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Earthquake trauma in the therapy room

Christchurch has experienced four serious earthquakes since September 4th 2010, with one being on Boxing Day that year, and the devastating one on February 22nd 2011 where over 180 people lost their lives, and where the central city has been devastated as well as many suburbs.

A State of Emergency lasted for weeks. I had started an article after returning to work after the Boxing Day earthquake. The most recent events on June 13th 2011 led to the premises of Talking Therapy having to relocate due to concerns about the safety of our building.

In the article I had begun to write about the experience of working with clients on the trauma of the earthquake, and in particular therapeutic difficulty (or wondering perhaps the more positive importance for the client) of shared experience of that trauma. After the third more devastating earthquake this experience of some shared aspect of the trauma seemed to be more present in the therapy room.

Most often in our work we are talking about traumatic events that the therapist has not experienced but that the client has. Most often those traumatic events are outside of the therapy session, whereas I have been in session with a client where yet another aftershock jolts and sometimes the client and myself have had to huddle under the doorframe until the earth settles again.

Doing both longer term therapy and brief work, I have worked with many clients since September 4th as Talking Therapy offered free earthquake trauma sessions, and contacted all local GPs with this offer in the first few days after the initial earthquake. I have also seen clients referred through employee assistance programmes. After the February earthquake Talking Therapy was contracted under Relationship Services and the Ministry of Social Development to provide up to six free sessions of Earthquake Trauma counselling.

Clients have been from all walks of life, of all ages and all with different experiences of trauma. Some had been workers who were out almost immediately after the big ones struck in roles of disaster relief, or restoring power and water, or dealing with citizens in severely affected areas. Some were young people newly living away from home; some were elderly and living on their own. Some were in areas where their house was wrecked, or where their house was completely intact and unaffected. Some were scared to return to work as that environment no longer felt safe. Some had children that they tried to protect; some were over the other side of the world on holiday and concerned about their families when communications were not working- so many different stories of trauma.

Many clients seemed to want to know if I was in Christchurch at the time of the first earthquake– maybe because this was what people were asking in the community at the time, or maybe there was something of knowing or trusting that I would understand or be able to help them because of my own experience, although each individual’s experience is unique. Although the earthquake is the traumatic event it is not a shared trauma but more a simultaneous trauma. It seemed important to many (although not all clients) and I became interested in this, trying to understand this marked difference.

The experience of trauma is often difficult to put into words, into a semblance of order as sense of time collapses differently. My own experience of the big one in September which occurred at 4.35 am was realising some time after that I had been hit across the chest by my bedside lamp and yet I had no actual memory of that happening. Our brains have very specific ways of dealing with unpredictable experiences of this kind. Any time that we are present during an event that threatens our own or other people’s lives, our brains go through two critical processes – immediately evaluating the risk, and instantaneously finding ways to avoid being destroyed. So for me once the danger was past I was able to start to make sense of and integrate the memories of that terrifyingly noisy darkness when all heaved around me. I kept coming back to a usual known of the earth safely supporting me, and the realisation that that was no longer so. It takes a while for us to reconcile a life-threatening event, like an earthquake, with our existing beliefs about the world being generally safe.

What was important for clients about wanting me to have experienced this too? Was it feeling understood, or the security of feeling that I was managing and needing that idealised figure? That I would have some answers? Few pushed for more information about what I had experienced, but there was still that sense of a shift in them when they understood that yes I had experienced the earthquake too.

When the February 22nd earthquake occurred I was in my downstairs office with a client and we both rushed to shelter under the doorframe as books flew off shelves, furniture fell over, pictures tumbled off walls. I could not keep on my feet and fell – and my client pulled me up. After the jolting stopped we made it outside to the driveway, and hugged each other. Other therapists came out with their clients and we checked how we each were. My shock would have been evident to my client – the absolute raw realness of that moment when the earthquake hit. What was that like for my client?

Talking Therapy offices were damaged in February 22nd and required repairs before being able to re-open. Our central location was difficult as services such as sewerage and water took some time to be reconnected, and also transport was difficult for many clients.

What effect has this had on ongoing therapy? Many clients have fled the city and so therapy has been disrupted and maybe even terminated. For those that have stayed in Christchurch most have needed to talk about February 22nd and process it in some way- and this now seems a little different than the previous two earthquakes. In the therapy room there is an increased awareness of shared trauma because of widespread extent of the loss and devastation. It is often accepted and understood that there is a shared grief – in buildings being lost, in landmarks no longer present in the city, and that there is a chance that in this not-so-large city of ours we are likely to either know or know of someone who has died or been badly injured, or that our house maybe “munted” or severely affected. And clients seem to look for our realness as part of their piecing together their understanding of this trauma. To know that we have felt terrified too, that we feel low as we grieve for our city, that we too suffer from lack of sleep when aftershocks keep rocking us at night seems important.

It seems to me that this is like a short discursion into something different within longer term therapy – that of shared or simultaneous trauma – and that it has a specific meaning within the therapy. It is focussed on the experience of trauma at hand, and most seem to require the reassurance that their feelings are within the normal range of what can be expected as a response to such devastation, and maybe some self reminders of their own particular coping mechanisms. This seems similar to what is required for those presenting for brief trauma work.

Now clients have to adjust to coming to therapy in a different location with most coping with yet another change in the ever changing world they find themselves in. Continuing aftershocks mean that buildings suffer as shaking continues to damage them, that streets get mended only to continue to develop more sinkholes, that liquefaction continues to the surface every so often. Our new building is a single storey bungalow in a suburban street, but in an area affected by liquefaction. Again adjusting to different surroundings in amongst the constant change of landmarks disappearing around the city has been difficult for clients- some choosing to expose themselves to very little of the devastation, others needing to see it for themselves to “make sense of it” and this change of location of our therapy rooms has been disruptive for some clients, and for some has been too much to manage.

This also is part of the increased stress that is felt after the two aftershocks on 13th June, as psychologically there feels a deeper distress as the trauma repeated again.

Previously resilient clients are now coming in, the continuing repeated trauma with the high levels of anxiety having an effect that they have never previously experienced in themselves. Again clients in longer term therapy often mirror the same experience as described previously, although there seems less of a need to confirm that their therapist has experienced the earthquakes- that seems almost understood and accepted.

It will take more time to more fully understand the importance of this shared trauma and its relevance in longer term therapy. Trauma – with its hypervigilance as we anxiously continue to experience aftershocks, grief with the loss of lives, depression and loss as we come to terms with the changes in our environment, and exhaustion as we move through all of this- will continue to be part of our work for some considerable time.

If you are worried that earthquake trauma is an issue for you or someone close to you and would like to start to make changes you can contact Talking Therapy.

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(03) 354 8045 info@talkingtherapy.co.nz