Recognizing this is a museum discussion group and not
one for disability work, I still believe the time has
come to offer this insight to us all so that we do not
have unnecessary flame wars as we react to the stress
of the last several days.

Advice from the Mental Health Newsletter

Yesterday, September 11th, 2001 an unknown terrorist
organization sponsored multiple coordinated attacks
against prominent targets in the United States of
America.  Two commercial airliners filled with
passengers and fuel were hijacked and flown directly
into the World Trade Center (commonly known as the
Twin Towers) in lower Manhattan, New York City,
resulting in the complete destruction of those
airliners, and the collapse of both towers.  The
attack occurred just after 9am in the morning in the
middle of the work week - a time surely calculated to
find the largest number of persons working inside the
two buildings.  The television tells me that 50,000
people work in those towers.  An unknown number of
people, certainly in the multiple thousands perished.
A third commercial airplane, also loaded with
passengers was hijacked and flown into the Pentagon
office building in Washington, D.C., the visible
command nerve center for the United States Armed
Forces, resulting in the partial destruction of that
building and further massive loss of life.  A fourth
commercial airliner was similarly hijacked but crash
landed in Western Pennsylvania.  Although all
passengers and crew on this fourth airliner were
disintegrated, which is a tragedy in and of itself,
thankfully, these terrorists were not able to harm
other lives.

There are not words to describe this inhumane,
incomprehensibly enormous tragedy and sickening
display of premeditated violence.

Human beings waking up on this day after and the many
days after to come will need to find ways to cope with
this awful event.  Here then, are some suggestions for
how to accomplish this task.

People reacting to losses and traumas tend to go
through a set of 'stages of grief' which are usually
listed as denial, outrage/anger, working through, and
resolution.  Although these 'stages' don't always
occur in this order, they are experiences that many
people will go through as they come to terms with this
event. Although a verbal description is not the same
as experience, it is nevertheless a good idea to know
what you and others are likely to feel.

Denial

You can't believe that this is happening, has
happened. It seems unreal, like a dream.  The world
may even seem unreal and you may go about your day in
a sort of fog. In the more serious scenarios, true
dissociation can occur where there is distorted memory
for the event.  Just this morning on the news, I saw
an interview with the parents of one of the
Pennsylvania victim's parents.  It seems that this
brave man was able to call his parents after the
hijacking, tell them he loved them, and also tell them
about the hijacking events.  The parents noted that he
"is a proactive sort of person" and would be someone
who would try to take action against the hijackers.
Maybe, they wondered out loud, maybe he helped crash
that plane into the ground rather than allow it to hit
a target.  I noted the parent's use of the present
tense in describing their son - the reality of the
son's murder hasn't quite sunk in yet.

Outrage/Anger

You are angry, furious, outraged at the event, at
being victimized, at the scope of the tragedy, at the
death toll of thousands of innocents, at the
vulnerability that has been forcibly brought to your
attention, at your own vulnerability.  You are hurt,
you may even find yourself crying.  You are both sad
and angry.  You want revenge.  You want blood.  You
want to take the eye of the perpetrator (who at this
point is not known), for having taken your own eye.
In the more severe scenarios, you will not wait to
know who did this, will not limit your anger to those
who legitimately deserve it, will not allow the
government and military to do their jobs, but rather
will race out to harm others who, in your own mind are
associated with the perpetrators.

If these are your feelings, please do not act on them.
Feel them, talk about them even, but do not act on
them.  The people you as an individual could harm are
not to blame for this tragedy.  They were not the
perpetrators. Instead, they are as much victims as you
are.  Allow the United States government to "hunt down
and punish" (in the words of President Bush) the true
perpetrators.

Working Through

Working through happens over time.  It is the process
through which one ends up sorting all the many
feelings out and weaving them into the fabric of ones
life so that, as it were, things return to 'normal'.
Many different feelings may be felt during this
sorting out process: anger and outrage may alternate
with periods of relative detachment, fatigue, sadness,
bursts of tears, even numbness at times.  You may find
yourself not wanting to feel anything, and then later
find yourself overwhelmed by feeling.  It is as though
you have swallowed an emotional meal that your body
and soul are not quite able to digest all at once.
Eventually, over time, most will find a way to digest
it all, and life will return to 'normal'

Resolution

Resolution is a relative term.  Mostly what it means
is that the acute emotional mess of working through is
resolved enough so that life has returned to a regular
rhythm, and once again, worry about paying the bills
and holding and keeping a job, and keeping your
relationships on an even track become the day to day
worries.  Some people will resist resolution in the
belief that to resolve and be over this tragedy means
that the horror has been forgotten and that the
meaning of the attack has been forgotten. Others will
find solace in spiritual teachings of forgiveness and
confidence in the ultimate ability for eternal
judgment to sort out things better than any human
being could.  For many people, resolution will be hard
to achieve until there has been some satisfactory
response by the United States government.

