Tackling trauma post-natural disasters in Nepal

Men, women and children are all susceptible to traumatic experiences in their lives. Nepal, however due to its topography is among one of the most disaster-prone countries in the world with landslides, floods, earthquakes and thunderstorms frequently occurring in the country. Experts link natural disaster experiences to trauma which makes people living in Nepal even more vulnerable to it.

Research, ‘Earthquake Exposure and Post-traumatic Stress Among Nepalese Mothers After the 2015 Earthquakes’ published in 2019 revealed that 24% of mothers indicated having Post-Traumatic Stress Disorder (PTSD) symptoms within clinical concern or a possible diagnosis. Mothers who faced the loss of a family member due to the earthquake made up the majority of women who showed PTSD symptoms. The study showed that the 2015 earthquake brought high exposure to traumatic events and PTSD symptoms among mothers who participated in the research. PTSD is associated with shocking, scary or dangerous events experienced or witnessed by a person. People with this disorder suffer from internal reminders in forms of nightmares and flashbacks and varying anxiety states.

Trauma has been linked to suicidal tendencies as well, which is a major public health problem in Nepal. The public health journal published by the World Health Organization, South-East Asia Region, in the year 2017 concludes that people suffering from psychological trauma are vulnerable to both depression and suicidal behaviours. The assessment performed by International Medical Corps in 2016 showed higher suicidal ideation in areas significantly affected by the earthquake of 2015 (Gorkha: 24.5%, Sindupalchowk: 25.1%), than in Kathmandu (8.3%).

According to the American Psychological Association, trauma is an emotional response to a terrible event like an accident, rape, or natural disaster. More immediate symptoms of trauma include shock and denial but the longer-term symptoms include unpredictable emotions, flashbacks, strained relationships, and even physical symptoms like headaches or nausea. Such traumatic experiences make it difficult for people to carry on with their daily lives and may need professional help.

Psychologists are now using various therapeutic techniques to help patients deal with trauma. “We usually combine cognitive-behavioural therapy and person-centred therapy while dealing with patients with trauma. Having said that, the treatment process of trauma is carried out in a very individualistic way, as every individual is different and counsellors need to cater to their own specific needs,” says experienced counsellor, Saluja Chand. Person-centred therapy (PCT) is based on empathy, positive attitude assuming that people have inherent motivation for positive growth, and that they are capable of improving their situation if they are provided with the right support and environment. Whereas, Cognitive-behavioural therapy (CBT) is done on the basis of the assumption that people have negative thoughts which result in emotional issues for people, therefore their cognitive patterns must be altered in order to better their situation.

“An interesting concept has now come up, that trauma actually gets stored in the physical body, not just the mind. Trauma releasing exercises (TRE) are now being introduced to patients,” says psychologist Salonika Neupane. “The decision to prescribe medications to a patient of trauma, is taken considering the symptoms the patient is exhibiting , and the anxiety levels they have,” she concludes.