This appeared last January 25th on the old OTBKB:

There wasn’t even a word for depression in Sri Lanka
until a few years ago. Not that they didn’t need it. Doctors there say
that people express their unhappiness by having pain, back aches, or
difficulty sleeping. And by commiting suicide. Apparently, Sri Lanka
has one of the hightest suicide rates in the world.

In New York there must be 40 words for depression. If not more. 

Sri
Lanka, with a population of 20 milliion people, has only about 30
psychiatrists. Very few of them speak the language of the Meulaboh
region, which was badly hit. Needless to say, therapy is not a common
activity in that part of the world. Unlike New York City, the Sri
Lankans are not held together by the loving thread of trained
therapists. Not to mention Zoloft.

There must be thousands of therapists in Brooklyn alone. 

No,
a stop at the shrink’s office is not a weekly occurrence in Sri Lanka.
How spoiled we are in New York City where the examination of one’s
navel is considered a necessity not a luxury. And yet, Smartmom
believes that navel examination truly is a form of preventive health
care. In so many ways, New Yorkers benefit from their weekly
exploration of self. Without it, Lord help us: New York would be a
whole lot more neurotic and/or psychotic than it already is.

Just imagine New York without therapy.   

But
in other parts of the world, there’s just too much else to do — like
survival — to have time for such things. Religious institutions
probably do their part. Buddhist meditation is just one example of a
spiritual practice that is, in its way, deeply psychological in nature.

The people of Sri Lanka are a stoic people with a strong belief
in god’s will, and a different (maybe better) relationship to death.
Even in a crisis of this magnitude, they carry on. Call it denial, call
it pragmatism, they are grieving quietly and privately while rebuilding
their lives. What other option do they have?

And yet, grief and
trauma can wreak havoc on people’s lives. Experts have observed that "
suicide rates drop in times of crisis but then bounce back up again –
to higher levels than they were originally," writes Denise Grady in the
New York Times.

Mental health experts the world have made
offers of help. But the Sri Lankian government is asking them to stand
back and respect the nature of the Sri Lankan culture. They believe
that the deep religious beliefs of the Sri Lankans and their strong
sense of community and family will help them through this tragedy. And,
in most cases, they are probably right.

One Sri Lankan
official quoted in the Times said that "too many irrelvant, inept,
strange ideas from other countries could do disservice to tsunami
victims." He was especially adamant that de-briefing, a technique where
disaster victims are encouraged to talk about traumatic experiences
after a disaster, would be especially harmful.

Smartmom is
familiar with this argument. She has been working with the FDNY since
December 2001 on a newsletter for the families of those who lost loved
ones on September 11th. After the WTC disaster, firefighters were
debriefed and urged to talk about the tragedy in great detail —
apparently it helped them a lot. They were also encouraged to partake
of the free counseling services available 24 hours a day at the
Counseling Service Unit.

After 9/11, many health care
professional from around the world offered their services to the FDNY.
Fairly quickly, the FDNY realized that mental health professionals
without the proper understanding of the fire department culture could
do more harm than good. Over time, the FDNY expanded its counseling
staff in order to provide appropriate care for those who were suffering
from various degrees of post-traumatic-stress and grief.

Firefighters
are also a stoic lot with a strong sense of family and religious ties.
For them, therapy helped them with the on-going grief and stress. At
first it was hard to convince those who are used to helping others that
they needed help. But many of them came around because they were
suffering so much. And their recovery was fairly rapid once they went
in for counseling. There’s no telling how much alcoholism, drug
addiction, spousal and child abuse, and suicide were avoided because of
this.

So, Smartmom wonders how the Sri Lankans will fare
emotionally. What of the parentless children, the parents who lost
their little loved ones, those who saw whole communities die — how
will they get through this? Is it true that this community will be able
to escape "post traumatic-stress" simply because of their cultural
background?

There is no one-size fits all solution to recovery
from tragedy. A person’s mental health prior to the event, resilience
and resourcefulness must all be taken into account. People are very
unique in the ways that they heal; in how they like to take care of
themselves.

Smartmom is grateful for her weekly trips to her
therapist, her shaman, the man who helps her "see." Her problems are
fairly minor compared to those of people in other parts of the world.
But still, she believes in the value of self-examination and is
thankful that she has the option.

Everyone needs help from time to time.