Disaster and Mass Trauma Rehabilitation

Dr. Ani Kalayjian, Founder & President ATOP Meaningfulworld

According to experts in disaster fields, 5 psychological phases are likely to occur after a disaster (American Red Cross Manual on Disaster Health Services). According to author’s research in over twenty disaster ridden countries around the world, these phases vary in length and intensity depending upon history of disaster, vulnerability, kind of disaster, extent of physical damage, and resources available.

1. Initial impact phase: characterized by increased anxiety and fears.

2. Heroic phase: survivors helping each other in efforts to deal with the catastrophe.

3. Honeymoon phase: experiences of joy at having survived and feeling important and special for receiving aid from various private and governmental organizations.

4. Disillusionment phase: increased frustration and resentment at officials and agencies for failing to provide assistance in a more timely fashion.

5. Reconstitution phase: thoughts and plans for reconstruction and acceptance of the need to assume responsibility for personal problems.



Though disasters differ in their intensity, my research finds these are universal reactions to disasters:

1. Shock and disbelief: In stage one; survivors are in shock, emotionally numb, and in some cases in denial, because the pain is too severe for any human being to bear.

2. Strong emotional response: In second stage, the survivor is emotionally aware of the problem and feels overwhelmed and unable to cope with it.

Common Reactions in Children:

1. Separation anxiety 2. Refusing to sleep or be left alone 3. Conduct disorder 4. Regressive behaviors: thumb-sucking, enuresis, or clinging behavior 5. Hyperactivity 6. Withdrawal 7. Somatic complaints: stomach ache, headache, joint aches, etc. 8. Sleep disturbances.

Common Reactions in Adolescents:

1. Withdrawal, 2. Anger 3. Increased aggression 4. Regression 5. Sleep disturbances 6. Nightmares 7. Increased daydreaming 8. Inability to concentrate 9. Irritability.

Common reactions in Adults:

1. Uncertainty and fear 2. Anger expressed toward builders and government officials 3. Feeling tense, edgy and jumpy 4. Loss of appetite 5. Sleep disturbances and nightmares 6. Withdrawal 7. Loss of concentration 8. Inability to make decisions 9. Aggression: domestic violence, increased alcohol/drug use, etc.

3. Acceptance: In this stage, the survivor begins to accept the magnitude of the disaster and makes and appropriate effort to address it. Survivors feel more hopeful and goal-oriented. At this time, survivors may take more specific actions to help themselves and their families.

4. Recovery: Last but not least is the recovery stage, in which survivors feel they have returned to their pre-disaster level of functioning. A sense of adjustment and well-being is restored and realistic memories of the traumatic experience are developed.


In chaotic and distressing times it is important to do the following:

1. Continue your pre disaster routine (as much as possible): work, school, housework, and other activities. Since there is a lot of uncertainty, it is best to focus on things that you have control, or can be certain about. Try to reduce the time you spend worrying about the things you cannot change; ask yourself “What can I do now?” rather than “Why did this tragedy happen to me, to us?” “Why are people so ignorant?”

2. Use your resources and support systems fully: Stay with family, friends, neighbors, and Co-workers;

3. Don’t hide your feelings talk it out: Talk, cry, and express, and share your feelings: grief, sadness, helplessness, or whatever else you may be feeling. You’re not in this alone. It is normal to have those feelings after such a disaster, and it is healthy to get them out of your system. If you don’t, they may be locked in your body, psyche, or soul, and become poisonous. Help your children to tell their stories, express their feelings, role model for them, or let them draw it;

4. Reach out to your spiritual support system: Go to your Church, Temple, Mosque, Park, or wherever else you may receive spiritual support. Meditate and pray. According to this author’s research, spiritual support has helped survivors tremendously;

5. Know your limits – and make time to rest, relax, recharge, and refresh;

6. Avoid self-medication: Drugs and alcohol may seem to remove stress temporarily, but in the long run they generally create additional problems or behavior that compound the stress you were feeling initially. Even caffeine and nicotine can have a negative effect on your ability to control the sources of anxiety in your life.

7. Find a positive lesson that you learned through this crisis experience: Every experience, as traumatic as they are, can have a positive meaning which is individually unique. After discharging negative feelings, the sooner you find that meaning the sooner you can gain control and heal. That does not mean that you avoid the grief and the expression of sadness. Take your time to cry, feel sad, and grieve, and then go on to discover a meaning.

8. Find love, and express love: Caring and loving produces positive feelings in us all, and helps us cope with the worst situation. Be generous with your hugs and physical expression of love, caring and compassion.


** Board Certified Expert in Traumatic Stress, and author of Disaster & Mass Trauma: Global Perspectives on Post Disaster Mental Health Management. Mass Trauma & Emotional Healing Around The World: Rituals and Practices for Resilience and Meaning-Making (ABC-CLIO 2010). Forgiveness & Reconciliation: Psychological Pathways for Conflict Transformation & Peace Building (Springer 2010). This sheet was originally developed in NYC for distribution on 12 Sept. 2001. For any details, contact DrAniKalayjian@Meaningfulworld.com


Useful websites: www.apahelpcenter.org, www.istss.org, www.selfhelpgroups.org,
www.psichi.org/pubs/articles/article_369.asp, www.meaningfulworld.com

"Let us present the same face to everyone."

-Lao Tzu