Survivors of Türkiye’s Earthquakes Need Mental Health Support

Life is a series of unpredictable events. The key lies in accepting the uncertainty and being comfortable with it. As a therapist, I am very fond of the cognitive-behavioural approach in which we draw a couple of concentric circles. In the inner circle, we list things which we can control, like what we wear while the outer circle is reserved for phenomena we cannot control, like the weather. The aim of this simple activity is to make the clients focus on what they can change rather than beating themselves up over things they have no control over. Little did I know how relevant this activity would become to my life after the earthquakes hit Türkiye and Syria on 6 February, 2023.

At IPAM (Ibn Haldun Center for Psychotherapy & Research), Istanbul, we are a team of more than fifty therapists and mental health professionals. I still remember the shock from the news of the quakes and feeling helpless on my way to New Delhi from Kashmir where I had just said my goodbyes to my family after a month’s vacation. As the news and devastation were still evolving, I called my wife in Türkiye to ask about her whereabouts and I was relieved to find that she and the family were safe. But within a few days, the death toll had crossed 20,000 and all I could feel was helplessness. Meanwhile, our supervisor and clinical coordinator were surveying the earthquake-hit areas to identify regions which needed immediate interventions.

I was initially entrusted with designing posters for children and adults that included deep breathing and relaxation techniques that could help affected people. By the time I reached Istanbul, our first team of fifteen volunteer therapists had reached Adiyaman—one of the worst-hit areas which lost more than 15% of its inhabitants to the earthquakes. I was part of the second group of volunteer therapists, and the primary aim was providing immediate psychological first aid and meeting the urgent demands of shelter, food, and clean water. The first month is known as the acute stress period. The actual therapy work starts after the initial month and the diagnosis of post-traumatic stress disorder is also given after the first month as many people heal by themselves in this period.

We were deployed at Egricay, a stadium with more than 400 tents and around five thousand inhabitants. When I entered the campsite, it looked very dystopian and chaotic. But humans have a way of finding order in chaos. The soldiers had done an excellent job of pitching all the tents and maintaining law and order. Our first group delegated the tasks to us and there was no time to lose. We partnered with the Turkish Red Crescent for on-ground and logistical support. I took a tour around and familiarised myself with the campsite and available amenities. This was going to be home for the next two weeks.

Each day, we paid tent visits to make notes of the needs of the affected people. Due to fear, many of the affected people had not left their tents, except for getting food, water, and other essential amenities. It was sad witnessing the plight of the affected people. Growing up in Kashmir, I have had my fair share of hard times—the 2005 earthquake, the floods of 2014 and the overarching political conflict. I felt a strange bond with these people; perhaps it was the suffering or the mutual sense of loss. Either way, I had a job to do—to work on the well-being of the affected people.

We worked with children a lot. We would do drawing activities and most of their drawings would have a house or a building in it—children’s way of expressing their wishes or perhaps what they lost. There was also separation anxiety among the children and the parents too. After the earthquake, some of the children wouldn’t leave the side of their parents and many parents wouldn’t let their children go far from sight. The sense of loss felt heavy, and I was reminded of Kashmir again and again.

I would talk to young men mostly and many of them carried what we call ‘survivor’s guilt’ borne out of the notion that questions why they are alive: ‘it should have been them who should have died rather than their loved ones.’ It was a difficult emotion to console. Many times, I felt this helplessness and feeling that no matter which intervention I used, ultimately, it wouldn’t bring back their loved ones. Though true, the stories which people told me did have a positive impact upon their narrators too. It helped them process the emotions and create some meaning out of what had happened. When stories are told in safe spaces, shame and guilt disappear slowly and acceptance comes in.

I was also surprised by the faith of Turkish people in God. People were not lamenting and complaining. They had, by and large, made peace with the fact that it was an act of God which they had no control over. Everyone was trying to help one another. Such faith brought a sense of unity among the affected people of the whole campsite. We all stood in the same lines waiting for food and water. We used the same facilities, and it made me ponder over the similarity in human suffering. There was a single mini grocery store in a container right outside the campsite. I went once and to my knowledge it was the only place where I used money in the period of two weeks. Cash and credit cards had no value as there were no takers.

The two weeks of volunteering ultimately gave me a significant perspective. Things can change overnight, literally, and we must embrace the uncertainty of life. One day you have everything—a house, a family, a car, a job, things you take pride in and within a single night, it can all well be gone. This can arguably happen to anyone. Things we work a lifetime for can suddenly become meaningless while what really would have mattered and been valuable often remain undone and what follows then essentially is regret, and regret is a huge burden to live with. In the words of Rabindranath Tagore, “Spring has passed. Summer has gone. Winter is here, and the song I meant to sing remains unsung. For I have spent my days stringing and unstringing my instrument.”

(This appeared in the print edition as "The Mind In A Quake")

(Views expressed are personal)

Yaqeen Sikander is a Psychotherapist & Research Scholar in Clinical Psychology at Ibn Haldun University