I met my team members at headquarters at 4 a.m. so we could begin the 1.5-hour drive up the mountain for a briefing with local firefighters. On this day, residents of the Lake Arrowhead area of California would also be allowed up the mountain to see the sites where their homes had stood just the week prior. Since that time, the roads had been blocked off and guarded by police, as the California wildfires were still smoldering and the area was considered dangerous. I was here to serve as a disaster mental health counselor as part of the American Red Cross effort to aid victims of the wildfires.
The residents assembled at the local school and received passes to enter the area that had been ravaged by fire. American Red Cross volunteers were also in place, offering shovels, rakes, water, snacks, masks, gloves, sifters and psychological support. Also greeting many of the returning residents were piles of ash, from which rose metal pieces resembling prehistoric monsters. What was now rubble had once been their homes.
This is an account of the residents’ coping efforts in the first days after the wildfires, as well as my thoughts on the role that mental health counselors can play in aiding victims caught in the midst of devastation.
The early stages of coping
Heroism: Residents’ faces wore expressions of fear, confusion and shock. One lady proclaimed, “I cannot recognize anything. Not one thing!” Initially, most picked up sifters or shovels and attempted to look for some familiar item, only to find that the entire contents of their homes had been reduced to a fine gray ash. As I approached one former homesite, a woman was running her finger over the gold rim of a piece of china. She looked at me and said, “My gold china.” From her pocket, she pulled out the head of a small statue and a broken piece of the base for a Lladro figurine. She repeatedly exclaimed, “Oh, Mommy, I am so sorry!” She then told me this had been her favorite piece. One week before her mother’s death, her mother had allowed her to pick out the piece. She had chosen the figurine because it looked like her mother.
Our role as American Red Cross disaster mental health providers was to offer a compassionate presence. This was a time to be human, to offer hugs, to place a gentle hand on their backs, to provide a confirming statement of the enormity of their loss or simply to just stand and listen. We left traditional counseling back home in our offices. In fact, there was no need to tell the residents we were counselors at all. We carried Mickey Mouse stuffed animals to give to the children. Eventually, when American Red Cross workers wanted the assistance of a mental health provider, they would simply say, “We need Mickey.”
Overwhelmed and dazed: A driver of one of the emergency response vehicles told me he had just seen a couple at their homesite. The woman was raking through the ashes looking for any valuables she could find. “But he just kept looking for a chisel, a 98-cent chisel,” the driver said in amazement. “He just lost a home worth hundreds of thousands of dollars, and he just kept looking for a 98-cent chisel!”
Mental health providers can help the other volunteers and first responders better understand that victims’ seemingly irrational responses are actually normal reactions given the circumstances. We can also educate volunteers about helpful responses to the survivors’ reactions. Most of these volunteers are on the front lines, dispensing food and materials to victims. All volunteers could benefit from taking a psychological first aid course, which could be offered at the deployment site.
Honeymoon: The community came together in a time of pain, need and loss. A temporary meeting site was established in the parking lot of a small park at the base of the mountain where 199 homes were lost. Community members manned the tables, passing out information to their neighbors about the first steps to take in the aftermath of the fires. Cases of water, shovels, rakes, masks, gloves, eyedrops, snacks and friendly hugs were all made readily available. One afternoon, a case of beer even arrived from a fellow resident.
A woman and her son drove through the former homesites offering homemade sandwiches to the workers and residents who were sifting through the burned out remains. Another lady stopped and asked where she could drop off clothing donations. Neighbors pitched in to help older residents dig through the ashes in hopes of finding items that somehow managed to survive the flames.
We worked hand-in-hand with the community, and they taught us what their needs were. Local responders and resources initially manage the situation until a disaster is elevated to a national level. Then the area becomes eligible for federal aid and other support services. When we respond at the national level, it is side-by-side with the local responders. It behooves us to follow the lead of the local experts concerning their community’s norms, values, traditions and socioeconomic characteristics. When all the volunteers and services are pulled out, the local responders are once again left with the needs of the community in their hands.
Anger: The National Orange Show Events Center was set up so those affected by the wildfires could meet with caseworkers and have their paperwork filled out and processed for eligibility of services. Being asked to produce verification of various aspects of their lives during such a difficult time made some people very angry. In one instance, caseworkers called me over because they felt threatened by a man who was yelling at them. They didn’t understand why he was so angry with them; they were only trying to secure necessary information so they could authorize services and financial aid for him. They were also upset because they had seen him hit his dog and yank her by the choker collar.
The man was frustrated because the system required proof of residence to become eligible for services. He claimed his license and registration were for his prior place of residence. Boiling over, he screamed, “I have no (expletive) gas money!” However, talking calmly to him and acknowledging his frustration, his feelings of separation from his girlfriend and his sense of dislocation eventually helped to defuse his anger. After he calmed down, the caseworkers eventually acquired the needed information.
Humor: Within two days of returning to the sites where their homes had once stood, the residents’ use of humor as a coping mechanism became evident. Signs appeared with messages such as “Open House, BYOB,” “We’ll be back” and “Yard sale.” One family made up a sign with their surname and street address. Many of the ash and rubble piles suddenly acquired “entrances,” as objects such as a wrought iron lawn table and chair were pulled from the debris and set up.
