Disaster survivors: a narrative approach towards emotional recovery

 

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Abstract

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Article

Introduction

This paper offers a discussion on narrative approach and methodology in relation to assisting in the emotional recovery of disaster survivors. The use of narrative and storytelling is proposed, which may be applied to address individual recovery through the construction of stories as well as assisting social community recovery through the sharing of these stories. By consolidating an understanding of survivor experiences factors can be retrospectively identified, which have helped or hindered the capacity of individuals and the communities to heal.

As literature suggests (Cox & Perry 2011, Diaz & Dayal 2008), survivors of disasters such as fire and flood may face extended periods of ensuing psychological suffering stemming from their experiences, which may include loss, disorientation and grief. In the context of social capital, the communities to which they belong may also endure affective dysfunction for an extended period of time (O’Brien et al. 2010, Aldrich 2012). The California Department of Mental Health (2011) maps the collective reactions of disaster. It suggests that community holds strong cohesion immediately after impact which is followed by a severe and extended period of disillusionment. This is followed by a gradual rise towards reconstruction which commences after one year. Within the reconstruction phase there exists a range of variables. It is within this phase that narrative work can potentially assist to promote progression through to recovery. Narrative can be used to understand and identify actions that may help individuals and communities to heal. This knowledge may build community resilience in the face of future disruption (Eyre 1999, Mooney 2011).

Contexts of emotional impact

Various studies have offered an exploration of the emotional effects and considerations of disaster, as well as the political construction behind their impact. Early studies recognised that the strength of communities can change from a position of solidarity to a position of uncaring, following disaster (Erikson 1976), once reliable support systems cease to function. This argues for a focus on rebuilding systems. However, Cox & Perry (2011) claim that current recovery scenarios typically demand unquestioning obedience of community in the recreation of pre-existing power structures, which, according to Mooney (2011) neglect emotional need. This social denial exacerbates the impact and the psychological distress becomes individualised and privatised (Cox & Perry 2011) as the urgency driving the recovery and rebuilding process obscures the social-psychological processes. This can have severe consequences where unmet emotional needs can ‘undermine long-term sustainability and community resilience needs’ (p.  408). Diaz & Dayal (2008) claim individual loss of sense of place constitutes the most catastrophic impact of natural disasters, compounded by the observation that people’s emotions are ‘catching’ (Kelham 2012) in a community. It is this observation which may also support the use of narrative as a cohesive device. Narrative is explored further on but entails an investigation into the actions and identity of the individual or community in order to develop a preferred or more useful story from which a new culture may be nurtured through the sharing of the narratives with the broader community.

Eyre’s work on disaster recovery has identified complexities around post-traumatic stress disorder and bereavement and loss (1998), while displacement has been identified as a possible cause of ‘profound feelings of grief and anxiety’ (Erikson in Cox & Perry 2011, p. 396). These effects can be long-term or even permanent, emphasising the need for attention to this often-ignored aspect of recovery. Narrative practice has the potential to help reconstruct a positive and healing culture within this context.

In their study of Britain’s foot and mouth epidemic, Mort et al. (2005) conclude that ‘The use of a rural citizens panel allowed data capture from a wide spectrum of the rural population and showed that a greater number of workers and residents had traumatic experiences than has previously been reported.’ This finding supports the value of undertaking a person-centred approach in the recovery process. In this study, the human impact was characterised by distress and feelings of bereavement as well as fear of a new disaster. Political mechanisms in the recovery process engendered a loss of trust in authority and governing systems by the affected community, along with a devaluing of local knowledge.

The study identified four key themes which effectively capture the range of emotional impact from the disaster. These themes are:

• Altered lifescapes concern the radical change in place during the crisis and its relationship towards health.
• Trauma and recovery largely concern the feeling of being trapped in a situation which one is powerless to change, involving distress, anguish, horror and re-traumatisation. Importantly in narrative work, it is within this category that qualities of endurance and sources of support were expressed by participants.
• Trust in governance echoes the inability to take control and make positive changes where chaos, loss of personal security, and powerlessness in the face of conflicting advice was evidenced.
• Knowledge and place Characterises a void between types of knowledge, from local experience and centralised sources.

