Chasing Life

'Welcome to Chasing Life. You know, the summer of 2005, that was a turning point in this country. Hurricane Katrina. It devastated New Orleans, the Gulf Coast. 1,800 people lost their lives, more than that. Hundreds of thousands of people were displaced. And in the midst of that chaos, something became undeniable. This was not just a disaster about physical damage. There was a psychological toll that was just as real and just as long-lasting, if not longer.

I love you, I need you. At New Orleans' largest public hospital, the goal of the staff today, that nobody dies.

I saw this firsthand.

We are at the point where it's developing nation medicine probably without the power, without light.

I was in New Orleans during Katrina. I was inside Charity Hospital. The storm had just brought the city to its knees and it was total chaos. There was no power inside the hospital and there was all these patients and it was hot. It was August in New Orleans. And every day the doctors would load up some of the most critically ill patients onto these boards, onto these boats, and they would paddle them across the flooded waterways from the hospital to the parking deck and then carry them up this parking deck to the very top and hope that a helicopter might land and evacuate them.

What's going to happen to some of these patients if you don't get them out of here. Two of them have already died here on this ramp, waiting to get out. Two died? In this very spot.

'There were these doctors who were just ambu-bagging air into these patients' lungs, because they didn't have power for the ventilators to work anymore. I still have a hard time reflecting on all that happened in New Orleans at that point. For me personally, it was one of the most defining experiences of my life. But the thing is that Katrina wasn't just about the storm. It was also about what came after, the displacement, the grief, the trauma that has lingered. Long after the floodwaters receded, nearly 20 years later. We've seen these kinds of catastrophic events become more common, wildfires, super storms, floods, pandemics, each one of them leaves behind wounds. Some of those wounds are invisible. So the question often is how do communities cope? How do they heal? What can we learn from the trauma of Katrina? That might help us weather the next crisis. My guest today has spent his career trying to answer those very questions. Stefan Schulenberg is a clinical psychologist and director of the Disaster Mental Health Institute at the University of Mississippi. He was just starting off his career when Katrina hit, and that storm ended up shaping his entire life's work. Today, he's gonna help us understand what has changed, what hasn't, and what we all need to know to be better prepared. Again, not just physically, but mentally. I'm Dr. Sanjay Gupta, CNN's chief medical correspondent, and this is Chasing Life.

We were all targeted, if you will, together by this natural disaster. Do you do you draw a distinction when you have these cataclysmic events that occur in society, such as a war or a natural disaster? How do you sort of think about the difference psychologically long term?

'Even in terms of disasters, when I'm talking about them, it's like no two tornadoes strikes are the same, no two hurricanes are the, it's every disaster occurs at its own unique socio-political, economic, cultural context. And when you're talking about the idea of being targeted or it's a very natural human response to want to blame. You know, and to want to reach out and like, there's this question of why, why did this happen? How did this happened? Why me? Why us? Uh, why now? And this is a critically important question for people to, to answer. Uh, and the more effectively they are able to answer that question in some way that, that fits with their, their worldview. Um, the better able they'll be able to adjust in the short and long term. And what are the best examples I can give of that in the case of like Hurricane Katrina, it could be, you know, if my worldview, if I believe in a, in a God that is very loving and very involved and, you know, has a plan for me, and then this horrible, horrible circumstance happens. How do I reconcile that? You know, how do I make some sense of that? What does this mean that this, this happened, you know, that this challenge is in, is in front of me. And in terms of, you know, like a conflict, say, where you're being targeted, where there's like human involvement, again, it's kind of like, how is it explained? I could explain it in the sense of I'm a good person and there's a bad person who's targeting me, or there's bad group of people who are targeting me. And for, for the worldview kind of sense, that's a way we can explain things. And, um, again, it's very natural in disasters. We want to blame, you know, for something like Katrina and the levees breaking. Who's to blame for that? Right. We knew that that was going to happen at some point, you know, why was nothing done? Why were we not more proactive? And blame is a way of discharging psychological pain, but it's not necessarily a, it, it an understandable one, but not necessarily a helpful one, as far as like helping people to to cope in the immediate short term and the long term.

'Well, why do you think humans sort of gravitate towards that then? Because I imagine there's, there's a strong desire to want to self-soothe and self-heal and the idea like, Hey, I need to understand what happened here. If it's not helpful to do that psychologically, which is what I think you're saying, why do we gravitate toward that?

I think we have to have a reason why. And that seems to be, in my mind, and that's something that we've encountered in various different disaster contexts. It almost kind of like, I think, of throwing you up against the wall where you're kind of, like, I don't understand, like this is so much bigger, I don't even understand, I don't fathom how this could have happened. How do I make sense of that? You know, how do I... process that? And how do I kind of go forward with that? How does that affect my worldview going forward? How do I explain if I believe that good things happen to good people and bad things happen to bad people, which many people do, how do I explain something horrible like a Hurricane Katrina happening to so many good — and that really causes such a major disruption for people and how they answer those questions goes a long way toward how they ultimately respond or recover.

