Kou Kunishige, Manager of DCNZ shared his experience to work with tsunami survivors in Japan. He spend there for one year and a half.

1. Talking with
Tsunami
Survivors in
Japan
Kou Kunishige
Diversity Counselling New Zealand

2. 11.3.2011
2011 earthquake off the Pacific coast of Tōhoku

3. Overview
 Earthquake
 14:46 JST (05:46 UTC) on Friday 11 March 2011
 Magnitude 9.0
 Moved Honshu (the main island of Japan) 2.4 m east
 Tsunami
 Reached up to 40.5 metres high in Miyako
 Travelled up to 10 km inland

4. Humanitarian crisis
 Toll at Oct 2014
 Death 15,889; Injured 6,152; Missing 2,598
 Evacuees more than 400,000 after the earthquake
Still 243,040 are evacuees at 11 Sep 2014
 Economic impact
 the Japanese government estimated that the cost of
just the direct material damage could exceed ¥25
trillion (US$300 billion).

5. Emergency Counsellor
(EC)
 The government was planning to send
ECs to schools as weekly rotation.
 However, High schools in Miyagi wanted
ECs to stay there, at least for three
months
 March 2011, planning to live in NZ. All
contracts in Japan finished. So
temporarily and unusually I was free.

6. Kesennuma
City,
Miyagi,
Japan

7. Nuclear Plants

8. High schools
 Kesennuma Koyo High School
 Vocational School to be a sailor,
engineer, or cook
 Kesennuma High School
 No damage from the Tsumani, so
the gyms were used for the shelters
and the Japanese self-defense
force camped on the school ground

9. Kesennuma Koyo
High School

11. Disaster Prevention Centre at Minamisanriku

12. What can you
do as a
counsellor?

13. How do you imagine the
students looked like?
After two months passed, the school were
eventually able to start their class. Then I started
to work.
There were students who lost their home, relatives,
loving ones. The school teachers were not
exceptions to this.

14. There can be so many
things you can imagine.
However there is
something you might not
be able to imagine.

15. There were ordinariness
and normality.
This was the moment when we could not believe
what we actually saw. Then we wanted to dig
something hidden underneath.

16. PTSD
How many people who develop PTSD do you
think I needed to deal with over two years?
The schools have more than 1,000 students. I
asked other schools in the area about PTSD.

17. Behind a TV camera
 A TV camera can focus something
standout, but not something ordinary.
 A proverb “seeing is believing”. But
how is it different from seeing
directly with our own eyes to seeing
through a media.
 A mount of information you obtain is
far beyond the information though a
media.

18. When people don’t see
what they imagined
 People try so hard to find out something
they imagined.
 People asked survivors to obtain what they
wanted. “You are hurt, aren’t you?”
 Media wanted to find out the kind of stories
they could imagine outside.
 Even professionals wanted to find. Some
believed that there must be such things.

19. First hand talk & Second hand
talk
 We tend to hear similar stories. We
can not assume that the number of
being-told represents the number of
existence of the story.
 The people tend to circular salient
stories. We cannot spot who told this
story to begin with.
 Original story & Circulated story

20. Stories circulated by
professionals
 Questions can be generated before hand.
Questions themselves would not be
questioned whether they are appropriate
for them or not.
 Questions can generate answers as they
require.
 Such answers will be taken and form
particular stories. Then they will be
circulated.

21. Echoes
The number of echoes
you hear doesn’t reflect
the number of the
incidents.

22. Ludwig Wittgenstein
The Blue and Brown Books (1958)
Instead of "craving for
generality” I could also have
said "the contemptuous
attitude towards the
particular case"

23. Why not PTSD?
Every event can be located in its
context – history, culture, and tradition.
Nothing can stand alone. So we need
to explore backgrounds, contexts of the
event. Otherwise, we will
misunderstand them.

24. Nuclear Plants

25. Tsunami Evacuation Site

27. A story of an expectation
 A student told me “When the
earthquake happened, I was near the
sea. I was quite sure that tsunami
would come and I should have 15 to
20 minutes to evacuate.”
 He went back to his house and picked up
what he needed, then went to the
evacuation area.

28. A story of a hunch
 A school teacher needed to evacuate
the students to the designated place.
He did. However, He felt something.
So they decided to move on to further
place, which was never considered
before.
 Later what they found was the
designated place wad destroyed by
tsunami.

