Thursday, October 15, 2009


Philippine Daily Inquirer/Opinion/by Ma. Ceres P. Doyo
(This piece is the continuation of last week’s column, “Deep calls to deep.”)

IN 2005, after killer landslides and flash floods brought the provinces of Quezon and Aurora to their knees, I wrote about the groundbreaking book, “Pakikipagkapwa Damdamin: Accompanying Survivors of Disasters,” (Bookmark) by psychologist Dr. Lourdes A. Carandang. The book was the result of her and her Ateneo de Manila University team’s efforts (funded by Unicef) to give psychological aid to survivors of the 1990 earthquake, the 1991 Mount Pinatubo and 1993 Mayon Volcano eruptions.
Carandang and her team’s “helping manual” could very well have been written for the 2005 Southern Luzon tragedy. It also found context in the catastrophic 2005 tsunami tragedy that killed more than 200,000 in Asia and Africa. And in the past two weeks’ deluge and landslides that paralyzed Metro Manila, Rizal Province and Northern and Central Luzon.

I am sharing again some of the insights from the book that might be useful for those who are helping individuals and groups, children in particular, deal with their recent traumatic experiences with the disaster caused by Typhoons “Ondoy” and “Pepeng” and by human beings as well.

Pakikipagkapwa-damdamin could mean empathy, and more. This Filipino word or phrase is not just a noun, it has been coined from both verb and noun. While the word empathy is rich and deep in meaning, its Filipino equivalent is so much more suggestive and active. Although it is a tongue-twister, I can easily visualize it. I can visualize persons reaching out and I hear the song “People who need people.”

Written in a narrative and personal tone, “Pakikipagkapwa-Damdamin” is different from other books on psychosocial rehabilitation in that it mainly uses the psychological, not the symptom-oriented, approach in examining the inner world of survivors by “letting them speak for themselves.” The phenomenology of the “carer” is also laid bare. How do they see themselves, sustain their level of energy?

The therapists discovered that the children were the barometers of the psychological and emotional climate of the community. No matter how the adults tried to conceal their feelings, the children always provided an accurate gauge of where the community was at.

And so the children were the perfect entry points for gaining rapport especially through games.

“Mirroring” entailed making the children feel that the therapist was one with them, like imitating the child’s posture or facial expression. The therapist entered the child’s world and made the child feel at ease and accepted.

The therapists came in with soft voices. They were friendly but not overeager, waiting for the children’s responses instead of demanding them.

The children set the pace for the interaction. The team’s enthusiasm must not overwhelm. Interaction was kept open so that the children could respond, feel safe, be in control and empowered.

Introductions, using names, sitting close and touching, making the children feel safe, listening and showing interest in their answers—these were some of the techniques to gaining entry to the children’s world.

Therapists also relied on non-verbal ways a child communicated. A child’s drawing could speak a thousand words. It is also a tool for drawing out more stories.

Writing, Carandang recalled, was an effective tool for rapport and self-expression among older children and adults. It even proved “infectious” and touched off a “writing wave” among evacuees.

“Working with adults who were in various emotional states was an essential part of the holistic multilevel process,” Carandang said. “We found out that they needed help to move on with their grieving process. Many needed help to get unstuck from their immobilized states that ranged from bitterness, pain and depression to suicidal thoughts.”

Blaming, quarreling, fits of anxiety, mental anguish, helplessness, hopelessness, loss of appetite, physical weakness—these were some of the symptoms the survivors experienced. For some, intrusive thoughts that would not go away could be a problem.

Talking about it helps, said a survivor. “We swap stories. I talk a lot about my own experience. I talk about what I think to my neighbors, the better to distract myself from my worries.”

Using story metaphors, play therapy, looking at things in a new light, talking about lessons learned, making use of their senses and their connectedness to nature—these helped children make sense of their experiences.

Carandang recognized the adults’ emotional bond with nature. Familiar nature scenes were used as metaphors to help them look beyond their present situation.

One therapist used the two mountains that marked the boundaries of the relief center—one barren, the other lush—to re-frame the outlook of an adult stuck in his feeling of loss.

Prayers, hypnosis and massage helped those suffering from psychosomatic reactions. Rituals and prayers done together could be a means to hasten community healing.

“Perhaps the most tender and touching part of the prayer service that our team experienced was the Offertory,” recalled Carandang. “The people offered themselves quietly to the Lord, calling Him ‘Amang mapagmahal’ (loving Father).”

The community offered a big rock to symbolize the strength of their faith. More compelling than the shared outpouring of grief was their will to live lives of enduring trust, faith and hope.

What about those who have been vicariously traumatized by the images? Carandang’s advice: “Take a break, connect with others and build communities of care. Trauma renders people powerless. Sharing stories help to heal the trauma and empower people.”