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West coast anxiously waits for 'the big one'

(by Luke Brocki, OpenFile)

According to many seismologists, a mega earthquake is overdue to decimate the Pacific coast. While OpenFile is covering this story from many different angles today, Vancouver reporter Luke Brocki talked to a local anxiety expert about what all this bad news and constant worrying is doing to our mental health. Dr. Joti Samra is a Vancouver-based clinical psychologist and president of the BC Psychological Association.


Luke Brocki: Have you ever dealt with earthquake anxiety or fears of natural disasters?


Joti Samra: Earthquake anxiety, clinically, is a very rare phenomenon, but certainly you see a lot of people that have what’s called generalized anxiety disorder. One of the features of generalized anxiety disorder is general, chronic, persistent worry about a range of things, out of the realm of what the average person would be worried about. Those individuals can become focused on whatever seems to be happening in the world.


LB: Right now, what seems to be happening around the world, whether we go to watch a disaster film or just flip on the news and take in the devastation in Japan, it’s easy to get anxious about this stuff, wouldn’t you say?


JS: First of all, it’s important to recognize that anxiety exists on a continuum and, in fact, a certain amount of anxiety, if it’s matched to a situation, is actually very adaptive. Anxiety serves a function. It helps us motivate, it helps us get prepared and respond to things appropriately. Simply being anxious doesn’t mean that it’s a problem.


LB: Specifically around natural disasters, when is this a healthy respect for a powerful natural phenomenon and when does it become something else?


JS: When individuals get past a point that’s helpful or effective. What that looks like is someone who is overly ruminative on a particular issue, not able to get beyond the helpful stage of anxiety. So we would say, okay, let’s talk about earthquakes and preparation: most of us have at some point heard or thought of the fact that, perhaps, we could at some point be put in that situation, so people will have appropriate plans. Make sure your family knows everyone’s contact numbers. Some families will say, let’s think of who we would contact and where we would meet if something were to ever happen. People may say, let’s get first aid kits, or some food. Remember the turn of the millennium? First aid kits were selling out.


LB: Okay. I have a first aid kit and a dog-eared copy of a survival handbook. Now what?


JS: I think the reality is we’re talking about things we cannot control. So anytime we’re thinking about ongoing persistent worry that’s not action-oriented about something we cannot control, that’s when it becomes a problem. So you go down that checklist and say, you’ve got the first-aid kit, maybe get some non-perishable food and let family know who would meet when and where. Beyond that, there’s virtually nothing anyone can do to control this. So any worry beyond that actually becomes unhelpful and not matched to the situation, like if people are finding they’re not able to move beyond that repetitive thinking about things, having trouble sleeping, overly focusing their conversations about what they would do in this kind of situation.


Perched on the precarious Juan de Fuca tectonic plate, Vancouver is a city where “The Big One” is an inevitability. The data in the map above shows every earthquake felt by Canadian monitors between 1627 and 1992. In that time, a ribbon of small to medium quakes has snaked up the west coast on a regular basis. More than two dozen quakes of magnitude 6.0 or higher have hit the coast, while two larger quakes, one 8.1 in 1949 and one 9.0—as large as the quake that recently rocked Japan—in 1700, speak to the region’s vulnerability to natural disaster.


LB: But we’re not talking about some imagined fear. Earthquakes have been happening around the world since the beginning of time and they strike suddenly and mercilessly. The Juan de Fuca plate has been pushing against the continent forever and geologists say we’re overdue for those plates to do some serious dancing, which would spell trouble for Vancouver. So is it not a rational thing, to be afraid of a natural disaster?


JS: It depends. You’d think a natural disaster intuitively seems to make more sense. You’d say, it’s the real thing, it’s actually happening, but people don’t initially realize that [the anxiety] might be out of bounds. Having a concern or thought about something is not at all irrational. But it’s when there’s no useful action served and it’s something out of our control, by definition we would say that becomes irrational. At this point people say, it could happen. Well, of course it could happen. I could have a truck drive into my office today. There could be a fire, there could be a murderer that catches me on my walk home. I knock on wood and hope those things don’t happen. I can be safe, be smart, not walk around at three in the morning on my own, but beyond that, do I worry about something that’s out of my control? Is there any value add to that? That’s kind of the key question. And if the answer is no, there’s nothing I can do differently, then by definition it’s an unhelpful worry.


