The requested article has expired, and is no longer available. Any related articles, and user comments are shown below.
© 2014 AFPOne in four tsunami children needs psychiatric care
By Kyoko Hasegawa TOKYO©2024 GPlusMedia Inc.
The requested article has expired, and is no longer available. Any related articles, and user comments are shown below.
© 2014 AFP
34 Comments
Login to comment
dbsaiya
You think? No s---t. Over 18,000 dead and you're surprised that the numbers were this high? Okuyama Makiko hit it on the head. And now ministry officials are going to contemplate what further measures are needed after the official report comes out in a few months? Japanese government is more concerned about the dang Olympics than the well being of its people and future generations. Psychiatric treatment, and counseling for PTSD should have been done in the immediate aftermath of the disaster. They also don't mention the number of PTSD amongst the first responders and the many JSDF and other search and rescue folks. Hey, Abenomics and the Olympics are on our side, life is good...
Ms. Alexander
Exactly! They are figuring this out almost three years later?! I would think all the kids needs care. Not just one in four.
Heda_Madness
They aren't figuring this out just now, there has been a lot of work done in the community by a number of NPOs as well as more official channels. I know that the Tyler foundation, Smile Kids and numerous others have been involved from pretty much day one.
Is it enough? Of course not, but then I doubt that there would ever be enough. 18,000 died. Tens of thousands lost their homes. This disaster affected many, many people and I doubt that any country has the capability to support everyone.
MarkG
Fortunately this is recognized. All to often these catastrophes long lasting result can be overlooked. I hope they all resume a normal, happy childhood.
Frungy
To anyone who actually knows what they're talking about this article gives all the evidence needed to dismiss psychiatry in Japan as pure quackery...
This, ladies and gentlemen, is a good example of cherry picking (using only data that confirms your hypothesis). Firstly, the sample isn't random, but rather consisted of hand-picked candidates. The parents probably only agreed to the testing because they had concerns about their children beforehand, thus creating a very biased sample of children already displaying symptoms. Add to this that they chose to conduct the research ONLY in areas "worst-hit" and you're adding another layer of confirmation bias, combined with the lack of any sort of control group that could provide some perspective to the study.
Oh, and the sample size is pathetically small. No peer-reviewed international journal would publish this study.
Hahahahahahahahahahaha!! Like the Tanaka-Binet? Or the KIDS checklist? The validation studies on these are utterly pathetic, consisting of the same type of cherry picking nonsense.
This research is pathetically flawed. And now people think it is a good idea to hand these kids over to these quacks to get treatment when these quacks have clearly displayed their complete lack of qualifications? Idiocy.
SenseNotSoCommon
If only this could give a sense of crisis about the dire overall lack of psychiatric care provision.
It would be great, too, to heighten awareness of 'stress', and how life-affirming, shame-free and drug-free corrective intervention (even self-help) can be.
smithinjapan
But I thought getting the Olympics was supposed to make everyone in the north happy! STOP spending money earmarked for relief on pet projects in Nagoya and Okinawa, or on the SDF on whaling ships, and constant TEPCO bailouts, and get it to the people in need -- like these children! It's sickening to read about this kind of suffering and the 'scarcity of doctors' and help when the fat cats rake in all sorts of profits claiming it's for the people suffering.
nath
Frungy makes some good points. It's been shown in studies that children actually bluff back from major traumas like this better than adults do. This article makes it sound like there is an epidemic going on, when in fact the study is likely inflating the numbers through its method of choosing the children.
pointofview
I thought Japan cared about children. For a country that has so many earthquakes why are they lacking in these types of services?
Bad2Dbone
Sad ways for these children, but after a big tragedy like this , the government , should had known and open a training program for this type of situation, but I guess the re-routed the help tsunami money for other things, shame , very shame (whale hunting,mascots,singing groups,logos , senkaku scandal, Olympics)
They just don't care about the kids!
sangetsu03
Agreed. It sounds like the Tohoku University of Medicine is fishing for grant money.
