Friday, March 7, 1997
Coping with 'loss
upon loss upon loss'

Emotional toll formidable
for disaster victims

The Cincinnati Enquirer

They may look, but they don't see.

They may feel, but the sensations are numb.

Their bodies may be hyped on adrenaline or immobilized by dread.

Victims of the Flood of '97 will face an emotional recovery almost as lengthy and formidable as the physical cleanup, mental health and disaster experts say.

Suzi Bosl of Xenia, Ohio, remembers the long emotional recovery from an April 1974 tornado that destroyed her family's two-story home.

''Every time the wind blows - and I suppose every time it rains for flood victims - that scary feeling comes back,'' says Ms. Bosl, now a nurse manager at Greene Memorial Hospital. ''I can remember for the next couple of springs after the tornado, I would panic every time there was a tornado alert or warning - grab the kids, throw the windows open and just panic.''

She likens the process of recovery to working through the stages of grief - denial (''which is that numbness''), followed by anger, acceptance and, finally, mastery of new coping skills.

''You learn to cope and how to handle things, but I don't know that it ever goes away,'' Ms. Bosl, now in her 50s, says. ''The memories are always there. If you have good coping mechanisms, you can deal with things.''

Emotions linked to disasters are different from everyday emotions, says Dave McClure, supervising nurse of St. Luke Hospital's Disaster Medical Assistance Team (DMAT), which set up headquarters Sunday in flood-ravaged Falmouth, Ky. Disaster victims frequently deal with what one rescue worker calls ''loss upon loss upon loss.''

Disaster also affects children in ways that adults might not understand, says Rachel Burrell, founder of Fernside Center for Grieving Children in Norwood.

''Children will be experiencing emotions they've never felt before, and this is very scary to them,'' Mrs. Burrell says. ''They sometimes don't have a name for their feelings, particularly the younger children. They may lose the concept that they live in a safe environment. They may be walking around in a daze because it all seems so unreal.''

Children's reactions will vary. Some will become angry or aggressive, others withdrawn or silent.

Many people will have physical symptoms that are rooted in emotional upset, Mr. McClure says. Common complaints include dizziness, lack of purpose, headaches, stomach problems, inability to sleep or irritability.

''They'll say, 'I don't know what's wrong with me,' or 'I don't know where to turn, where to go,''' Mr. McClure says. ''You need to get them to calm down, review and talk about what's just happened to them, help them take stock of what they have and that they're still alive, and get them to focus on the positive.''

Sometimes, disaster victims and overworked rescue workers need to be told directly what to do, such as take a break, catch up on sleep or eat something.

''People run on adrenaline, and their clocks run for 24 to 48 hours, and then they're just totally decompensated,'' he says.

Children need good listeners who will confirm their feelings and instill a strong sense of safety, much of which has been shattered by disaster, Ms. Burrell says.

''You have to realize you can't fix it for these kids,'' she says. ''They'll be changed by this forever. They need a lot of love and support, a lot of listeners. They need to tell and retell the story. Each time, they may be able to tell a little bit more.''

For children and adults, grief has ups and downs, just like river levels, Ms. Burrell notes.

''Don't draw any time line on someone else's grief,'' she says. ''Don't say things like, 'It's been three months since the flood, and it's time to get over it.' Realize that this takes forever to get over.''

Tips for recovering from loss and disaster.

Talk about your experience to someone who will listen compassionately.

Use feelings, not just statements, to describe what's inside (for example, ''I feel sad,'' ''I am angry at Mother Nature,'' ''I feel lost.'')

Take care of basic physical needs - sleep, regular meals, frequent breaks, time for fun - so you can recover emotionally.

Exercise or take regular breaks from cleanup work to give your mind a mental break.

Memorialize what you've lost. Participate in funerals and memorial services (and allow children to do the same). Take photographs and establish new living spaces as quickly as possible to provide comfort and continuity.

Focus on the positive (what you have), not on the negative (what you've lost).

Keep things in perspective. Realize that a disaster is a rare occurrence. Reassure children that they are safe and cared for.

Accept help from others.

If you or someone else shows signs of mental stress, seek professional help. Trouble signs: excessive crying, withdrawal, lack of interest in anything, sleeping too much or too little, irritability, agitation, inability to concentrate or think clearly, fatigue, noticeable change in appetite, thoughts or statements about death or suicide.