Do you think psychologically then it is, if you're, if you're helping someone after, in the aftermath of some terrible thing like that, do you lean into this idea of the mechanics of what happened here? Is that important or is it more important after in the aftermath of something to just say, look, don't let this shatter your worldview. These things happen. There's more of a randomness to it. How do you, how do you think about it?

'There's nothing like a disaster to make people feel confused, disoriented, to make people question their sense of significance or purpose. Resilience is, is the, the common response that you would expect that people have this, this tremendous capacity, uh, you know, for, for bouncing back and recovering from things. And, you, know, we're looking for ways to help facilitate that. And there's also this idea of post-traumatic growth. That some people will go through these horrible, horrible experiences. And somehow, you know, uh, maybe the disaster brought them closer to their spiritual beliefs. There's nothing like a disaster to help us reorient to what is truly important. A disaster gives us a more immediate sense of, I don't want to take this for granted. You know, we're grateful for, for what we have. Uh, and so, um, even in the context of the disaster. The grief and the turmoil and all these things, we spend a lot of time studying gratitude. I think we're growing as a science is we're not just studying kind of like the symptoms, you know, or looking for diagnoses, but we're looking for, well, what are ordinary responses to extraordinary experiences like a disaster and helping people to understand that.

I find that's a really important point, even on a more individual level, sometimes even with my patients, they want some context. I'm feeling this way. Is this normal? Is this abnormal? And I think it can be helpful to, in that sense, at least remind them that they are not grieving alone.

Absolutely.

Because they've gone through this together, but they're not grieving alone.

Absolutely.

I want to ask about the broader relevance of this, but just as a reporter who was there in the anniversary, do you think anniversaries are important to note, to commemorate in some way, or do they open up wounds of this terrible thing?

Something like a Katrina. So there was so much horror. And again, it can be a reminder of grief. It can be reminder of loss. But alternatively, I think there are tremendous lessons that come from those experiences. And as a psychologist, I try to pull even from the very stuff, I'm looking for the positive, you know, so I'm looking for, you Know, that sense of gratitude, that sense of growth, I look for a sense of lessons learned. And so for something like Katrina, it is a great example of so many things that went wrong. But I also believe that it's incumbent upon us, you know as citizens to kind of remember these experiences and ask that kind of question, are we more prepared? What have we learned? Are we better able to deal with these kinds of disasters? There will be another Katrina. And of course, there have been other just super awful — you know, Hurricane Sandy comes to mind, Hurricane Harvey comes to Maria comes to mind. Um, and that's the question that I always have is, are we better? Are we going in the right, uh, direction, you know, as a culture? Um, are we, and where do you come down on that? Do you think we are? I think we're not learning. I think as much as we should be and applying it as much as we, uh as much, as we could be. Uh, there's a, a positive psychologist by the name of Christopher Peterson and he boils down positive psychology into the simple phrase, other people matter. And so that, that was kind of his, you know, his statement. And I think that is a critically important idea. And, you, when you look at other disasters in some ways, I feel like we're going in the wrong direction. You know, it's, it. We need to not just be looking out for ourselves and our own loved ones, but we need be looking for our neighbors, the other folks that are in our community and ultimately, I kind of liken it to, we are all in that same boat. And it's not, if a disaster's gonna happen, it's gonna be, when is it gonna happen? What is it going to be? Are we ready for it? And, you know, anywhere in the United States that you think about, and really anywhere in world, but, but certainly the United states, it's like we have rock slides, mudslides, hurricanes, tornadoes, wildfires, you know, not to mention like, uh, house fires, extreme temperatures, you know, so many things, there's nowhere that you can be, you know, where you're not, um, necessarily having to consider some of these things at some, some point we're all affected by, by something. But there's also this idea, this illusion of invulnerability. You know, it's like, well, I watched this on the news. This happens to other people. Like, this isn't going to happen to me. This isn't gonna happen here to our community. And trying to help work through that and just kind of say, when you see something on the news, some event, it takes just a second to kind of, say, am I ready? If something happened here, you know, to my family, am prepared for it or what, what might I do? Um, so you see like a, a story in the news of a house fire. Uh, and then it's, it's taking that extra moment to kind of go, if my house were on fire, what do I have a plan? You know, is, are the folks in my family, are they, are they prepared, do they know what, what to do? And it's not about living in fear. It's about being proactive. And when we're proactive, it helps kind of rewire our brain. You know, so that we're better prepared. If we kind of think through this and have kind of walked through this preparation, we'll be better able to function in those stressful moments like we would hope we would.

