BU Today: Is the trauma from losing one’s home and possessions in a natural catastrophe different from other forms of trauma, in terms of the emotional and psychological blow?

DeVoe: How people respond to the loss of their home and possessions in a natural disaster will depend on many things, including their wealth and access to “recovery resources,” whether and how quickly the community rebuilds, direct exposure to what are terrifying experiences of the fires—for example, did they evacuate ahead of time, just in the nick of time? Did they witness and experience the fire up close? Were they able to bring any important things and personal treasures, pets, etc., with them when they evacuated?

Experiencing this kind of catastrophe is distinct from other kinds of individual-level trauma, specifically interpersonal/familial violence, rape, sexual assault, and related trauma, because natural disasters happen to entire communities. With interpersonal trauma and violence, there is often stigma, secrecy, and shame, whereas with a natural disaster/catastrophe, it is a communal trauma, and community responses help people move forward. Nonetheless, grief and loss over the destruction or loss of one’s home, sense of community and place, and severing of community and social networks can have devastating emotional, psychological, and developmental impact. 

For kids, how they respond and recover will be partly connected to how their caregivers and important adults support and respond to them, and how quickly they can get back into important, shared, and daily routines—day care, school, friend and social activities. There are already important disenfranchised people and communities that cannot easily access official supports and who were already struggling with homelessness/housing insecurity, food insecurity, precarity in access to work and schools, etc. This disaster will compound these grave realities.

Official responses to natural disasters by government and other entities—e.g., FEMA, state and local resources, insurance companies—often make things worse and more traumatic and protracted for survivors. As we have seen in other disasters, notably Hurricane Katrina, official responses laid bare structural racism and discrimination, on top of the traumatic experiences and aftermath of the hurricane itself. The LA fires will exponentially tighten and worsen one of the most expensive and tight housing markets in the US and will be out of reach for lower-income and poor survivors.

BU Today: As devastating as the aforementioned losses are, some people are grieving loved ones killed in the fires. Presumably, that’s a whole different level of trauma, requiring a different therapeutic approach?

DeVoe: When the death of loved ones is sudden, unexpected, violent, or traumatic, survivors can experience what’s called traumatic grief, which can be distinct from the experience of grief and loss that happen in an expected developmental lifespan time frame, as when an elder who has been ill dies, or even when a younger person dies after long, chronic illness. The traumatic circumstances and nature of deaths in natural disasters and mass casualty events often make the grieving process even more complex. 

For people who are survivors of early or other trauma, experiencing a catastrophe like the fires or other natural disaster can exacerbate already challenging circumstances. In disasters, survivors may experience guilt at not being able to save or reach loved ones, [or] trauma responses such as unwanted and disturbing images and dreams, etc., related to the death, and may have difficulty grieving because of the traumatic elements of the death. We are already hearing from survivors whose homes were spared, but their entire neighborhoods are gone. There are specific therapies that aim to support survivors dealing with traumatic grief that support and move through the traumatic aspects of the death and the tremendous loss. Access to these therapies is uneven and can be expensive. But survivors also are helped by rebuilding, spiritual connections and practice, and community/mutual aid supports.

BU Today: What kinds of therapies will be most effective in helping survivors? 

DeVoe: Professional helpers and trauma researchers often anticipate and imagine that there will be a wave of demand for trauma-specific therapies in the aftermath of community and natural disaster catastrophes. However, as we witnessed in New York City in the weeks and months after the 9/11 attacks, this wave did not emerge. Trauma experts from all over the country descended upon NYC to train local practitioners in evidence-based therapies for PTSD and individual trauma. But many survivors will be resilient and are helped dramatically by rebuilding, reestablishing routines and rituals and social connections, and relying on family and community networks and relationships for support.