'Play therapy' essential for children who suffered trauma from twin quakes

Defne, 9, cannot forget the earthquakes in Turkiye. She failed to hold back her tears when she spoke to a news reporter of a private news channel about it.

“Here they distribute toys, they distribute everything … they help children, sad children, over there … But I can’t forget … the earthquake … I’m trembling with fear,” the young girl from the country’s southern province of Hatay said, her voice quivering, before she burst into tears.

Defne is among the thousands of children who have been left traumatised by the powerful twin earthquakes which jolted the southern region of Turkiye on 6 February.

At least 42,000 people lost their lives, and more than 108,000 people were left injured by the massive quakes. According to UNICEF, around 5.4 million children across Turkiye have been affected by the tragedy.

Clinical psychologist, Zeynep Bahadir, spoke to Anadolu about the symptoms that earthquake-affected children may show in the wake of the deadly disaster, fear and anxiety being one of them. They may feel scared about what is happening, or something that they have not experienced before.

“Even if they are not physically harmed, the experience of feeling the ground shake and changes around them can be real traumatic,” she said.

If the intensity of the earthquake is very severe, children who have been directly affected or have witnessed injuries and deaths around them, can be at the risk of Post-Traumatic Stress Disorder (PTSD) symptoms, which can lead to flashbacks, nightmares, avoidance behaviour and very high level of anxiety.

Children can also experience separation anxiety, depending on their age, with pre-school children being more bound to their parents and wanting to remain closer to them than before.

According to her, fear can persist in children long after the earthquake has passed, which sometimes can be temporary and, in other cases, can later adapt into their lives.

Bahadir, who has also worked with the Turkish Red Crescent, says that children can also become depressed, particularly if they have lost someone, or if their lives have been disrupted. This can lead to hopelessness, loss of interest in activity, appetite and sleep. Behavioural changes such as irritability, anger, struggling with school activities and homework can also take place.

Using play as therapy

But before children are given therapy or taken to a psychologist, Bahadir feels that children should be provided a space to play, and emphasises on ‘play therapy,’ which is the most effective for young children.

“They (children) should be given space to express themselves. Playing is the most important tool for them.”

The expert says that it is important that children play with toys related to the event. In this case of an earthquake, toys such as wooden blocks, ambulances, cars’ repair kits, doctor sets, trucks, excavators should be incorporated in their play.

“They (children) should not be avoiding them because toys are their words. They can express themselves with these toys. They can play with these to digest the situation.”

Drawing is also helpful, she points out, and by giving children colours, paper and space, they can be observed. Stories which symbolise the event can also help. Citing an example, she said that stories of migratory birds can be narrated to children to understand why they had to leave their homes and move away.

The psychologist says that the approach of adults is important. They should not avoid facts, but refrain from giving lengthy and confusing information to the children.

Give a short but very precise explanation of what happened, she said.

To minimise the impact of the tragedy on children, the government and many organisations are providing psychological aid to the earthquake victims – UNICEF being one of them.

Behavioural changes

Sema Hosta, head of Communication, UNICEF Turkiye, told Anadolu that psychosocial support was given to the children in tents, camps and service points.

For each age group, the support being offered is different as psychologist impact on children may differ, as every age group needs to be considered separately.

“School children can react very differently; they can be angry or even aggressive. A child who was never aggressive before may try to hurt their siblings physically. What we have to do is to understand what those children feel and direct them to psychological help as a first step,” she says.

The 0-2 age group will want to be as close as possible to their parents, but the 3-5 age group will react differently and may feel guilty and feel the need to cry all the time and not want to stay alone at any time.

“If you have lost your loved ones such as parents or kids, this is bound to affect your psychology and worsen the post-traumatic symptom,” she said, adding that singing, drawing and playing can help children to get out of the trauma.

“The effect of the twin earthquakes on families and children is devastating … Children are the ones kind of more traumatised than the adults, like in any disaster, either man-made or natural.”

But psychosocial support helps. Hosta recalls that a young person contacted them through social media and told them that their counselling during the 1999 earthquake in Istanbul helped him. “You helped me and my friends a lot back in 1999 with your psychosocial efforts, and I’m sure that you’ll do whatever you can for the affected children now. We are ready to undertake any responsibility to help them too,” he wrote to her.

Long-term trauma

A* agrees that psychological aid is extremely vital for young survivors. Although she did not opt for therapy after experiencing the 1999 earthquake, she feels counselling helps to understand the situation that follows after the disaster.

A* was 10 years old when the 1999 earthquake shook Izmir and adjoining areas. She and her family were in Yalova at that time, having arrived from Kayseri, barely three nights ago, to settle in the town.

A* vividly remembers that night. She was awake, and had returned to the bed after using the toilet, when she suddenly felt the ground shake.

“I couldn’t understand what was happening. I thought a truck was passing on the street that’s why everything was moving.” Her mother and two aunts led her out of the house and, together, the family spent the night outdoors. In the morning, A* left for Istanbul, to live with her grandparents.

“I was very scared. I didn’t return to Yalova for six months, even though my parents were there. I remember seeing broken glass, hearing too many sounds after the earthquake.”

Unfortunately, experiencing the 1999 earthquake impacts her even today, as she still is terrified.

In 2015, she was in her office in her university when a magnitude 5.8 strong earthquake shook Istanbul. “I started to scream. I couldn’t move but I was just screaming,” she recalled.

After the 6 February earthquakes, she is having difficulty sleeping at night. “I can’t sleep now, thinking about what if an earthquake strikes where I am.”

(*Name changed to protect identity​​​​​​​)

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