Professor of Psychiatry and Founding Rector of Üsküdar Üniversitesi Prof. Dr. Nevzat Tarhan made special assessments on earthquake psychology for TRT Academy Journal’s “Disaster Management and Media” issue.
TRT Academy Journal: On February 6, 2023, we experienced a devastating earthquake that affected 11 of our provinces. Thousands of people lost their lives in this earthquake. Millions of people were directly and indirectly affected by this situation. After the earthquake, traumas occurred in individuals who experienced the earthquake and those who watched earthquake footage from the news. How can you explain the psychological dimension of this process?
Nevzat Tarhan: The February 6 earthquake was a very large regional earthquake. It was even called "the small apocalypse" by those who experienced it. Two more major earthquakes occurred on the same day. In fact, this earthquake broke the norms even for geoscientists. Therefore, it needs to be addressed separately for those who experienced the earthquake, for other people in our country, and for the responsible administrators. For those who experience an earthquake like this, there is first a sudden shock effect. When there is a shock effect, people freeze, looking around senselessly. In this state, anger, fainting, talking to oneself, and laughter can occur, and these situations were experienced after the earthquake; many examples of this were seen. Generally, after that initial shock period, a protest period emerges, and the person does not accept or rejects the situation. They do not want to believe that their loved ones are trapped under the rubble. The third period is the bargaining period. During this period, if a person is under the rubble, they may harbor thoughts like "even if various things happen, I wish I would die later." The fourth period is the acceptance period. This situation can last a few days for some people, while for others it can last for months. If this process exceeds eight weeks, it is considered a disorder. Medication is not given to individuals unless they experience these conditions very severely and their social adaptation is not disrupted. We all went through this process together. During that period, as a university and hospital, we established a psychosocial support line. Nearly 30 psychologists and around 20 psychiatry specialists conducted screenings with trauma survivors via WhatsApp or Zoom. In our meetings, we discussed what kind of cases we encountered. For example, in one of the cases, five people were trapped alive under the rubble. The survivor we spoke to lost their mother, siblings, and father under the rubble. After the third day, they were left alone. On the fifth day, they were rescued. The survivor stated that they did not respond when the rescue team came to save them. The survivor told the teams that they wanted to die at that moment and said, "If you had reached us earlier, all of us would have been saved." This young survivor had very serious post-traumatic stress disorder, which we call flashbacks, re-experiencing, inability to sleep, and seeing it in dreams at night. There are perhaps hundreds of stories like this. It is very difficult to understand the people there from afar unless you experience it yourself. They experienced a very great trauma.
Here, the other important point is that other people in our country also experienced secondary trauma. We were not in that region at the time of the earthquake, but thanks to the media's role there, the trauma experienced in the region became globalized. We corresponded and spoke with people from abroad, and they were also truly affected by this earthquake. The rapid delivery of aid by our people to the region with trucks became a topic of discussion worldwide. Perhaps if it were another country, everyone would flee and look out for themselves. Even Generation Z, which is heavily criticized by Generations X and Y, organized aid efforts with their own means and through universities. We witnessed this at our own university as well.
TRT Academy Journal: After the earthquake, many human stories were witnessed through both media organizations going to the region and individuals' shares on their personal social media accounts. What is the impact of this situation on human psychology, especially for viewers?
Nevzat Tarhan: Such an event is now a fact of life. Remaining insensitive or fleeing from this event would not be a healthy response. It would be healthier for our citizens living outside the earthquake zone to empathize with the people living there. We can say that this was largely the case in our country. After the first few days of shock, those who went to the regions stated that there was plenty of resources and that the state was present. I also said in broadcasts that we could actually make cities "buddies" (sister cities) for such situations. For example, we gave an award to Merzifon Municipality within the scope of the High Human Values Awards. As soon as they learned about the earthquake, they dispatched both fire brigades and food vehicles in the early hours of the morning. There are many beautiful examples like this. These examples need to be experienced. The fact that Generation Z, which we often call very conformist, also experienced this shows that our sociological heritage continues. Of course, we don't know if this will continue in 20 or 30 years. We need to keep this heritage alive. In this regard, families cannot perform cultural transmission, and the media does the opposite. For this, the state now needs to integrate human values and cultural values into the education system. It needs to create reflexes that will protect our accumulated values and explain this methodologically within scientific standards. By implementing high school-level projects such as community services, random acts of kindness projects, aid projects for the elderly, and aid projects for disadvantaged people, it is necessary to keep people involved in these responsibilities.
TRT Academy Journal: In the first question, we talked about the psychology during the earthquake process. After individuals' conditions are accepted as cases following an earthquake, how can individuals recover from this psychology and state of mind, or can they? What is the duty of individuals and the state here? What should we do individually and collectively to recover from this state of mind?