LB: I gotta tell you, I’m getting a little worried right now.


JS: There are some helpful cognitive strategies and behavioral strategies. Ask yourself a few questions. Is it even tenable that this could happen? So we could say, ya, it’s not irrational that this could happen. But your next question should be what useful function is it serving me to worry about it now, this minute? Is there anything I need to do? And if a person says, you know what, I don’t have a first aid kit; I should get that. Okay, check that off the list. And if they say, you know what, I’ve never talked to my immediate family about where the heck we would meet if cell phones were to cut out; Okay, let’s find a location. And it might make sense to get some non-perishable food, just in case. All of those are actually adaptive things. But you very quickly run out of helpful things to do.


LB: What about getting the hell out of Vancouver or Los Angeles?


JS: Well, you could say I’m going to move and live somewhere I think is safe, but really is that a rational response? Probably not. Is thinking about an earthquake happening all day and all night for a day, a week, a year, 10 years, or 20 years, going to help? No. In fact, it will probably make you more anxious. The serenity prayer helps: God grant me the serenity to accept the things I cannot change, the courage to change the things I can and the wisdom to know the difference. I’ll say that to all my anxiety patients. Because any of us could die in a car accident on any given day and, in fact, the probability of that is much higher than dying in an earthquake. But do you need to be concerned with that anxiety everyday?


LB: Maybe?


JS: Of course not! Because it actually interferes with function. It interferes with quality of life. And there’s zero value added to worrying about that.


LB: So what about treatment options? I’ve heard of psychologists using desensitization therapy to deal with certain patients and their fears. For example, with arachnophobia, introducing a spider into the room and then closer to the patient and maybe even into their hand as their fear responses gradually subside. I can’t imagine something like this being available for a fear of earthquakes…


JS: No, that won’t work. The most effective strategy for that kind of thing is teaching your body to physiologically relax. Because what happens when you’re anxious, people get shallow breathing, their temperature rises, people sometimes might feel dizzy, they might feel stomach upset. There are real physiological changes that happen when we get anxious. One of the things that’s actually really helpful is practicing relaxation strategies, such as deep breathing, diaphragmatic breathing, progressive muscle relaxation, just things that could relax the tension from a physiological perspective. Because it’s hard to feel anxious when you’re physically relaxed. The bigger strategy is something called thought challenging.


LB: Erm…what?


JS: Here’s a behavioral response for something like a disaster: frequent Internet checking. So someone who is Google-ing earthquakes to no end and what might happen and how it’s coming, that’s actually going to feed your anxiety, so behaviorally, what you’d want to do is not do that. You do the opposite of what your urge is, because that’s not a helpful response. And then thought challenging. Going through and looking at your thoughts: Are these realistic, are they accurate, are they helpful, are they controllable, is there action I can take?


LB: In my business, I have to stay up-to-date with world events. Today, it’s pretty hard to turn on the news and not see natural disasters, even retrospectives of natural disasters. Massive earthquakes, for example: we’ve got Los Angeles in ‘94, Kobe in ’95, Haiti last year, Christchurch in February and now Japan again, this time in the country’s northeast. It’s easy to think about these and run with it toward fears of “The Big One” in Vancouver.


JS: So start with not doing the things that are feeding that, fueling that fire. But it’s really hard. There’s no cookie-cutter approach. There are often reasons that people are more predisposed to anxiety. Not always, but certainly past life experiences make a difference. Other stressors, with more general stressors in your life, you’re more likely to get anxious about any one thing. So don’t watch the news. The Internet is the biggest enemy for anyone that is super-anxious. There’s so much unhelpful information out there that escalates fear. You could take any symptom, even the most benign symptom, and within 30 seconds on Google you somehow think you’re going to die.


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