After the break, the professor reveals how meaning, purpose, and connection can help us survive the worst moments of our lives. Plus, we're going to share some simple habits that can make you more resilient starting today. That's next.

'Is it predictable who you think is likely to be able to rise up in the moment and potentially be a person who's more likely to have post-traumatic growth?

'Well, I think there's, there are certain concepts that, that are studied in, in positive psychology and meaning is one of them that is very, very important. And a lot of times when I say meaning, folks are like, what do you mean by meaning and the modern science of meaning it's, it's broken down into kind of three, uh, areas. There's the worldview. There's my sense of like, how does the world work? And you know. What do I expect is going to happen? You know, what, what is a normal day? Like, you know, we all have that kind of, kind of sense of how the world works. And, um, there's a sense of significance and that's our, uh, like the sense that we matter, you know, and so sometimes people will use the word mattering. I like the word heft. It's like everybody, you know, every human being has dignity, has the capacity for integrity. They have inherent. And we need to feel that, you know, we need to feel like we're valid. You mentioned validating kind of, uh, you know, someone's perspective that they're not alone at the, what they're feeling and thinking is, is, you know, is normal. And that's incredibly important, but we need to come through these events and feel like we, we have value, you know, were important. It doesn't matter who we are or what, what our station is or socioeconomic status or all of that. It's like we all have. Inherent value, inherent worth, and are we retaining that, you know, in that process? And then the other piece is purpose, you know, which is this kind of idea of goal direction, you know, and so are you living your life in a way that is consistent with your values? That is critically important for people's well-being. And there, you people. Often struggle in the sense of everybody else is telling us like what's important. You know, everybody, you get all of these messages, you know, it's kind of like, what does your own voice say? Your true kind of internal voice say about where you should be going. You know what you should do. What were you made to do? What do you feel like you were sort of born to do, do you feel like your, you're kind of walking on that, that path? Thank you very much. Those folks who have a better sense of like kind of a more crystallized worldview, they have a much better perception that they that they matter. They have a much better congruence, you know, with their goals. These folks will be more resilient. They are more protected against things like depression and anxiety. They're less likely to use drugs and abuse drugs and alcohol. The question that I often have for people, which is like, what is your why to the how, you know, what does the reason that you're doing all of the things that you are doing. I have an eight-year-old son and he means the, he means the world to me, you know, and so, um, what are, what, what are our motivations? You know, what is truly the good stuff? What truly matters? And the more in touch we are with that, the more resilient we are, and the more likely when we go through these kinds of circumstances, which we will, the more able we'll be who we want to be, the more resilient will be, and more likely we'll be able to evolve and kind of grow from it. And so those concepts, that's what we. And that's what we are finding to be especially important. What is it that makes human beings at their absolute best when things are at their absolute worst?

Yeah, it's really interesting, again, having covered so many of these stories. You go into a situation, and you're in the aftermath of something awful that has happened. And you see these some characters, some people within that environment, who have just risen up. And they have become these leaders and really been very helpful in very objective ways. But what was interesting to me, Professor, is that when I'd interview some of these people, I'd say hey. A week ago, before this happened, if I told you you're going to be the person that's going to rise up and do this, oftentimes they would say something like, no, no. That's not me. I'm not that person. I'm, not that sort of heroic sort of person. And yet they become that person in the face of a challenge. And I've always wondered if that is something that they are just born with and had not realized if they nurture it. Throughout their lives, are the people who are those heroic figures, are they born that way, do you think?

I think, I think they can be both. I think that's a great, great question. Um, and that's something we actually focus on and talk about quite a bit as, as well as, is you have, you can be trained to operate in that kind of way. Like if you're a first responder or that sort of thing, you can be trying to kind of know what to do. And there's this danger of this kind of bystander effect, you know, of people almost being frozen and just sort of watching things unfold. And you can be trained to overcome that or override that. And, um, ordinarily in a disaster response, the hindsight bias, you know, is always 20, 20, but there are folks that actually kind of wrestle. Like I should have done something. Maybe they had a circumstance like where they felt like I should have jumped in there. I should've said something there. You know, I should of been more proactive. And that kind of thinking about it very often can be associated with guilt. You know, again, I should have done something. Why didn't I do anything? And you're thinking about. And for some people you're almost priming yourself for when something does happen again, then you're in a position to do something about it. You almost have to conceptualize yourself as a person. Like I'm somebody who could do that. I'm somebody, you know, if there was an absolute need, I could, you have to believe that. You have to be able to tell yourself that. But again, it can also be trained and it can kind of come from that sense of, maybe I'm a little disappointed in myself that I didn't respond the way I thought that I should have in this other circumstance. So when something else happens, I'm gonna step in there.

Can you give a concrete example of a positive psychology practice maybe that people can incorporate into their lives that could help them survive, find purpose after a disaster, but also as you're saying, help overcome this, this bystander effect.

