Paul Valent

Paul Valent

MBBS, DPM, FRANZCP
Consultant liaison psychiatrist, psychotherapist, traumatologist,
Co-founder and past president Australasian Society for Traumatic Stress Studies,
Writer.

Seared by the Fires

March 31, 2020

Among current concerns about corona virus, economic and political downturns, and climate change, let us not forget survivors of our recent major bushfires. Understanding their survival and its costs, now becoming apparent (The Age) will not only help them, but can help us all as we lurch currently from one stress to another.

Bushfires have laid much of the foundation of understanding trauma in Australia. Here are some thumbnail sketches our hospital outreach team found in the 1983 Ash Wednesday bushfires.

Among our first encounters was a group of men in a pub who told us that guilt was their worst problem. Their houses still stood while their neighbours’ were destroyed. Of course they invited the neighbours to live with them, but they still felt guilt for their own survival.

Guilt often alternated with anger. A woman was furious with her uncle who tried to save his cattle ahead of herself and her children. When he returned sad and singed, she felt guilty, and drove him to hospital. She was angry again because the drive endangered her and her children.

We were directed to three previously brave fire-fighters who were hiding in an attic. They explained that they were totally exhausted and avoided any reminders of fires.

An old man took to bed depressed. He drew aside a curtain in his darkened room. ‘Look at this moonscape. I am too old to see it revive.’

A six-year old boy who avoided his mother confided to us that she was a witch. He realized that when, her head framed by background flames, she had screamed that she’d kill him if he didn’t get in the car. He was still taking magic pills to keep himself safe from her.

GP attendances soared with a plethora of symptoms, such as sleeplessness, nightmares, inability to think, and many physical symptoms. Others were buffeted by emotions and thought that they were going mad. Alcohol consumption, domestic discord, car accidents, and regressive and aggressive behaviour in children all increased.

The initial euphoria of survival and mutual generosity gave way to new frustrations and self-concerns. Bureaucracies were unfeeling and incompetent. Rebuilding met blocks at every step. The previously welcome guests were felt to be overstaying their welcome.

The wide variety of stories had two features. One was that to us they were obviously related to the bushfires. The other feature was that to our surprise, within days survivors disconnected their distress and symptoms from their experiences.

Under the auspices of the Red Cross, we developed a pamphlet ‘Coping with a Major Personal Disaster’. Modifications of the pamphlet are available online and are still distributed in disasters by the Red Cross in Australia and overseas. Apart from warning about car and home accidents, the pamphlets described the types of symptoms that we had found, and assured people that they were normal responses to abnormal situations. The (re)connection provided much relief to people who had thought that they were going mad.

A general understanding of the source of symptoms was one thing; resolving and healing them was another. To do so, people needed to revisit and reconnect with their bushfire experiences.

A salient feature of our research was that at the core of life and death experiences, bushfire survivors had responded according to instincts, such as fight and flight, rescuing others, attaching to rescuers, achieving goals, relinquishing valuables, competing, and cooperating. These instincts had evolved for maximum community survival, and in fact resulted in relatively low casualties in the disaster.

We now know that the turmoils of disasters frequently demand more than one instinct. As people prioritise, they place rejected instincts into deep freeze in hidden parts of their minds. As they thaw, the instincts signal their existence, often in fragments, such as physical, psychological, social, or moral distress.

The distress must be understood by mind and heart. If it is understood that the need for underlying instincts is past, they and their signals can be assimilated into history and wisdom. If symptoms signal current needs, for instance to grieve losses, it helps to address such needs.

Disasters test and expose our humanity. They are also potential sources of self-knowledge and wisdom. Such wisdom may help us to deal with our current stressful situations.

Paul Valent is a retired psychiatrist who was a pioneer of traumatology in Australia. He has written many articles and books on the subject of stress and trauma.

 

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