Trauma has occurred when symptoms have developed and have become visible. One type of trauma results from natural disasters such as earthquakes, tornados or hurricanes, forest fires, floods, volcanic eruptions, landslides, or tsunamis. These types of experiences are particularly insidious because they tend to traumatize large populations of people at once, and can result in epidemics of Survivor Guilt along with other PTSD symptoms.

Like many causes of trauma, natural disasters can be sudden and overwhelming. The most immediate and typical reaction to a calamity is shock, which at first manifests as numbness or denial. Quickly—or eventually—shock can give way to an overemotional state that often includes high levels of anxiety, guilt or depression.

If victims have lost their loved ones or their homes, they may feel helpless. This can be exacerbated if they have to live in shelters without support from relatives or friends for extended time periods. However, living with other survivors can be a time to reconnect, talk about the event with others, and help to reframe the event. Being able to help another survivor can reduce helplessness, and may start the healing process.

Natural disasters in particular can bring victims a feeling of being betrayed by “their god,” which can result in a loss of faith.  Making peace with “the divine” might be one step toward healing and gaining faith back.

It’s hard to predict when PTSD will set in with a survivor of a traumatic natural disaster. Some victims seem at first perfectly (or even abnormally) fine, only to be beset with symptoms later on.  Survivors are recommended to seek professional guidance if they find themselves unable to regain control of their lives or if they continue to suffer from PTSD symptoms for more than a month.

Victims do not need to have experienced a disaster firsthand in order to suffer from PTSD. As an example, an emigrant from Haiti living abroad at the time of the recent earthquake could be profoundly affected by the countless hours of television coverage of the disaster, especially if they still had family living in Haiti at the time of the event who they were unable to contact or gain information about.

It’s very important with natural disaster trauma that the victim give himself time to heal and pass through an appropriate mourning process. Only by processing the experience over a realistic period of time is healing possible.

Over the next few months, I’ll touch upon the most common types of trauma and the ones I see most frequently in my practice. You can also read a longer version of this article on Examiner, Psychology Today, and Womens Radio (published 3/3/10).

One unfortunate side effect of a calamity such as the recent earthquake in Haiti is a phenomenon known as Survivor Guilt. Obviously, Survivor Guilt affects those who are fortunate enough to survive a traumatic event such as a natural disaster.

The phenomenon of Survivor Guilt is especially insidious because those who are afflicted with it are under the impression that they have done something wrong, and that their own survival is somehow responsible for the death, injury or trauma of others.

Interestingly, The DSM-IV (The Diagnostic and Statistic Manual of Mental Disorders—the professionals’ guide to mental illness and diagnosis) lists Survivor Guilt as a symptom of Post Traumatic Stress Disorder, and not as a malady in its own right. Like other symptoms of PTSD, Survivor’s Guilt is a distorted reaction to a traumatizing experience.

What Survivor Guilt Looks Like

Survivor Guilt is defined by a pattern of symptoms such as anxiety, depression, social withdrawal, sleep disturbance, nightmares/flashbacks, and emotional lability (instability). As we know, PTSD can also manifest as physical symptoms, which is the body’s way of expressing pent up stress.

Proactive Reactions to Disaster

Those of us who live in earthquake-prone places such as the Bay Area find it easy to feel empathy for those who are suffering in Haiti. After all, it could easily be us. And we can derive lessons from this tragedy.

Dr. Peter Levine, a well-known trauma therapist, offers the following suggestions, which he calls “Emotional First Aid” for trauma. (You can read the expanded version of this list here. http://www.summerjoy.com/September112001/levinepeter.html)

Fortunately, many of these suggestions are inherently practical in the wake of a natural disaster—such as an earthquake—that affects an entire community and displaces people from their homes.

1. Get together with family and friends for support.

2. Organize and meet in community/neighborhood groups.

3. Don’t be isolated.

4. Try to get the information about your loved ones ASAP… without getting hooked on traumatic images on the TV.

5. Refocus on your resources and support systems, and keep your mind occupied.

6. Stay active, volunteer, and help.

7. Encourage people and yourself not to tell their stories in a repetitive way which ultimately deepens the trauma.

Therapy for Survivor Guilt

Once Survivor Guilt has been diagnosed, therapy is of course the most appropriate form of action.

A therapist working with a traumatized victim of a natural disaster will help the patient to formulate alternative and more positive views on the situation and will also help the patient consciously recognize how their own trauma is affecting their behavior. It’s important for the afflicted person to understand that their own actions did not cause or exacerbate the situation, and that they in fact were a victim.

The next and most important step for conquering Survivor Guilt is to pass through an appropriate mourning process. Only then can the patient continue on with their life.