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Terrorist Aftermath: Trauma

Keep an eye on yourself and others

WEDNESDAY, Sept. 12, 2001 (HealthDayNews) -- When tragedy strikes, a person's first response often may be numbness instead of pain and agony. Others may immediately fall into tears and mourning, and some will become hyper-vigilant as they fear for their safety. Experts say such varied emotions are normal reactions to disasters and not necessarily a sign of coping difficulties.

But a disaster like the terrorist attacks on New York City and Washington, D.C., can lead to serious mental trauma, even among people who aren't directly involved, the experts say. They caution that everyone should be alert to watch carefully how they and their loved ones react to yesterday's horrible events.

"There's nobody in the country who wasn't affected in some way by this," says Joshua Miller, a Red Cross mental health counselor and professor at the Smith College School for Social Work.

Recovering from the tragedy will be a major challenge for many, even with expert assistance, Miller says. "I really believe this is new territory to some extent. Yes, there have been terrible things that happened in other countries, but this country has not experienced anything like this before. We're all going to have to learn as we go ahead and realize this might be a unique situation."

Victims and witnesses will be hardest hit, but they won't all react in the same way, says Elizabeth Vermilyea, trauma specialist and training director at The Sidran Traumatic Stress Foundation in Baltimore.

"Some people are just emotionally sensitive to tragedy, while others have a different sort of temperament," she says. "There's an innate resilience that can play a role, along with proximity to the tragedy, what you actually saw, how horrified you were by what you saw, and whether you felt your life was threatened. Two people can have the same experience and interpret it differently."

Vermilyea says, "After a shock of this magnitude, you can expect to have a lot of visualizations about what happened. People will keep seeing it in their mind's eye. You can expect people to really struggle with sleep, to feel very much on guard and emotionally numb. This is a very natural reaction to an event like this. People will have extreme fluctuations in their abilities to think and concentrate, to process information."

Statistics suggest that about 30 percent of those affected by tragedies will develop serious problems over time, she says. "There will be a portion of people who will have a much harder time, whether they were close to a particularly horrible experience or not."

People may go on to develop post-traumatic stress disorder and suffer from endless replays of the event, obsessive avoidance of similar situations and a hyperactive nervous system "that keeps people on guard," she says.

The desire for protection will come as people sense they are vulnerable, she says. "The loss of a sense of safety is a profound damage in situations like this. You could think of it as not only psychological but spiritual damage. Core issues of safety and good will and being able to be protected are called into question, if not shattered by the experience. I think people search very carefully to make this predictable --- 'If this had been done, if that had been done.' That's really an effort to separate yourself and make something that's truly unpredictable more predictable."

This tragedy is different from others in that victims will be grieving with an entire country, Vermilyea says. "In more individual traumatic experiences, it's harder to get that sort of support. When the nation is under fire, there's a huge amount of support among communities, and people really mobilize."

As people cope with the loss of life, their friends and relatives must be prepared to listen, she says. "We have to be gentle with people and understand that unusual behavior or feeling or ways of being are very normal responses to traumatic experiences. We've got to be very tolerant of that. People are going to have to tell their stories, they're going to have to talk about what they saw, how they felt. They're going to have to express their horror. We need to have them express it in their own time, not force them to talk but make it clear that we can listen."

What To Do

Are you available to help victims of airplane crashes through their grief? If so, contact AirCraft Casualty Emotional Support Services.

Learn about the treatment of post-traumatic stress disorder from this fact sheet created by the National Center for Post-Traumatic Stress Disorder.

Also, here's information on how to give blood.

SOURCES: Interviews with Joshua Miller, Ph.D., associate professor, Smith College School for Social Work, North Hampton, Mass.; Elizabeth Vermilyea, M.A., trauma specialist and training director, The Sidran Traumatic Stress Foundation, Baltimore
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