Recovering from terrorism

QUESTION: How can we, as parents and people, recoup from this traumatic event? What can we do to deal with our fears, and worries that things will never be the same again, never be safe?

ANSWER: The terrorist attack on our country has left us stunned, saddened and disoriented. This event is a life changing one for our country and ourselves. Never before have we been invaded in this manner and magnitude, although most other countries in the world have endured terrorism and war, having to live with it on a daily basis.

What can we do? What can we learn? How can we heal? And what kind of stress symptoms should we expect or watch for?

What we can do

Turning sadness and helplessness into action is an important part of the healing process. Lighting a candle, giving blood, and other simple everyday acts of kindness are immediately healing to ourselves and those we come in contact with during this period of change. Reach out to your community, call your friends and relatives. Connect into the fabric of life surrounding you. While reaching out and connecting is always a necessary part of mental health, we easily forget that these loving connections are what give our lives meaning.

What we can learn from others

In struggling with how to adjust to this enormous change in my personal safety, what I can and cannot control and how to respond to this tragedy, I found myself listening to and recalling the experiences of others who had endured tragic situations which threatened their lives and survived.

One of my clients was a prisoner of war for 6 years during world war II. He never believed he would live to have a future. His life was spared. He went on to raise a family and become an important and contributing part of his community in the United States. His overall adjustment to his imprisonment was an attitude that everyday was a gift. He valued each sunrise and sunset, as what could be his last. While this could sound morbid, for him it was not. He was able to love and live his life with a gratitude few of us are fortunate enough to experience on a daily basis.

Reflecting on what we can control and what we cannot is frightening, but necessary for our mental health. Making choices about what risks we will take in life is always important, but now includes hazards of terrorism in our daily living. Living with courage, with "heart" as the French derivation of the word implies, is our only option if we are not to fall into fearing to live our lives at all. This amounts to looking at what kind of person you want to be in the life that you have, the time you are alive on this earth.

Living life with more vigor, passion and commitment is paramount to fighting terrorism, whether it is external or internal demons that haunt you. Consider using this period of anguish and disorientation to identify your priorities and question whether you are living your life in line with what you value. Do not shy away from expressing yourself politically and in other external ways, seeking to make a positive difference in the world. But take time to reflect on the acts of kindness and generosity possible in your daily life, and your experience of connectedness to and caring for others.

After all, love was much of what the personal calls of the victims of this tragedy focused upon...calling loved ones, and telling them they loved them. Underneath it all, we return to those we love as the most meaningful gesture to be made when faced with the inevitability of death. However cliché this may seem, it is a truth to be recognized, and perhaps incorporated into our everyday living.

I have often thought, although I am not a Buddhist, that Buddhist philosophy embraces life because it embraces death as a part of living. This is still a mind-boggling concept to me, but one that a tragedy such as this one, brings home because it brings death closer to our awareness. Living with death by our side is said to bring out the best in us and our appreciation of what life offers. Perhaps this is what we have control over now, is our own attitude about how this tragedy will affect our own daily actions and ability to respond to our loved ones on a daily basis. "Healing" is derived from the old English word "hoelan" to make whole. How we integrate what has happened in our lives is up to each of us.

How can we heal

The definition of posttraumatic stress disorder is defined as a person being or exposed to a traumatic event in which, both 1) being involved in or witness to threat of life or serious injury to self or others, and 2) a person's response to the threat involves intense fear, helplessness or horror. For children, (and adult , too) this may be expressed as disorganized behavior or increased agitation.

Certainly all of us have been subject to this exposure through this traumatic national event. How we handle stress will vary, however, and some of us will have more difficulty than others with coping with this trauma. Not all of us will experience posttraumatic stress disorder. Some may experience a less serious acute stress reaction, which lasts anywhere from 2 days to 4 weeks, while others will have pre-existing symptoms of anxiety exacerbated.

All of us have experienced some of the following symptoms in the initial days following the terrorist attack. But if these symptoms continue for more than one month and are severe enough to cause an inability to function in your job, family or social responsibilities after this time, you may need to get professional help to cope.

Acute stress disorder will usually resolve in 3 months, but more chronic cases may last as long as 6 months, following the event. In some cases, delayed onset of symptoms may occur up to 6 months after the traumatic event has occurred.

If the 2 or more of the following symptoms persist after 4 weeks, consult a mental health professional for help coping:

1) numbing, detachment, absence of emotions
2) being in a daze
3) recurrent , daily images of the traumatic event
4) complete avoidance of any conversation about the trauma
5) difficulty falling or staying asleep
6) irritability or outbursts of anger or tears
7) difficulty concentrating
8) hypervigilence
9) exaggerated startle response

If, after one month, the trauma continues to be experienced in one or more of the following ways below, and you experience 2 or more of the symptoms listed below which cause you to be unable to function in family, work or social life, you may be experiencing posttraumatic stress syndrome, a more serious condition which needs professional attention.

1) the trauma is recurrently recollected in images, thoughts and perceptions.
2) recurrent distressing dreams of the event. (for children, frightening dreams of varying content)
3) Acting or feeling that the traumatic event is recurring.

1) efforts to completely avoid (not reduce or monitor exposure) thoughts or conversations about the tragedy.
2) diminished interest in activities that used to hold importance
3) feeling of detachment or estrangement from others
4) restricted affect ...unable to express loving or affectionate feelings
5) sense of foreshortened future...giving up on personal career goals, family marriage or future goals

All of us will be continually dealing with ongoing uncertainty and anxiety. Consider the following guidelines in managing stress and preventing mental health problems:

1) Focus on doing the best job you can in the post in life that you currently have. Attend to the responsibilities of your job as a parent, a community member, spouse and worker.
2) Be sure to normalize your life, by maintaining your schedule and ongoing commitments as much as possible.
3) Share feelings and join in community ritual to share grief and reinforce a sense of human belonging.
4) Take time to enjoy life. Laugh, play sports and engage in activities that reaffirm your personal life, values and relationships.
5) engage in activities and practices that calm you, such as yoga, walking, golf, meditation or any other activity that soothes your mind and body.
6) Value life by expressing your love in words and actions to others who are in your life!

The past week's events have made our lives both larger, and smaller simultaneously. We have become part of the angst that other countries under fire have experienced and lived with on a daily basis. We feel their pain, their support of the horror we have experienced, and the grief of those families across the nation that are intimately affected by loss of loved ones. We are also experiencing the restrictions that terrorism has brought in its immediate aftermath, the fear and anxiety that changes the ease in which we have moved through our country and the world.

But we are not imprisoned by fear. We are empowered by acting to unite with our local, national and world communities against that which does not respect and honor life.