If someone is in pain, they are suffering. Trauma is extreme suffering. But trauma isn’t only caused by a plane crash or category 5 hurricane. Other events, from a car accident to unemployment, a suicide or a sexual assault, can also cause trauma. This chapters deals with the similarities and differences of “everyday trauma” (drug addiction, homicide, illness, accidents, etc.) with more public, high-casualty events. How do we comfort loved ones after these events? What are the challenges in comforting someone suffering from a more private disaster?
There are over 70,000 house fires every year, and for those who live through them, they are monumental disasters. One may never “get over” the losses from a house fire. When people have so little to lose, a house fire is traumatic because whatever belongings they have are gone. Those who have more resources in these situations are naturally going to be more resilient. As long as no one is hurt, survivors are often told and may also feel that it is just stuff. But that stuff can include treasured memories, photographs and documents, and heirlooms and collections that simply cannot ever be replaced.
There are almost 6 million car accidents a year in the United States causing more than 40,000 fatalities. If you have ever been in a car accident, whether or not it involved a fatality, it is a disaster that never leaves you. The memory, sights, and sounds of the crash are likely to be a recurring nightmare for years. Adding the number of car accidents to the number of fires, it is easy to already see how many people are traumatized. When suicide and opioid or other drug overdoses are added in, the number of everyday disasters or private traumas families face increases even more. Each loss, each event, whether on a small private scale or the larger more public event from an active shooter or climate chaos, needs to find comfort. All are spiritually painful. All require special care.
There are those who would say that the mass murder in Las Vegas at the country music festival was worse than the mass murder in Orlando at the Pulse nightclub because more people were killed in Las Vegas. Does that make the disaster less important due to body count? There are those that would say Newtown was worse than Columbine because the victims were kindergarteners and first graders and not high school students. There are those who would say that Katrina was the worst hurricane ever with 1,800 fatalities without realizing that more people were killed in the great Galveston hurricane of 1900. That death toll was estimated at between 6,000 and 12,000 people at the time. Or saying the Paradise wildfire in California was worse because eighty-five persons were killed while the one in Arizona only killed eighteen firefighters.
But one should never compare disasters. For someone who is suffering, “their” disaster is important and unique. And as we in the disaster community know, another one is always just an unthinkable moment away. As mentioned earlier, the American Red Cross responds to over 70,000 house fires each year, yet it is the one or two (and in recent years, more) mega disasters that draw all the attention. However, it is these smaller individual tragedies that actually impact communities and families and where support and comfort are needed just as much.
There is fast death and slow death. Fast like having twenty-nine seconds before the plane hits the ground or slow as when the prognosis given is six months to live. In this chapter we will discuss the less public traumas that people have to deal with.
There are so many children trying to live amidst extreme poverty, malnourishment, or domestic abuse by a parent. There is hypersensitivity and posttraumatic stress, such as when a sibling is killed by gunfire or a parent murdered. The violence experienced is akin to wartime because there is a war going on: a war on poverty, a war on racism and violence, a war on drugs, a war on human trafficking. Some of these are historically ongoing disasters without end, but it is still important for the comfort community to try to alleviate the suffering whenever possible.
When two people get married, it is a beautiful thing—sharing lives and joys, pain and hardships—one is no longer alone. However, when things go wrong, no one gives money to a divorce victim unless there is a settlement or child support. There are tax penalties. Homeowners/car insurance goes up solely because of divorce. There is no small comfort when one feels a sense of failure for being unable to provide for one’s family. Add the element of disaster to the dissolution of a marriage and issues relating to death benefits or expenses, and the complexities soar. Emotions already may be exposed and damages of disaster may be brutal. There may not be a quiet harbor in the storm of divorce. When counseling someone going through a divorce, the most important thing is to listen nonjudgmentally. Helping them adjust to a new family situation and honoring the new composition of a family will be a comfort.
Ask anyone who’s lost a job or been laid off—it’s a disaster—and depending upon many factors, it’s emotional and spiritual violence. Add a natural or human-caused disaster and the fear of the unknown is profoundly magnified. Being able to provide for one’s family is a basic characteristic of family life. Not being able to provide may provoke feelings of shame or worthlessness. The damage and destruction caused by a storm or wildfire takes away whatever precious little one person may have saved or been given. Disasters do not discriminate based upon societal status or income. Those with resources may still have resources after a fire, though diminished. But an unemployment check is in many cases inadequate before and after a disaster.
For a family who has lost a loved one, a single murder can be as stressful as a mass shooting. But the press coverage can be quite different. Depending on the circumstances, it may barely make the news at all. Sensational media of all types of murder are everyday occurrences. Imagine for a second how it would feel to actually know someone whose death is plastered on the front page.
