Speeding the recovery from psychological aftershocks.

Immediately following the 6.7 Northridge quake, most managers and business owners expected to face serious levels of disarray among their employees. Absenteeism was high, as many people had to cope with finding new homes or picking up the pieces in their old ones. Parents stayed home to be with children and commuters struggled to find new routes. No one expected it to be business as usual.

However, it has now been several weeks. Most people have a place to stay, the aftershocks have subsided, traffic has been rerouted. Time for everything to be back to normal on the job, right? Wrong. The psychological aftershocks are still arriving.

Barry Gibbons, former CEO for Burger King Corporation in Florida, steered the company through the difficult period following Hurricane Andrew. He emphasizes that the nature of recovery from such a widespread disaster is much more like running a marathon than like running a sprint. Mr. Gibbons has noted that during the second month following the storm, the initial push to survive was succeeded by weariness and fatigue. As employees' reactions evolved, different forms of workplace support became necessary.

The manager of a Los Angeles County office has noticed something similar. "Ninety five percent of my employees are back at work and everyone has found a way to make their commute. But things just aren't right. So many people are calling in sick! It seems like everyone has the sniffles. And when they are here, it's like slow motion. Things just aren't moving along. Everyone is so grumpy!"

Sound familiar? This office presents a classic picture of what is called Post-Traumatic Stress. It is normal and quite common for all of us to display a certain set of psychological symptoms following any major trauma, such as a car accident or an earthquake. Some symptoms set in immediately, while others may show up later, after the initial demands of coping with survival have been met. Many employers in quake damaged areas are now reporting the same types of reactions in their workers.

Some of the symptoms, such as apathy, poor concentration and forgetfulness, hit especially hard at workplace productivity. It may seem as if these people just aren't trying, but actually these are normal and often unavoidable reactions. However, there is a way to shorten the duration of these symptoms. Mental health experts in the armed services have developed psychological interventions called "Critical Incident Debriefings." These are designed to help groups of people through these kinds of traumas and shorten the time frame of adverse reactions. Providing these services for employees at the workplace during a time of severe and widespread stress can considerably improve morale and help restore productivity. Debriefings are also useful in identifying the small percentage of employees whose stress symptoms are likely to last longer than the normal four weeks and who will need more intensive help. In a typical workplace debriefing, a clinician conducts a two to three hour on-site group meeting with employees. The structure of the debriefing provides time for people to describe their experiences, ventilate feelings and get concrete information about what to expect, what is normal and how to cope. Research has shown that the more opportunities people have to talk about their experiences with a sympathetic listener, the faster they get over them. Finding out how to best comfort their children is also a major help to many employees. Dr. Meg Sheehan, a psychologist who is conducting debriefings in the downtown area, describes this process as a good tool for spotting those with special needs. "At one debriefing, a woman refused to talk but had tears coming down her face during the entire session. At the very end, she finally spoke and described how her apartment had been totally destroyed, how her son had been buried in debris and how she had thought he was dead. Luckily, she was wrong about that. Now, she was living in her car, unable to make any decisions or reach out for help. Obviously, she was unable to work. After the debriefing, I was able to talk with her for awhile and hook her up with a therapy counselor and a relief worker to sort out her immediate needs. Within a week she was able to return to work."

Dr. Susan Brace, a West Los Angeles psychologist, was faced with the specialized situation of debriefing a group of medical workers. "Imagine, not only were they all required to work a second shift caring for critically ill hospital patients, but most of them could not find out if their own families and homes had survived. Some didn't know until Monday night that their children were okay. The fear and shock that these workers lived through on that long Monday had a big impact on their morale and energy."

An important part of the debriefing, according to Dr. Judith Rosenstock, is helping the individual to thoroughly reconstruct how he or she felt while the earthquake was happening. Having treated many people affected by the quake, she has found that this is often the most helpful aspect of the treatment. Dr. Killorin Riddell of Beverly Hills stated that, "Among many of the parents I have counseled at a FEMA Disaster Assistance Center, helping them to better assist their children with this experience restores their sense of control. They can then function better in both their occupational and personal lives."

Professionals trained to understand and respond to the needs of disaster victims can speed the process of emotional recovery. Dr. Leonard Levy, CEO of Camino Real Psychology Group, said, "We are all accustomed to consider the physical aspects of disasters. Often, though, we may underestimate the time and tools needed to effect emotional repairs. On-site counseling and debriefings can benefit both workers and employers."

More than any other factor, recovery from the earthquake will depend upon how the concerns and capacities of people are recognized and responded to with appropriate management.

Dr. Monty Clouse is a clinical psychologist in private practice in West Los Angeles. He has also worked as an organizational consultant, and counsels people affected by the earthquake for FEMA and the Red Cross.

POST-TRAUMATIC STRESS COMMON SYMPTOMS

* Fatigue

* Irritability

* Anxiety

* Apathy, Emotional numbness

* Headache, Nausea, Dizziness

* Minor illnesses

* Difficulty concentrating

* Confusion, Forgetfulness

* Insomnia

* Nightmares

* Increased drug & alcohol use

* Mood swings

* Jumpiness 

* Recklessness