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Psychological first responders: good people doing better

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CHILDREN watch a movie on a projector screen inside a temporary evacuation center for residents affected by Taal Volcano’s eruption, in Padre Pio Shrine, Santo Tomas, Batangas, on Jan. 15. — REUTERS/ELOISA LOPEZ

By Carmen Aquino Sarmiento

THE SYNCHRONICITY of Taal’s eruption with the government’s inexplicable slashing of its disaster response budget, are dauntingly inauspicious for this Lunar New Year. After all, the Philippines ranks as the third most disaster-prone nation worldwide. Just for tropical depressions, hurricanes and storms, other countries may go through one or two super-sized typhoons a year, but we average nine, often having to extend the alphabet just to give them names. Despite some grumbling on social media that we citizens should not be doing the government’s job on our own coin, many stepped up and made up for the bureaucracy’s glaring shortcomings. There were even jokes that the Taal Volcano refugees were gaining weight at the evacuation centers from the private sector’s generosity, or maybe they were manas (bloated) from all the high-sodium instant noodles and sardines.

Providing emergency food rations, medical care, clothing and temporary shelter, are just the first hurdle of disaster response. In the shadow of the volcano, survivors continue to live with heightened anxiety and foreboding. For the many who survived on the tourist trade by Taal’s caldera, the dire new reality was that their homes and livelihoods are irrevocably gone. They need more than relief goods in the long run.

Thus, when the RCW (Reintegration for Care and Wholeness) Foundation, an Alternative and Holistic Health Service in Varsity Hills, Quezon City announced that it was giving free, one-day intensive workshops over a series of weekends till February, to train volunteers in post-disaster care, psychological first aid and healing interventions, a good number heeded the call. Many of the RCW responders were already in the helping professions, such as pastoral counselors from nearby Ateneo’s CEFAM (Center for Family Ministries). Half-a-dozen psychology students from Don Mariano Marcos Memorial State University in La Union came with their teacher. She brought her husband along too. Another married couple, the Lapid’s, came all the way from Pasay. They had actually been on Volcano Island, enjoying the usual tour on horseback with their pre-teen daughter and two nieces, when Taal began belching smoke.

Amidst the barrio folks’ alarms of “Umaalborot ang bulkan — kumukulob na!” (The volcano is acting up — it’s ready to blow!) their guides had taken them to safety first, calmly trotting alongside their horses to reassure them. The guides had refused to overburden the beasts by clambering onto their backs with their customers. Only after the Lapid family had boarded a banca back to Talisay did the guides turn around to go to their own homes and families, which were at least two kilometers from the shore. The decency, gallantry, and heroism of these simple folk had inspired Allan and Joy Lapid to learn how to be more effective volunteers for the displaced like the guides. It was a plus that she was a licensed guidance counselor and he was a tutor as well.

“Psycho-therapy is expensive,” candidly admitted the first facilitator of the day. The most modestly priced hour-long counseling session with a clinical psychologist costs more than the minimum wage.

Happy are those with trusted friends whom they can vent to for free. However, in a large-scale disaster, entire communities, including the survivor’s friends and family, might all be adversely affected and in need of help as well. RCW seeks to multiply the number of Psychological First Aiders who would step in after the survivors’ immediate basic needs had been met. Volunteers should always have their own food and water, so as not to further deplete the victims’ or survivors’ precarious supplies. Donations are usually intended for survivors, not volunteers. Bear in mind that just being dislocated from one’s home to an evacuation center, is already extremely stressful. Do not take from the little they have.

In a disaster, survivors lose not just their material possessions, or, in the worst case, their loved ones, but also, a sense of control over their lives.

During the first week or so, they may manifest forms of psychological trauma, most commonly: shock, paralyzing fear, panic attacks, dissociation, sleeplessness, irritability, difficulty making decisions, confusion, clinginess, even guilt over having survived.

Ideally, small core teams of volunteers would be available to administer Psychological First Aid.