Murder, for me, is not an abstract concept. My friend Connie was murdered in New York City in 1984, and her body was found in a trunk on a balcony in midtown Manhattan. Her death was in the newspapers every day and made the cover of New York magazine. Connie and I worked together at Brooks Brothers during the Christmas crush. I had taken a sabbatical from the parish to come out of the closet and ended up at Brooks Brothers (from the high altar to the tie counter). Connie was a preppy redhead from Virginia and had a great sense of humor. It was about nine months later, when we had already moved on to other jobs, that Connie was killed and her boyfriend/pimp arrested for her murder. It was a shock, but the way I coped was to remember our times together, just hanging out and eating pizza after work. I celebrated her charm and boisterous personality and I mourned for her untimely end.
When I was doing my clinical training, a colleague’s son was murdered. Dorcas and I were in peer group together during my first unit of clinical pastoral education (CPE). She was from Ghana, and our CPE group bonded over the loss of our supervisor who had been fired for having a heart attack.
We got word that her twenty-five-year-old son had been killed in Japan where he had been working during the big earthquake of 1995. To lose a son in a natural disaster is bad enough, but upon further investigation, authorities told her that her son had committed suicide. He was six feet tall and was found hanging from a five-foot bridge. It cost $12,000 to ship his body back to the States for burial, and a wealthy classmate of ours paid the entire cost. Rumor had it that he had been killed by a Japanese mob during the chaos of a natural disaster. Just when you thought it couldn’t get more complex.
It highlighted the art and science of pastoral counseling. You do not want to force someone to talk before they are ready. So in our group we let her share memories of her son and his childhood and just let her process through her grief. It was because of our support that she completed the course and did not drop out despite her overwhelming sadness. We all prayed and listened and cried together, and somehow this awful experience probably led to us becoming better at our jobs.
Trauma humanizes us. Just like my friend Dorcas became a more empathetic chaplain because of her son’s death, I probably came to be more empathetic because of an incident that happened in my teen years.
When I was fifteen years old, I was asked by a teacher to help count money for a fundraiser after school. We sat side by side with piles of coins to be wrapped and counted. The table covered our laps. He unzipped and put my hand on his erect penis. I kept moving my hand away. He kept putting it back.
That year, I missed 30 days of school out of 180 and did everything I could to get attention. Even while not aware of the underlying motivation, the emotional pain surfaced in chronic tardiness for marching band in the morning. I caught sinus infection after sinus infection. The day I was to be admitted to the National Honor Society, the principal withdrew my name and initiated a “better behaved” student. The same thing happened to me for the American Legion’s Boy State conference where, because of my absenteeism and acting out, I was summarily dropped. Did the principal have any awareness or training on how to deal with a sexual predator on the high school faculty? Did nobody notice that my behavior had taken a serious turn for the worse?
I took all that anger to college and excelled, in part, to get my parents to notice me. Then I went on to Yale Divinity School, where closeted faculty sought disciples to share sacred intimacy. Helping others can become a distraction for not taking care of oneself. What is past is past until it resurfaces again and again. In other words, it never passes. After the Age of Aquarius and before the Age of Consent, with the Vietnam War going on, King and Kennedy being assassinated, and a world gone crazy, whom could I tell? Whom could I talk to? After all, I thought I had been an equal participant. My shame was my own. It was 1968.
Back at my fortieth high school reunion, I reconnected with my old classmates and my old rock band reunited and played great therapeutic rock and roll. I was able to directly ask a classmate why he had been so mean to me and discovered that he had also been abused by the same teacher. I thought I was the only one. Even after forty years, it was so good to talk.
Now when I am assessing the behavior of teenagers, I am cognizant that they may have experienced some form of abuse. My own experience and learning from my friend that we were not alone has definitely deepened by empathy for kids who are deemed troubled.
Sometimes a murder becomes a national headline. The killing of Matthew Shepard was a major disaster to the gay community and to human rights everywhere. Beaten by two young men he met in a pool hall, they used the “gay panic defense” and left him tied to a rail fence on a hill overlooking Laramie. Shepard did not die immediately. He died a day later in the hospital. He had been taken there after being found hours later after being exposed to the frigid January weather.
I had the privilege of taking a group of hospital chaplains to that hillside in Wyoming several years after Shepard’s murder. We were meeting at a conference in Denver. On the bus ride, I was able to play a videotape listing all the victims of hate crimes. I also broadcast a segment from Disney’s Tarzan, when the young boy realizes that he is different from the apes that had raised him and sings a song about being different. Being different sometimes leads to disaster. Being different sometimes leads to a crime.
