After the storm: Katrina's impact on psychological practice in New Orleans.

Abstract

The impact of Hurricane Katrina on 4 senior New Orleans-based psychologists, both professionally and personally, is described. The authors are pediatric, adult, and family therapists and neuropsychologists; by employment, they are medical center academics, independent practitioners, administrators, and staff/consulting psychologists at medical and psychiatric hospitals. Their diverse experiences following Katrina are similar to the experiences of many individuals in the professional community of the Gulf Coast. In the face of the storm, they departed New Orleans and afterward returned at varying intervals. The homes of all of the 4 New Orleans authors were damaged or destroyed. All of their practice locations were closed for varying periods, and 2 were closed permanently. Of the 4 who returned to New Orleans, only 2 remained 18 months after the storm; the others had relocated to other states. This article reflects on their collective experience as mental health professionals living in New Orleans after Katrina and lessons learned from that experience.

Shared Trauma: When the Professional is Personal

“…My decision to move to this new department was based on careful examination of my preparedness to handle work that was so closely related to my experience on 09/11. Cognizant of the warnings about the ''wounded practitioners'' who practice in an effort to heal their own wounds (Faust et al 2008), I had been working in my own treatment through this decision and made it, confident that I could bring an added value to my work with that population. I was not naïve in this decision and soon garnered additional supports including: returning to school for formal education in advanced clinical practice; securing the guidance of a private supervisor; taking advantage of both formal and informal sources of support available through the clinic; and maintaining an active social life and self-care regimen.…”

Trap of Conflicting Needs: Helping Professionals in the Wake of a Shared Traumatic Reality

“…Much of the literature on professionals working in a shared traumatic reality either states or implies that their distress in the wake of a communal disaster stem from the role conflict between their obligations as professionals and their needs as individual members of the stricken community (Green 1985;Loewenberg 1992;Raphael 1986;Rosser 2008;Saakvitne 2002;Shamai 2005). There is extensive documentation of the stress and distress that professionals experience as they are torn between the needs of their families and their concerns for their safety, on the one hand, as their responsibilities as professionals working in a crisis situation (e.g., Faust et al 2008;Hobson et al 2001;Matthews 2007;Shamai and Ron 2009). There is also extensive indication that they are able to attend to their professional responsibilities only after they have assured themselves of the safety and well being of their loved ones (Loewenberg 1992;Rosser 2008;Saakvitne 2002;Shamai 2005;Shamai and Ron 2009;Somer et al 2004).…”

“…Among emergency workers, group interviews conducted by Somer et al (2004) with hospital social workers in Israel during a period of frequent terror attacks reveal the workers' shame, discomfort, and self criticism for their self-perceived failure to empathize with their clients at certain moments. Faust et al (2008), who worked with victims of Hurricanes Katrina and Rita, noted their own failure of empathy: ''The experience has, at times, made us less active or open as psychotherapists, distracted or unintentionally selective in listening to the stories of our patients'' (p. 5).…”

“…It is a key means by which the therapist may come to know and comprehend what the patient might be experiencing consciously or unconsciously (Book 1988). A thorough review of the publications in English which cover the subject of professionals working in a shared traumatic reality reveals indications of self-perceived lapses of empathy among both emergency workers who provide services in the acute phase of the disaster (Faust et al 2008;Somer et al 2004) and psychotherapists engaged in longterm psychotherapeutic relationships that started before and continued during and after the disaster (Batten and Orsillo 2002;Keinan-Kon 1998;Kogan 2004;MillerFlorsheim 2002;Saakvitne 2002). To be sure, many professionals in both situations experience the conflict of attention to self versus attention to the client as temporary and normal for the situation.…”

“…Such distress has been repeatedly documented after both natural (e.g., hurricane, earthquake) (Faust et al 2008;Marmar et al 1996;Matthews 2007) and manmade (war and terror) (Eidelson et al 2003;LevWiesel et al 2009;Seeley 2003;Wee and Myers 2002) disasters, among both professionals who provide emergency services immediately following the disaster (e.g., Boscarino et al 2004;Shamai and Ron 2009) and those who conduct ongoing psychotherapy before, during, and after it (e.g., Frawley-O'Dea 2003;Keinan-Kon 1998;Kogan 2004;Saakvitne 2002;Tosone 2006). Since September 11 th , the distress of both sets of professionals has been described as rooted in the 'shared trauma' or 'shared traumatic reality' experienced by both helper and helpee and/or therapist and client (Kretsch et al 1997;Saakvitne 2002).…”