In the days following the World Trade Center disaster, workers in New York's midtown office towers rushed for the elevators at the slightest rumor of a fire or bomb. Victims of Oklahoma City's 1995 disaster returned to their old psychiatrists. Across the U.S., people passed fitful nights as televised scenes of fiery jet crashes replayed in their heads.
Certainly, the deadly attacks on the World Trade Center in New York and the Pentagon in Washington will inflict their greatest psychic pain on those who lost loved ones or experienced the horror firsthand. Millions of others across the country, however, are also experiencing emotional trauma. "An event like this affects everyone's mental health," says Dr. Stuart Yudofsky, chairman of the psychiatry department at Houston's Baylor College of Medicine. Watching such dramatic and violent events, even on TV, and knowing that thousands of Americans have likely died can produce acute stress. "We'll probably all have some of the symptoms," says Dr. Arthur Rousseau, an Oklahoma City psychiatrist who worked with victims after the bombing that killed 168 there.
Just realizing that a certain amount of psychic upheaval is normal and recognizing its symptoms can lessen the anxiety. Difficulty sleeping, eating, or concentrating, irritability, and jumpiness--especially when a plane flies overhead or when around tall buildings--are all possible symptoms.
Those experiencing more severe stress may find it hard to keep the horrible images from popping back into their minds or they may suffer from nightmares. Others may go out of their way to avoid all mental cues--like the Brooklyn residents seen walking with their heads turned away from the ravaged Manhattan skyline just across the East River. Some may experience emotional numbness, says Dr. Michael Blumenfield, a member of the American Psychiatric Assn. committee on disasters. Survivors who narrowly escaped the carnage could feel guilty or depressed, he adds.
LESS TV. Children might have bad dreams and worry about the death of their parents, says Dr. David Fassler, a psychiatrist who specializes in helping children deal with stressful events. Young kids may become clingy and regress to earlier behavior, such as wanting to sleep with their parents or wetting the bed. Parents should respond by creating opportunities for their children to talk, perhaps having younger children draw pictures to express their feelings. Questions should be answered honestly, in a way the child can understand, says Dr. Fassler. Be there as your kids watch TV reports and, especially for younger children, limit how much news they see. Return children to their normal routine to re-establish a sense of security. Keep in mind that children take their emotional cues from watching you.
Most Americans will not experience debilitating symptoms and will recover once the crisis is past, says George Bonanno, who has done grief studies at Columbia University in New York. Some, however, will be surprised by the depth of their response. Rescue workers may be hit by a delayed reaction, six months or even a year later. Barbara Crown, a veteran Red Cross volunteer who counseled some of the 700 licensed mental-health volunteers comforting victims in New York in the days after the attack, says those who help in such disasters can suffer post-traumatic stress symptoms, as well.
Many who survived the ordeal will be haunted by images of those who did not make it. One World Trade Center survivor, says Dr. Blumenfield, recalled the sight of people left behind in wheelchairs because they couldn't maneuver the stairs. Fred Rickert, an electrician who was working on the 34th floor of the north Trade Center tower before it collapsed, stood on the New Jersey shore after being evacuated by ferry. Rickert escaped uninjured but appeared stunned by the memory of the 25 to 30 firefighters he passed on the stairs on their way up into the doomed building.
DIVERSION. People who have lived through other severe traumas will be hit hard by scenes from this one. Oklahoma mental-health professionals went on local TV stations and manned caller hotlines as many in that city relived memories of the bombing there. World War II vets recalled that era's kamikaze pilots. Survivors of rape, serious traffic accidents, or violent deaths of loved ones, are also more susceptible. Anyone predisposed to phobias or anxiety is vulnerable.
Talking about the events and being open with your emotions can help ease the stress, says Dr. Rousseau. He recounted the story of an Oklahoma City woman who dealt with her grief six years ago by pulling into a convenience store whenever she felt overwhelmed and buying a pack of gum as an excuse to talk with the clerk.
Not all professionals agree here. If emotional displays and repeated discussions don't feel right for you, don't feel compelled to talk, advises Dr. Sally Satel, a Washington (D.C.) psychiatrist. Bonanno's studies indicate that many people suffer more for verbally dwelling on their losses. For one thing, continually talking about negative emotions can drive away friends and relatives needed for support. "I think the idea that everyone needs to be expressing it and reliving it is wrongheaded," says Bonanno.
One strategy recommended by psychiatrists is to take a break from the tragedy. Turn off the coverage on TV. Read a light novel or take in a movie. To regain a sense of control and channel your emotions in a positive way, donate blood, food, or cash to the rescue effort. Children might write letters to firefighters or the mayor of New York. If stress symptoms keep you from functioning at work, in school, or socially, or persist for more than a month, seek professional help.
As horrific as the events of Sept. 11 are, says Dr. Rousseau, there are some positive emotional aspects. Many of his regular psychiatric patients have told him the tragedy helped them put their own problems into perspective. And there is inspiration to be taken from the stories of heroism: the New York City firefighters who lost their lives trying to save others and the passengers on United Airlines Flight 93 who may have foiled their hijackers' plot. Disasters can bring out people's compassionate side. Dr. Rousseau recalled the New York City volunteers who arrived to help out in Oklahoma City and how amazed they were by the generosity of the local people. "They said it never would happen in New York." Now, he said, the world is seeing they were wrong.
By Carol Marie Cropper
With Kate Murphy
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