While a narrative approach would likely address each theme area, it could further provide a frame for emotional and political investigation, yielding potential for policy improvement around recovery. It is an effective approach to help strengthen engagement, supporting Aldrich’s view that strategic activities to deepen trust between authority groups and community members are a key area for potentially enhancing cohesion during and after the event; where social infrastructure through reconnecting, rather than fragmenting existing ties, ‘may determine viability and resilience of communities hit by disaster’ (2012, p. 24).

In her exploration of post-disaster rituals and symbols, Eyre (1999) suggests that unresolved issues relating to the political conditions around responsibility and justice in relation to disaster can potentially create ongoing trauma, where anniversaries may serve as a sore reminder of the little that has been achieved. She distinguishes this type of emotional reaction from grief stemming from the actual event, adding that the grief created may further be exacerbated when it is dismissed as unresolved grief stemming from the actual event. In contrast, she has found that event-based grief expressed through ritual can influence feelings of community solidarity (p. 25). Therefore it is important to understand the context of the grief and how ritual may assist with the emotional recovery process.

The rationale for storytelling in disaster

In 1999, Eyre posited: ‘…to whom will the distressed turn should the tenth, twentieth or thirtieth anniversary be the occasion of the first feelings of flashback and other symptoms of post-traumatic response?’ (p. 26). However there is still a gap in contemporary recovery processes. This is evidenced by the continuing culture of recovery policy, which is focused on infrastructure and economics (Cox & Perry 2011). Largely, social counseling only occurs in an ‘ad hoc response’ (National Rural Health Alliance 2004). While ‘psychological first aid’ (Taylor et al. 2012) is provided to disaster sufferers in an immediate response, the emotional impact of disaster is not well understood and is often discounted in recovery activities. It is however gaining momentum in the literature as a significant impact with potentially long-term effects. Mooney et al. (2011) discuss the need for addressing individual recovery as part of a community recovery approach, where evidence suggests that the psychosocial recovery needs to build a supportive culture that engages and empowers individuals and communities.

Whittle et al. (2010) examine the aftermath of the 2007 floods in Hull, UK, noting that ‘we need to keep hold of the ways in which forms of resilience and vulnerability were created, revealed and disrupted during the flood and, significantly, the flood recovery process. And we need to learn from these…’ (p. 131). They follow with a recommendation to examine and evaluate the norms, practices and disputes around the recovery of the built environment. This paper extends that recommendation into the sphere of emotional recovery where narrative practices are well-placed to unveil relevant actions and reactions. It is a hypothesis that by constructing and, importantly, communicating narratives around useful elements of the recovery story that may remain unidentified in part until the narrative is woven together. Emotional recovery may be aided both on an individual and a community level. The sharing of positively constructed narratives would then inform understanding of the elements involved in the landscapes of action and identity experienced by individuals and communities. As such they would demonstrate the useful functioning of social networks, norms and trust and assist recovery and the building of social capital.

It is anticipated that a narrative approach could potentially influence disaster recovery policy and funding towards a more holistic approach. This approach is based on what is found to be important to the individual in the first year following a disaster, when the immediacy of the trauma has subsided and the less extreme effects stemming from the event are revealed. Cox and Perry (2011) suggest that ‘reorientation, the individual and collective negotiation of identity and belonging in the wake of disasters can be painful, stressful and confusing, but it can also be transformative’ (p. 409). This is a key point for disaster afflicted communities to gain a richer understanding of their changing literal and metaphorical landscape(s). The subjective nature of the story assists in a transfer of learning through its empathetic quality. This could benefit communities at risk in acknowledging lessons learnt. Such an experience-based investigation would be well-placed to potentially influence policy, where the clarity of transfer along with the theoretical argument supporting the findings could be considered holistically.

