of course, it’s impossible to seize control of our fates fully, and that lack of control and the resulting sense of helplessness is often the most troubling emotional reaction you’ll encounter in survivors of natural disasters. While some weather events are predictable, many natural disasters are largely unexpected, or they seem so remote and unlikely that we can shrug them off and carry on living where we want to - in a flood plain on the coast or by a river, in the vast swath of the US referred to as Tornado Alley, even on the side of an active volcano. And then when the volcano erupts, or the fourth “hundred-year flood” occurs in a decade, or the tornado’s path cuts through one’s town, survivors feel powerless and sometimes question whether they want to stay in a place that no longer feels safe.

The takeaway point here for readers is that from the mental health perspective, we often frame natural disasters as not quite as terrible for survivors relative to events resulting from human-caused behaviors. While that is generally (though certainly not universally) true, we also need to remember that less terrible is still terrible enough, as the accounts you’re about to read make clear.

The six case studies in this section describe two major hurricanes, a flood, a tornado, a mudslide, and a wildfire that not only burned thousands of acres and destroyed more than a hundred structures, but took the lives of 19 firefighters. These events hit major cities and small towns across the United States. All involved numerous fatalities as well as property damage that displaced residents, so some survivors were both homeless and bereaved. Several of the disasters damaged or destroyed important parts of community infrastructure including roads, schools, places of worship, and even hospitals. Some raised questions about whether certain neighborhoods should ever be rebuilt or if those locations were simply too hazardous to allow people to return to in the era of climate change.

The authors of these case studies are all experienced mental health professionals and most had extensive disaster response experience prior to the events they describe here, but one (Rodgers, in the next chapter you'll read) was doing her second major deployment, and we suspect many readers will identify with the trepidation she describes when heading into the scene. Most deployed to distant regions to provide support, and they describe the challenges of entering an unfamiliar community and trying to connect with residents and local responders who might mistrust outsiders. They also all describe their mixed feelings about reaching the end of their deployments and returning to the normalcy of home, knowing there were still so many unmet needs at the site. On the other hand, one of our authors (Ryan, Chapter 8) was working in her own community through the complex recovery from Super Storm Sandy and describes the exhaustion of participating in a response that lasted for months. New DMH responders would do well to consider your pacing as you head into a response: Are you looking at a sprint or a marathon?

The authors worked in diverse settings, often moving from site to site and doing outreach in impacted communities. This brought many of them close to scenes of devastation and exposed them to difficult sights, sounds, and smells. One responder (McCleery, Chapter 4) provided support via telephone from a 211 call center after Hurricane Katrina, experiencing a surreal contrast between the intense emotions he was exposed to while fielding questions from people desperately seeking food, shelter, medical care, and information about missing loved ones, while working from a safe and relatively comfortable space distant from the physical damage. Most describe working long days, sometimes followed by sleepless nights in a staff shelter or sharing a motel room with a chatty - or snoring - roommate. All emphasize the importance of actually practicing good self-care, including accessing social support on-scene and from home.

As the case studies in this section show, natural disasters can literally shake the foundation beneath survivors’ feet, or wash away their entire community. These are the most common kinds of events DMH responders are likely to be deployed to, in their own communities or in other areas. They’re an important training ground for what might seem like more intense reactions in a human-caused event, but as the diverse experiences and important lessons learned by the authors of our chapters in this section show, responding to these events is the core of disaster mental health response. You can’t do better than starting with learning from their experiences.