Disillusioned
Only one in four? I am sure that nearly every kid that has been displaced needs some kind of psychiatric counselling. He article states there is a lack of psychiatrists to counsel these kids. What are they doing about it? Nothing, of course! Most of these kids will just grow up with their emotional issues and join Japan-Inc. in the future.
sighclops
@pointofview
Mental health services in Japan are basically non-existant, as it's frowned upon and seen as "a sign of weakness" (Unbelievable, I know).
Frungy
Actually, no.
Psychiatrists don't give counselling, they give medication. The average length of a psychiatric consult in Japan is 5 minutes, pretty much just walk in, they take a look at you and give you drugs. This is the LAST thing these kids need.
Even if psychiatrists did give counselling this would be the wrong approach. What these kids need is a supportive and loving family environment. The "trauma debriefing" approach currently in vogue in Japan has been REPEATEDLY shown in international studies to worsen problems, not diminish them. People recover from trauma by coming to terms with it in their own way, there is nothing to make sense of and counsellors can do very little to help. It needs time, sympathy and for the families to be moved out of refugee centers and into proper housing.
And this last point is the real issue. The kids are still traumatised because their lives haven't normalised yet. The problem is not the trauma, that's just a symptom of ongoing uncertainty in their lives. The REAL problem with these kids is that their lives aren't stable. Many are still living in refugee centres with their parents, or their parents are unemployed because key industries have been damaged and have yet to recover. The failure here is that the Japanese government has been spending TRILLIONS of yen on cleaning up the nuclear disaster (which honestly isn't going anywhere) while people have sat in refugee centres or at home without jobs for years.That's the story behind this story, the cost in human suffering caused by the Japanese government's wasteful and misguided spending on the Tohoku disaster.
slumdog
Actually, Iwate, Miyagi and Fukushima are prefectures, not just 'areas'. Iwate is the second largest prefecture in Japan. So, within those areas are places that were badly hit and others less so.
From the article:
So, they were attempting to make a comparison with other areas of Japan.
You have a good point here. The sample size is much too small to make an accurate analysis.
However, if this article brings attention to the shortage of psychiatrists and the llack of access to good psychiatric care in Japan, then we are well served by it.
Lastly, just because you disagree with someone does not mean they are "quacks".
Jim Poushinsky
My understanding of recognizing and healing the effects of overwhelming trauma in children comes from my own experience as a survivor of multiple childhood traumas that I have been able to heal, and from a career as a professional child & youth worker and social worker with knowledge of the research in this field.
I think all the children up to age 5 who survived the overwhelming trauma of the tsunami will suffer from varying degrees of PTSD for the rest of their lives, unless they receive meaningful help to heal themselves. This is because the minds of very young children instinctively dissociate the incoming sensory data of overwhelming trauma away from consciousness, so they can do whatever is required to survive. Such dissociation is a survival mechanism. For example, a young child who sees mother swept away in a flood would understandably panic and become helpless, but if that information does not come into consciousness, then the child can do what is required to keep from being swept away too.
If this dissociative instinct is used in early childhood it remains an active coping mechanism for traumatic situations on into adulthood. If it is not used the ability to dissociate goes away, and older children fully experience trauma and react to it as adults do who were not traumatized in early childhood. That is why most people do not develop PTSD in reaction to traumatic events in later life, but those who do were likely exposed to trauma as young children.
With regard to healing such trauma, this can only happen if the child is in a safe place with loving caregivers who allow and encourage the child to bring the dissociated fragments of sensations, feelings, and thoughts from the traumatic event that are active in the subconscious mind, into conscious awareness. When enough such pieces are processed to form the event, the child will abreact to this information by fully experiencing what happened, while supported by caregivers. Only then can it become a memory and fade with time. And recognizing it is over allows the mind/body to turn off the state of emergency with its constant fight or flight preparedness, and finally return to normal.
Drugs can provide some temporary relief by countering the body's state of PTSD arousal, but they are no longer needed when the mind permanently heals by connecting with and processing the dissociated fragments of the trauma.
