No K and Katrina Brain: Lessons Learned from the Therapists of New Orleans about Living and Working in a Devastated Community

Reading Adrienne Harris's meditation on Sandy (in this issue of D/R), on helplessness, terror, and no K, reminded me of the first visit I made to New Orleans in October 2008, three years, a month, and a few days after Hurricane Katrina had devastated the region. I had been invited to develop a program for local mental health professionals who were still trying to make sense of the impact of the storm on themselves and their patients. Many of them were alarmed by the epidemic of senselessness that had swept into the city with the storm and continued to bedevil their lives and their practices.1

Most of the clinicians I met with in New Orleans had evacuated before Katrina. Two days later, they found themselves watching television helplessly as the city flooded and burned, uncertain whether they would ever return home. They were exposed to scenes of collective death and vast suffering, an apocalyptic vision in which many feared they were seeing the end of New Orleans and their lives as they knew them. On their return home, they were startled by the presence of armed militia, discouraged by how few neighbors had returned, and by the fact that many familiar venues—stores, places of worship, restaurants, homes, and professional offices—had been abandoned. “Katrina was a nightmare, but we still haven't woken up,” one told me in 2008. Many found themselves in the state of psychic equivalence where fantasy and reality merge, outside and inside are no longer easily distinguished, and familiar boundaries become porous. Most disorienting of all was the ongoing experience of mindlessness, Bion's no K. This state of mind, that is, of no mind, was so familiar to everyone in New Orleans that it even had a name: Katrina brain. The apocalyptic anxiety New Orleaneans had experienced had disrupted their ability to think clearly and flexibly, to use thoughts constructively, to imagine different outcomes to different situations, the kinds of thinking that clinicians depend on in their work