ABSTRACT
Being a general practitioner in Australia at the time involved intensive outreach and home visits, and this has always given his both confidence in and a sensitivity to the meaning of outreach to peoples’ own places of home and community and the particular issues of “helping” relationships in such settings. The uncertain and acute nature of the postdisaster environment, the lack of a “patient” label for those to whom outreach is offered, and the mental health worker’s or psychiatrist’s identification with those affected that occurs in disasters can all compromise attempts at intervention. Vulnerability factors may lead to feelings of helplessness and preoccupation with structured approaches to reassure oneself in the face of distress and chaos, to excessive empathic involvement, or to numbing, automatic, or withdrawal responses. Nevertheless, engagement with disaster-affected persons also helps one to recognize the powerful forces of resilience in almost every case. There are also new things to be learned.
