CRISIS OPTIONS

9/11 Article: How to Cope

We All Saw It. What Has It Done To Us?
What Can We Do About It?

by Jim and Jeanne Caverly

Tuesday, September 11, 2001, was like no other day for almost everybody. Both the World Trade Center in New York City and the Pentagon in Washington DC came under attack by terrorists.

One of the tenets of the worldview of most Americans up to 9-11-01 was that of safety. Yes, we have been exposed to this thing called terrorism in our recent past, but for the most part, it was a single attack perpetrated in a manner and with consequences that allowed us to retain our worldview without major adjustment. Those close to the epicenter of past attacks knew life had changed; but, for most of us, it was a return to life as usual. The magnitude and nature of the 9-11 attacks has altered the worldview of most Americans.

What's ahead? How will this one week impact on each of our lives? Where are we headed as a nation? All tough questions. No easy answers.

During my years of employment as an FBI Agent, one of my assignments was to serve as the Team Leader of the FBI's Critical Incident Stress Management (CISM) Team. I had opportunity to work with that team at the recovery site in Long Island after the crash of TWA Flight 800. I spent time with some of the folks from Oklahoma after the bombing of the Murrah Federal Building in Oklahoma City. Since 1990, both Jeanne and I have worked closely with numerous survivors of police officers killed in the line of duty.

Each tragedy is somehow unique and yet one thing remains the same. As we listen to immediate survivors, to those who serve as rescue personnel, and to those who experience vicarious exposure (through media reports and other second-hand exposure), we hear the same reports. People exposed to critical incidents frequently experience a variety of reactions, including, but not limited to, one or more of the following:

- general irritability or anger
- depression
- feelings of unreality
- fear
- insomnia and other sleep disturbances
- unable to concentrate or focus
- intrusive images or thoughts
- deep sadness
- physical pain, often in the neck or lower back
- nightmares and/or flashbacks
- loss of or excessive appetite
- increased smoking
- alcohol or drug abuse
- migraine headaches
- hyper-alertness
- startle reactions
- avoidance of stimuli connected to the trauma

No one has been able to forecast who will be most affected and which symptoms will be most troubling. Some report delayed reactions, others report no unusual reactions. The most important thing to know about critical incident stress reactions is that they are normal reactions to abnormal events and usually begin to subside in intensity within thirty days following an event. The continued presence of troubling symptoms can cause severe debilitating consequences for both your emotional and physical well-being. If you find you are experiencing severe stress reactions for longer than 30 days or that they are significantly hampering your ability to function, then you might consider seeking additional help in the form of professional counseling and/or medication from your doctor. Physical symptoms may indicate the need for immediate medical evaluation and should never be ignored. When in doubt, always contact your physician.

Reactions to trauma can impact on your ability to return to work, affect your interpersonal relationships and significantly reduce your overall quality of life. There is no magic to eliminate the horrible reactions and feelings generated by the attacks in New York and Washington DC. There are some positive and pro-active things we can do to help both ourselves and our loved ones adjust as we face the future.

1. Family - share your concerns with family members. Use family rituals (dinner together, Sunday picnics, going to church together, etc.) to encourage closeness and to regain a sense of control over your life.

2. Rest - get enough rest (at least 8 hours per night). Drink warm milk or chamomile tea to relax at bedtime.

3. Exercise - stick to your regular exercise routine. If you don't have one, consider walking 20-45 minutes every day. Consult with your physician before beginning an exercise program.

4. Diet - eat well-balanced, regular meals - even if you don't feel like it. Minimize your use of sugar, soda, caffeine, nicotine and alcohol.

5. Social Support - use your support system. Return to your normal routine, as much as possible. Do things you enjoy. Limit the amount of time you spend re-visiting the tragedy through TV, newspaper, and magazine reports.

6. Talk - with friends, loved ones, co-workers, clergy, a counselor. Let others know what is going on. Withdrawal and "stuffing the pain" can make recovery more difficult.

7. Reach out to help others. We have all been affected by this tragedy. By helping each other, we will help ourselves and our country move forward.

The following guidelines are offered to assist you in helping children deal with a traumatic event:

1. Always tell children the truth. Answer their questions directly and clearly. Do not give more information than they asked for. Children will ask more questions if they want more information.

2. If you don't know the answer, say: "I don't know, but I'll find out" or "Let's find out together." Then do it.

3. Explain in a concrete, direct way what has happened. Use everyday, matter-of-fact language. Use accurate terms (dead, death, suicide, grieving, etc.). Be sensitive and gentle.

4. Explore the child's perceptions of the event. Correct misunderstandings. Discuss difficult subjects if the child brings them up (suicide bombers, terrorism, etc.). Be prepared to do this properly.

5. Assure your children that you are doing everything you can to keep yourself and them safe.

6. Limit TV watching so that you and your children are not constatntly re-traumatized by media coverage of search and rescue efforts, clean-up efforts, funerals, etc.

7. When kids are processing trauma (play-acting, playing with dolls or other figures, drawing, writing, etc.), let them do it as long as they are not hurting themselves, someone else, or property.

8. Stick to the child's regular schedule and established routines as much as possible, especially in relation to bedtime. Spend extra time with your children at bedtime.

9. Introduce a family ritual (such as burning a candle, saying a prayer at meals, etc.) for a limited time after the event to acknowledge your own and your child's reactions.

10. Pro-active activities (collecting money for the relief effort, sending sympathy notes or cards, expressing sympathy by drawing pictures or writing letters, etc.) can be very instrumental in giving children a sense of control and meeting their need to "do something" to help.

11. Hold, hug and touch your children often. Be more tolerant of unusual behavior.

12. Help your children to identify, label and express their feelings. Let your children know these feelings are normal. Model honesty by describing your own feelings at a level that is comfortable and appropriate for the child. Allow your children to mourn or grieve over their losses.

In the words of Dr. George Everly of the International Critical Incident Stress Foundation, "Terrorism is psychological warfare. This is a war that is won, not on the battlefield, but in the mind." And from Nina Hershberge who grew up with terrorism in Israel: "The most important point - the aim of terror is to break your spirit. The best way to fight back is to do tomorrow the same things you did yesterday. Don't let them break your spirit."

Both Jeanne and I experienced a myriad of emotions surrounding this tragic event - inability to focus, deep sadness, and anger, among others. We have come to the conclusion that the best way for us to honor the memory of the victims and their families is to maintain our faith in the goodness of others, our hope in the future, our trust in democracy, and our belief that good will triumph over evil. We will focus with a clear mind on what we can do - one interaction at a time, one day at a time - to help America move forward.

Note: If you find this information helpful, please pass it on. Permission to reprint entire article is granted. This information is not a substitute for professional care. If you have concerns, please seek professional help. For more information on critical incident stress and helpful coping techniques, see: www. icisf.org or www.emofree.com.

 

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