Social capital and disaster resilience

O’Brien et al. (2010) explore disaster management through social learning in order to provide insight into coping and adjustment towards disruptive challenge, stating that lessons identified from disaster remain largely unincorporated into wider governance processes. They support effective community engagement practices in preparedness in order to establish low risk, and state that a focus on people and their environment, rather than the event, needs to occur. A narrative approach would provide such a focus. Aldrich (2012) claims that social capital best explains why communities build quickly after disaster, or else fail to do so. For example, few agencies seek to ensure that communities stay connected while in shelters or temporary housing during the disaster and recovery phase (p. 23). Mooney (2011) supports this claim and offers a strengths-based approach to recovery including goal-setting and problem-solving to aid disaster affected communities to focus on the potential for longer-term objectives. In light of this literature a narrative approach towards disaster survivors could contribute to the theoretical understanding of resilience through story analysis of relevant action and identity pertaining to the situation, thus deepening understanding and promoting cultural solidarity. Such community connectedness supports resilience against future shock. Resilience is taken here as an individual’s tendency to cope with adversity which may result in the person (or community) returning to a previous state of normal functioning, or operating without negative effects (Masten 2009). In a psychological framework, it is the result of one’s capacity to interact with their environment and processes that either promote well-being or protect against the overwhelming influence of risk factors (Zautra et al. 2010).

Image: ABC, Reproduced under licence 13/329.

Aftermath is an ABC Open project that encourages community members to tell their own stories.

Norris et al. (2008) discuss disaster resilience as emergent from social capital, along with other factors, through a sense of belonging, sense of community, place attachment, and participation in society. Cox and Perry (2011) explore place as significant on a psycho-social level for disaster sufferers, as the ‘ground upon which social capital and community disaster resilience are built’ (p. 395). From this perspective, Cox and Perry argue that place is both ‘the material and social site for the development of social capital, anchoring a sense of self, and a sense of self in relation, through memory and the meaning invested in that site through repeated interactions’ (2011, p. 396). They claim that disaster represents the interruption of a seamless narrative, not only for the presence of the disaster event, but for the influx of resources into the community at precisely the time when those impacted are experiencing profound disorientation (p. 408). The use of narrative devices in recovery is an opportunity to literally change the narrative, following the response phase.

Eyre (1999) suggests that individual and collective expressions of grief may be therapeutic, as is also recognised in narrative practice. She explains the use of ritual in times of social crisis as collective representations of social groups and cautions against rituals dominated by political figures and identities, rather than affected communities. By empowering affected people through such ritual they may discover and confirm shared meaning. Thus strengthening social capital through sharing narratives may yield a renewed sense of social balance and morale.

Eyre (1999) cautions against rituals dominated by political figures and identities rather than affected communities.

Reflective narrative practice

A person-centred approach is best placed to (re)build social capital and psychological resilience in relation to disaster, by offering reflections and insight into useful activities surrounding the disaster event. It is not a life course approach (Hutchison 2011) which is suggested but, rather, an approach to take place in the reconstruction phase of disaster. As narrative reflects a subjective truth at any given point in time (Czarniawski 2011), it is not the intention to reflect oscillations in community cohesion but focus on constructing a preferred narrative (White & Epston 1990). Narrative can reveal pertinent information regarding community cohesion and healing, or alternatively what might have improved emotional well-being, but didn’t transpire.

Shotter (2003) supports a reflective approach towards exploring suffering and distress over a problem-solving approach, so that a dialogue may begin for issues such as disorientation to be explored. Cox and Perry (2011, p. 409) cite this approach as bringing a revelation to survivors who, until offered the opportunity to reflect, would not otherwise be aware of their feelings of deep disorientation ensuing from the event. This is confirmed elsewhere through an oral history project where the bereaved experienced narrative transformations or ‘epiphanies of self-understanding... [through] some fairly obvious questions which the interviewees had apparently not asked themselves before’ (Kelham 2012, p. 57).

Storytelling is a reflective act, according to Clandinin and Connelly (2004), where narrative inquiry is its academic partner. Reflection was first termed by Schön (1983) and stems from lifelong learning principles where the person examines their experiences in order to learn from them (Bradbury 2010). Its emotional influence is a powerful characteristic in relating ‘lessons’ to the audience of the disseminated narrative (Benozzo 2011).

In some forms of narrative it is preferable to allow the participant to recount the story uninterrupted, where it would, in fact, be regarded as intrusive to use questioning. Only when the story is completed should it be followed with prompts such as ‘what happened before/ after/ then...?’ (Bauer 1996, p. 7). In other forms of narrative, reflective devices are embedded as part of the process through specific types of questioning in order to help the person through a critical incident. This approach is the result of seminal work by White and Epston in the social work domain. In this way, White et al. (in Shapiro & Ross 2002) employ the following question types.