'The number one protective factor for people is going to revolve around their social support. And so making sure that you're connected to your loved ones, and these kinds of things can very much be an insulating factor. So the other people matter, I think, is critically important. I think the idea of the meaning piece, it can sound very, very difficult, but this That's why I. Tell most folks if they haven't read Man Search for Meaning, they should read Man Search for meaning. Um, it's a life-changing read and having this kind of sense of, um, you know, Frankel talks in this book about his experiences. He was, uh, in the concentration camps during World War II and he lost most every member of his family. And the book talks about being able to find meaning even in those circumstances. And so, um, I had read that book originally, like in 1994, and it was immediately life-changing in the sense of, if he could find meaning in what I perceived to be the worst circumstances imaginable, you know, for somebody to, to experience, it's like, my goodness, this is applicable to, you know any range of circumstances and the research has borne that out. And so very simply for people, what I would say is to recognize your own inherent value, you have dignity and worth and value. We don't always feel that sometimes depression or anxiety eats away at our sense of, you know, that we matter, but recognizing that you matter, other people matter, having that sense of like, am I listening to my inner voice? Am I doing what I feel like I need to be doing? And we all have to do things we don't want to do. But even in those kinds of times, sometimes we're able to draw a sense of value from it. There are also studies that link meaning to better prognosis in terms of like cancer, in terms a range of what are regarded as purely medical disorders. There's a huge mental health component to it. And so meaning this idea of meaning the perception of meaning the perception that my life has. Value that I know what I want my life to be about is absolutely critical for people to feel connected and to feel good about themselves and is a tremendous protective and growth factor in people.

'You know, I started this podcast talking just from my own personal perspective, having covered Katrina and going there and being at Charity Hospital. You know when my reporting time over there was sort of coming to an end, it was, you know, we'd been there for a few weeks I think at this point, into September of 2005. My youngest, my child, who was just three months old at the time, was my oldest child. She's now 20 years old. I suffered a pretty bad injury and I wasn't home. I was in New Orleans and I was in the middle of a lake essentially on a boat and we were sort of doing this surveillance story about trying to understand what had happened there. Very hard to get ahold of us. And my wife through her own miraculous abilities was able to get satellite phone, call me, tell me what had happen. And my producer at the time, this man named Tommy Evans, who's this incredible guy, I was paralyzed because it's my three-month-old baby, you know? And he somehow got the boat captain to take us to the shore. Another friend of mine, a guy named Miles O'Brien, was a pilot. He helped arrange a plane to get me out of there, because it was a disaster area, as you well know. And I was able to land and she's doing well, but it was a very significant head injury. But I just bring that up to say that 20 years later, like I still think of Tommy and I still think of Miles and I think of these guys and what they were able to do for me. And that mattered to me. And so people's actions in the moment really matter. If you, Professor, could leave listeners with one takeaway about living in a world where as we've talked about, disasters are a part of life. Or I think maybe for some people, they thought I would never be in a tornado or a hurricane or a fire, whatever. So if you wanna leave listeners with one takeaway about living in that sort of world, what would it be?

I mentioned this a little bit earlier. It's not, if something's gonna happen, it's gonna be when something happens. And we just don't know what it will be or when it will, or to what extent it will. This is not about living in fear. Sometimes people feel they kind of shy away from preparedness or don't wanna think about it because I don't want to live my life in fear and that sort of thing. And I think really in positive psychology, there's now a science of prudence. And I think it's, you know, it's kind of a simple understanding of the idea of these things happen, they're going to happen, you know, if I haven't had something impact me yet, I'm blessed and fortunate. I'm grateful, but something will happen at some point. Um, am I prepared? You know, what kind of person would I want to be? My own belief is that, you know, it's a part of our role as, as citizens, you know, is to, to just be vigilant, uh, we don't live in a safe world. Uh, I'm not sure we've ever lived in a safe world, you know, and, um, it, it it's, a matter of being prepared, you know, It takes just one or two extra seconds. You go into a movie theater, for example, of just taking an extra note where the exit is, you know, or, um you know on like a plane, you know, they'll say, you know, take a note where the exit aisle is, you know, and it's kind of like, well, you actually not just want to take a note where they exit out, you're actually want to sort of count the number of seats, because sometimes what might happen, you could have some smoke could fill the cabin. Maybe you can't see a thing, you know? And so these, these, there are extra kinds of things like that, that you can do, uh, that they don't really take a lot of mental energy of just kind of going like, okay, I'm just making a mental note of this is sort of the path. You know, the exit or what have you. You want to envision if you imagine what kind of person you want to be, you know you're much more likely to kind of follow through with that. And that's why I think that there's a lot of mental preparation that's important and then the actual like physically doing it.

That was Stefan Schulemberg Clinical psychologist and director of the Disaster Mental Health Institute at the University of Mississippi. Thanks for listening.