So I recommend all the child survivors of the tsunami be helped to heal by allowing them to express the dissociated fragments that are in their subconscious minds. This can be done by paying attention to and recording their dreams and anything unusual or out of context in their daily life that they think or feel or say or act out in play and other behaviour. Encouraging them to draw or sculpt whatever is on their mind is also useful. Ask them to tell the story that is in their art, and record it. Such information will, over time, bring the traumatic pieces to conscious awareness, particularly if they are able to review all of it whenever they wish. And finally meditation for healing can be very useful in pulling the pieces together for older individuals.
If anyone wants to discuss this further I would be happy to correspond. I am retired now, and have time and the desire to pass what I have learned to others who find this knowledge useful. A final thought - nobody heals another person, we each must heal ourself. But we don't have to do this alone. It is much easier to do with loving and understanding people in a caring community. Best wishes to all survivors of the tsunami, and to those who want to help them.
slumdog
Yes, this idea is quite common among laypeople such as yourself. You talking about the conclusions of NICE, Cochrane, Wesseley and others, right? However, recent medical science and research suggest that if done properly and in the correct timing, trauma debriefing actually can be helpful. Perhaps it is time to get with the times.
Here in this article, they are mostly referring to its use for emergency workers, but it does seem to clearly refute the studies you mentioned.
http://bps-research-digest.blogspot.jp/2012/01/is-it-time-to-resurrect-post-trauma.html
justbcuzisay
It saddens me that they focus on school and work, not the emotional well-being of the child.
Frungy
From the article: " in the three areas worst-hit by the catastrophe—Iwate, Miyagi and Fukushima."
The article stated "areas". I was using the terminology from the article. You do think you have made a telling point, instead you've just proven your inability to read the article.
Unaffected vs worst-hit areas. That's called researcher bias.
The comparison is high vs none rather than high vs low. It provides a warped image.
Except that the way it is bringing attention to the "lack of access to good psychiatric care" is by showing that the psychiatrists doing this research are quacks.
Actually, the inability to do basic research properly does show that they're quacks. ... which brings me onto...
Trauma debriefing has been clinically disproven time and again. There are methods such as TRiM that are successful, but cost-benefit analysis has shown time and again that normalising the situation and allowing people time has shown comparable results to clinical intervention, but at little to no cost (apart from the cost of some sick leave/social benefits).
And if you're presenting yourself as an expert then I'd like to know your qualifications.
slumdog
Sure, you are making it seem like a strange thing that they would visit prefectures affected. Where would you have them go to study about the affects of the earthquake?
No, that is a control. They are purposefully comparing areas hit and those not hit. That is their point. What is yours?
Not in the article I presented which refutes your claim. Not recent studies. If you are going to claim knowledge, you should at least make an effort to be knowledgable.
You first. When you continue to make statements like this:
It certainly calls your qualifications into question. So, what is your training and what are your qualifications?
CraigHicks
Actual example of child psychology I heard on the radio: In a class room one day while the children were eating graham crackers and drinking milk there was fire alarm test. After that day one kid stop drinking his milk every day for several months. The teacher noticed he wasn't drinking milk and ask "why aren't you drinking your milk?". The kid answered, "because I don't want the fire alarm to go off again".
Extrapolate that to the tsunami and loved relatives disappearing. I have no special knowledge of psychology but its not hard to imagine it would help some kids to rationally communicate their experiences in order to iron out logical and emotional kinks. Of course it should be done with utmost sensitivity --- here's where my knowledge ends.
slumdog
This matches current thought on the subject by experts in the field. Also, as you write, it also seems to be common sense as well.
Frungy
No, they didn't. They cherry-picked data from the worst affected prefectures and attempted to generalize to all areas affected by the tsunami. The tsunami significantly affected areas as far north as Nemuro in Hokkaido, and as far south as Amami Oshima in Okinawa. Not all areas were equally affected. They're then taking that data from the WORST affected areas and making statements about ALL childred affected by the tsunami, for example, "One in four nursery school children caught up in Japan’s 2011 tsunami disaster has psychiatric problems caused by the horrors".
Do you see the problem now? You cannot say that children in Kanazawa (an insignificant 0.2m tsunami wave) had the same experience as children in Ishinomaki, Miyagi (more than 7.6m tsunami wave). Because that's what these researchers are doing, they're taking the worst case and portraying it as the average case. But apparently your grasp of basic research methodology is insufficient to grasp this basic error.
