Creating Spiritual and Psychological Resilience Creating Spiritual and Psychological Resilience Integrating Care in Disaster Relief Work Grant H. Brenner, Daniel H. Bush, Joshua Moses EDITORS New York London Routledge Routledge Taylor & Francis Group Taylor & Francis Group 270 Madison Avenue 27 Church Road New York, NY 10016 Hove, East Sussex BN3 2FA © 2010 by Taylor and Francis Group, LLC Routledge is an imprint of Taylor & Francis Group, an Informa business Printed in the United States of America on acid-free paper 10 9 8 7 6 5 4 3 2 1 International Standard Book Number: 978-0-7890-3455-7 (Paperback) For permission to photocopy or use material electronically from this work, please access www. copyright.com (http://www.copyright.com/) or contact the Copyright Clearance Center, Inc. (CCC), 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400. CCC is a not-for-profit organiza- tion that provides licenses and registration for a variety of users. For organizations that have been granted a photocopy license by the CCC, a separate system of payment has been arranged. Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. Library of Congress Cataloging-in-Publication Data Creating spiritual and psychological resilience : integrating care in disaster relief work / edited by Grant H. Brenner, Daniel H. Bush, Joshua Moses. p. cm. Includes bibliographical references and index. ISBN 978-0-7890-3454-0 (hardback : alk. paper) -- ISBN 978-0-7890-3455-7 (pbk. : alk. paper) 1. Disaster relief. 2. Disaster relief--Psychological aspects. 3. Community mental health services. 4. Church work with disaster victims. 5. Social service--Religious aspects. I. Brenner, Grant H. II. Bush, Daniel H. III. Moses, Joshua. HV553.C74 2009 362.2’042--dc22 2009014785 Visit the Taylor & Francis Web site at http://www.taylorandfrancis.com and the Routledge Web site at http://www.routledgementalhealth.com Contents Preface vii Introduction xi Contributors xix CTION ISE Foundational Considerations for Effective Collaboration 1 Fundamentals of Collaboration 3 Grant H. Brenner 2 An Anthropologist Among Disaster Caregivers 19 Joshua M. Moses 3 Disaster Relief Emotional Values 25 Sandra Buechler 4 Principles of Risk Communication 39 Vincent T. Covello 5 Ethical and Legal Considerations in Postdisaster Interdisciplinary Collaborations 75 Anand Pandya 6 The Psychospiritual Impact of Disaster An Overview 83 J. Irene Harris, Susan Thornton, and Brian Engdahl CTION ISE I Collaboration in Action: Tensions, Challenges, and Opportunities 7 Collaborating With a Community College in Post-Katrina New Orleans Organizational and Personal Reflections 97 Rick Daniels v vi Contents 8 Working as an Ally to Underserved Communities The Role of Faith, Coordination, and Partnerships in Response to the 2001 World Trade Center Attack 105 Maggie Jarry 9 On Reentering the Chapel Models for Collaborations Between Psychiatrists, Communities of Faith, and Faith-Based Providers After Hurricane Katrina 125 Rebecca P. Smith, Julie Taylor, Gregory Luke Larkin, Carol S. North, Diane Ryan, and Anastasia Holmes 10 Collaboration in Working With Children Affected by Disaster 133 Daniel Gensler 11 Making Referrals Effective Collaboration Between Mental Health and Spiritual Care Practitioners 147 Patricia Berliner, Diane Ryan, and Julie Taylor 12 “To Do No Harm” Spiritual Care and Ethnomedical Competence Four Cases of Psychosocial Trauma Recovery for the 2004 Tsunami and 2005 Earthquake in South Asia 157 Siddharth Ashvin Shah SECTION III Collaboratively Nurturing Resilience After Catastrophic Trauma 13 Rituals, Routines, and Resilience 181 Koshin Paley Ellison and Craig L. Katz 14 Fundamentals of Working With (Re)traumatized Populations 195 Yael Danieli 15 Reaching Out to Create Moments of Communal Healing Personal Reflections From the Edge of the 9/11 Abyss 211 Alfonso Wyatt 16 Normative and Diagnostic Reactions to Disaster Clergy and Clinician Collaboration to Facilitate a Continuum of Care 219 Glen Milstein and Amy Manierre Index 227 Preface Disaster defies definition, but not practical understanding. On my 35-year watch in the field of disaster human services, formal practices for reducing disaster’s anguish have grown dramatically, including the fields of disaster spiritual care and disaster mental health. The essence of this work is pres- ence, compassion and technique. The first two are constant. It is technique that evolves. The key to future success will be growing our ability to work in dynamic partnership, not only between the disciplines of spiritual care and mental health but among all the pillars of the house called disaster human services. The mind and spirit are inseparable. And health, nutrition, family, domicile, work, and community are essential. That is why this book is for all disaster human services practitioners—not only spiritual caregiv- ers and mental health professionals. None is fully ready to serve without a strong