The many changes that have occurred since Sept. 11 have been dramatic since many aspects of our lives – from the economy to our sense of safety – have suffered a severe blow. Many musicians are having much more difficulty finding work, which is adding to their levels of stress, tension, depression and sadness.

Traumatic situations cause people to have very strong emotional reactions, including anger, fear, confusion, disbelief, humiliation and grief. Some people respond immediately, while others have delayed reactions – sometimes months or even years later. Some experience these adverse effects over a long period of time. There is no “standard” pattern of reactions to the extreme stress of traumatic experiences, as last month’s MAP column explained.

In one way or another, all Americans have been victims of the World Trade Center attack. There are many different kinds of victims, each experiencing different, yet similar, reactions:

• Primary victims who lived through the event;
• Grieving relatives and friends of primary victims;
• Rescue and recovery workers;
• The larger community involved in the disaster and its aftermath. This includes those who live in the neighborhood, in the New York City area, in the whole country – and, indeed, in the world.

Each of these situations is traumatic, and trauma inevitably brings loss. In the wake of the WTC disaster, many people have been finding themselves re-mourning old losses. It is possible that we never experience any loss in isolation from other, past losses. The recent events may well have triggered suppressed and postponed grief in you, grief that remains from earlier life experiences.

Experiencing grief is complicated in this situation. You may still feel numb or angry, and not yet ready to grieve. Or, if you did not lose someone directly, you may feel that you are not entitled to grieve, since so many have lost more than you have. This way of thinking may be a defense against – or an obstacle to – acknowledging the legitimacy of your own feelings. In ordinary bereavement, there are numerous social rituals that support a person through the process. By contrast, there are no customs or common rituals that recognize the mourning that results from traumatic life events.

Certainly, grief resulting from the WTC catastrophe is justified, and it may be hard to bear, not just because of the death of loved ones, but also because of the loss of our former illusions of security and safety, of basic trust, and of a sense of control over our very existence.

The task of recovery requires that we eventually reestablish a sense of safety, remembrance and mourning, and reconnect with ordinary life. These goals may be difficult to accomplish, given the ongoing threats of further terrorist attacks, but establishing safety should begin with self-care, such as exercising, eating well and getting adequate sleep. Remember that severe, chronic stress, worry and anxiety may undermine anybody’s health. This is a particular problem for seniors, since the immune system weakens as we age. Symptoms like migraine headaches, elevated blood pressure, gastrointestinal disorders, sleep disorders, racing heartbeat or chest pain are common reactions of an over-stressed individual.

People express grief physically, emotionally and psychologically. Allowing yourself to grieve is important. There are many ways to cope effectively with your feelings:

• Seek out caring people who can understand your feelings of loss;
• Express your feelings;
• Limit your exposure to news media. Saturating yourself with news about critical events or world terrorism may heighten your anxiety. Try to resume your regular routine from before the attack. The chances are good that you didn’t allow current events to become the primary focus of your day, and didn’t ignore family or work responsibilities to keep up with breaking news stories.
• Take care of your health. Keep in contact with your physician. Be sure to eat well, and try to rest more than usual. Be aware of the danger of developing a dependence on medication or alcohol to deal with your feelings. Alcohol, overeating, sexual acting out or other addictions are all ways that people may try to escape tragic events and emotions.
• Keep a regular schedule. This will allow you to feel that some things are back to normal in your life.
• Learn stress-management techniques like relaxation, meditation or yoga;
• Take time out for walking, reading or whatever healthy pursuit makes you feel better;
• Do the things you do well, in order to experience that sense of mastery and control;
• Postpone major life changes or impulsive plans, such as moving, marrying or deciding to have a child. Rather, give yourself time to adjust to current circumstances, and be patient with yourself and others who are struggling to cope.
• Seek outside help when necessary if you are feeling overwhelmed.

It is normal to want to vent rage to relieve the incredible pressure – to dump the anger one feels during this type of disaster on someone else. However, impulsive reactions of hostility will not relieve overwhelming feelings of pain. Only mourning and grieving will release this kind of extreme mental pressure. Openly dealing with your feelings, including anger, will prevent these feelings from building up and help you avoid exploding on others, getting depressed or becoming self-destructive.

Consider seeking professional help if your stress and anxiety are not subsiding. Anyone who experienced previous trauma could be at a somewhat higher risk for emotional strain now. If you would like to schedule an appointment for a free consultation with a social worker in the MAP office, you may call (212) 397-4802.

Sources:

• “Hidden Dangers of being ‘Retraumatized’ From Terrorist attacks” by Dwight Bain in www.CultureShockTV.com;
• “Handling Anxiety in the Face of the Anthrax Scare: from the American Psychological Association in http://helping.apa.org/daily/anthrax.html;
• Traumatic Stress: The Effects of Overwhelming Experience on Mind, Body, and Society by Bessel A. van der Kolk, Alexander C. McFarlane, and Lars Weisaeth, Eds.;
• Trauma and recovery: The Aftermath of Violence-from Domestic Abuse to Political Terror by Judith Herman, M.D.