After visiting the hill above Laramie, we met for reflection at the Episcopal Student Center at the University of Wyoming there, with the hospital chaplain who had been supporting Matthew Shepard’s mother and father. How do you comfort someone whose son has just been savagely beaten and is on the verge of death and then dies?
There was a national and international outpouring of love and support for Matthew and his family after news of the murder hit the news. Though not able to reverse the outcome of death, his parents found some comfort in all the heartfelt messages, even though they could not take away the grief.
Children are not supposed to die before their parents. It’s not the natural order of things. But it happens more than one likes to imagine, and when it does, parents and families are in great need of comfort.
Once, I was called at 4 a.m. by parents wanting a blessing for their baby, who had been stillborn at twenty-four weeks. I did not know if they had other children or if this was their only child. I asked to hold the baby. It felt like I was holding only blankets as I said a blessing and prayer for their child. When I was done, they asked if I could stay with their baby for a while. No other family members would be coming to the hospital that night, and it was hard for them to leave the body. Of course, I agreed. This couple was deeply religious, and for them, the baby’s death had been God’s will. Even in their grief, they found comfort in this belief.
I was told another story, about a young clergyman and his wife who had just had their first baby. It was during the midst of winter in the countryside. They had settled near the family farm and he had begun preaching in the neighborhood church. As children, the minister and his brothers used to play in the creek that cut through the pasture. Anxious to get home to his wife and new baby, he took a shortcut across the frozen creek, but the ice was weak in places and the young clergyman fell through the ice and drowned.
At his funeral the next day, the visiting bishop decided to start with the hymn, “Shall We Gather at the River.” While no offense was intended, the careless choice of hymn harmed instead of comforted. The grief-stricken wife never set foot within a church again. Good intentions but poor execution.
When American Airlines flight 1198 was landing during a rainstorm in Little Rock, it slid to the end of the runway and partially collapsed over an embankment. There were fatalities and injuries, and survivors were taken to six area hospitals, but many passengers simply got off the plane and walked or caught a ride home.
Authorities had a hard time tracking down the survivors and the whereabouts of all the passengers, not knowing whether they had escaped safely or were lying injured somewhere in the vicinity during the darkness and the storm.
Although passengers may have escaped physical wounds, surviving an air crash is something that stays with you. Whether a United DC-10 crash landing in Sioux Falls, South Dakota, or an Asiana 777 in San Francisco, the psychology of survival and the meaning of the event becomes a part of one’s biography.
The survivors of the Miracle on the Hudson in New York had some bruises and aches and pains, but for the most part, hypothermia from standing in the frigid waters until rescue was the primary diagnosis. Later that evening many chose to fly on to Charlotte to be with loved ones and finish the trip. Can you imagine getting back on an airplane the same day you crash landed in one? Many did because they were reassured that the crash had a plausible explanation—a bird strike that shut down both engines—and that their air safety was assured.
A colleague stayed with survivors both on the warming bus on the Hudson waterfront and later at the Marriot at LaGuardia where they were having dinner and awaiting the flight. He observed that most were eating alone and that the dining room was quiet and reflective. He thought it was remarkable that none of them appeared to commiserate with each other. It appears the best course of action to them was getting back on a plane with the promise that within hours one would be in loved ones’ arms. And that was a comfort.
When I read about any new airline crash or problem, I think about the family members of Malaysian Airlines flight 307; five years after the disappearance of the plane, no wreckage has been found in the entire Indian Ocean. Regularly scheduled updates on the search, as well as a continued search, can assist families, and financial support can be of some comfort, but until one knows what actually happened, there can be no peace of mind.
In the Western world, pets are now considered members of the family. Feeding and caring for pets is now a billion-dollar industry. Emotional support dogs and therapy dogs are now regular presences on airliners and in restaurants. Animal cruelty is punished severely.
When a beloved pet dies, it can also be a trauma. I know this first-hand. We used to have three dogs: Hazel, a bichon mix; Sherman, a poodle mix; and Woody, a Welsh corgi. Woody needed insulin shots twice a day. One weekend we were going out of town and needed someone to watch them, so we asked our neighbor, Chuck. He was a little anxious about giving Woody injections, but we were able to explain to him everything he needed to do.
When we returned Monday morning from our weekend trip, we called Chuck from the airport and he told us that Woody was “missing.” Chuck had been unable to find him in the garden the night before, and since the garden was fenced, and the other two dogs were inside, he had gone home. After taking a cab home, we met Chuck and went into the fenced backyard garden.
We found Woody floating in the koi pond. I jumped in and picked Woody up in my arms and sat in a chair deeply weeping.