Should the manifestations of psychological trauma be extreme, exacerbated, or extended beyond the first two weeks or so, those administering Psychological First Aid must also have the discernment to refer the suffering survivor to a more skilled professional. Psychological First Aid volunteers must remember the Three L’s: Look (be observant and actually “see” the survivor who is with you), Listen (with compassion and full attention), and Link (to the proper professional or agency as needed). So put that cellphone away unless it is to let a survivor use it to let relatives elsewhere know how she is.

The mnemonic for the effective volunteer’s attitude is 5 A’s: appreciate, accept, affirm, approve, and be affectionate, but without getting touchy-feely. A volunteer offering Psychological First Aid must not impose her presence upon the survivor. Proper introductions are first made on both sides, just as permission must be asked for and freely given. Here are other important DON’Ts for volunteers when establishing rapport with survivors:

• Do not force confidences, or start what you cannot finish. Even for paying clients, being cut short because one’s therapy hour is up, is very diminishing. It is empowering to the survivor to simply talk while the volunteer actively listens and sympathetically mirrors back.

• Don’t use their vulnerability or being a captive audience as an opportunity to evangelize or to proselytize about what your personal faith system presumes to be the supernatural or metaphysical causes for whatever mysterious and indiscernible higher purposes (e.g., putting them to the test?) for their suffering.

• Don’t suggest what you in your fallible wisdom believe to be reasons for said suffering — not even to give them a crash course on climate change, the unjust socio-economic and political order, government corruption and corporate greed.

• Do not express derogatory opinions of other groups’ or government agencies’ relief efforts. It’s not the time nor the place for playing the blame game.

• Do not claim you know just how survivors’ feel, and your bluff certainty that they can bear this hardship and tragedy.

• Do not urge them to cheer up/buck up, get over it and move on. They will do this in their own time while you respectfully but empathetically guide them. Help them to realize that they will gradually be able to rebuild their lives — perhaps never the same life, but as we Pinoys say: Habang may buhay, may pag-asa. (While there’s life, there is hope.)

RCW offers a more advanced workshop in using “feeling words,” particularly in the local vernacular, to mirror back what the survivors are feeling. The poor are the most adversely affected by disasters, and generally, they are more comfortable with their mother tongues, rather than with the colonizer’s English. Most Filipinos have a working knowledge of Filipino though, since the producers of mass media are still Manila-centric. E.g., after the KENTEX fire, a young widow repeatedly moaned: Kalunos-lunos ang itsura niya! (How pitiful he was!) as she recalled how her factory-worker husband’s burned remains were handed to her as a small, twisted bundle in a black plastic trash bag. Affirmations in Filipino may more effectively resonate with survivors in their grief, such as: Nasasabayan ko ang lungkot ninyo. (I am with you in your sorrow.) Tanggap ko ang galit at balisa ninyo. (I accept your anger and your anguish.)

Remember it’s about them, not you. The goal is to gently help them return to normalcy. So please do not post selfies of you, moist-eyed and trembling-of-lip in the survivors’ midst, just to prove you were there and how sensitive, noble, and tender-hearted you are. Respect their privacy at the very least. Respect and respond to your own needs too: eat properly, get enough rest, and take a break when you must. As Mama RuPaul declared: “If you don’t love yourself, how you gonna love somebody else?”

Because a volunteer cannot give what she does not have, self-care for helpers and caregivers is essential. Therapeutic modalities for one’s self such as practicing mindfulness, breathwork, meditation, tai-chi/shibashi/qi-gong, even less known practices such as EMF (Emotional Freedom Technique through Meridian Tapping, a.k.a. Psychological Acupuncture) are encouraged. As one’s skill in these grows, they may be shared with willing survivors. None of us is perfect and to varying degrees, we all need healing too. The phenomenon of the wounded healer is very much a thing. Just like the moon, we do not need to be whole to be beautiful, or to share our light.





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