No, that isn't a control, because it is unrelated to their claims.
You didn't present an article, you made a passing reference to some people. Secondly, you misspelt Wesseley, it is actually Wessely. Third, you're not referencing a paper, you're referencing some authors, learn to know the difference. In response: "Psychological debriefing is a waste of time" by Wessely and Deahl, 2003 (so much for your idea that Wessely is in favor of trauma debriefing) - a quote from the paper "These studies provide no evidence for any benefit of the intervention. All the modern studies fail to show any advantage to debriefing."
Cochrane has ZERO publications on the subject of trauma debriefing, so there goes your next supposed expert.
Oh, and you're clearly not an "expert" or you'd know that trauma debriefing is a technique designed for WORKPLACE trauma, not for little kids traumatised in a tsunami, and that it should be used within a certain timeframe, in a certain way, etc. (Hawker, Durkin and Hawker, 2010, "To debrief or not to debrief our heroes: that is the question").
No worries, I already know your qualifications, namely zero, zip and zilch, because you don't even know how and when trauma debriefing should be used, which is something at even a first-year intern would know.
slumdog
? Whatever are you talking about? The three main areas affected by the tsunami were Iwate, Miyagi and Fukushima. Again, where do you think they should have gone? Hawaii? You are not making much sense.
Even a read of the headline shows you to be incorrect:
The research was specifically about tsunami children. Again, you are not making any sense.
Yes, it is if they are comparing affected and unaffected areas, which is what they were doing.
Have a look again. I linked the article for you. It refutes what you have been claiming.
Gee, thanks for the correction. I totally apologize if my misspelling confused you.
The paper is in the article I linked. Try reading it.
Sigh, your response is from 2003, mine is from 2011 and is response to Wessely. Again, read before commenting.
I mentioned that in my post above, but in the article it makes it clear that it can be useful for victims of trauma as well. You really should actually read the article before commenting.
I wrote above:
I can see you still have not even managed to read it.
You wrote above:
You were again mistaken it seems as Hawker, D., Durkin, J., and Hawker say it can be helpful.
No, no, no. Don't try to slip away so easily. You have claimed you are a 'medical professional'. So, what are your qualifications and what is your area of expertise? I question them because you once completely incorrectly claimed that the word 'insane' was a medical term. It is a legal term, but not a medical one.
According to you above, it is never. I believe the article I have linked shows you to be incorrect.
TrevorPeace1
On your side, Jim Poushinsky. I'm not a child psychologist, just a behavioural scientist of sorts, and having held a woman in my arms who, by good fortune or ill, watched the tsunami destroy her home of Nobiru Beach from a nearby hilltop and who the collapsed in front of me, a year after the disaster, looking out from the seawall at that devastated place, I can attest to only one thing - what she witnessed first-hand (and I didn't) will last forever in her mind. And her emotional turmoil and almost endless sobbing will stay in my mind as long as I live. In the minds of children...I can only imagine with horror.
LBW2010
I was in Tokyo for the earthquake and it sure left me messed up. I had panic attacks and insomnia and claustrophobia for months. Ended up seeing a physician and starting a course of sleeping medication. Also did a lot of "coming to terms with it" on my own. I'm still troubled by it. I can't begin to imagine what it would be like for a small child in Tohoku.
I agree that the best way to do right by these children is to stabilize their lives as quickly as possible. That means taking real responsibility (looking at you, Abe) for putting evacuees back in proper homes and schools. That means providing ready access to top-of-the-line counseling services. And, above all, getting Tohoku back on its feet economically as soon as possible.
Good thing they're holding the Olympics in Tohoku. Oh wait...
NathalieB
I agree LBW2010 - a friend of mine was in Tokyo and those reactions of vertigo, headaches and nausea the article was talking about in reaction to trauma - she had all of those too. She wound up in hospital and they suspected for a while she had a brain tumor (she got the all clear after an MRI) but she hasnt yet fully recovered.