We invited Chuck to dinner that night at the house and reassured him that it had been an accident and that nothing may have prevented what occurred. Maybe Woody had a heart seizure and fell into the pond. Maybe as an elderly dog, he just didn’t see well enough at night and slipped into the water. We wanted to make sure Chuck knew that we didn’t blame him and were concerned with his welfare, his trauma as well as our own.
In 1994, I gave up my modeling career and started taking clinical and pastoral education and became a chaplain. This was at the height of the AIDS epidemic. An “out” chaplain was still pretty much a novelty at the time, and after I completed training, I was hired to work on the AIDS unit at Cabrini Medical Center, in part to support GLBTQ+ patients. Cabrini and its hospice allowed pets in patients’ rooms. The presence of these pets helped the chronically ill feel less pain, improved appetites, and helped to lower their anxiety levels. The pets offered unconditional love. (Walking them was left to me and the other chaplains.)
We came up with innovative ways to comfort those who were not responding to treatment and were at the end of their lives. Celebrating Christmas in July with a scrawny pine branch tree with a patient is a memory I will always treasure. I produced World AIDS Day celebrations and brought in Broadway stars to sing. There were weekly Protestant services for the patients held by staff in the Cabrini chapel. There were Catholic services daily and a rabbi on-call.
At the Cabrini Hospice, it was a comfort to help patients with “unfinished business.” If there were any family matters or pressing concerns before one died, it was important to start the conversation. What would it mean for you to not get better? Do you have any unresolved issues that might be worrying one at the end of life?
What was my “qualifier” for disaster chaplaincy? The AIDS pandemic.
I loved Cabrini, now closed, because a core group of dedicated elderly Italian Catholic nuns were one of the first hospitals to admit AIDS patients even before the world knew what it was. This was a time of not touching door handles or using public water fountains. In those first years, thousands would die in New York hospitals, including Cabrini. It was also a time for staff support groups who were dealing with the emotional impact of daily fatalities and “failure to thrive.” Oftentimes, the professional intersected the personal, as sometimes I would walk into a room and recognize the patient as someone I knew. I met my husband through a couple who were living with HIV/AIDS who are alive today through treatment advances and life-saving research. I also came out at a time when sex could mean death. I remember the dead and perpetual grief. There was little comfort being a gay man in New York City during the 1980s and early 1990s.
I lost my best friend Tommy.
Tommy died in 1991 after working as a professional photographer in New York City. Tommy was from Warren, Arkansas, the pink tomato capital of the world. Tommy’s mother, Manette, would FedEx tomatoes to him and at least half of them would survive whole and the other’s would immediately go into a vodka sauce. On one of his last hospitalizations at St. Luke’s Roosevelt Hospital, he swung his legs over the side of the bed and started singing, “Just two little girls from Little Rock,” and those assembled would all crack up with laughter.
Tommy would share a house on Fire Island every summer. In The Pines and Cherry Grove, renters and owners started to die and houses sold, and each summer would end with a huge dance on the beach and then sadness. There was just so much grief and suffering.
I didn’t realize that Tommy was sick. I really couldn’t imagine anyone who was such a close friend, good person, and so informed and intelligent being infected. Yes, my florist had died, and my barber, too, and every week the Times had the obituary of someone famous that had died of pneumonia or lung cancer. But that was understandable as a way for the families and loved ones to “save face” from the stigma of acquiring and dying of HIV/AIDS. And they were other people. One afternoon I saw medicine bottles under Tommy’s nightstand and I finally got it. It was still extremely difficult to talk about because there were all these complex feelings about not giving up hope and the overwhelming reality that he might soon die.
Hospitals came into being through religious groups who believed in the mission to care, heal, nourish, and comfort the sick and dying, to have mercy on those in need, and work for justice, social justice in this case, for those who died before a treatment, vaccine, or cure could be found. Think about what they could have contributed to benefit all mankind and the quality of life and collected wisdom for all of us. Tommy was such a beautiful soul; I miss him, and his generous spirit that keeps his memory whole. Just because you’re dead, doesn’t mean you’re not here.
We are comforted by the memory of those who died too soon, and that memory empowers us to continue to comfort others and model that comfort for those who came after and those who survived.
In 1996, protease inhibitors arrived and patient outcomes changed, with much greater chances not only of survival, but for a normal life span. These new AIDS treatments suddenly gave hope and turned an acute illness into a chronic one.
Can you imagine the power of this? Before, the diagnosis of HIV/AIDS had been a death sentence, and now, with treatment, there was the promise of a full life. There had been an entire generation of gay men who had been wiped out between 1981 and 1996—the Dark Ages—because treatment wasn’t yet available that would lessen toxicity or create a whole legion of other medical issues/outcomes. AZT, for some activists, was poison, and there were AIDS denialists who argued against basic science as to the cause of the virus and its origin.
