Why Do Some Hurricane Survivors Thrive After Disaster?

You’ve probably heard of PTSD, post-traumatic stress disorder. But what about its counterpart, post-traumatic growth? The term was coined in the 90s to describe the positive psychological growth that researchers documented in people who had been through traumatic or highly stressful life events. Psychologists and sociologists conducting long-range studies on survivors of Hurricane Katrina – which hit 20 years ago and remains one of the most devastating natural disasters to hit the US – are continuing to learn more about it. So how do you measure post-traumatic growth? Can it co-exist with PTSD? NPR mental health correspondent Rhitu Chatterjee https://www.npr.org/people/578890280/rhitu-chatterjee explains what scientists have found so far … and how it could help shape disaster relief efforts in the future. Interested in more psychology and social science stories? Email us your question at [email protected] mailto:[email protected]. Listen to every episode of Short Wave sponsor-free and support our work at NPR by signing up for Short Wave+ at plus.npr.org/shortwave http://plus.npr.org/shortwave. See pcm.adswizz.com https://pcm.adswizz.com for information about our collection and use of personal data for sponsorship and to manage your podcast sponsorship preferences. NPR Privacy Policy https://www.npr.org/about-npr/179878450/privacy-policy

• 0:00Speaker 00

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• 0:19Speaker 01

  Hey, Short Wavers. John Hamilton here in the guest host chair. And joining me today is Ritu Chatterjee. She covers mental health for NPR. Hi, Ritu.

• 0:28Speaker 02

  Hey, John.

• 0:29Speaker 01

  Ritu, I know you've been reporting on mental health of people who lived through Hurricane Katrina. It has now been 20 years since that storm devastated New Orleans. What have researchers learned about the survivors?

• 0:41Speaker 02

  Well, you know, the one thing that stood out to me was how much the research has revealed about human resilience. Researchers have really been able to see what this looks like after following more than a couple thousand survivors for nearly a dozen years. And one of those researchers is David Abramson. He's a social and behavioral sciences professor at NYU.

• 1:00Speaker 03

  Around the 13, 14-year mark after the hurricane, people had begun to have a sense that they had come to some sort of stability in their lives.

• 1:13Speaker 01

  Okay, 13 to 14 years. I mean, developing resiliency is apparently not a quick process. It can take time.

• 1:21Speaker 02

  Yeah. And also remember Katrina was one of the most devastating natural disasters in the US. Some people lost pretty much everything except their lives. So here's what Abramson and his team learned about the mental health of the nearly 1,000 survivors they looked at. This is right after the storm.

• 1:38Speaker 03

  We found that somewhere between 40 and 50% of the people in our cohort were expressing very high levels of mental health distress, complicated grief, anxiety, and depression.

• 1:55Speaker 02

  And you know, John, other researchers looked specifically at symptoms of post-traumatic stress disorder and found over 40% of survivors had PTSD in that first year after the storm.

• 2:05Speaker 01

  Wow, so people had all sorts of mental health struggles right after the event. But it sounds like researchers found that many survivors recovered, I mean, eventually.

• 2:15Speaker 02

  Yeah, and this was beyond just finding stability. One of the things that they asked survivors about is called post-traumatic growth.

• 2:24Speaker 01

  OK, new term for me, Ritu.

• 2:26Speaker 02

  Yeah, so post-traumatic growth is something that psychologists have documented in people who've gone through, you know, serious illnesses, natural disasters, accidents. And they have specific questionnaires they use to assess people for post-traumatic growth. But the bottom line is, people who go through this say that, yes, I suffered a lot, it was terrible, but I grew through that experience.

• 2:50Speaker 04

  There's the saying by Friedrich Nietzsche, right? That which does not kill us make us stronger.

• 2:55Speaker 02

  That's Nunoq Pham, and she's an adjunct professor at Tulane University. She studied post-traumatic growth, and she's also a Katrina survivor herself.

• 3:05Speaker 01

  So today on the show, what Katrina survivors tell us about post-traumatic stress and post-traumatic growth.

• 3:12Speaker 02

  And how one can lead to the other.

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• 4:41Speaker 01

  Ritu, let's go a little deeper into what you've been learning about how an event like Katrina can have a lasting effect on a person's mental health. I'm sure you've heard a lot of personal stories.

• 4:51Speaker 02

  I certainly have. And as I mentioned earlier, researcher Nuno Pham is a Katrina survivor herself. And her story, her personal story, ties into some of what her own research and other studies have found about Katrina survivors. Now, Pham was a teenager when the hurricane hit on August 29, 2005.

