Hurricane Trauma and Psychology: Mix Well, Stirred but not Shaken

By Stephen A. Ragusea, Psy. D., ABPP
November 7, 2017 - Last updated: November 9, 2017

Hurricane Irma and ResilienceOn Sept. 10 Hurricane Irma’s eyewall passed over my home and made landfall in the Florida Keys as a Category 4 storm.

My wife and I were long gone; we had evacuated first to the home of friends in Orlando and then continued on to Georgia to seek sanctuary with our younger son and his family. Meanwhile, the Florida Keys were exposed to gusts of wind much higher than the sustained winds of 136 mph and some of those wind bursts were tornadic in nature, destroying great trees, cars, boats, homes and metaphorically, people’s lives.

According to local authorities, only one person’s death in the Florida Keys was directly attributable to Irma but thousands of lives have been profoundly and irretrievably altered.

Thousands of homes were destroyed in the Florida Keys, and further damage was done in many Florida locations. Sewage systems backed up. Folks lost electricity, potable water, incomes, homes and a sense of security.

How did all that impact Florida’s psychologists and their patients? Of course, physiological and safety needs represent the very foundation of Maslow’s hierarchy. People were scared. Plenty scared.

Many evacuated northward in an effort to escape the “Cone of Uncertainty” that predicts a hurricane’s path.

In so doing, some patients lost track of pets they left behind and felt profound guilt. Some experienced symptoms of anxiety, including panic attacks accompanying an inevitable sense of danger and the knowledge that their homes might not be standing upon their return. Some became profoundly depressed, believing “My life as I knew it is over.”

Psychologists found themselves doing psychotherapy over the cell phone in their car as they, themselves, evacuated and endeavored to cope with many of the same fears: “Will my office still be there?” “How much damage will be done to my house?” “What will I do with my patients?”

One psychologist helped an 87-year-old man with dementia evacuate north, another assisted a 50-year-old brain-damaged patient to escape, yet another tried to get an anorexic patient to eat enough food to allow her to successfully escape the storm’s wrath by evacuating.

Complicating all this were clogged highways, closed restaurants, gas shortages, water shortages and an absence of available hotel rooms. Hospital-based psychologists sometimes slept in the hospital where they worked to help calm the patients during the storm as windows blew out and patients screamed in terror. Ironically, some demented hospitalized patients remained blissfully unaware of the destruction all around them and engaged in their normal activities as 150 mph winds shook the hospital walls.

When people returned to their homes, they found widely varying levels of Irma’s aftermath confronting them. There were downed trees everywhere along the highways. Orange  groves were stripped of their fruit. Buildings were sometimes moved, intact, from one side of the road to the other. Some people’s houses were badly damaged or gone. Some faced freezers and refrigerators that were deprived of electrical power for a week. They contained rotten and fermenting food that needed to be discarded to allow the needed cleaning and deodorizing. Some had years of loving gardening work obliterated in a few hours of hellish wind. Some returned to no damage at all. And, some of those folks have actually expressed what psychologists call “survivor guilt.”

Personally, our family returned to little home damage. We were exceedingly lucky.The only damage done to my office was our sign, which blew over in the parking lot. But there were many trees that needed to be cleared in both places and, thanks to my two Stihl chainsaws, after four hours of  work, I was able to clear our driveways.

As of this writing, after 10 days of hot work, we’re still clearing our yard and piling debris. In a few minutes, I’ll return to my office to see the patients who have successfully trekked back to Key West. Then I’ll see some patients at my local rehab hospital. After that I’ll return to the growing 8-foot-tall debris piles on our street, as my community works to recover from the storm and return our lives to normalcy.

We are all tired. Very tired. In fact, the one self-descriptive adjective I’ve heard from psychologists and patients all over south Florida is “exhausted.” The adrenaline rush that fuels our flight-or-fight response and all that followed has left folks drained, emotionally and physically. Those with few mental and physical resources are struggling the most, while those possessing psychological resilience are faring the best.

Here in the Keys, some trees were, stripped of leaves and are already green again and starting to bloom. Yes, we all believe we can return to paradise. And, by the time you read this, we should be well on our way.

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Stephen A. Ragusea, Psy. D., ABPP, is a clinical psychologist with a private practice in Key West, Fla., with more than 37 years of experience. His services range from individual and family therapy to psychological assessment, consultation and expert testimony. His email address is:

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