The intensity of this process of grieving and working
through will likely be in relationship to how closely
you have been impacted.  Those who have lost loved
ones will be hardest hit, as will those who do the
actual rescue and emergency work.  Those who know
people who were lost, but are not related to them will
be hit to a lesser degree.  Those who only saw this on
the television and heard it on the radio will have an
easier time.

Trauma Disorders

Those people most directly impacted by the violence
and death are at heightened risk for experiencing
trauma disorders.  A trauma disorder occurs (in the
broadest sense) when a person is not able to follow a
normal process of grief through to resolution, and
instead gets stuck in it, reliving the emotions and
memories associated with the trauma over and over.
There are two forms of trauma disorders: Acute Stress
Disorder and Posttraumatic Stress Disorder.  As the
names suggest, the big difference between these two
disorders is that Acute Stress Disorder happens
directly in the aftermath of a trauma, while PTSD by
definition cannot occur until six months after the
occurrence of the trauma.  Trauma disorders are
characterized by: 1) heightened startle responses,
arousal, and anxiety reactions, 2) avoidance of trauma
related people, places, things and memories, and 3)
intrusive re-experiencing of the trauma in the form of
nightmares, waking dreams and memories, and sometimes
even hallucinations.

See Your Doctor

If you have been traumatized, it isn't a bad idea to
see your doctor, or even better, a Psychiatrist with
an understanding of trauma.  Doctors may be able to
prescribe a treatment plan for you that will help
address and help you work through your traumatic
circumstances.  Such a plan will likely include
medication and psychotherapy.

Encourage But *Do Not Force* Talking

It is most important that people exposed to a trauma
be encouraged, *but not forced* to talk about what
they have experienced.  Traumatized persons are very
vulnerable to being flooded with the emotion of what
they have experienced - it is quite important that
they be able to speak about what they have witnessed
in a safe environment in front of people who will have
the strength to witness what they have to say and feel
without themselves becoming overwhelmed, angry, etc..
Many lay people will have a difficult time doing this
and so, in many cases the task of encouraging
traumatized people to talk will be best left to
trained mental health professionals.  If you are a
traumatized person, consider seeking psychotherapy at
this time.  If you know of people who have been
traumatized, encourage them to participate in
psychotherapy sessions.  Both individual psychotherapy
and group psychotherapy sessions with other persons
who have experienced similar or the same traumas can
be very helpful to trauma victims.  In some cases,
therapy may be the thing that prevents trauma victims
from crossing the line from Acute Stress into
Posttraumatic Stress Disorders.

Combating Helplessness

Most all people are on edge in the aftermath of a
national trauma like that we have just experienced.
Don't be surprised if there is an increase in the
number of household arguments you have.  Don't be
surprised if you find that fears and phobias you had a
handle on before (fears of flying in an airplane, of
being in a tall building, etc.) become exacerbated.
Chalk this up to the normal process of working through
and trust that in most cases these will recede as this
event becomes resolved (and if they don't that there
is effective therapy that can help).  In the mean
time, there are a few things you can do to combat
feelings of helplessness:

1) Give Blood.

The Red Cross and hospitals in the New York City and
Washington D.C. areas are in need of blood.  Be part
of those who help the victims get the blood that they
need by donating some to your local Red Cross or Blood
Bank.  Call 1-800-GIVE-LIFE (1-800-448-3543) or try
the Red Cross' website (which seemed to be down when I
just checked it, hum - more attacks or just
coincidence?)

2) Talk About It.

If this tragedy is bothering you, talk about it with
others who also want to talk about it.  This sort of
talk could happen anywhere, at home, work, with a
therapist, with a religious leader, etc.  It doesn't
have to be formal.  Just watch out for expressions of
violence and anger.  It's really okay to talk about
being angry, hurt, devastated, etc. but it is *not
okay* to threaten others with violence (see my plea
above under Outrage/Anger).  Let the government handle
that part.

One further note:

Some of you may have noticed that editorials have been
few and far in between lately.  We regret the
inconvenience, but rest assured that this is necessary
right now.  MHN will be undergoing a software
transformation in just over one month from now and
we're working hard to get everything ready behind the
scenes.  Normal content delivery will resume shortly.

Mark Dombeck, Ph.D.
Director, MHN




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Indigo Nights
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