One Year Later, and Still Struggling

Mental health experts offer coping techniques for the 9/11 anniversary

TUESDAY, Sept. 10, 2002 (HealthDayNews) -- The searing images of September 11 still haunt.

Study after study has shown that the prevalence of mental health ills among American children and adults has increased in the wake of the terrorist attacks.

And mental health experts say the first anniversary of 9/11 will rub raw emotional wounds that have only begun to heal.

Yet acknowledging the still-shocking memories of the Twin Towers and pieces of the Pentagon lying in ruins, realizing how well we've coped since, and trying to move on with our lives are the best ways to deal with the emotional upheaval that will accompany the next few days.

There are five questions people ask themselves when exposed to traumatic events outside their normal experience, says Florida State psychologist and trauma expert Charles Figley:

What happened? Why did it happen? Why did I act the way I did when it happened? Why have I acted the way I have since that time? What if it happens again, and will I be able to cope?

"The vast majority of people have had a year to figure it out, and have already answered those questions. But the anniversary date forces them to revisit what has happened since that day and fine-tune their feelings," Figley says.

"Anniversary responses are important in a useful sense," he adds. "You can see the anniversary of a traumatic event as climbing a mountain. You can look up and see that you still have a long way to go, but you can also look down, see how far you've come and celebrate that."

Figley is founder of Green Cross Projects, a group of 150 trained and licensed "traumatologists" that he formed in response to the 1995 Oklahoma City bombings. He and members of the group spent several weeks last fall counseling employees who worked at the World Trade Center.

He suggests people do something "tangible" to mark the 9/11 anniversary.

"People can use the occasion to do whatever they feel is important," he says. "If remembering the day makes you step outside of your own individual cell and realize we're connected as neighbors, as a community, as a state, nation and world, then do something to show that. Like giving blood, or hanging up a flag at your house."

For those more directly affected by the terrorist attacks -- people who lost loved ones or those live in New York City and Washington, D.C. -- the memories will be far more painful. Their best way of coping may be to avoid dwelling on the anniversary, says a noted New York therapist.

"The people I know who have lost someone are quite private about it, dealing with it in their own ways," says Dr. Naomi Leiter, a Columbia University psychiatrist who has been treating a number of patients who lost loved ones or friends in the World Trade Center attack.

"Most of them are going on with business as usual," she adds, and she recommends that approach when dealing with the anniversary.

"Try to make the day as ordinary as possible," she says.

Rather than taking the whole day off from work or school, she suggests going to church or synagogue or observing a moment of silence.

Above all, stay away from the television, Leiter says.

"The whole city has been traumatized, and I hope that the anniversary will be used to put the event to rest," she says. "There's a wonderful saying in yoga that 'the past is history, the future a mystery and the present a gift.' One really has to move on."

Others susceptible to a so-called "anniversary reaction" could be people for whom the terrorist attacks unleashed personal anxieties that may have had nothing to do with events of 9/11.

For instance, war veterans and people mourning the deaths of loved ones are particularly vulnerable.

Figley's advice: Try to confront those anxieties head-on. Doing so is often liberating and will allow you to resume a more satisfying life.

There's even a place for denial in handling the anniversary of 9/11, Figley says.

"Sometimes we don't want to get more information. We just don't want to hear it," he says. "Denial is often the salve that takes care of our society."

The National Mental Health Association offers these recommendations for coping with the anniversary:

  • Do something positive that will help you gain a greater sense of control. Give blood, start a new class or try something you find especially enjoyable after work.
  • Get plenty of rest and exercise. Remember to eat well. Avoid excessive drinking and risk-taking activities.
  • If you start to feel overwhelmed by your feelings, ask someone you know for help. It's not a sign of weakness. Talk with a friend, family member, doctor, minister or religious advisor. Often, sharing your fears and feelings is enough to relieve stress and realize that other people share your concerns.
  • Recall other times you experienced emotionally taxing events and how you handled them.
  • Don't compare yourself to how others around you are dealing with the Sept. 11 anniversary. Everyone experiences and copes with stress differently. Remember not to judge other people's emotions.

What To Do

The National Mental Health Association offers this tip sheet for dealing with the Sept. 11 anniversary. For more on coping with the stress of traumatic events, visit the American Psychological Association.

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