The painful metamorphosis of grief

Innovative therapy outreach leaves some rehabilitated, others at risk of breakdowns

PESHAWAR: The city was not prepared to handle the psychological rehabilitation of hundreds of families, just as it was not prepared to bury the bodies of over a hundred children.

A team of psychologists eventually reached over a hundred families, but ot before experts – in Pakistan and abroad – scrambled to find more experts, to train teams. And, as they built teams and protocols over a three-month period, families withdrew deeper into grief.

After a month of therapy, some of which was not well-received, 20 families were removed from the list of those considered vulnerable by the Lady Reading Hospital-led team of therapists. This is amid psychologists’ fears of families suffering severe emotional breakdowns during loaded events such as festivals and December 16 commemorations.

Withdrawal

“People would advise me to stay calm but the explosions at intervals inside would not allow it; three of my sons were inside,” recalled Zeb Hussain, the father of Mujahid Hussain who died in the terror attack.

“What would you do if your sons are caught in a war zone? It felt like my world was coming to an end; I thought I would breathe my last with every explosion.”

Two sons, Shahid Shah, a tenth grader, and Majid Shah, a fifth grader, were rescued but Majid Shah did not make it.

“I lost my world. I just wanted to stay in a quiet, dark room, out of everyone’s reach, even my own family,” shared Hussain. He confined himself to one room for months. “He was clinically depressed but we made progress – about 40 per cent improvement,” said Dr Adnan who has been offering outreach services to Hussain and family.

He said four sessions have been conducted with measurable progress as Hussain was slowly returning to a healthier routine.  “It cannot be done in ablink of an eye; we expect he needs more sessions but as far as I have observed, recovery has begun.”

Measures taken

Around eight days after the carnage, mental health experts arrived in Peshawar and started training teams of psychologists and psychiatrists. The most important aspect was collecting data on the families keeping in mind security concerns. This process took three months.

Experts trained students from the University of Peshawar, faculty from National University of Science and Technology (NUST), Khyber Teaching Hospital and Combined Military Hospital.

According to officials, some families got in touch with the CMH Peshawar for therapy. Around 100 families were reached by LRH teams. Some were reluctant and many regretted the therapy.

“We were clueless [about how to proceed] and honestly were not prepared for it but we had to do it at all costs,” says Dr Mukhtiar, LRH psychology department head. “We had to launch our activities but implementing it was massive hurdle.”

The teams were told to adopt culturally-oriented guidelines and outreach services. “This was why 90 per cent families benefited from outreach services and only 10 per cent visited therapy centres.”

“There was no concept of mental health in Peshawar and what was undertaken after the APS attack has not been done during the entirety of my career,” Mukhtiar told The Express Tribune.

UoP Psychology chairperson Dr Erum Irshad told The Express Tribune many families approached them and were offered free services on campus.

“Over 40 families were in close contact with the department which has the required set-up in place.” She said initially they attempted providing outreach services but those were later withdrawn.

More needs to be done

Interviews of survivors and bereaved family members reflect loved ones, teachers, friends are struggling to emerge from their cocoon of grief and still need professional help.

Mir Alam, a teacher at APS, told The Express Tribune, “For the first two months, students spent the days participating in games and recreational activities.” He added that many students find it hard to forget their fear.

“He wakes up at night, screaming in terror, ‘Mama, he is here, he will kill me.” Said Mrs Zafar, the mother of APS survivor Shehryar Zafar, 15.