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December 14, 2018 Friday 02:28:48 PM IST



Ever since the great floods that brought death and devastation on the people of Kerala, the government and other agencies, including the UN, are tirelessly and strenuously striving to assess the cost of rebuilding the damaged infrastructure, houses, livestock, agriculture, and other assets. The prospect of rebuilding the State is indeed daunting, and its cost, heavy. One of the most significant challenges of rebuilding Kerala lies in rebuilding the shattered human lives with all its ramifications. In this connection, we should make an attempt at giving emphasis on the psychological implications of rebuilding Kerala. Some illustrations taken from real life situations, point to the importance of rebuilding human lives, taking into consideration the specific psychological needs.

   Seema, a student of ninth standard, bright and bubbly, a social butterfly, has undergone tremendous changes in her moods and behaviour, after the flood. Her house was damaged in the flood and the family had to move out to a new location. Now, Seema shows no interest in studies; she is socially withdrawn and moody; sometimes she experiences nightmares. She still has flashbacks of the fateful flood with all the frightening memories attending on it. Add to these worries are her scary dreams of drowning. During such deadly dreams, she wakes up in shock, shouting, “Help, I am drowning”.  Seema is so nostalgic about her former home. She misses her home, neighbourhood,  friends, playtime and moments of fun there.  

  John, a 33 -year- old, textile merchant, experiences depression, panic attack, total despair, and thinks of ending his misery by committing suicide.  His small clothes store, the mainstay of his family, was inundated in the flood. John has no clue whatsoever as to how to reconstruct and rebuild his small business. His family is in dire straits, but John has lost all confidence, hope and energy to survive the ordeal.

       Mrs. Jain, a 60- year- old woman, complains of panic when it rains heavily. She experiences the ‘doomsday’ (flooding days) again so vividly that she gets a numbing experience. At times, she behaves frantically and hurriedly. Her social behaviour has drastically changed for the worse. Of late, Mrs. Jain is moody and withdrawn.

 Psychological needs

    The above mentioned cases illustrate the need to address the persistent and paralyzing mental health problems that people face in the aftermath of a great tragic event such as the recent floods. Any attempt to rebuild Kerala, must pay special attention to the vital process of reconstructing the shattered human lives, with special attention to their psychological needs. In order to understand and intervene in such stress situations, a basic knowledge about Post Traumatic Stress Disorder (PTSD) will be valuable.

   PTSD can occur in people who have experienced traumatic events such as  natural disasters (the recent floods), serious accidents, terrorist act, war/combat, rape, or other violent personal assault. Nearly everyone will experience a range of reactions after a trauma, yet most people recover from initial symptoms naturally. Those who continue to experience problems may be diagnosed with PTSD. People who have PTSD may feel stressed or frightened even when they are not in danger. The PTSD symptoms cause significant problems in social or work situations and in relationships. They may impair your ability to go about your daily tasks.

Symptoms of PTSD 

     PTSD symptoms are generally grouped into four types: 1) Re-experiencing trauma with intrusive memories, repetitive and distressing images or sensations, flashbacks, dreams, etc. 2) Avoidance and emotional numbing: some of the affected persons may avoid certain people and places that remind them of the trauma and avoid talking to anyone, keeps aloof, withdrawn, etc. 3) Hyper-arousal or feeling ‘on edge’: one may feel very anxious and find it difficult to relax. They may constantly be aware of threats and easily get startled. This state of mind leads to irritability, angry outbursts, insomnia, etc. 4) Changes in physical and emotional reactions such as trouble in sleeping and concentrating in activities, negative thoughts, irritable nature, getting easily frightened, etc. Symptoms may vary over time or vary from person to person.

     Treatment of PTSD involves use of psychotherapy and psychiatry. In both treatment modalities, the patient’s ‘risk and resilient factors’ will be taken into consideration. Group and family support therapies may be used as the need arises. Short-term and long-term strategies may be in place as the symptoms persist along with other co-morbid problems.

Dr. Jose Cletus Plackal

Licensed clinical psychologist, BET-MRT, Jeevas Centre, Aluva, Kerala.

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