Narrative question types

• Deconstructive: To show how stories are constructed and to situate the narrative in a larger system.
• Renaming: To support participant efficacy by sharing authorship and expertise.
• Perspective: To explore other people’s views of the participant.
• Opening Space: To allow hopeful actions to surface; highlight participant efficacy regarding the issue.
• Hypothetical (Miracle): To stimulate participant imagination and identify different futures.
• Preference: To make sure that the exceptional moments are preferred to the ‘problem story’.
• Story Development: To explore and linger on elements of the preferred story.
• Redescription: To help the participant recognise preferred qualities in themselves and probe implications for identity.
• Bifurcation: To help the participant recognise preferred qualities in themselves and probe implications for identity.
• Stopper: To refocus participant when s/he seems to get stuck in the old story.
• Audience: To identify supportive witnesses to the new or developing story.

This focus addresses psychological issues and possible resolutions as central to the investigation. This reflective narrative methodology of the White et al. (2002) model incorporating Brookfield’s method of reflection (1998) provides a reliable framework for the approach. Brookfield’s perspective harmonises well with narrative practice through his view that autobiographies are ‘one of the most important sources of insight into teaching to which we have access’ (1995, p. 31). His use of four lenses fits with the questioning guidelines correlate with White et al. These have merged as follows:

• Lens 1: Autobiography. Participants can begin to view their critical incidents as collective experiences and can further access a deeper level of emotion. This lens fits with ‘Deconstruction’ as it provides context for the individual within the collective framework
• Lens 2: Through the learners’ eyes. Survivors are able to view themselves objectively and understand how the audience interprets (or misinterprets) their experience. This lens would help survivors relate more responsively. This lens fits with ‘Perspective’
• Lens 3: The experience of colleagues (adapted to: the experience of other disaster survivors). Other survivors serve as critical mirrors, reflecting back. Sharing experiences with other survivors through access to their narratives and thus increasing perspective may enhance the opportunity of uncovering useful information. An additional feature of this lens is for the personal benefit of the survivor, in helping to resolve feelings of being disenfranchised, afforded through the shared experience. This lens fits with ‘Renaming’ and ‘Perspective’ (shared experience).
• Lens 4: Accessing theoretical literature in order to label areas of confusion. Introducing labels can potentially help survivors ‘name’ their confusions in regards to the disaster event where disorientation and isolation are among the key themes that we are concerned with. This lens fits with ‘Redescription’ (ie labeling the confusion).

Ethical considerations

Any execution of the proposed approach would need to address ethical considerations. As an exemplar of ethical issues regarding disaster survivors, Muller (2010) specifically deals with trauma in accessing survivors of the Black Saturday bushfires in Australia. The guidelines presented were developed by the media in the coverage of the bushfire victims and offer a useful approach. While the approach would not entail media coverage, but rather an in-depth exploration of emotional issues, and, in part, their resolution, any attempts to execute such an investigation should aim to avoid intrusion. Further and to the contrary, an invitation for survivors to share their stories would provide an opportunity for release and better understanding of their own experiences. Those who fear vulnerability within such an activity would potentially decline the invitation.

Conclusion

It is proposed that a narrative approach towards addressing emotional impact of disaster survivors could provide five key benefits. Firstly, narrative inquiry is primarily acknowledged for its capacity to help people, either individually or collectively, to reframe their experience and create meaning in their lives (Clandinin & Connelly 2004). Subjectively, these stories allow survivors to express the experience in their own words and to understand the ‘why’ behind their claims (Lyons & Kubler LaBoskey 2002). Secondly, their communities could collectively benefit through the sharing of stories, thus acknowledging the emotional or psycho-social impact. The form of narrative proposed would assist in this aim. Thirdly, narrative is recognised as a powerful tool in transfer of learning through its aim to communicate meaning (Bruner 1990). The extent to which these stories help to address other afflicted communities is a key consideration. Fourth, the approach could potentially influence policy through a more holistic approach towards recovery. Finally, any case studies ensuing from the execution of such an approach could provide a valuable education resource for multiple user groups including communities-at-risk as well as emergency services workers, due to the emphasis on the perspective of the survivor.

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About the authors

Dr Kargillis and Associate Professor Gillham are academics in the Educational Scholarship group of the School of Nursing and Midwifery at Flinders University. The aim of this group is multidimensional but includes a focus upon cognition and learning enhancement.

Dr Kako is a member of the Flinders University Disaster Research Centre.