Sometimes the Listeners Need Compassion Too : Coping: After helping disaster victims, many trauma counselors face tears, nightmares and sleeplessness as they confront their own grief.

When she hears a tiny baby cry out, Caroline Graham still gets a chill. In Mexico City after the 1985 earthquake, she was part of a mental health team sent to help the victims and spent some time there trying to comfort babies whose parents were dead, hospitalized or missing.

Graham, who at the time was working on a master’s degree in psychology, returned to her Texas home feeling drained and powerless. After three weeks of sleepless nights, she sought help for herself.

“Each day I was there I listened to people’s stories and tried to help them cope, but I didn’t feel like I was helping enough. I realized I couldn’t do this kind of work.”

After earning her degree, Graham began working for a marketing firm, but she still takes an interest in relief efforts. “I’m one of those people who sends a check to the Red Cross right after a disaster. I feel even though I can’t be there to help, I should be doing something.”

Graham’s experience reflects a growing issue in the disaster relief community. After an earthquake, flood, bombing or other crisis, trauma counselors are immediately dispatched by organizations such as the American Red Cross to help victims cope and to “debrief” rescue workers and emergency personnel who may be suffering mental anguish from spending hours searching for survivors.

These men and women are trained to look for telltale signs of trauma--the rescue worker who sits against the wall holding his knees up to his chest and staring into space; the woman who’s lost her home and family yet sits in a shelter calmly doing needlepoint; the man who slaps other victims on the back and tells them to cheer up, laughing as though nothing is wrong.

They help people “process” their immediate trauma, listening as they recount the things they’ve seen, heard and felt. To those they help, counselors are seen as selfless, strong individuals who are there when needed. But after a 15-hour day, they return to empty motel rooms and have to deal with their own feelings about the disaster, sometimes with tears, sleepless nights or nightmares and vomiting.

“No matter how many disaster sites you’ve been to or how well trained you are, this stuff gets to you,” says Tom Williams, president of the International Assn. of Trauma Counselors in Denver.

“Charles Figley, a psychologist at Florida State University and a leader in this field, coined the term compassion fatigue, and that sums it up perfectly. It’s something you have to deal with or you won’t be doing this kind of work very long.”

*

Although some are paid by businesses to give comfort to employees after a crisis, most trauma counselors are volunteers who are ready to drop everything and rush to a disaster site if called.

“There’s a real adrenaline rush; it’s exciting to be at a disaster site at first,” Williams says. “But it’s not easy work.”

Williams, who always keeps a packed suitcase in his closet and an eye on CNN, has found that certain people thrive on trauma work. “They’re usually in their 30s and up. There’s a certain maturity you need to handle the stress.”

To keep his head while working a disaster, Williams gets together with his team every day. “We’ll talk about what we’ve gone through and what we’ve heard. It’s just a way to see how we’re all doing as a team.”

“There have been times when I’d hear a tap-tap-tap on my door in the middle of the night and it would be another counselor who needed to talk,” says Judith Tuohey, a registered nurse and trauma counselor from Lake Forest who has volunteered at 22 disaster sites, including Oklahoma City for two weeks. “Of course, while you’re talking the clock is ticking and you don’t get much sleep. That’s just part of the job.”

Mental heath workers generally stay only 10 to 14 days at a disaster site to help prevent burnout, but the effects linger. Two weeks after she had arrived home from Oklahoma, Tuohey still had nightmares. When someone walks by her who’s just eaten a Lifesaver, she remembers the masks rescue workers had to wear that had been soaked in wintergreen to conceal odors at the site.

The smell of gasoline when filling up her car takes her back to a small jet crash near John Wayne Airport last year that killed a planeload of business executives, as well as the 1986 Aeromexico crash in Cerritos.

“I’ve got a great husband and family I can talk to,” she says. “And I can always talk to other counselors who have seen the same sights and heard the same things; that makes a big difference.”

“When I’m at a site, people will come up and ask, ‘How are you doing?’ and I’ll say, ‘Fine.’ Even when I know I’m not fine,” says Judy Albert, a marriage, family and child counselor and certified trauma counselor in Huntington Beach.

“In Oklahoma City I was helping a chaplain who had been notifying families that their loved ones were confirmed dead in the bombing. He was having a hard time dealing with the job and he just described these horrifying scenes to me. I had tears in my eyes as he talked.”

Albert dealt with her anguish the day she left for home. “I went out to the site, and looked around at all the flowers and poems people had left and just wept. It was my catharsis.”

*

Just as some disasters are worse than others, some also have more impact on the trauma counselors.

“With the Northridge earthquake, although many people were upset, there wasn’t a great loss of life, just property,” says Dusty Bowencamp, a disaster health services supervisor for the American Red Cross in Los Angeles. “The counselor would spend 15 to 20 minutes with the average client and get them going in the right direction and move on, working a 12- to 14-hour shift.

“In Oklahoma City, there was a tremendous loss of life and a feeling that this was a senseless tragedy. The victims needed much more emotional first aid, with counselors spending one to two hours with them. Because of the effect on the counselors, they only worked four-hour shifts.”

When a disaster occurs, local trauma counselors can respond quickly, sometimes getting to the site just as the police and firefighters arrive. In Oklahoma City, they began working within 10 minutes of the bombing. But local counselors are not always the best people to have treating victims.

“At the Loma Prieta earthquake in 1989 and at Hurricane Andrew in 1992, there were many counselors working who were worried about their own families and property,” Williams says.

“Once the local mental health people have leveled off and found their footing, they provide excellent insight into the community for the rest of us,” Tuohey says.

*

The long days and restless nights of trauma work can be brutal, whether the counselor is local or from out of town. “When you’re putting in a lot of hours and not paying attention to needs like food, sleep and relaxation, you’re not in the best shape to work,” Williams says. “The counselor needs to sit back and take a break, otherwise, they’re not much help to the victims they’re working with.”

Recognizing one’s own humanity appears to be a prerequisite to becoming a successful trauma counselor.

“You try to be brave and you read all the books, take the classes, get the degrees, but if you can’t cry at something terribly bad, something’s wrong,” Tuohey says. “You have to recognize that the same sights that can make someone else sick, can make you sick. You can’t deny your own humanity.”