Dr Fran Vertue
The earthquake of September 4th 2010 and again on February 22nd 2011 have had a significant effect on most people living in Canterbury. Our reactions to the earthquakes are not universal, but are as individual as we are. One person’s reactions and coping styles might be completely different to the next person’s. We know that allowing ourselves time to grieve and process what has happened, in our own way, is essential to the recovery process.
Most people are affected by further aftershocks, images, sounds, or movements that remind us of the earthquakes. Usually our reactions to these reminders will fade after time. However, some people may continue to experience very high levels of anxiety which impacts on their quality of life. They may feel unable to return to activities they engaged in prior to the earthquakes and may find themselves ‘stuck’ in unhelpful thinking.
An example may be “Lydia” who avoids going anywhere without her handbag, in particular her cellphone, and refuses to go into multi-storey buildings. This is causing her problems as her work place is on the fourth floor. In addition to this, she takes very short showers for fear that another earthquake could occur while she is in the shower and she would be unable to seek help. Lydia also spends a great deal of her day worrying about the possibility of another earthquake and what she would do if this happened. She reports a lot of “what if” thinking and she tends to ignore any information that does not support her worries.
People experiencing on-going high levels of anxiety, which negatively impact on their ability to return to life as normal may benefit from Cognitive Behavior Therapy (CBT). CBT is a time limited, skilled based therapy, which helps people recognise and manage unhelpful thoughts and behaviors.
Using CBT, Lydia firstly explored her beliefs about the earthquake. The concept of uncertainty was explored – whereby she recognised that a lot of her anxiety stemmed from the need to gain certainty about the next earthquake. She recognised that no-one is able to be certain about when earthquakes occur. Specific techniques were taught to allow Lydia to ‘sit with’ her uncertainty, instead of struggling against it. She also recognised that she had been ignoring a lot of information that contradicted her worries. For example, Lydia remembered that during the February earthquake, she did not have a mobile phone and she managed extremely well.
A number of behavioral experiments were established to help Lydia test out her fears. For example, she agreed to walk around the block without her handbag or mobile, to test out her fear that “there could be another earthquake and I wouldn’t be able to get help”. She also decided to have showers for increasingly longer periods of time to test out her same fear. Lydia started to go into multi-story buildings to test out her fear that there could be another earthquake, but also her fear that she would become overwhelmed with anxiety and have to leave.
As a result of engaging in these experiments, Lydia noticed that her anxious predictions did not occur and her anxiety reduced. A big step for Lydia was recognizing that her anxiety had no impact on when another earthquake might occur, nor did it help her to cope in any way. In fact, she realised that instead of helping her, her anxiety was holding her back from re-building her life after the earthquake.
As a result of engaging in CBT, Lydia reported that her anxiety had significantly reduced and that she was starting to enjoy activities that she used to engage in before the earthquake (including going back to work) – as a result, she noticed her mood improved, too. She gained a sense of control of her feelings about the earthquake and said that she no longer felt terrified.
If you are noticing recurrent unhelpful thoughts, avoiding things you used to do, and feel that this is negatively impacting on your quality of life, seeing a CBT therapist may be of benefit to you.