Nevzat Tarhan: After 8 weeks, it is necessary to seek expert help. However, it is not appropriate to try to make sense of things for individuals within these 8 weeks. Attempts to rationalize, such as "It could be worse, look, you survived, there are those who lost their lives," will backfire. The person is in a period where emotions are intense. You cannot reach them through persuasion during that time. During that period, emotional sharing, alleviating their loneliness, holding their hand and waiting, making them feel your presence, and meeting their basic needs will provide comfort. It is important not to bring up the topic unless the person asks. This also applies to individuals who still haven't overcome this trauma. Therapy has already begun for those whose mental health still hasn't improved, who cannot return to their routines on their own, and whose lifestyles are affected by trauma. The condition of these individuals is called complicated grief. Unresolved grief is named as such. Individuals experiencing this grief require expert help. In their case, the previously used debriefing method, which involves making sense of grief to alleviate it, is also not currently being used. Individualized trauma treatments are being applied. First, the person's personality profile is determined, identifying their strong and weak methods. Along with this, by strengthening personality traits apart from the trauma, the person is enabled to overcome the trauma on their own. Approaches related to trauma are only applied if the person wishes. Beyond this, instead of a problem-solving method, a positive reinforcement method is adopted. With this, as the person develops positive personality traits, they logically resolve the trauma themselves, put it aside, and return to routine life. In this situation, the trauma is not forgotten or mummified, as that would not be correct. In this situation, the trauma is miniaturized. Its memory is kept alive but made smaller.
TRT Academy Journal: Does the state provide any support for individuals who need psychological help? We mentioned that approximately 15 million people were affected. Does the state have an initiative at this point?
Nevzat Tarhan: We have dozens of videos on this subject. Anyone who wishes can choose the one suitable for them from these videos, watch it, and send us their questions. Our psycholinguistic support line also received support from the Ministry of Health and various organizations. Ultimately, trauma occurred, and there are methods and coping mechanisms related to that trauma. Here, coping strategies come to the forefront. For example, in the USA, people who have experienced trauma due to wars and suffer from post-traumatic stress disorder are still under follow-up in hospitals. At this point, Americans prefer to direct people towards substances and entertainment as a coping mechanism, and many of these trauma survivors become alcoholic. Of course, there are also healthy coping mechanisms. One of these methods is the religious coping method. In this method, individuals mentally take refuge in a higher power. People who can manage to surrender to a higher will, knowing that these events are not coincidental, that they have a meaning, and that there is an all-knowing, predicting power, can use this method. Another coping mechanism is for people to become passive and depressed. In this way, they withdraw into themselves as a coping mechanism, but these individuals experience loneliness and unhappiness in this state, and most become depressed. Therefore, being able to take refuge in a higher power in this event can make people feel better. At this point, science is not ignored, of course; it is still adhered to. We will follow science and then surrender. There is a beautiful saying in Anatolia: "Be ambitious in your studies, and content in your harvest." That is, you will be accepting in achieving results, but assertive in taking precautions. The most important lesson we should learn from this is that, since we live in an earthquake zone, our institutions responsible for earthquakes should be constantly vigilant, like firefighters. AFAD, Kızılay, all of them should be like that. All institutions should have reacted instantly. We need to learn this lesson. Instead of questioning the past now, we should be critical about what we will do next. Therefore, as a society, we need to stop being an Eastern Society and become a System Society. Because we are not a System Society, we expect such sudden decisions and everything from the leader. In system societies, everything works automatically. When you expect everything from the leader and the state, it doesn't work. Even managers in the smallest units need to take initiative. This is how it is in system societies. Job descriptions are pre-defined; managers know how to take initiative and do not wait for orders. This, I think, could be one of the conclusions we draw in terms of management systems.
TRT Academy Journal: Professor, one of the groups undoubtedly affected by the earthquake is children. AFAD and various municipalities immediately set up playgrounds in the earthquake zone. When we watch these images, children seem not to be very affected, but they were certainly among the most affected. From this perspective, what are the effects of earthquakes or natural disasters on children? What can be done for children in the short and long term?
Nevzat Tarhan: In this regard, it is necessary to differentiate between children aged 0-10 and those over 10. Abstract thinking skills do not develop in children until the age of 6. For the first 10 years, children are completely dependent on their parents. At this age, a child will look to their parents and react according to their parents' reactions. Therefore, there is no need to worry too much about the first 10 years. For that age group, it would be more appropriate to focus on the parents' state of mind. Trying to remove children from the environment, not showing them the environment, or creating uncertainty would be a greater trauma for that age group. This, of course, also applies to adults. The most reassuring thing for society in these situations would be to eliminate uncertainty. We need to answer questions like: "Will we be forgotten in the earthquake zone?" "Will we have a home again?" Crises have both a threat and an opportunity aspect. As a society, focusing on the opportunities of crises rather than their threats will now yield better results.
TRT Academy Journal: Professor, after disasters, there are people rescued from under the rubble or those still in shock. Microphones are extended to these people, or their images are captured. These images are also shared on social media platforms for engagement purposes. How do you evaluate this situation?
