Overcoming Disaster Fatigue, Part 2: Some Solutions

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PSYCHIATRIC VIEWS ON THE DAILY NEWS

The current challenges we in psychiatry face in terms of patient care and social psychiatric problems are many and rising. The government is reducing resources at the same time that the prevalence of many disorders is rising, and the polycrisis consists of multiple overlapping social crises, including the climate crisis, wars, and political divisiveness. As Part 1 of this column indicated yesterday, that can cause feeling overwhelmed emotionally. One solution is to withdraw and simplify one’s focus, such as on individual patient care and taking some time off. There are others, such as these options to replenish emotionally.

1. Become aware. This is akin to our familiar need to monitor our countertransference—that is, how we are reacting emotionally.

2. Raise awareness in others. Bring up this risk to colleagues and loved ones that are usually supportive, reliable, and insightful.

3. Testify. Express your emotional concerns publicly in a psychologically safe environment.

4. Condense your concerns. Focus on a more limited number of concerns.

5. Use your particular strengths to act. That may be joining a project, contacting politicians, or in my case, writing.

6. Mourn losses adequately. It may seem paradoxical, but those who care most and work most to prevent and address disasters often have the most difficult mourning process because they did care so much.

7. Increasing resilience. Increase emotional strength with a renewed vision and community support, but also be aware that too much resilience can be numbing and thereby even risky.

8. Hope. Although only the United States voted “no” for the establishment of the 1st UN International Day of Hope that just passed on July 12, hope is always essential to move forward positively.

The most difficult disaster situations are those that are continuous and strong, as they leave little time and opportunity for such recovery processes. This is not unusual in war, such as more continuous bombing, or on inpatient wards with multiple volatile and suicidal patients.

On the other hand, we must worry about small disasters, more everyday ones that feel traumatic. They add up and help explain the country’s burnout epidemic of physicians.

By nature, we in psychiatry want to provide psychological help whenever and wherever we can. That can make us more vulnerable to disaster fatigue as we run forward into addressing disasters rather than running away. In addition, we are often Jungian “wounded healers” with our own history of personal traumas and leftover vulnerabilities to current triggers of them. So we also need systems—whether political or psychiatric—that reinforce human and healing potential more than ever.

Dr Moffic is an award-winning psychiatrist who specialized in the cultural and ethical aspects of psychiatry and is now in retirement and retirement as a private pro bono community psychiatrist. A prolific writer and speaker, he has done a weekday column titled “Psychiatric Views on the Daily News” and a weekly video, “Psychiatry & Society,” since the COVID-19 pandemic emerged. He was chosen to receive the 2024 Abraham Halpern Humanitarian Award from the American Association for Social Psychiatry. Previously, he received the Administrative Award in 2016 from the American Psychiatric Association, the one-time designation of being a Hero of Public Psychiatry from the Speaker of the Assembly of the APA in 2002, and the Exemplary Psychiatrist Award from the National Alliance for the Mentally Ill in 1991. He presented the third Rabbi Jeffrey B. Stiffman lecture at Congregation Shaare Emeth in St. Louis on Sunday, May 19, 2024. He is an advocate and activist for mental health issues related to climate instability, physician burnout, and xenophobia. He is now editing the final book in a 4-volume series on religions and psychiatry for Springer: Islamophobia, anti-Semitism, Christianity, and now The Eastern Religions, and Spirituality. He serves on the Editorial Board of Psychiatric Times.