A kōrero with Dr Sarb Johal, part 1: Dealing with uncertainty, survivor’s guilt, and all sorts of emotions right now
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Dr Sarb Johal is a clinical psychologist with over 30 years of experience under his belt. A specialist in disaster management and emergency psychology, Dr Sarb has advised the UK and New Zealand governments and the World Health Organisation through some of the major public health crises of this century.

With communities around Aotearoa still reeling from the devastating Cyclone Gabrielle and other severe weather events, we couldn’t think of anyone better for a kōrero about how we can look after ourselves and our loved ones as we tackle this challenging period ahead.

It’s been several weeks since the January floods and Cyclone Gabrielle ravaged many parts of the North Island. For those who have been impacted, the initial shock or denial will likely be fading by now. Can you describe some of the emotions people might be experiencing now?

Dr Sarb: In his book The Developing Mind, Dan Siegel describes how everyone has a range of intensities of emotional experience they can comfortably process. This is the ‘window of tolerance’, and it varies widely. For some, this window is wide: they can feel reasonably comfortable even when experiencing high levels of emotional intensity. This allows them to think, feel, and behave flexibly, even when going through extreme experiences.
We do best in challenging circumstances, like the January floods and Cyclone Gabrielle, when our window of tolerance stays wide. This means we’ve had enough experience coping with past events, are well-practised at regulating our emotions, and haven’t experienced too much trauma previously in our lives. We can think calmly, even when chaos surrounds us, without feeling overwhelmed or withdrawn.     

What if somebody goes above their ‘window of tolerance’?

Dr Sarb: People have been talking about the adrenaline that has taken them through the first few days of the response after the Cyclone passed. Going beyond the window of tolerance, commonly brings excessive energy, but also agitation. We can become alert to and deal with threats, but it can also leave us feeling anxious, irritable or angry. We can feel out of control, overwhelmed, or distrusting of others. 

What does going below our ‘window of tolerance’ look like?

Dr Sarb: We can feel numb and want to withdraw and isolate ourselves from others. We can also feel foggy-headed, exhausted, flat, powerless, hopeless and helpless. 
It’s useful to remember we may also become quite cut off from our own emotions and bodily sensations. This may be a way of detaching from what is a genuine threat – in this case, the daunting tasks that faces those who have been affected by these traumatic weather events. 
Alongside all this, people may be experiencing a genuine sense of grief: for their homes, precious possessions with sentimental value, and a sense of loss of place, of land they loved and worked on, a way of living. These are real experiences and important to work through, because they may be felt for some time to come.
These severe weather events have been traumatic for many. If we’re worried about someone, whether it’s a whānau member, a friend, neighbour, or colleague, how can we best support that person? What are some of the signs someone may need professional support?

Dr Sarb: Mental health support is important for everyone. We all experience stress, sadness, and other negative emotions as part of life. But when these feelings become unmanageable or interfere with our daily lives, it’s essential to reach out for help.
Here are some signs that you or someone close to you might need this help:
  • Feelings and talk of hopelessness or worthlessness If someone is feeling useless or desperate about their current state, it’s time to seek support. If they mention any of this, it could mean something worse than just feeling low.
  • Different eating habits or changes in appetite Appetite shifts could mean a person’s mood is changing and it’s important to take note. If someone suddenly reduces their eating without saying why, or eating too much, this can be a sign of emotional issues.
  • Sleep difficulties A person may struggle to sleep because of racing thoughts, or they may sleep far more than usual to escape from reality. If somebody is feeling sleepy all day, it could be more than just fatigue, like depression or anxiety, so they should visit a GP.
  • Increased drug/alcohol use Drugs and alcohol can provide a distraction from stress, but they won’t make the problem go away. Look out for increase in substance use from yourself or those close to you. The sooner you seek out help from a health professional, the better.
  • Difficulty concentrating If somebody is dealing with anxiety or depression, they may find it tough to concentrate on tasks and listen during conversations. They might be too consumed by worrying or feeling down to think properly. If this continues for a number of weeks, it’s worth talking to a nurse or a GP. 
  • Isolation from social events/activities If a person is not into socialising, hobbies, or activities like before, it could be a sign something’s not right. Similarly, if activities that used to bring them joy just aren’t helping right now, something may be amiss, and extra support could be helpful.
  • Physical symptoms without an apparent cause Stomach aches, headaches and feeling worn out might mean depression or anxiety, even if the doctor doesn’t find anything wrong.
What about tamariki? How can we rebuild a sense of security and routine for our children – especially if their circumstances have now changed?

Dr Sarb: For kids, being able to express what is going on for them in terms of their thoughts, feelings and physical sensations is helpful. Learning some simple grounding skills, such as mindfulness, is great too. Getting back to routine by returning to school and kindergarten will make a big difference in building a sense of safety and security again.

Many of our whānau will be feeling quite unsettled and experiencing a great deal of uncertainty right now, for example, not knowing when they might return to their homes, or whether insurance will cover their losses. Farmers who have lost or endured damages to their land, livestock, crops, or infrastructure will likely be making some big decisions and adjustments going forward. Do you have any advice on how to cope with this state of not knowing? How do we regain a sense of control and predictability in uncertain times?

Dr Sarb: Everyone responds differently to a crisis. We can choose many different strategies to cope, and they tend to fall into one of two different categories: problem- focused and emotion-focused strategies.
Problem-focused strategies are all about actively engaging with the outside world in order to deal with the threat. This might mean making plans, getting more information, or confronting the threat head-on. Emotion-focused coping is, instead, directed inwards. It’s all about attempting to change how we respond emotionally to stressful events, rather than trying to do something about the event itself. This could look like meditation and humour. Less effective emotion-focused strategies might include denial, distraction, and substance use.

Is one of these types of strategies better than the other?

Dr Sarb: Both can be good, depending on what the challenge is. Problem-focused coping, such as figuring out a plan for future farming in a rapidly changing environment may be helpful. But if you’re overwhelmed by anxiety about that challenge, or you can’t control the problem, then it can be useful to try changing how you emotionally respond to it.
Try to understand what you can control, and what you can’t. And maybe understand how you can come together with others to influence factors outside of your own individual control. If that’s not possible, then it might be time to consider different options. Thinking widely and strategically is hard when we are under stress. Often, we can only bring this kind of thinking to bear if we have deployed our emotion-focused coping first.
We’ve heard from a few people who haven’t been directly impacted by the events that they’re feeling survivor’s guilt. What’s your message to them?

Dr Sarb: There are people who feel like they have got off lightly compared to neighbours who may only be a few metres away. As well as the guilt, they may also feel other emotions alongside it, such as compassion. I would encourage those who are experiencing survivor’s guilt to acknowledge the guilt part, be thankful for the survival part, and act on other connecting emotions such as compassion. Use this to provide solace and practical help to those who may not have been so fortunate.

To read Part 2 of this interview, click here.