Nevzat Tarhan: First of all, those people are wounded people. If you have a wounded pet, you know it won't let itself be petted. The reason it does this is not because it's angry with you or doesn't want you, but because it's afraid of being hurt. At this point, our earthquake-affected citizens are wounded; they can say anything, and they should. If they don't, they might fall into a deeper depression, and those responsible might not realize their mistakes. At this point, such exceptional events are also media's lifeblood, and one must be aware of this. For this reason, these situations will, of course, be news, but it is beneficial to present positive and negative news more balanced. I am not talking about hiding these news; of course, this situation will shake people's trust even more, and traumas will turn into uncertainty traumas. This causes future anxiety and paves the way for greater traumas. This will be the same for both adults and children. Some people are also currently "ego-surfing" in the media and using every event to display themselves. This is, of course, the disease of Narcissism. A book called "The Narcissism Epidemic" has also been published in the USA. In Narcissism, people feed on praise and applause. Such individuals try to capture something extra in such situations just to get praise and collect more likes. This used to be the media's job, but now everyone does it for their own social media. This is, of course, a result of the popularization of the self-centered human type. This is unfortunately also a nightmare of modernism. Here, there is a fetishism of self-display. This was also experienced in the earthquake zone. Some people adopted the idea of capturing visuals of those in need of help during the earthquake instead of helping them. As technology makes our lives easier, it can also drag our humanity down in some situations. Unfortunately, we saw this in this region as well. We hope these are marginal types, but when we observe social media, we also see that these people are becoming mainstream. This is a very dangerous situation for the future of humanity.
TRT Academy Journal: Due to losses and traumas experienced after the earthquake, how should individuals redefine their lives socially with themselves and their families? Can a person overcome this situation on their own without psychological support?
Nevzat Tarhan: The person must accept that they have experienced a major event. They should continue their life by accepting the situation they have lived through without mummifying it. If they can say, "I am doing my part," their conscience will be at peace. If they are doing something that requires them to take responsibility, they should fulfill their duty related to it and return to routine. This is our advice. In addition, as we said, it is necessary to eliminate uncertainty in these people's lives. It would also be beneficial for the aid activities provided to these people after the earthquake to continue until they return to their routines. For example, we have a question on the post-traumatic growth scale. There is an option here: "I started treating my relatives better." People can gain such insights in terms of maturing themselves. If they can achieve these gains, events that seem like disasters will, in the long run, turn into spiritual gains for us. "Spiritual" here has two meanings. One is in a religious, mystical sense, while the other is semantic, meaning deriving a meaning from this event and making a logical definition. People should ask themselves, "What did this event teach me?" and draw a new goal and roadmap for themselves. They need to change their aspects that only think about their own comfort, aiming for an unlimited life with capitalist greed. If such a person suggests to themselves, "I need to develop my benevolent aspects and hone my negative ones," then this trauma will surely become a blessing for the region. Trauma is ultimately a disaster, but evils are actually part of perfection. They are opportunities to move towards perfection. If there were no diseases, we wouldn't even need to know where our heart is. All of these have an existential meaning. The one who produces a machine also immediately provides its instructions for use. Just like that, our creator is the one who knows what is best and most right for us. Therefore, I would say that people should look at this event with the eye of what the creator's message is. During these periods, people's greatest enemies are hopelessness and pessimism. If we fall into this, the brain withdraws, and the body gives up, which can lead to sudden deaths. Therefore, it is necessary to keep the feeling of hope alive and not fall into pessimism.
TRT Academy Journal: Professor, there are two incidents. The first is a crane operator who lost his family but goes to help in the rescue efforts of other people instead of retrieving their bodies. In another example, an AFAD volunteer disappears for about half an hour while organizing rescue efforts. While those around him complain about this, it turns out that the AFAD volunteer went to retrieve his family's bodies. In these examples, we see people participating in rescue efforts by sacrificing themselves and their families. How do you evaluate this situation?
Nevzat Tarhan: All the volunteers working in that area had their fingers wounded from digging through the rubble. Let's say they are heroes. These are individuals who transcend their own ego. Human virtues are in six groups, and one of them is the virtue of transcendence. This exists in the sociological structure of our society, but it is not genetic; it is learned later. Capitalist morality has currently destroyed the world. An American in the USA consumes as much as 5 people worldwide. The market should have ethics. Humans were thought to be homo economicus, but it turned out that they are homo psychologicus. Therefore, humans are not just beings who maximize self-interest; humans are happy when they maximize good and beauty. They also feel at peace themselves. If you examine the brains of people who go to help, you will surely see that they secrete happiness hormones. There is a peace that comes from helping. That is why in Islam, there is the teaching that the giver, not the receiver, gains. Truly, the giver gains both spiritually and inner peace in this world. They also gain rewards related to the eternal realm. Therefore, keeping this feeling alive is for the benefit of humanity. The actions of volunteers coming from abroad also made us feel that humanity is alive, not dead.