• 5:09Speaker 04

  I was living in Jefferson Parish, which is the parish adjacent to Orleans, which where most of the floodwater appeared.

• 5:17Speaker 02

  Pham and her parents are originally from Vietnam, and her parents had just bought their first home back then. And they'd been living in it for just about a month when they got the news about the approaching hurricane.

• 5:28Speaker 04

  We just thought of it as another storm. It's going to come, it's going to pass. We're going to take a hurricane, as some of us like to call it back then.

• 5:37Speaker 02

  And so they packed their bags with clothes for just a couple of days and went to Houston, Texas, and checked into a hotel.

• 5:43Speaker 01

  That was optimistic on their part, right? I mean, I'm betting that hotel stay was a lot longer than they expected.

• 5:50Speaker 02

  Yeah, two months or so, according to Pham. And when they finally returned home, they found that they were lucky their house hadn't flooded, but there was still a lot of damage from the winds.

• 6:00Speaker 04

  So like the roof and things like that had to be replaced. The back patio was gone, and that needed to be replaced, windows.

• 6:09Speaker 02

  And Pham remembers that it took a big toll on her parents' mental health.

• 6:15Speaker 04

  I think my parents were really stressed out during that time. I think, you know, as an immigrant, purchasing their first house, they weren't sure how they would rebuild. So I saw the physical sign of stress. They weren't sleeping a lot. There was a lot of insomnia, just a lot of like worrying, just like constantly talking about what are we going to do next?

• 6:38Speaker 01

  Yeah, yeah, I mean, that takes me back. You know, I was in New Orleans more than a year after Katrina hit, and there were still these mountains of debris piled up on the neutral grounds, you know, those median strips that separate traffic. Even people who'd spent their whole lives there were having trouble getting their homes repaired or rebuilt. I imagine it was even harder if you'd come from another country.

• 6:58Speaker 02

  Oh, absolutely. And like many first generation immigrants in her community, Pham's parents didn't speak much English, which made things even harder. Like, how do you even find out where to go, how to apply for relief funds? So Pham says her parents asked her for help with the paperwork. And it wasn't just her. This was happening with other kids and other parents all throughout the Vietnamese community down there.

• 7:21Speaker 04

  It kind of became this thing where the younger kids in the community who knew how to navigate the computer, who knew how to fill out forms, we did it for our parents and then we just did it for others in the community.

• 7:35Speaker 02

  You know, Pham says she had to grow up really fast and become an adult in many ways, and she says it was really formative.

• 7:42Speaker 04

  The Katrina experience made me grow as a person, also made me rethink about how, um, how do we recover from a major trauma?

• 7:54Speaker 02

  And years later, as a graduate student at Tulane, Pham analyzed data on more than 300 Katrina survivors and learned that the kind of personal psychological growth that she experienced was actually common among many other Katrina survivors. And this is what psychologists call post-traumatic growth.

• 8:13Speaker 01

  Right, so tell me a little bit more about that term. Has it been around for a long time?

• 8:17Speaker 02

  Yeah, since the mid 1990s, actually. You know, PTSD as a mental health diagnosis came in 1980 after the Vietnam War. And then around 1995, 96, two psychologists, Richard Tedeschi and Lawrence Calhoun, introduced the term post-traumatic growth to describe some of the positive psychological changes they and other researchers had been documenting among many people who'd been through these traumatic or highly stressful life events. So in the case of post-traumatic growth in Katrina, I want to introduce you to another researcher who's been looking into this, sociologist Mary Waters at Harvard University. She actually had been following over 1,000 single parents in two community colleges before the hurricane.

• 9:01Speaker 02

  And when Katrina hit, she and her colleagues decided to study how this group of people recovered over time.

• 9:06Speaker 01

  And what did they find?

• 9:08Speaker 02

  You know, nearly two-thirds of the cohort reported post-traumatic growth 12 years after the storm.

• 9:14Speaker 06

  What they would say is that the storm was terrible. I would never choose to live through that disaster. But they said, given that I went through it, it was one of the more positive things that happened in my lifetime because it got me on a new trajectory and I see my children flourishing and I see myself flourishing in these new possibilities.

• 9:38Speaker 01

  Flourishing? That is not the word I expected to hear her say.

• 9:42Speaker 02

  Neither did I when I first talked to her, John. But for what it's worth, I should emphasize that the trauma of the storm, you know, the displacement, loss of homes and loved ones, did leave a lasting scar on people's psyches. Here's Waters again.

