Psychologist on flood victims: “The epitome of powerlessness and horror”

The flood disaster was a shock – the emotional wounds often only show up later. tagesschau.de spoke to the psychologist Elisabeth Mick, who helped in the Ahr valley from day one.

tagesschau.de: When you think back to the first few days today, what do you remember?

Elisabeth Mick: The first few days felt like being in a movie and not like something real. We psychologists call this derealization or dissociation. Many people experience that. You are driven and you function. Depending on the person, this state of shock lasts for five to 14 days. Few of them had a normal sense of time. Everything becomes blurred, the feeling of hunger, the need to sleep, even the need to go to the toilet. It goes unnoticed because the body “works” under adrenaline control.

tagesschau.de: What was your mission like back then?

Mick: I’ve been walking around and looking to see who I see. Glassy eyes, staring gaze, severe tremors – these are signs. I offered interviews to these people. Some accepted it gratefully, others said that it was just too much for them. Sometimes other emergency services also drew my attention to someone.

Above all, I tried to help people stabilize. The point is to give those affected a feeling of security and to make them aware of what happened is over. The bond with others is also important. That was difficult for many because the telephone network was not working and not everyone knew that loved ones were safe.

“Shrinkers are sometimes still disreputable”

tagesschau.de: How has psychological help changed in the meantime?

Mick: There is also the psychosocial emergency service with trained emergency pastors. They run through the streets and speak to people directly. But now there are also other offers of help, telephone hotlines for flood victims, courses for parents and children and on-site consultation hours. A network www.sofortaktiv.de of 400 trauma therapists also offers therapy places at short notice.

From my point of view, anyone who tries to get psychological help can get it. However, it is also stigmatized in a rural region like the Ahr valley. The shrink is sometimes still notorious. Better to try it alone or with a bottle of schnapps.

tagesschau.de: Where do so many trauma therapists suddenly come from who are otherwise missing?

Mick: The therapists from the network are not all from the region; some of them offer their services online. The Rhineland-Palatinate Association of Statutory Health Insurance Physicians has now agreed to cover the costs. A lot is also done on a voluntary basis.

“The worst is helplessness”

tagesschau.de: How do you know that you or someone else need help?

Mick: Most of the time, people have a gut feeling with themselves or with others that something is wrong. Or when someone is stuck in a single emotion for too long. It doesn’t matter whether someone is depressed, afraid or not taking a break. A healthy processing process is like a pendulum between active, confident phases and sadly withdrawn moments.

The worst feeling we experience is helplessness. That’s why people try to do something. If that is not possible, the soul develops a feeling of guilt. At first this is easier to bear than the helplessness. A neighbor told me that she had canceled a birthday party because she couldn’t celebrate a birthday, while there are people in the Ahr Valley who are so badly off. This irrational feeling of guilt must be overcome again.

“Why them and not me?”

tagesschau.de: Many of those affected noticed how neighbors called for help and they were unable to help.

Mick: That was one of the worst experiences. For many it was the epitome of powerlessness and horror and then the feeling of guilt for survival: “Why them and not me?” These people often develop the classic symptoms of post-traumatic stress disorder. That means, in nightmares or during the day in flashbacks, they see the pictures again, hear the voices, smell the smells and have the feeling that it is happening again.

tagesschau.de: How can therapists help then?

Mick: First of all, it is a matter of stabilizing the person affected and gradually making it clear that the matter is over. Then it is important to integrate the memory into an overall context. As long as the brain does not have the opportunity to sort out the event, there will always be a flashback. It’s like being in a well-stocked library with a book lying around unsorted.

“We don’t know in advance what is too much for the soul”

tagesschau.de: The work was also challenging for many professional helpers. Did you accompany them too?

Mick: Most professional helpers, fire brigades or soldiers from the German Armed Forces, are the type of person: “I don’t mind.” But emergency responders who find body parts of babies, for example, experience images, sounds and smells that need to be processed. Then there is secondary trauma. That is, you can be traumatized by just watching someone else experience something difficult.

tagesschau.de: Can you protect yourself from trauma?

Mick: I would say no. Of course, you can make yourself aware of situations in advance, for example when looking for bodies, what could happen and make a plan for what to do next. But we do not know beforehand what is too much for the soul. One can hardly prepare for when the soul is overwhelmed. Not everyone who sees a corpse is traumatized by it.

At the same time, any trauma, no matter how bad it is, can be resolved or integrated. What happened cannot be undone, but you can learn to live with it well so that the memories become part of the past.

“It takes months to realize”

tagesschau.de: The state ceremony for the flood victims will take place next week. How important is that

Mick: Very important. We humans need rituals in order to understand and to be able to take the next step. That is why there are mourning rituals in all cultures and religions. Grief is a feeling that needs consolation and human closeness. It is also a tribute to the people who are no longer with us.

tagesschau.de: We hear again and again that the processing will take a long time. Would you agree with that?

Mick: We needed the first shock phase behind us. Viewed from the outside, all the houses have now been gutted and the dry phase begins. Then slowly the loss becomes noticeable. It is said that with such disasters it takes up to three months to realize everything for the first time. Not everything has been processed yet. It takes time to leave the old behind, to develop new perspectives and to sort out what is left and what is not. That can take another three to four years. Those who cannot do this alone need long-term psychological support.