Page 161 - Creating Spiritual and Psychological Resilience

130 Creating Spiritual and Psychological Resilence

was stable, friendly, and not in acute distress, though he spoke in sentences
that were somewhat disorganized. He showed us that he had medications with
him, but had not been taking them. We were able to understand why the shelter
director liked him; he had an endearing charm, and vulnerability that made
one instinctively want to take care of him. This situation appeared stable for
the moment. We had to work with the shelter leader to help him understand
and accept that we had no solution to this problem: There was not a hospital we
could arrange that would take in this fellow, and, in fact, that this would be true
even if the hurricane had not occurred. The shelter director understood quickly
and was very responsive to our efforts to reassure him that, in the short term,
this fellow did not appear to pose a risk and was much more likely to do well
with regular medication. The shelter director walked over with us and we met
briefly with him and the nurse and talked with both of them about the specific
medications. The fellow offered to take them every morning if the nurse would
keep them for him, which was mutually recognized as the best that could be
done under the circumstances.
The individuals described above each illustrate aspects of the resilience of
individuals who provided postdisaster services in faith-based communities in
Louisiana after Hurricane Katrina. The parishioner at the first chapel was expert
at triage; her experience raising 12 children had prepared her well. Therefore, in
addition to trying to identify people in need of psychiatric evaluation, she was
also mindful of the needs of her colleagues, and was able to identify an oppor-
tunity for us to provide support to her pastor. She possessed the implicit skills
to connect people who are there to provide support to people who need it, a skill
that is invaluable after a disaster.
The pastor who can admit to his own need for comfort, when confronted with
feeling of inadequacy in the face of social problems, sets an example of self-care
that every disaster mental health and spiritual care provider can relate to and
by which they can be inspired. At the second chapel, the shelter leader was able
to gracefully accept that there was no immediate solution to his problem and
to facilitate communication about how to work within these limitations in the
short term. Such acceptance and willingness to work constructively in the face
of disappointment is very adaptive in any postdisaster mental health setting
and sets an example for professional spiritual and psychiatric care providers.

The Evolution of a Model for “Spiritual Supervision”
Between a Chaplain and a Psychiatrist

Much writing about disaster mental health concerns characterizes what
happens during the actual disaster response. Therefore, it is easy to overlook
the opportunities for building collaboration during disaster preparedness
phases (pre- and postdisaster). While interdisciplinary exchanges are often
accomplished in the context of formal “debriefings” or “defusings” postdi-
saster, it is helpful as well to seek out informal avenues for discussion and