Contents
The material is specially for those who are forced to leave their homes, as well as for those who interact with refugees — volunteers, social workers and just caring people.
Emergency assistance differs significantly from the usual psychological counseling and, moreover, psychotherapy. There are separate areas of study: emergency trauma therapy, short-term shock trauma therapy and others. Techniques that are applicable under normal conditions do not work, and sometimes worsen the condition of people who find themselves in emergency situations.
It is important for volunteers and all those who today help refugees from hot spots to understand how you can really support people, and what you should not say or do. And how to remain stable for those who were forced to leave their home and part with loved ones? To answer these questions, we spoke with our expert, psychologist Anastasia Gurneva, who in 2008 worked with refugees from South Ossetia.
What it takes to stay resilient in an emergency
The people we call refugees survived the bombings. It’s really scary. Some have lost loved ones or been injured. Someone was left without a home — that is, without everything that was connected with the comfort and safety of their family for many years. Taking only what they need, they flee from their native land, where their lives are now in danger. This whole situation is a lot of stress. And at this stage it is important that it does not turn into a psychological trauma.
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What is needed to protect against psychological trauma?
1. Resources. This applies to a variety of things — food, warmth, housing, clothing, sleep, emotional warmth.
2. Possibility of choice. In such a situation, it is extremely important that a person has the opportunity to choose at least something — the color of the toothbrush, the garnish, the scarf. When it is impossible to influence big circumstances, the right to choose even in small things helps to maintain stability.
3. Timeline continuity. A break with loved ones, with a home, with a hometown can become part of the trauma. It is important for people who find themselves in such a situation to feel that life does not stop.
You need to maintain a routine (brushing your teeth, combing your hair, maintaining sleep and wakefulness).
It is very important not to cut off, but to maintain ties with those who have remained and are not nearby. Call up, exchange messages, photos. If it is temporarily not possible to maintain contact, look at photos, talk about loved ones. Make plans.
It is important that a bewildered person be able to preserve, to be aware of his identity. “Yes, I have now left the house and left, I have a temporary shelter. But it’s still the same (or the same) me — with my biography, with some personal things, with the same love for my loved ones.
Two approaches to work with victims in emergencies
Traditionally, two approaches have been used in dealing with victims of emergencies.
The first is, relatively speaking, to «spoil» peopleto create an artificial resource space for them. For example, send immediately to sanatoriums, children’s holiday camps. But practice shows that this works only temporarily — after rest, a person has to return to real life. Work, study, live with your memories and feelings after the experience. And faced with all this, a person feels helpless. He was «taken on hand», but he did not feel his strength and ability to cope with difficulties.
The second is to give people the opportunity to continue to remain in their social roles., to function and cope with their duties in new circumstances, already safe. For example, in Israel, a bus driver who survived a terrorist attack necessarily returns to work soon and, with the necessary support, travels the same route. Thus, faith in his abilities is fixed in him — he retains not impotence, but the ability to act, to be useful to society, in demand. And this is very important for mental stability and the future life of a person.
What assistance can be provided to refugees
People in a situation of uncertainty need specificity. What can they get from the state? Where exactly and how? What can I contact volunteers with, where to go? If you have such information, please share with them. Even better, write or give out an information leaflet with useful contacts.
If you see that the person is confused, you can show empathy. If right now he is not in the role of a victim, but is trying to understand what awaits him and what to do, support by helping to build a plan for the next steps. For tomorrow, next week, for the future.
What to do with a shock injury?
If a person has recently experienced a strong shock, for example, someone died before his eyes, he may be in a state of shock, in a stupor. How to help him?
The first reaction is often the desire to stir up, to bring out of the stupor. But this is just not necessary. If the victim has a freezing reaction, sudden actions will not help.
You need to ask simple and clear questions to which he is likely to answer “yes”. For example: “Can you feel your left leg? Can you sit down? You can stand up? Can you lean against this tree?» etc. It is important to understand that now a person, as they say, does not feel the ground under his feet. And therefore, questions should lead him to a feeling of support in the body.
Forget the on-duty words “everything will pass”, “this is for the best”, “everything will fall apart” and others. «Hold on» — why? What to hold on to someone who has lost his sense of support? Such expressions seem to shift the responsibility onto the victim himself — and from them he is no better off.
When psychotherapy is inappropriate
Let’s turn to biology. In a life-threatening situation, fight-or-flight mechanisms are activated. Refugees, as the word itself tells us, are fleeing. That is, their goal is to gain safety. All the resources of the body are directed to this.
People come, settle in temporary housing, try to find their bearings. And many are still in shock from the experience. Right now, they don’t need psychotherapy or «peacetime» psychological consultations with suggestions to «get angry», cry, somehow «react emotions» and «feel their pain in the body.»
Survival First
The first task of refugees is survival. Biological mechanisms work, corresponding hormones are produced. People are busy with questions about where to live, what to eat, how to provide warmth for children. And if you are not a specialist in psychological assistance in emergency situations, it is better not to interfere with their psyche. This is not the place for aspiring psychotherapists-enthusiasts.
Then experience
Only later, when a person discovers that he and his children are safe, that there is food and shelter, the next stage begins — living, understanding what happened. That’s when the time comes for psychological counseling and psychotherapy, reacting feelings, mourning and other processes.
Buddhist sages believe that kindness should always go hand in hand with wisdom. Therefore, it is so important to understand what kind of your support will be useful to people right now, and what should not be done even with good intentions.