A THEMATIC MODEL OF COPING AND HELP-SEEKING: LIVED EXPERIENCES OF ANXIETY AND EMOTIONAL REGULATION AMONG FLOOD-AFFECTED COMMUNITIES IN PAKISTAN, 2025

Abstract

Background: Floods are recurrent climate disasters in Pakistan that produce long-lasting psychological burdens which often outlast visible reconstruction. Despite high population exposure, little is known about how affected communities interpret, regulate, and cope with flood-related anxiety within local religious and family systems. Objective: To develop a culturally grounded thematic model of anxiety, emotional regulation, coping, and help-seeking among adults affected by the 2025 monsoon floods in Pakistan.

Methods: Using reflexive thematic analysis, semi-structured interviews were conducted with 15 purposively sampled adults (8 women, 7 men; ages 29–56) from Sindh and Punjab approximately one month after flooding. Interviews were transcribed in original languages, translated into English with back-translation checks, and analyzed inductively to generate themes.

Results: Six interlinked themes emerged: Immediate Trauma Response; Persistent Environmental Anxiety; Emotional Regulation in Cultural Context; Coping Strategies; Barriers to Formal Help-Seeking; and Collective Resilience and Post-Traumatic Growth. Participants described acute fear during the flood that conditioned everyday weather cues into chronic hypervigilance and intrusive re-experiencing, expressed through idiomatic and somatic language. Emotional regulation was relational and gendered: suppression preserved family functioning and social reputation, while women used private female networks for disclosure. Religious practices and mosque-based communal support served as primary regulatory resources, but sometimes moralized persistent symptoms, discouraging formal help-seeking. Poverty, travel costs, service scarcity, and reputational stigma created major access barriers. Community-based, faith-integrated supports and mutual aid were important resilience mechanisms.

Conclusions: Flood-related anxiety in Pakistan is an ecological phenomenon shaped by faith, collectivist emotion norms, and structural inequities. Disaster mental-health responses should be embedded in religious and community platforms, decentralized, low-cost, and gender-sensitive to address both psychosocial needs and access barriers. The thematic model offers a culturally attuned foundation for designing hybrid community-faith interventions.