Earthquake, Collective Trauma, and Consequences

In the early hours of February 6, 2023, while the cities in the earthquake region were shocked by enormous destruction, the rest of the country started the day trying to understand the magnitude and impact of the earthquake and what exactly had happened.

Among all disasters, earthquakes have different characteristics. They are neither controllable nor totally predictable. It is impossible to figure out how much of the resulting trauma is natural and how much of it is man-made. With a disaster such as an earthquake, beliefs that the world is safe and controllable might be destroyed and devastated. Hence, posttraumatic stress and anxiety symptoms were found to be more prevalent and long-lasting after earthquakes (1). Consequences of earthquakes, such as lack of shelter and immigration, are the factors that perpetuate the trauma. This sort of disasters can disrupt individuals’ core beliefs about predictability, consistency, and justice (2).

Earthquakes are also among the causes of collective traumas. After disasters such as the February 6 earthquake, which affect large numbers of people directly or indirectly with their sequela; severe mental reactions can be observed even in people who do not live at the trauma site (3). The helplessness experienced in the face of the witnessed event and the inability to cope with the existing situation can affect huge masses. The grief of the losses cannot be managed, and the task of coping with the trauma might be transferred to the next generation. In other words, the trauma which is put in the refrigerator can be passed from generation to generation (4,5). Therefore, interventions that target collective traumas are of great importance in terms of the mental health of that society both in near and potentially in distant future.

Collective traumas are closely related to social identity (3). They affect the processes associated with the sense of belonging to the society and being a group member. “Tearing of the social fabric” and “loss of social trust” may occur after collective traumas (6). Adults who are the victims of social traumas may experience feelings of guilt and shame as they cannot protect their children (5). The extent to which collective trauma will affect mental health is related to cultural differences, chronicity of trauma, and variability in meaning-making (7).

A recent systematic review indicated that approximately 24% of people affected by disasters present clinically significant posttraumatic stress symptoms, 28% depressive, and 23% anxiety symptoms within the first six months (2). It also reported that posttraumatic stress symptoms demonstrated a gradual improvement; whereas, depression and anxiety symptoms persisted for months and even years in adults (2). Women, children, older adults, people with low education, the poor, people with low socio-economic status, minorities, immigrants, people who were exposed to trauma in the past (especially in childhood), those who have psychiatric disorders or have a family history for psychiatric disease and people with maladaptive coping styles are known to be more vulnerable to trauma (8,9). Luckily, psychiatric symptoms or disorders do not develop in every individual who experiences traumatic events.

After crises, positive changes are also observed in the form of enhancement in the ability to cope with stress, improvement of interpersonal relationships, increase in self-esteem, and increase in positive thinking skills. This process is called “post-traumatic growth”, and development of awareness of new possibilities, increased compassion, and a change in life philosophy and priorities may occur as an adaptation response to trauma. These positive changes include the appreciation of life, being grateful for being alive, establishing more meaningful relationships with others, feeling an increase in personal strength, changing priorities, and being able to look at life from a more existential perspective (3,10). A recent systematic review that analyzed post-earthquake qualitative studies reported that post-traumatic growth involves changes in “self-perception,” “interpersonal relationships,” and “religious perspectives” (11).

Highlights

• Earthquakes cause collective traumas.

• After earthquakes anxiety symptoms are observed more frequently and for longer periods compared to other disasters.

• Posttraumatic growth can also occur after collective traumas.

Particularly, the statements related to “solidarity”, which is located under the theme of change in interpersonal relationships, are essential in terms of being a guide for those who work in the mental health field (11). The best thing to overcome this trauma we have been through is to ensure that the solidarity across the country is as high and uninterrupted as possible (3). Systematic reviews showed that posttraumatic growth decreased over time (12). The decrease in financial, medical, and psychological assistance and social support provided in the first period, was thought to be a factor in this decline (12). This finding depicts the importance of continuing psychosocial support without interruption. Posttraumatic growth was found to be higher in adults than in adolescents and children, and was explained by the relationship between adulthood and psychological maturity (12). In this context, it is crucial that psychosocial support activities carried out in the earthquake region should include interventions specialized for children and adolescents.

Tedeschi and Calhoun pointed out that posttraumatic growth can occur in a way that affects the whole community or the country after collective traumas (13). Socially shared schemas can change, opening the door to new ideas and developments (14). Changes in moral, economic, or cultural norms can stimulate positive social transformation and lead to social posttraumatic growth (13). Collective traumas may facilitate the construction of new social meanings and social identity; new purposes and values may be gained. However, establishing these new meanings can only take place over time when the focus shifts from losses to the lessons learned from trauma (15).

We hope that after the earthquake, social gains will be built together with new cities. Enhancing social support and focusing on the strengths of our people during the society’s search for meaning after the earthquake can sprout social posttraumatic growth. It is important to provide opportunities for expressing feelings and thoughts during this cognitive processing. In order to heal our wounds, to increase our psychological resilience, and to reinforce the much-needed solidarity; it is necessary not to be discriminating, to bear a hand from the less affected to the most affected, and to be united.

Kahramanmaraş-centered earthquake on February 6, 2023, killed tens of thousands of people, and changed the lives of millions of people forever. We respectfully bow in front of the memory of all our people who lost their lives in this awful disaster and embrace those affected by the catastrophe with solidarity. We would like to express our gratitude to search and rescue teams and healthcare workers who rushed to help at the peril of their own lives and to all big-hearted people who shared whatever they had to provide support.