And her trauma wasnt even anything to do with the tsunami, but that during and after the quake she was separated from her children as she was at work. She had nightmares about them being in trouble and being unable to get to them. If it can affect grown adults in Tokyo in that way, you can only imagine the trauma the poor children in Tohoku would have suffered. It was traumatic enough for us just watching the video footage of people fleeing.
Im no mental health expert but it seems to be common sense to me to get the children (and adults for that matter) into a stable environment, with a permanent residence, a new job, schools and normality/stability, followed then by an available local counsellor to provide support as and when needed and regular scheduled visits to monitor progress. Surely that cant cost that much?
Jim Poushinsky
Trevor Peace1 - I believe your friend will heal with time, because from your description she is aware of much of what she saw and felt and thought during the traumatic experience. If she finds the experience is causing her problems in her day to day life with intruding thoughts, feelings, sensations, fears, anxiety, sleep disturbances, or any of the symptoms of PTSD which are routinely misdiagnosed as every form of mental illness, then she would benefit from psychotherapy that assists her to recognize these disruptions of her present life as missing pieces of the original event. When understood this way, the event will be experienced in full in the conscious mind, and the person will see how and know why the dissociated material affected them to the present. They can then complete their reaction to the trauma, and it will finally be over and become a memory that can fade into the past.
A complication for healing severe PTSD in adults is the very real possibility that the obvious trauma of the tsunami is actually the latest in a string of dissociated traumas going back to early childhood, which can include birth trauma or events while in the womb. Those seeking to help trauma victims need to keep an open mind so they can accompany the person wherever the healing path within the person's mind leads. I have seen people spontaneously heal when they realized the nightmares causing their chronic sleep disturbance or phobic fears originated in dissociated trauma from the death scene in a past life, or even from a UFO abduction. If the big picture they fit the traumatic fragments into makes sense to the trauma survivor and results in their healing themselves, the effort has been successful. It needn't conform to whatever passes for conventional views about life, the universe, etc. It's all a Great Mystery anyway!
TrevorPeace1
Thanks, Jim Poushinsky. I'll think of that when I wrap my arms around her again. I didn't know her when she broke down in front of me, and when I did something terribly un-Japanese by wrapping my arms around her for the first time, but she's a friend now, and we'll be back to Nobiru Beach when I return to Japan in April. Kindest regards.
Nicole Kunihisa
I'd like to share my own first hand experience of the earthquake, as a survivor.
I was 26 living and working in Miyagi Prefecture at the time of the earthquake. And while my town was safe from the tsunami, we felt the full effects of the earthquake and its aftershocks. After 3 weeks of living in those conditions, I was fortunate to find another job in Ishikawa Prefecture (where there are rarely any earthquakes), and have been living here for the last 3 years.
It took more than a year to finally learn to relax living in my new, safe environment. I would lie down to sleep and wake suddenly because I thought I felt an earthquake (when there were none). 2 1/2 years after the earthquake, I went to a fire station on a tour, and had a full on panic attack (my first ever) when they turned on an earthquake simulator for the group I was with. I was standing in the hall, not sitting in the simulator; all it took was the recorded noise of the earthquake to send me running out of the building. Literally.
I hope that someone, ANYONE, will reach out to these children and HELP them. Especially because of the way that mental health care in Japan is not taken seriously at all. It absolutely breaks my heart to think about how they must be dealing with it day to day...
Jim Poushinsky
Reading comments from people still suffering the traumatic effects of the Japanese earthquakes and tsunami brings tears to my eyes. I used to be so dissociated from my own PTSD that I could separate my self and not be so affected. One of the effects of healing PTSD is reconnecting with feelings so I now empathize with those who are suffering, and cry at their stories. Makes me wonder how those in power can ignore suffering humanity, and cause more hardship by their inaction or wrongful action. When my mother died of undiagnosed brain cancer I was 13 years old. I walked out into the night and said to the universe "There is enough suffering in this world from natural causes that we can do nothing about. We don't need the suffering people inflict on each other, and I will do whatever I can to stop it." That was 54 years ago, and I still think the same.
Guy Totaro
Any ideas as to how to reach the author of this story? I'm interested in some follow up information as well as sharing my relief program with her.