• To what extent has the family directed its efforts constructively and regenerated new lives, or are struggling or even given up e.g., become dependent on welfare? • Are family relationships harmonious, or have earlier tensions worsened or new ones developed? • Has the family created a family narrative of the disaster, in which they all feel esteem, or are they bearing secret wounds in a ‘conspiracy of silence’? • Are families energies creative or diverted to maintaining a facade and absorbed in maladaptive preoccupations? • Is any member of the family vulnerable or suffering symptoms and illnesses and to what extent are they symbolic of family stresses and strains?
33 Adults • Is the individual readjusting to new circumstances reconstructing a new life and fulfilling roles in family and community or is the individual still under the influence of the disaster, past vulnerabilities and subsequent stressors? • Are defences still active and are they adaptive or have they turned into compulsions (e.g., overwork, substance abuse, sexual cravings), phobias (of triggers symbolic of the disaster), depressions in the absence of grief and to gaps in memory and of parts of self? • Have maladaptive and traumatic responses solidified into biological, psychological and social symptoms and illnesses and if so, which ones? •
Can these responses be made sense of by tracing them to particular survival strategies in particular disaster contexts?
• Finally, have new and fulfilling self narratives of the disaster experience evolved, with deepening wisdom of one’s own human capacities and frailties or is the person consumed with anger, guilt, sense of injustice and shattered beliefs? • Is there creativity and spurt to new life or is the person disconnected externally and internally, wasting and decaying? Children Have children recovered their expected developmental phases and their sense of security, belonging and future? Have they grieved their losses and readjusted to new relationships, homes, friends, schools and routines? Have they done so on a deep level, or only superficially to please adults? Have their earlier symptoms resolved, are they more chronic, or have new ones developed? What sense can be made of the symptoms, relating to which manner of survival in what context? Ultimately, have the children absorbed the story and meaning of the disaster into their lives in a way which is no longer threatening? Or has it radiated fear into their lives? Having made assessments of disaster affected populations one can plan and execute interventions.