Mental health for survivors following a disaster

My work in Japan changed dramatically on March 11, 2011, when the magnitude 9.0 earthquake and tsunami in Tohoku occurred. Operation Blessing’s disaster relief expert had flown to Japan to initiate relief efforts. I initially assisted them as a volunteer but that turned into a full-time role leading their efforts in Tohoku. This work expanded to other areas and has continued for the past 13 years through an office in Sendai.

Addressing trauma

It wasn’t until my involvement in disaster relief that I came to truly appreciate the impact of traumatic events on mental health. As we met those who had experienced significant trauma, we realized that merely addressing physical needs such as food and water was not enough. We had to understand the trauma, and implement programs that also provided psychosocial and spiritual support to address the grief and loss these people were experiencing. This journey has been a learning curve, helping not only others but also myself personally. I learned firsthand how secondary trauma, or compassion fatigue, could affect an aid worker due to constant exposure to trauma victims as well as what steps one needs to take to recover and protect oneself.

You are normal

One of the essential messages we learned to convey to survivors at shelters (hinanjo) and temporary housing (kasetsu jūtaku) was that the unusual symptoms many experienced—sleeplessness, hair loss, lack of appetite, and anxiety—are normal reactions to traumatic events. For those experiencing these symptoms, hearing “this is normal,” that there is nothing inherently wrong with them, can be reassuring. Their bodies are simply reacting to the trauma, a response supported by scientific literature. Engaging in human interaction, crafts, artwork, music, and community involvement can help alleviate these symptoms for many people. Recovery varies for each individual; some recover more easily than others. Previous traumas, such as childhood abuse or domestic violence, may exacerbate symptoms and those people require more time and expert care.

Seeing the blue sky

I remember Mrs. Miura, the wife of a fisherman from the Kesennuma area which was devastated by the tsunami. They lost their home, boats, and even the beauty salon she operated overlooking the harbor. We had provided her husband with a small fishing boat, one of 40 given to the local fishing community. She joined us for an ochakai (tea party) at a temporary housing facility where she learned about trauma and self-care. I will never forget her words from 12 years ago when she said goodbye: “Aozora ga miete kita” (I can see the blue sky). This Japanese expression conveys a sense of relief or optimism akin to seeing clear skies after a storm. Since then, we have hosted many ochakai designed to provide trauma relief to those in temporary housing through arts, crafts, and cooking.

Trauma and children

Recently, eight months after the Noto earthquake of January 2024, we held a two-day event with Christian artists and entertainers for children at the temporary housing there. Later we were told that several children who had not eaten well since the earthquake were now eating properly. Many of our programs across Japan after a disaster provide opportunities for adults and children to engage in activities and discuss their experiences with our staff and volunteers. We have seen positive changes in children and their families through these efforts.

In Minamisōma, Fukushima, 25 km north of the damaged nuclear plant, we continue to hold events for children, all of whom were born after the disaster and had no direct experience of it. However, as the offspring of parents who endured the trauma of March 2011 and the ensuing nuclear disaster, they unknowingly grapple with the effects of trauma, living in homes filled with uncertainty and restlessness. It is well-documented that trauma can be passed down through generations.¹

Post-traumatic growth

One of the big lessons we also learned was the concept of post-traumatic growth, the understanding that trauma can spur someone on to psychological and spiritual growth.² Trauma does not have to be a dead-end experience but an opportunity to become stronger, improve relationships, discover new possibilities, grow spiritually, and develop an enhanced appreciation for life. A powerful metaphor we have shared in seminars along these lines is the traditional Japanese art of kintsugi, where broken pottery is repaired using lacquer mixed with powdered gold. This mends the brokenness in a way that makes the object unique and more beautiful than it was prior to being damaged.³

Trauma is an issue for all

Mental health is a concern not just for disaster survivors but for anyone, as life has challenges, and trauma is prevalent in work and relationships. Over the years, I have observed that it is also a significant issue for Bible-believing Christians in Japanese churches and even within the missionary community. Unfortunately, most pastors lack training in mental health, and there are few Christian psychiatrists or counselors in Japan who can provide perspectives on mental health beyond secular viewpoints. Recognizing the need for a balanced and expert Christian approach, we invited Dr. Grant Mullen, a Christian mental health physician who practiced for 25 years in Ontario, Canada, to conduct a series of seminars in Japan on behalf of Operation Blessing. These seminars were based on his book Emotionally Free—A Prescription for Healing Body, Soul, and Spirit, which was translated into Japanese.⁴

A doctor’s journey

Initially an anesthetist and general practitioner, Dr. Mullen was drawn to psychiatry after many of his patients sought help for emotional pain he was not trained to address. Several were Christians who were not being helped within their churches, feeling ashamed to discuss their struggles. Dr. Mullen realized many of these problems were due to chemical imbalances in the brain and could be effectively treated with appropriate medication.

When a female patient challenged Dr. Mullen in a gruff man’s voice and was only silenced by rebuking in the name of Jesus, Dr. Mullen came to understand the role of the demonic in some cases and the mental anguish the enemy seeks to inflict. He also learned how the believer’s authority, as outlined in scripture, could set people free from such influences.

Dr. Mullen then faced a personal crisis in his marriage. Taking a pill was not the solution, nor was it apparent that a demon was involved. After seeking Christian counseling addressing negative thought patterns and emotional wounds, they learned the importance of dealing with emotional baggage. Through these experiences, Dr. Mullen developed his three-part approach to mental health, integrating medical, psychological, and spiritual methods that he teaches together with his wife, Kathy, around the world. He encourages anyone seeking emotional freedom to consider each of these three aspects—body, soul, and spirit—when dealing with mental or emotional struggles.

Resources to share

Wherever we’ve held these seminars in Japan we have received overwhelmingly positive responses, with many participants sharing that they have been personally helped and have gained tools to assist others around them. One of our goals is to help the Japanese church better understand mental health, enabling recovered church members to reach out and support others, both Christian and non-Christian.

Dr. Mullen’s book Emotionally Free (Kokoro no Kaiho こころの解放) is available for purchase in English or Japanese on our website at: https://objapan.org/drgrantmullen There are also links to seminars on our YouTube channel https://www.youtube.com/user/operationblessing, such as trauma relief sessions held in temporary housing and Dr. Mullen’s Emotionally Free seminars in Japan, presented in both English and Japanese. Dr. Mullen’s website can be found at drgrantmullen.com.

If you are interested in becoming involved in our programs as a volunteer or participating in a future seminar or have questions, please contact our mental health programs coordinator at keiko.takahashi@objapan.org in English or Japanese.

1. Mark Wolynn, It Didn’t Start with You: How Inherited Family Trauma Shapes Who We Are and How to End the Cycle (Viking, 2016).
2. Richard G. Tedeschi, Crystal L. Park, and Lawrence G. Calhoun, Posttraumatic Growth: Positive Changes in the Aftermath of Crisis (Lawrence Erlbaum Associates, 1998).
3. “About Kintsugi Hope,” Kintsugi Hope, https://kintsugihope.com/vision (accessed October 22, 2024).
4. Essence Publishing, 2017
Photos submitted by author