In the aftermath of the recent earthquakes that have devastated Nepal, Jeffrey Kottler has found that some of the most effective counseling tools available are empathy and a listening ear.
Kottler, a professor of counseling at California State University Fullerton, is in Nepal to join the earthquake relief efforts of Empower Nepali Girls (ENG), the nonprofit he founded 15 years ago.
Empathy comes easily, Kottler says, because he’s just as afraid and stressed by the constant
aftershocks that shake the South Asian country as its native residents are. A 7.8-magnitude quake left much of Nepal in ruins on April 25; the destruction was made worse by a 7.3-magnitude quake on May 12.
Kottler has set up a “counseling corner” in the medical tents organized by ENG. People have been standing in line for hours to be treated, he says.
Counseling Today is posting a series of online articles about the conditions in Nepal as Kottler sends in his travel journals from the field. More photos and information is in our first article here.
Jeffrey Kottler’s travel journal: May 14
I used to think seeing 10 clients a day was a busy day, but we treated 158 medical and 41 counseling cases at the medical/trauma clinic we set up in two school classrooms. This was the first of five that we plan for the hardest hit areas. People from all around the area lined up patiently outside our “offices.” While Matt, our medic, Monet, our triage specialist, and two of our ENG scholarship girls who are now nurses worked furiously in room to treat broken bones, abrasions, infections, wounds and all kinds of trauma-related symptoms, I worked with various families, children, adults and couples. At one point, there were so many people lined up at the door toward the end of the day I just invited them all in for a group session.
With 17-year-old Chhusang Sherpa acting as my interpreter and assistant, I talked to people about their nightmares, insomnia, hypervigilance and struggles losing their homes. The few in the region who were willing to talk about their fears felt isolated and alone, as if they were the ones who were weak. One woman told me her husband and children accused her of being “cowardly” because she startled so easily and refused to enter their house, preferring to sleep outside.
I saw two 70-year-old friends together presenting various chronic medical complaints for which our medic and nurses had no treatments. They were both extremely hard of hearing, so I kept yelling (through Chhusang) that their symptoms became worse because of the stress they were under.
I saw a family concerned about their 5-year-old son who had been trapped in a building during the first earthquake and was now mute.
I saw two young mothers, with their children, who wanted to talk about their fears because they said nobody else would listen. They reported that most of their neighbors and family were acting as if things were normal, making it difficult to tell their stories.
I saw a political leader who, because of his position, was not able to admit to anyone that he was terrified all the time. He couldn’t sleep. He could barely function. I told him that because he was a leader, it was his responsibility to help others talk about their fears and concerns.
I saw an older woman who couldn’t get in to see our doctor, so instead she came into my office to hold my hands and look into my eyes. We sat like that for several minutes until she smiled, thanked me and walked out. I turned to Chhusang to ask her what that was about, and she just shrugged.
I saw a 96-year-old man who was in remarkably good health but felt he was going to die soon. It seemed important to him that he tell me about his life. He must have enjoyed our time because he returned later in the afternoon for another session.
Then there were cases when I was so far out of my usual standards of care that I could only shake my head. One man complained of vertigo, which made perfect sense to me, because I have also been dizzy since the earthquake, feeling as if the ground is constantly moving (which it is!). I reassured him the symptoms would go away, but he insisted on some medication to make him feel better. So I “prescribed” some little orange pills, one in the morning before breakfast and one in the evening before dinner, and he’d feel better. They were aspirin.
I saw a 6-year-old boy and his family because of their concern that he wasn’t “normal” since the earthquake. I tried to engage the fellow, but he just kept hugging his mother. Once I offered him a chocolate mint energy bar as a bribe, he started talking about his fears to me and his family, reassuring them that his reactions were absolutely and perfectly normal, given the circumstances.
I saw a mother who broke her arm saving her child from a collapsed building during yesterday’s earthquake (a 7.3-magnitude quake May 12), and she had refused to go to the hospital to get it X-rayed and fixed. Matt (the medic) sent her to me to persuade her to go or she might lose the function of her arm. I tried to be gentle, but during the translation, Chhusang scolded her and told her she owed it to her child to take care of herself.
I looked at Chhusang with awe and admiration. In the time we’d spent together, this high school girl was becoming quite the counselor herself.
I tried all kinds of things during the sessions: normalizing their fears, explaining about trauma and its symptoms, inviting them to share their stories, teaching deep breathing and relaxation strategies, introducing a little self-talk, encouraging them to talk to others and literally holding them.
But I found what often worked best, especially with the children, was sharing with them that I felt much the same way they did: out of control, scared and overreacting to any sound or movement. We mostly laughed about that together.
For more information on Empower Nepali Girls, see empowernepaligirls.org
See recent photos and updates from Nepal at ENG’s facebook page
Bethany Bray is a staff writer for Counseling Today. Contact her at firstname.lastname@example.org