Talking with

Tsunami

Survivors in

JapanKou Kunishige

Diversity Counselling New Zealand

11.3.20112011 earthquake off the Pacific coast of Tōhoku

Overview Earthquake

14:46 JST (05:46 UTC) on Friday 11 March 2011

Magnitude 9.0

Moved Honshu (the main island of Japan) 2.4 m east

Tsunami

Reached up to 40.5 metres high in Miyako

Travelled up to 10 km inland

Humanitarian crisis Toll at Oct 2014

Death 15,889; Injured 6,152; Missing 2,598

Evacuees more than 400,000 after the earthquake

Still 243,040 are evacuees at 11 Sep 2014

Economic impact

the Japanese government estimated that the cost of

just the direct material damage could exceed ¥25

trillion (US$300 billion).

Emergency Counsellor

(EC)

The government was planning to send

ECs to schools as weekly rotation.

However, High schools in Miyagi wanted

ECs to stay there, at least for three

months

March 2011, planning to live in NZ. All

contracts in Japan finished. So

temporarily and unusually I was free.

Kesennuma

City,

Miyagi,

Japan

Nuclear Plants

High schools

Kesennuma Koyo High School

Vocational School to be a sailor,

engineer, or cook

Kesennuma High School

No damage from the Tsumani, so

the gyms were used for the shelters

and the Japanese self-defense

force camped on the school ground

Kesennuma Koyo

High School

Disaster Prevention Centre at Minamisanriku

What can you

do as a

counsellor?

How do you imagine the

students looked like?

After two months passed, the school were

eventually able to start their class. Then I started

to work.

There were students who lost their home, relatives,

loving ones. The school teachers were not

exceptions to this.

There can be so many

things you can imagine.

However there is

something you might not

be able to imagine.

There were ordinariness

and normality.

This was the moment when we could not believe

what we actually saw. Then we wanted to dig

something hidden underneath.

PTSD

How many people who develop PTSD do you

think I needed to deal with over two years?

The schools have more than 1,000 students. I

asked other schools in the area about PTSD.

Behind a TV camera

A TV camera can focus something standout, but not something ordinary.

A proverb “seeing is believing”. But how is it different from seeing directly with our own eyes to seeing through a media.

A mount of information you obtain is far beyond the information though a media.

When people don’t see

what they imagined People try so hard to find out something

they imagined.

People asked survivors to obtain what they

wanted. “You are hurt, aren’t you?”

Media wanted to find out the kind of stories

they could imagine outside.

Even professionals wanted to find. Some

believed that there must be such things.

First hand talk & Second hand

talk

We tend to hear similar stories. We can not assume that the number of being-told represents the number of existence of the story.

The people tend to circular salient stories. We cannot spot who told this story to begin with.

Original story & Circulated story

Stories circulated by

professionals

Questions can be generated before hand. Questions themselves would not be questioned whether they are appropriate for them or not.

Questions can generate answers as they require.

Such answers will be taken and form particular stories. Then they will be circulated.

Echoes

The number of echoes

you hear doesn’t reflect

the number of the

incidents.

Ludwig Wittgenstein

The Blue and Brown Books (1958)

Instead of "craving for

generality” I could also have

said "the contemptuous

attitude towards the

particular case"

Why not PTSD?

Every event can be located in its

context – history, culture, and tradition.

Nothing can stand alone. So we need

to explore backgrounds, contexts of the

event. Otherwise, we will

misunderstand them.

Nuclear Plants

Tsunami Evacuation Site

A story of an expectation

A student told me “When the

earthquake happened, I was near the

sea. I was quite sure that tsunami

would come and I should have 15 to

20 minutes to evacuate.”

He went back to his house and picked up

what he needed, then went to the

evacuation area.

A story of a hunch

A school teacher needed to evacuate

the students to the designated place.

He did. However, He felt something.

So they decided to move on to further

place, which was never considered

before.

Later what they found was the

designated place wad destroyed by

tsunami.

