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I am a clinical psychologist trained in social network intervention in the 1970's. Socnet readers may be interested in a "network therapist" 's perspective on meeting the mental health needs of the displaced from Hurricane Katrina.
----- Original Message -----
From: David Trimble
To: [log in to unmask] ; NMTPmail ; MASSPSYCH
Sent: Wednesday, September 14, 2005 4:13 PM
Subject: Imagining a Response to the Mental Health Needs of Katrina's Survivors
(September 14, 2005)
As people displaced by Hurricane Katrina arrive in Massachusetts and elsewhere across the country, the clinicians who meet them struggle to find ways to address their multiple traumata from natural disaster, social marginalization, and disastrous government response. Recognizing that the enormity of the situation risks immobilizing the human imagination, I propose one imaginable strategy for serving the displaced without becoming instruments of the social alienation that is compounding their trauma.
The early arrivals at Camp Edwards at Otis Air Force Base on Cape Cod (a region with a shallow, seasonal economy that is at the end of its summer's tourist season) had been taken, in some cases reluctantly, from their homes and other refuges directly to an airplane. The Boston Globe reported that they were provided with neither food nor water on the flight. It was only when they were in the air that they were told they were headed for Boston (not, as they had believed to Houston!). They disembarked from their plane to the heartfelt standing ovation of over a hundred volunteers, among them many culturally competent mental health professionals. They were provided showers, clothing, food and drink, diapers and toys for the children, and compassionate human encounters with the volunteers. The military housing complex afforded somewhat more quiet and privacy than afforded in the mass centers, such as sports stadiums, that others had encountered in other settings. Banks of telephones and a few internet-connected computers were made available at no charge.
As generous and hospitable as their welcome was, there are enormous challenges to addressing the emotional well-being of these displaced persons. Their circumstances have separated from their homes and from their social networks, among the most important buffers against traumatic stress. Many of them were enormously resourceful in finding ways to survive in their wounded city. Others are quite fragile - with chronic physical and/or mental illness and/or substance-dependence. Suddenly, they find themselves cut off, with no voice and no power in the decisions that have set them down in the woods of an economically marginal region whose nearby metropolitan area has recently distinguished itself as the most expensive place to live in the United States.
How can we, as professionals, find ways to address the mental health needs of the displaced? Before reaching for an answer, we have to specify the needs. From a family and network therapy perspective, paramount among those needs are recognition, compassionate witnessing, restoration of agency, and restoration of personal community. These displaced people and their families and clusters of kin and friendship, predominantly working-class and poor African Americans, have been further marginalized - stripped of identity and dignity by their depictions in the mass media, and by the relief actions of government that has had neither time nor inclination to attend to the particularities of their lives. Their pain, loss, confusion, and anger require compassionate witnessing. Restoration of agency, or empowerment, is particularly critical for the resolution of trauma, and particularly difficult in the situation that the displaced on Cape Cod (and Utah, and countless other alien settings) find themselves. The Gulf Coast diaspora has been particularly destructive to people's social networks, those personal communities in which all of us come to know and understand ourselves, and in which we are sustained.
Imagine this strategy for addressing those needs: It is decentralized, grounded in the acts and intentions of the displaced, with professionals serving and facilitating more than leading, using their expertise to support displaced persons' efforts to find health and strength in collective action. Imagine it beginning first in one place or perhaps in multiple settings, each setting developing its particular form, as shaped by its local participants. Culturally competent mental health professionals would facilitate regular community meetings, whose agendas would include times for witnessing each other's stories of survival, loss, and love, times for sharing practical information about resources and actions to restore some semblance of "normal" life (e.g., job, housing, transportation opportunities, ways to find scattered loved ones), and times for making sense of their social situation, and developing collective responses.
Marginalization by class and race contribute to the challenges of those who did not have the resources to depart New Orleans by their own means. They are more challenged to find friends or relatives who can afford them shelter; they don't have easy access to email or the Web; etc. They will need to rely on each other. In community meetings, the professionals would be available to help the groups to handle intense emotional states and to heal wounds engendered by trauma. They would afford access to critical social and economic resources. They would support critical social awareness and collective mobilization for social action, by posing questions to help the displaced deconstruct their situations in the broader social context, preventing paralyzing internalization.
Collective social action is essential for the displaced to build community and restore agency. As we envision building community, we must see beyond the boundaries of the artificial groups assembled to fill airplanes sent to distant places. Holding that perspective, we can imagine ways to nurture the emergence of community within those groups, community that supports its members in their search for home.
Mental health professionals could support the development of newsletters, instruments for each settlement to find its own voice, and for members of each settlement to find survivors from their own personal communities (The elements for such potential collaborations between professionals and displaced people are forming. "Radio Astrodome" has emerged from among the displaced in Houston, as an instrument for reconnection with missing kin. The International Network for Social Network Analysis listerve has started a conversation about using the tools and concepts of network analysis to support efforts to re-connect personal communities.). Newsletters, posted on websites as PDF files, can support people's searches for each other, provide a forum for witnessing people's stories, and afford a voice for collective action. They can be printed and distributed, first among displaced persons in mass shelters and smaller shelters, and eventually along lines of connection among kin, friends, and other network members. As newsletters take form, they may become vehicles for concrete political action. They might address the challenges of property speculation gentrifying areas of New Orleans cleared by the storm and flood, thus threatening to perpetuate the exile of the poor. They could support efforts to secure absentee ballots for the displaced to vote in local and national elections.
The wounds Katrina inflicted on the human spirit will persist long beyond restoration of the physical structure of Gulf Coast or healing of the bodies of Katrina's displaced survivors. We believe that addressing the needs of displaced people at the levels of personal community and wider social context is integral to the appropriate application of professional skills to heal those wounds. This will require humility, tenacity, and cultural competence. For professionals to be useful, they will have to collaborate with displaced persons, help them conduct gatherings that combine emotional healing and support with practical action, and make their own access to social resources available to the people that they serve.
This was written by David Trimble, a psychologist licensed in Massachusetts. It is intended for free distribution.
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