Coping Ahead: Working with Clients to Prepare for Disaster Anniversaries
Over the past month, I have noticed that some clients I see are having subtle setbacks: sleep disturbance, vague panic symptoms, irritability, restlessness, avoidance. During Louisiana’s hurricane season, many people know these symptoms are mostly normal, and may resolve after September. Others may be more vulnerable to these shifts in mood, behavior, and bodily sensations. As we pass the one-year anniversary of Hurricane Ida, we can work with our clients to acknowledge and normalize this painful time as well as promote strategies to assist with healing.
The anniversary of a hurricane or other disaster can provide an important opportunity to review a client’s gains as well as process reactions to the disaster, continue to work through grief responses, and collaborate to cope with unhelpful reactions ahead of time. Anniversary reactions that are more intense may require more targeted treatments for trauma, anxiety, or other significant symptoms. It is also important to recognize that not every survivor of a disaster will experience an anniversary reaction. A great first step in identifying where your client stands along this spectrum is to add an acknowledgement of this upcoming hurricane anniversary to your session’s agenda, with the goal of identifying anything your client is experiencing, recognizing the importance of the anniversary, and helping clients respond to memories and disaster cues in new ways (or to return to abandoned coping strategies). Psychoeducation about common anniversary reactions and unresolved grief may also be useful to your client.
Some common anniversary reactions include heightened emotions, intrusive memories or imagery of the event, frustration or feelings of helplessness, avoidance, and reflection. Because of the cyclical nature of hurricanes—and especially as we are existing with an ongoing backdrop of COVID-19 and social and political conflicts—many common strategies for responding to thoughts and feelings are less appropriate. Probability estimates, reminding clients that they are objectively “safe,” and exposure to feared cues may not be effective and may even be harmful and invalidating to our clients’ experiences. Recovery from a hurricane takes time and is an ongoing process of healing.
One way to discuss trauma cues around a disaster anniversary are to share common triggers: news media coverage, the voice of a certain weatherperson, seeing blue tarps, personal losses associated with the hurricane, and shifts in weather. Trauma cues are unique to each person and may not be easily identified, so sharing general cues may help prompt reflection of what is distinctive for your client. Just talking about these things together can be validating and bring relief in the therapy setting.
Once disaster cues have been identified, acknowledge emotional, behavioral, and bodily reactions to cues. Again, you may share common reactions (e.g., withdrawal from support systems, urge to engage in substance use, panic) or maybe your client has already identified the impact of feeling re-traumatized. Depending on your client, it could be important to affirm the importance of culture and diversity and recognize the intersection of your client’s identities and the way they experience these reactions.
As you continue to normalize and validate these reactions, you can next move toward reviewing what has helped your client cope in the past as well as develop a plan for continuing the healing process. There are standard practices for coping that can be reviewed with clients: talk about your feelings, take care of yourself and keep routines, limit media viewing, self-sooth, accept help from others, utilize spiritual practices. You and your client may be able to identify other strategies unique to them, particularly related to their own personal customs and traditions. Helping our clients stay involved in their lives and encouraging them to turn toward loved ones and the community for support are valuable approaches. Writing up a coping plan with your client so they can take it with them is also useful.
Ultimately, it is important to meet your client where they are in their recovery journey. These conversations can help clients understand that there is room for ongoing discussions about trauma anniversaries and can teach them that their responses to what is happening in our world are natural and common. Self-judgement, shame, and comparison with others around experiencing setbacks can lead to avoidance, so we can take the lead and check in on our clients when we know of an upcoming anniversary. If we are experiencing our own setbacks during this time, I hope these strategies can provide a basic way to check in with your own experiences so you can continue to work toward healing and recovery for yourself.
Dr. Sonia Baluvelt is a licensed clinical psychologist in Baton Rouge, Louisiana. Dr. Blauvet works with adults clients from all backgrounds and pays special attention to cultural factors related to mental health. Find more on Dr. Blauvelt and her private practice here.