At 14:28 on May 12, 2008, a major earthquake of magnitude 8 occurred in Wenchuan, Sichuan Province. The disaster was severe, with landslides, house collapses and heavy casualties, and it touched the hearts of people all over the country.
In such a disaster event, people in the disaster area faced with the death of their loved ones, injuries and loss of property, the survivors and aid workers had considerable psychological shocks and effects, such as helplessness, strong fear, dread, sadness, self-blame and other emotions. Such experiences can easily form personal traumatic experiences and cause some disaster victims to develop traumatic stress disorder, therefore, emergency psychological crisis intervention is particularly important.
Psychological crisis intervention, simply put, is to let the person being intervened speak out the disaster event experienced, the inner feelings and experiences, to vent out the emotions, to downplay the fear, anxiety, self-blame and many other negative emotions brought by the disaster, so that the person can resume normal life and physical and mental health as soon as possible.
In theory, the sooner the psychological intervention after an earthquake, the better. As much as possible, intervention should be carried out before the bottom of the mind falls out, and the shortest possible time should be used to return to the most normal state, therefore, psychological crisis intervention is an important part of the emergency relief system. But psychological crisis intervention must be done only after the survivor is physically safe to provide targeted psychological assistance. Psychological professionals are needed to professionally screen and diagnose the survivor, intervene immediately for the different levels of disaster impact, and help him to voice his inner experience and vent his negative emotions in a timely manner. The more timely the intervention, the faster the psychological recovery of the survivor, and the later the effect, the worse. Therefore, the following issues should be noted during emergency psychological crisis intervention.
Time and focus objects of emergency psychological crisis intervention
The best time frame for emergency psychological crisis intervention is within 4 weeks after the disaster, mainly to carry out psychological crisis management and psychological crisis assistance.
The people who need the most psychological intervention after the earthquake are those who are most affected by various adverse factors and the most seriously infected psychologically. Usually the first group we rescue is the survivors, i.e., those who are directly injured but survive, and alongside them are the families of the dead. The psychological crisis intervention population is generally divided into four levels. Level 1: Survivors of the disaster, such as the families of the deceased, the injured, and the survivors. Level 2: Witnesses (including rescuers) at the disaster site, such as victims who witnessed the disaster, on-site commanders, and rescue personnel (firefighters, military police, medical rescue personnel, and other rescue personnel). The third level of the population: people related to the first and second level of the population, such as survivors and relatives of witnesses. Level 4 population: rear rescue workers, those who carry out services or volunteers in the disaster area after the disaster, and even all those who are prone to psychological infection because they are concerned about the situation in the hardest hit areas every day after the earthquake, etc.
The focus group of the emergency psychological crisis intervention population is the first-level population, i.e., the survivors who experienced the disaster firsthand, such as the families of the dead, the injured, and the survivors. Then it will be gradually expanded to cover the fourth level of the population for general psychological awareness and education.
The mindset of survivors after a disaster will show fear, helplessness, fear, sadness, and a very important emotion, which is unjustified self-blame.
Emergency psychological crisis intervention; catharsis of emotions is especially important
After suffering from accidental trauma, survivors will have various experiences including physical pain, fear, helplessness, fear, sadness, regret, blame, etc. and the need for emotional catharsis. The most important technique of psychological crisis intervention is to help survivors vent these feelings and emotions.
For the shock is particularly strong, often showing strong acute stress reactions, such as bewilderment, numbness, narrowed attention span, disorientation, disorganized speech, and in some cases, wood stiffness. Some will behave very calm and composed for a period of time, even numbingly calm, as if they can bravely cope with the catastrophic event and behave very calmly, often suppressing their emotions. This situation especially requires various ways to express their feelings of personal experience and stimulate them to vent their emotions and experiences. Otherwise, if it is difficult to release and catharticize emotions, it often easily leads to depression, anxiety, schizophrenia, etc.
(1) Crying is the most direct way to recover from trauma
It is good to shed tears or even cry under this painful blow. Try to express and vent out your feelings, and you will have a chance to recover from the pain. If you force yourself to suppress your true emotions or thoughts, it will cause tension and physical discomfort, which will prolong the recovery time. Therefore, saying it out loud, or even shouting or crying it out, is an important natural way to vent.
(2) Group discussion and communication
Group discussion and communication is an important and effective way of catharsis. In group discussions, individuals with the same degree of hurt are put together. Through emotional stimulation, empathy later, the mutual comfort and support of their peers is the best effect, in addition to Rogers’ patient self-support therapy is very effective.
(3) Venting their emotions through music
Music is one of the most suitable tools for psychological counseling and psychotherapy. Its non-verbal, figurative form of thought and its closest proximity to the deeper consciousness of the person make it in a sense superior to other psychotherapeutic methods. Music also transcends age and language limitations, so all people can benefit from music therapy, regardless of gender, age, intelligence, or knowledge of music. Because music has a strong contagious effect, different melodic music makes people feel differently. Alternately playing some melancholy and uplifting songs is conducive to their emotional release, which then stimulates mental ability and potential, promoting the survivor’s desire to survive and willpower to overcome difficulties, music therapy can soothe and regulate emotions.
(3) Helping people to help themselves, acting as volunteers to make survivors feel less guilty
For adult survivors who are willing to serve as volunteers, assign them tasks such as distributing food and water, and for older children, help children with their homework and take them to play games, so that they can take some responsibility and help them re-establish their self-identity and improve their resilience. The last thing you should do is sit idly by and listen to the cries around you. The same goes for adults; don’t do nothing, but don’t overwork yourself and become easily depleted either.