Hope was found in action and ACT UP and other gay rights organizations that helped accelerate research and treatment and approval of new medicines. Some industries had been devastated—including the fashion industry—and there were fundraisers and benefits in memory of so many of my co-workers, colleagues, and friends. At New York Hospital, when one went in for blood work or medical appointments, the waiting room had fresh orchids donated by the fashion designer Bill Blass to create beauty and counter anxiety for those waiting to hear their test results.
There were support groups for physicians, nurses, social workers, chaplains, and other staff dealing with the weekly loss of their patients. Only comfort care could be provided at the end and the accumulated death toll had an effect. For those who lived through that era, there was PTSD and emotional and spiritual damage. But this is not the exclusive domain of those lost to AIDS. Recitation of the names of those lost is a major part of the 9/11 memorial each year, and mourners look for the names of those they know at the Vietnam veterans memorial. In the Jewish religion, the names of those who have died are called out on the anniversary of their death.
I remember those I personally lost during that time:
James Beran
Tommy Carraway
Stuart Greenspan
Bill Wingfield
Ben Bencini
Yanni “Haircuts”
“Florist” 30 West
Serge “Glorious Food”
“Florida Mag” Craig
Palm Beach “Liar”
Frank Moore
“TWA” Milan
“CK Underwear” Milan
Richard Bruce
“Episcopal Priest” DC
Robert Woolley
Gabriel S.
Ken Reichley
Herb Ritts
Robert Metzger
Michael Palm
Steven Romero
Mitchell Price
Oren M.
Paul Douglas
Dan Taylor
Joe Hartney
Tim Clement
Bob Hattoy
Writing their names—even years later—is a way to provide comfort to ourselves and others. To quote Thomas Campbell, “To live in the hearts we leave behind is not to die but to live forever.”
There is a higher incidence of domestic violence and other forms of violence against humans and pets after a disaster. The complexity of disasters may add stressors as the cause, but that does not honor or respect individual incidents. Note the recent suicide of a Newtown father and two Parkland high school survivors and the rash of suicides linked to the lack of services in Puerto Rico after Hurricane Maria. Deep, unresolved grief resulting in death coming even months or years after initial trauma only highlights how fragile the recovery can be.
Large-scale disasters, including terrorism, enhance feelings of helplessness. Individuals are more prone to acting out with a high incidence of sexually transmitted diseases, depression, posttraumatic stress, and, again, domestic violence. These disasters create immense mental and spiritual care needs that generally are unmet or delayed across an entire generation of the impacted.
After the catastrophe has “ended,” there will often be a second wave of abuse and violence. Building relationships before the disaster and strengthening family coping skills and community resilience will mediate the impact of both everyday disasters and catastrophic events.
Being on the lookout for that one alienated student and following “if you see something, say something,” has time and time again prevented school shootings and bombing plots. One does not have the luxury of “minding one’s own business” in modern society. Family engagement—however that family is defined—is key to awareness and turning small comforts into larger-scale community emotional wellness.
Take care of yourself.
Be part of a team of comforters assessing your community’s emotional health.
You don’t have to comfort everybody.
Be curious and respectful.
Give affirmations to others who may be comforters.
Take time to remember special people in your life.
Never lose your sense of awe and wonder, as it will lift your emotions and spirits.
Laughter can be comforting and defy fear.
Celebrate the good times, know what’s special, and claim your authority.
To mourn is to remember the love—comfort is always valued.
This is a checklist to use to help anyone who has experienced a trauma.
Help people meet basic needs for food and shelter, and obtain emergency medical attention (Safety)
Provide repeated, simple, and accurate information on how to get these basic needs (Safety)
Listen to people who wish to share their stories and emotions, and remember that there is no right or wrong way to feel (Calm)
Be friendly and compassionate, even if people are being difficult (Calm)
Offer accurate information about the disaster or trauma, and the relief efforts underway to help survivors understand the situation (Calm)
Help people contact friends and loved ones (Connectedness)
Keep families together; keep children with parents or other close relatives whenever possible (Connectedness)
Give practical suggestions that steer people toward helping themselves (Self-Efficacy)
Engage people in meeting their own needs (Self-Efficacy)
Find out the types and locations of government and nongovernment services and direct people to those services that are available (Help)
When they express fear or worry, remind people (if you know) that more help and services are on the way (Help)
Source: SAMHSA, “Psychological First Aid for First Responders: Tips for Emergency and Disaster Response Workers,” NMH05-0210.