understanding of all other sources of disaster help. There is no disaster without loss, suffering, confusion, and distress. Disaster disrupts person, family, home, and neighborhood. Disaster dam- ages community. Never in their lives do people need skilled comforting and guidance more than after a disaster. You who deliver spiritual care and mental health services succeed by bringing emotional and spiritual support and then by removing measures of pain from each person’s disaster experience. You do this not only with courage and commitment but also with a surprisingly complex and grow- ing array of learned skills and knowledge. Kai T. Erikson, a sociologist, put disaster mental health into the national discourse with his landmark 1976 book, Everything in Its Path: Destruction of Community in the Buffalo Creek Flood. The searing emo- tional and spiritual anguish he related, largely through the words of the victims, launched a broad-based search for more effective response. We are still on that quest, and this book brings us forward. vii viii Preface In 1972, I got a job going to fires at night for the American Red Cross. New York City was burning in those years. Four fires per 8-hour shift, 12 per day, over 4,000 incidents a year, each of which left at least one family homeless. I drove mostly impoverished families to Red Cross hotels and explained how and where to get more help the next day. Those who emerged from fires with nothing to wear benefited from the 24-hour clothing-and- spiritual care of Adventist Community Services’ “retired” Pastor Adam Layman and his disaster boutique on wheels. For me, the disasters just got bigger and farther away: a major air- plane crash near JFK airport; a social club fire that killed 87 immigrants; floods in southern states; refugee camps at the Thai–Cambodian border; earthquakes in Italy, India, El Salvador, and Colombia; famines in Sudan, Ethiopia, and Somalia; war in Angola; genocide in Rwanda; and then back to tornados, hurricanes, wildfires, and terrorism in the United States. For all their superficial diversity, what made each event a disaster was extreme disruption of body, mind, spirit, family, home, livelihood, and community. Those of us privileged to be the ones who personally bring the comforting resources of the larger community to disaster victims must and do struggle to find ways to be as effective as possible. We are obliged to be as good as we can be. Our challenge is to know how to comfort the sufferer and to bring him to someone who can provide for his needs. Bishop Stephen P. Bouman, in his book Grace All Around Us: Embracing God’s Promise in Tragedy and Loss, lists first steps in his outline of disaster response. Show up. Attend first to the ripples on the surface. Accompany the pain on the road. Respond, res- cue, reach out, call, pray, touch, embrace, feed, shelter, touch, cry, reassure. He relates the tender guidance of a South African bishop in New York after 9/11: In our culture when tragedy happens, we don’t all visit at once. We come a few at a time, so that each time the person in sorrow has to answer the door and tell the story again of what happened and shed the tears. As the story is told again and again, healing can begin. Bouman tells of Kathleen O’Connor’s reflection on Lamentations: To honor pain means to see it, acknowledge its power, and to enter it as fully and squarely as we can, perhaps in a long spiritual process. To do so is ulti- mately empowering and enables genuine love, action for others, and true worshipfulness. This is hard and necessary, but we have to do this and much more. Preface ix When the World Trade Center was attacked on 9/11, psychiatrist Anthony Ng was Medical Director for Disaster Psychiatry Outreach and Chair of New York City’s Voluntary Organizations Active in Disaster (VOAD). A year or so later, I asked him about his foremost lessons from this event. His response was singularly clear. Tony said this: “Do NOT consider yourself a disaster mental health professional until you can come to the arena with a comprehensive understanding of all available disaster human services, and the ability to effectively connect people to them.” This is our challenge: To be fully equipped to comfort and assist. There are numerous solutions to most of the causes of suffering and distress in most disaster victims. While death, trauma, and total destruc- tion cannot be undone, most needs are temporal and can be addressed. We must have the training and real-time information necessary to con- nect people to shelters, temporary housing, home repair, legal services, family reunification, health services, child care, disaster unemployment compensation, occupational equipment replacement, eviction prevention, funeral assistance, consumer fraud protection, home debris removal, pet care, mold prevention, and insurance guidance, to name but a few essen- tial services in disaster relief and recovery.