Mental care after the Hanshin-Awaji earthquake

-Tremendous earthquake without sufficient equipment-

When the earthquake hit Kobe at 5:46 in the morning of January 17th, I was sleeping at home. I was woken up by the sudden loud sounds from the earthquake on that morning. To tell the truth, I never thought a big earthquake might hit the Kobe area, I didn't prepare for such a disaster. Take my experiences after the earthquake into consideration, of course I feel so sorry for those who were killed by the earthquake, now I can say that it was an important experience to come across the Hanshin-Awaji Earthquake. It is to my regret that I did not have enough knowledge and preparation for this natural disaster. I hope the new challenges of the "Environmental Disaster Prevention Course" at Maiko high school will be successful.

-1/17,At a safe shelter right after the earthquake-

Around 7 am, I went outside. The Suma area where I lived was one of the severely damaged areas but fortunately my house was not so badly damaged because it was located on the mountain side and remote from the center of the tremor. First, I tried to go to my study room at Kobe Gakuin Women's College, which is located in the Nagata area. Because trains had stopped and other transportation was not available, I had to walk there. My study room was a mess. After exchanging information with various people there, I visited Hyogo High School, one of the safe shelters in the Nagata area. The very first idea that occurred to me was about "physical care" rather than "mental care". It was obvious that the refugees were hurt; so physical care comes before mental care on these occasions.

-PTSD (Post Traumatic Stress Disorder)-

A few days later, I began to think of the necessities for "mental care" because I saw many refugees who were hurt and shocked by the death of their family members, the loss of their homes and the loss of their beloved animal companions. Being injured and hurt by external shocks such as disasters, refugees might have invisible damage in their minds. Technically, this is PTSD. Those who suffer from PTSD are afraid of sounds even if they are not so loud and sensitive to subtle tremors. They experience symptoms such as fever, headache and diarrhea which may be induced by PTSD. There are still about 4,000 children who suffer from PTSD according to recent surveys, even after 6 years have passed.

-Helping each other-

I began various kinds of "mental care" in the 1st week after the earthquake. First, the best thing I could do was to listen to the victims' stories and situations when the earthquake occurred. Some people may not be able to continue to talk due to the flashback of tragic scenes, so I just stayed close to them and watched them. In the process of talking with refugees, I felt so overwhelmingly that it is important to help each other as much as we can.

-Expressing the anger-

Since food and water were distributed to safe shelters, refugees tried hard to survive and help each other. Faced with these hard situations, refugees may have angry emotions like "Why should we suffer from these disasters and difficulties?". I think it is important to release all anger to the outside. Then the anger will be calmed and the victims can think positively and help each other in 2 weeks or so.

-Reproduction of disaster scenes in play-

About 3 weeks after the earthquake, around the restart of classes at school, we, clinical psychologists, went and joined the talks and play of schoolchildren at each school. Children first drew pictures and sang songs. In these activities, they looked cheerful and energetic. At some junior high schools, students destroyed thick board of papers and then ignited fire on them. This is the reproduction of earthquake disasters. Their parents and adults were worried about the negative influences on their children. However to reproduce the shocks is one of the remedies for PTSD. It can mitigate the children's PTSD symptoms and be helpful for them.

-Special care for invisible damage-

An impressive point is how important it is to help and keep in touch with others after a traumatic event. Right after the earthquake, many people stayed at safe shelters, but in a half year or so, the refugees gradually began to move to temporary housing and then later, they moved to permanent housing. Thanks to the restoration projects, the damaged buildings and bridges have been repaired or reconstructed and the "visible" damage caused by the earthquake has decreased. On the other hand, those who moved from temporary to permanent housing might suffer from "mental illness". At first glance, we might tend to think it is enough to restore only visible damage, but in fact it is not enough. The shock and "mental" (invisible) damage inflicted by the earthquake continues even after moving back to permanent housing. It is a so-called "secondary symptom" and old people especially are suffering from it now. These shocks can be mitigated just by local students' visiting them, doing something for them, and listening to them.

-Be aware of unconscious damage-

When I perform "mental" treatment, I always try to listen to the refugee's experiences and stories very carefully. Just by talking about their stories, they can be cheered and cured. If so, why are some people even now suffering from PTSD? One of the reasons is as follows: When we suffer from tremendous shock or impact, we try to restrict our consciousness and push the shock to the unconscious part of our minds to protect ourselves and forget about it in our usual lives. But when we face an occasion such as hearing the sound from a helicopter, oppressed shock may burst back into our consciousness from our unconsciousness. This is a so-called "flashback". We can mitigate the shock of flashback by expressing oppressed shock to the conscious part of our minds. I can not predict how long it will be necessary for us to keep doing these treatments.