(4) Listening, companionship and physical soothing
For survivors with excessive psychological stress, such as a parent who has lost a child, listen to his catharsis, do not interrupt him or her to talk or cry, listening is a form of support, accompanying, shaking hands, patting his or her shoulders or hugging to make him or her feel safe.
(5) Farewell ceremony for the deceased
Survivors’ tribute to the deceased or collective tribute activities, such as children’s pretend play with alternative roles in dialogue, flying kites, writing what they want to say to their dead relatives and friends on kites and flying them, or burying small notes, or carving words on stones, or drawing pictures, etc. The main purpose of these activities is not to avoid reality and to express their emotions, which are good ways to vent their emotions. We must all support and understand and not stop their behavior.
For the death of a loved one or friend, whether adult or child, it must be done: do not hide it, otherwise it will cause more psychological damage. There is a farewell ceremony for the death, and for the child, it is important to let him know that the loved one or companion has left him/her forever and gone to another world. The goodbye ceremony is very important; it is a process of closure and acknowledgement of the truth. Although it sometimes takes time to move from acknowledgement to acceptance of the truth, acknowledgement is a necessary part of acceptance.
The farewell to the dead is not only an acceptance of reality for the survivors, but also an important way of emotional catharsis, which has a very important meaning for the survivors, and the farewell ceremony as well as the tribute is very important in crisis intervention.
In addition, the psychological intervention after the earthquake disaster can not be done by psychological professionals alone, but should be driven when the forces include local government organizations, community managers and various types of medical personnel at all levels, volunteers, etc., to spread the concept of psychological rescue and some simple psychological rescue techniques, to establish a strong psychological intervention network, to spread the basic psychological knowledge and psychological intervention methods, in order to allow more people to benefit.
After the Wenchuan earthquake disaster, the party and state leaders have repeatedly stressed the importance of post-disaster psychological rescue, fully reflecting the “people-oriented, people’s livelihood ” governing philosophy. The Chinese Psychological Association, the Central Institute of Educational Sciences, Beijing Military General Hospital, Peking University and other major universities and related scientific research institutes, have advocated and set up earthquake relief psychological assistance groups, and have successively sent expert team teams to carry out some emergency psychological crisis assistance.
For how to carry out “psychological intervention ” after the disaster, to help people to summon up the courage to live again and rebuild the meaning of life, this is both a job that requires extremely strong professional skills and experience, but also a very important “battle ”.
According to the definition of psychology, there are three criteria for judging psychological traumatic events: first, endangering human life; second, unpredictable; and third, unstoppable no matter what is done. Wenchuan earthquake obviously belongs to a major psychological traumatic event. Some experts believe that “after a traumatic event, 70% of the people can recover naturally through the coping strategies they have. As much as 30% of the population, on the other hand, will experience different symptoms one after another from days to decades after the disaster. If these people do not receive professional help and treatment, they will suffer personality changes and distortions that are likely to last a lifetime.
For the general 70% of the population, general psychological rescue efforts and general techniques of psychological intervention can help them recover naturally. The key is that for the other 30% of the population, specialized treatment by counselors, psychotherapists, and psychiatrists is really needed.
It is evident that scientific psychotherapy, on the one hand, advocates early intervention to contain the problem at an early stage, which is the ideal working model advocated by mental health workers. On the other hand, since psychological rehabilitation takes a long time, and some serious psychological disorders arising from disasters take a longer time to recover, psychological rescue is a very long-term work, which requires not only enthusiasm but also lasting scientific relief.
In view of the above, on the one hand, we need timely psychological crisis intervention, psychological guidance and emotional catharsis for its survivors; on the other hand, we do not need to panic too much, because we need to fully believe in human’s own psychological recovery and adjustment ability, believe in the human will power to overcome any crisis and difficulties. During the short-term stress period, especially the first level of people who need to intervene, that is, the survivors of the disaster, such as the families of the dead, injured, survivors, they show some abnormal psychological reactions, which is inevitable, some psychological barriers exist at this time, we can not ignore, but we also can not overly strengthen its concept. We must accept this reality, and some emotional reactions are themselves accompanied by the stress process, with the passage of time and psychological crisis intervention, some stress reactions will gradually reduce or fade away. Generally it takes a few months, but for survivors with high trauma and low psychological resilience, it may even take years to recover slowly.
So how to intervene and how to intervene? First of all, there is a need for nationwide planning and management, such as how large a team of psychological professionals is needed, where to set up psychological intervention points, and how to set up intervention points? According to the international experience of psychological crisis intervention, each psychological crisis intervention point should have at least one local psychiatrist, one psychotherapist, one psychological counselor, one social worker, etc., and should have a simple environment with a place for children to play or a place for simple entertainment such as reading newspapers for those who need intervention. For victims who are found to have severe post-trauma and stress stress reactions (e.g., chronic post-earthquake insomnia, dullness, alcoholism, depression, panic reactions), immediate intervention should be implemented.
Only in this way can the network system and social support system for psychological intervention be established and carried out in a planned and systematic manner, scientifically and rationally. Otherwise, if psychologists have to visit and screen tent after tent to find victims with psychological problems in this way, the work will last a long time and will not be efficient, and many problems will even be overlooked.
Schools are the first place to resume classes, and some schools are now back in session, so psychological assistance starts with schools, finds orphans, or those who have lost a parent or sibling, and intervenes, then slowly extends to their guardians and neighbors. Schools are more organized and have a more concentrated staff, so psychological intervention can be done in class groups or in group therapy. And train local school teachers and organizational workers to be local resources to do follow-up long-term interventions. Since psychological counseling generally takes two to three years, the sustainability of external interventions is not strong, so it is especially important to cultivate local resources.