29. How they tell about tsunami
 Adults told children, even in the early phase,
“What you have to do when you become a
grandparent is to tell what you experienced
to your grandchildren.”
 Toward nature, people need to find a way to live
with, rather than to stop it.
 This is not a human-made accident. You
don’t need to forget. The community would
carry it with you.

30. Concepts of PTSD
 The big incident would cause some
psychological disturbance even if one
month passes, and the symptoms last
more than one month. Then it makes
his/her life so difficult.
 The rates of developing PTSD after a
traumatic event very from around 10%
to sometimes 40%. Is it?

31. DSM Criteria for PTSD
 Criterion A: stressor
 Criterion B: intrusive recollection
 Criterion C: avoidant/numbing
 Criterion D: hyper-arousal
 Criterion E: duration
 Criterion F: functional significance
 The disturbance causes clinically significant
distress or impairment in social, occupational, or
other important areas of functioning.

32. Research on PTSD
 Many researches are about the symptoms which
are considered to belong to the PTSD.
 NOT the number of PTSD diagnosis. They
often don’t show the prevalence rates of
PTSD.
 The question is how the symptoms are
related to “PTSD” itself.

33. PTSD Checklist (1)
Weathers, Litz, Huska, & Keane (1994); National Center for
PTSD
1. Not at all 2. A little bit 3. Moderately 4. Quite a bit 5. Extremely
 1. Repeated, disturbing memories,
thoughts, or images of a stressful
experience?
 2. Repeated, disturbing dreams of a
stressful experience?
 3. Suddenly acting or feeling as if a stressful
experience were happening again (as if
you were reliving it)?
 4. Feeling very upset when something
reminded you of a stressful experience?

34. PTSD Checklist (2)
Weathers, Litz, Huska, & Keane (1994); National Center for
PTSD
1. Not at all 2. A little bit 3. Moderately 4. Quite a bit 5. Extremely
 5. Having physical reactions (e.g., heart pounding,
trouble breathing, sweating) when something
reminded you of a stressful experience?
 6. Avoiding thinking about or talking about a stressful
experience or avoiding having feelings related to it?
 7. Avoiding activities or situations because they
reminded you of a stressful experience?
 8. Trouble remembering important parts of a stressful
experience?
 9. Loss of interest in activities that you used to
enjoy?

35. PTSD Checklist (3)
Weathers, Litz, Huska, & Keane (1994); National Center for
PTSD
1. Not at all 2. A little bit 3. Moderately 4. Quite a bit 5. Extremely
 10. Feeling distant or cut off from other people?
 11. Feeling emotionally numb or being unable to have
loving feelings for those close to you?
 12. Feeling as if your future will somehow be cut
short?
 13. Trouble falling or staying asleep?
 14. Feeling irritable or having angry outbursts?
 15. Having difficulty concentrating?
 16. Being "super-alert" or watchful or on guard?
 17. Feeling jumpy or easily startled?

36. What is helping?
 They are “normal” symptoms. As we are
“flesh-and-blood persons, we react, feel
anxious, not to sleep, not to want to see.
 Symptoms are not from disorders nor illness.
 You don’t need to FIX those symptoms. But
they need to take care of themselves as
much as possible.
 A high school girl saw tsunami and the people
who were taken by tsunami.

37. Factors which PTSD
doesn’t deal with
 How big it is depends upon how people
perceive it.
 What it means depends how the people
around them respond to it.
 How much they have to suffer is not only the
degree of the incident itself, but how difficult
for them to restore their life.

38. The people wanted to talk
 But, not to a person who has a tag of
“Mental Health Care”.
 If you ask them “Can you tell me what
happened, as I need to know as much as
possible to help “other” people,” they
would tell you so many things.
 Don’t offer “counselling”, but offer an
opportunity to talk.

39. resilience
 Don’t give a name of disorder to people easily even
if you recognize some symptoms.
 Treatments which the notions of PTSD lead won’t be
necessary. You don’t need to deal with them directly.
 What they need is to have enough time, space to
restore their health.
 Then various supports after the event are needed to
restore their daily life.

40. Tsunami Wall
The 14.7-metre (48ft) wall below will do little more
than protect rice paddies, at a cost of $230m.

41. Moving a village