• 9:56Speaker 06

  In the year after the disaster, when we found people, 44% of them reported symptoms of PTSD, intrusive thoughts, avoiding areas that would trigger the terrible memories, panic attacks, those kinds of things.

• 10:13Speaker 02

  And then four years later, she says, they found 32% reported symptoms of PTSD, and 12 years later, it was 17%.

• 10:21Speaker 01

  Yeah. You know, it sounds like, on the one hand, this is one of the worst natural disasters to ever hit the US. Not only did it kill over 1,000 people, there were all these lasting mental health impacts. But a lot of survivors say they experienced post-traumatic growth. Are these like two sides of the same coin?

• 10:41Speaker 02

  Yeah, you can you can put it that way. And the most surprising thing to me was that among Katrina survivors, even people with PTSD symptoms reported post-traumatic growth. In other words, post-traumatic stress and post-traumatic growth can exist in the same individual. Here's Mary Waters again.

• 11:02Speaker 06

  In some ways, the stronger your PTSD, the stronger the traumas that you experience, the more growth you report. So it's it's definitely tied to going through something which challenges you in a very strong way.

• 11:17Speaker 01

  Kind of reminds me of what Nuno Fames said earlier about what doesn't kill you, you know, makes you stronger.

• 11:22Speaker 02

  Yeah, and you know, researchers like Waters have also learned important things about resources that can make it more or less likely that people will come out stronger after a trauma. Here's one of Waters' collaborators, psychologist Sarah Lowe at Yale.

• 11:39Speaker 07

  Financial instability after the disaster, that was associated with consistently low levels of post-traumatic growth. So I think financial resources really matter, both pre and post-disaster.

• 11:52Speaker 02

  Another factor, she says, is social support.

• 11:55Speaker 07

  So feelings of closeness with others, companionship, that someone's there for you if you need it, a sense of purpose or meaning in life, that one's life has meaning and direction.

• 12:06Speaker 02

  And you know, Lowe says that those who had more social support after the storm were more likely to say they grew from their trauma.

• 12:13Speaker 01

  Makes sense.

• 12:14Speaker 02

  And another thing that Nuno Fames learned from her work is that something called self-efficacy also helps.

• 12:20Speaker 01

  Wait, wait, self-efficacy?

• 12:22Speaker 02

  Yeah, so that's like your own assessment of your ability to get things done, to overcome challenges. So if you have that sense of self-efficacy before a disaster, it makes post-traumatic growth more likely afterwards.

• 12:35Speaker 01

  So these are things that we, I guess, as a Society can think of providing communities with that are disaster prone and maybe to buffer them from the impacts of natural disasters.

• 12:45Speaker 02

  That's exactly what these researchers think. And they say it isn't just after a disaster, but also before. Can we make sure people in disaster prone areas, you know, have the financial resources to be able to weather and recover from disasters better? Can we make sure that families and neighbors stay together when people are displaced during disasters? Because we know how much social support matters in people's recovery.

• 13:10Speaker 01

  But the other lesson, it seems to me, is like, people might need mental health care for a long time after disaster hits, right? I mean, despite all the post traumatic growth, rates of PTSD were still high, even after a dozen years.

• 13:24Speaker 02

  Absolutely, John. And relief efforts normally don't last that long. But I want to end on a hopeful note. Nuno Kram says these findings on post traumatic growth made her think of disaster recovery sort of like the Japanese art form kintsugi, which involves mending broken pieces of pottery with lacquer.

• 13:44Speaker 04

  It's sort of embracing flaw and imperfection. And I think that particular philosophy should be applied within the disaster field. Because what we're trying to do is, again, we are acknowledging that there are negative outcomes, but how could we build upon that experience for people to come out better?

• 14:06Speaker 02

  In other words, she says, survivors of a natural disaster can mend the cracks left behind by the disaster if they have the right resources before and after the event.

• 14:18Speaker 01

  Well, Ritu, thank you for sharing this reporting that you've done.

• 14:21Speaker 02

  Thank you, John. It was lovely to talk to you.

• 14:26Speaker 01

  This episode was produced by Hannah Chin. It was edited by Viet Le. Tyler Jones checked the facts. Robert Rodriguez was the audio engineer. Beth Donovan is our senior director and Colin Campbell is our senior vice president of podcasting strategy. I'm John Hamilton in the host chair. Thanks for listening to Short Wave from NPR.

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