How they tell about tsunami

Adults told children, even in the early phase,

“What you have to do when you become a

grandparent is to tell what you experienced

to your grandchildren.”

Toward nature, people need to find a way to live

with, rather than to stop it.

This is not a human-made accident. You

don’t need to forget. The community would

carry it with you.

Concepts of PTSD

The big incident would cause some

psychological disturbance even if one

month passes, and the symptoms last

more than one month. Then it makes

his/her life so difficult.

The rates of developing PTSD after a

traumatic event very from around 10%

to sometimes 40%. Is it?

DSM Criteria for PTSD Criterion A: stressor

Criterion B: intrusive recollection

Criterion C: avoidant/numbing

Criterion D: hyper-arousal

Criterion E: duration

Criterion F: functional significance

The disturbance causes clinically significant

distress or impairment in social, occupational, or

other important areas of functioning.

Research on PTSD

Many researches are about the symptoms which

are considered to belong to the PTSD.

NOT the number of PTSD diagnosis. They

often don’t show the prevalence rates of

PTSD.

The question is how the symptoms are

related to “PTSD” itself.

PTSD Checklist (1)Weathers, Litz, Huska, & Keane (1994); National Center for

PTSD1. Not at all 2. A little bit 3. Moderately 4. Quite a bit 5. Extremely

1. Repeated, disturbing memories,

thoughts, or images of a stressful

experience?

2. Repeated, disturbing dreams of a

stressful experience?

3. Suddenly acting or feeling as if a stressful

experience were happening again (as if

you were reliving it)?

4. Feeling very upset when something

reminded you of a stressful experience?

PTSD Checklist (2)Weathers, Litz, Huska, & Keane (1994); National Center for

PTSD1. Not at all 2. A little bit 3. Moderately 4. Quite a bit 5. Extremely

5. Having physical reactions (e.g., heart pounding,

trouble breathing, sweating) when something

reminded you of a stressful experience?

6. Avoiding thinking about or talking about a stressful

experience or avoiding having feelings related to it?

7. Avoiding activities or situations because they

reminded you of a stressful experience?

8. Trouble remembering important parts of a stressful

experience?

9. Loss of interest in activities that you used to

enjoy?

PTSD Checklist (3)Weathers, Litz, Huska, & Keane (1994); National Center for

PTSD1. Not at all 2. A little bit 3. Moderately 4. Quite a bit 5. Extremely 10. Feeling distant or cut off from other people?

11. Feeling emotionally numb or being unable to have loving feelings for those close to you?

12. Feeling as if your future will somehow be cut short?

13. Trouble falling or staying asleep?

14. Feeling irritable or having angry outbursts?

15. Having difficulty concentrating?

16. Being "super-alert" or watchful or on guard?

17. Feeling jumpy or easily startled?

What is helping? They are “normal” symptoms. As we are

“flesh-and-blood persons, we react, feel anxious, not to sleep, not to want to see.

Symptoms are not from disorders nor illness.

You don’t need to FIX those symptoms. But they need to take care of themselves as much as possible.

A high school girl saw tsunami and the people who were taken by tsunami.

Factors which PTSD

doesn’t deal with How big it is depends upon how people

perceive it.

What it means depends how the people

around them respond to it.

How much they have to suffer is not only the

degree of the incident itself, but how difficult

for them to restore their life.

The people wanted to talk

But, not to a person who has a tag of

“Mental Health Care”.

If you ask them “Can you tell me what

happened, as I need to know as much as

possible to help “other” people,” they

would tell you so many things.

Don’t offer “counselling”, but offer an

opportunity to talk.

resilience

Don’t give a name of disorder to people easily even if you recognize some symptoms.

Treatments which the notions of PTSD lead won’t be necessary. You don’t need to deal with them directly.

What they need is to have enough time, space to restore their health.

Then various supports after the event are needed to restore their daily life.

Tsunami Wall

The 14.7-metre (48ft) wall below will do little more

than protect rice paddies, at a cost of $230m.

Moving a village