Survivor guilt: Driving up the mountain road, we encountered a man who was walking. We asked him if he wanted some supplies. He initially responded that his house was OK, but then he broke down in tears. “I did three tours in Vietnam and came home,” he said. “All my neighbors lost their homes, and I have mine.”
On another street, one lone house stood amid rows of ash plots. As I was talking with a family who had lost their home, a woman spoke up, pointed to the house and said it was hers. With tears in her eyes, she said she felt terrible that her home had survived the wildfires while her friends had lost everything. I eventually led her to realize that her home could provide a place for neighbors to come and support each other, break bread together or even have their basic needs of a restroom met.
Re-experiencing trauma: The scene the Vietnam veteran encountered on the mountain triggered a question from his past: “Why did I live and my buddies die?” Old wounds were torn open by the metaphor of his house surviving intact while all his neighbors’ homes perished in the fire.
In 2003, wildfires in California also destroyed many homes. The recent fires have retraumatized many of the people who lived through that experience. At the service center, I was called over to see a woman who was crying. She and her husband were applying for aid. She told me they had lost everything in the 2003 fires and had just been getting back to normal. The latest fires had brought back all the bad memories. I helped them understand that it is normal for old traumas to return to the surface when experiencing a new loss. In these situations, mental health workers should offer compassionate understanding and acknowledge the magnitude and far-reaching effects of the current loss.
The mental health provider’s role
Traditional counseling and therapy stay home when you are deployed to a disaster site. What is needed above all is a compassionate presence. On site, I am Louise or “Mickey,” not Dr. Graham. In most instances, there’s no need for the people I’m helping to even know that I am in the mental health field. Survivors need to have someone hear their stories, acknowledge their pain and the extent of their loss, and display empathy. Sometimes silent listening, a hand on the back or a hug is what conveys caring best. At times, the mental health worker needs to just “be” rather than “do.”
During disaster response efforts, the roles of professionals and nonprofessionals often become blurred. Traditional counseling methods such as reflection, paraphrasing, silence and interpretation are helpful, but nontraditional methods are also indispensable. Performing outreach in the areas where supplies are being handed out is an effective method of establishing contact and initiating the helping relationship. Prior to Hurricane Katrina, volunteers remained at the shelters and service centers to work with survivors. Now we go into the affected areas to work with the people wherever they are located, be it on the hillside, in a trailer, at a community shelter or in a parking lot. In my experience, this led the residents to recognize me more readily as a “helping face.” The next time they needed something, they would feel more comfortable coming over and speaking with me because a relationship had already been established.
Due to my accent, I quickly acquired the nickname “Boston.” When I returned to the homesites, residents would recognize me, say “Hey, Boston,” and walk over to talk. One man who had attended Boston University had a son who was helping sift through the rubble. I had previously told the man that I had gone to Boston College, so he started calling me “BC.” On the third day, he saw me and yelled, “Hey, BC.” He walked over and explained that a man needed help getting down the road with his boat. Utility trucks were all over the hill, and many of the roads were impassable. I was honored to have established enough of a relationship that he felt comfortable seeking me out. This is not traditional counseling. You do what is needed at the moment, and consistent presence allows that to happen.
Another lesson I’ve learned is to never make a promise unless you are 100 percent positive you can deliver on it. In one instance, I started to respond to a resident, “Tomorrow I will …” I caught myself and instead said, “I never know where they will send me tomorrow, but if I am back here I will …”
While a counselor’s official function as part of the disaster response team is to provide mental health support, you’re just as likely to find yourself helping to unload a truck of supplies or handing out water and snacks. Approach these as opportunities to interact with the other volunteers, establishing relationships and assessing how they’re coping with the devastation and the grief of the survivors. These shared times will result in more volunteers calling on you if they think a survivor might need “Mickey.” Likewise, after unpacking cases of water together and sharing a few laughs, volunteers will be more comfortable coming to you when they’re feeling overwhelmed or stressed.
Flexibility and adaptability are the cornerstones of a disaster response operation. People are asked to change plans, assignments and even sleeping quarters at a moment’s notice. Normal routines, including what you eat and when you eat, are disrupted.
Re-entry home is not as smooth as one might think, even though the American Red Cross assigns mental health volunteers to help its other disaster response volunteers to debrief. Disaster response volunteers are thrust back into their normal day-to-day world, but they still have one foot firmly planted at the disaster site. A piece of your heart remains behind with the many people whose sorrow you shared, and intrusive thoughts tend to pop up even as you attempt to tackle your daily demands. Did that lady ever find her wedding ring in the debris? Did the elderly lady recover the cast iron pan her deceased mother had given her?
Be prepared to feel a bit dissociated from your normal daily routines, even as you resume your professional and family responsibilities.
Louise Graham is a member of the American Counseling Association and an associate professor in the Graduate Department of Counselor Education at Bridgewater State College. Contact her at lgraham@bridgew.edu.
Letters to the editor: ct@counseling.org