After the Attacks, the Trauma and the Grief May Linger

The attacks on the World Trade Center and the Pentagon have inflicted not only physical wounds, but emotional damage as well in many of us. You do not need to a survivor, emergency worker or witness in order to feel these effects. Many in the general public are finding themselves affected.

You may experience trouble sleeping, nightmares, and fatigue, or find yourself crying for no apparent reason. Intense anger, as well as shock, numbness, fear, grief or guilt are other possible symptoms.

Although we may know that our lives have been profoundly and unalterably changed, we must understand that it may take time to put the tragedy in its proper perspective. Most of you will find it helpful to talk about your experiences, thoughts and feelings to family members and friends. However, some of you may not be able to get back to our normal routines, even after several months. This is especially true for those who have been directly affected by these traumatic events –– or who have lived through previous trauma or loss and may find that the events of September 11 have awakened many of these older wounds.

If this is the case for you, you may be experiencing symptoms of Post-Traumatic Stress Disorder (PTSD), or Bereavement. If you suspect that you may be suffering from such symptoms, answer the following questions:

1. Do you experience repeated nightmares or flashbacks of the traumatic events?
2. Do you experience intense physical and/or emotional distress, or the same terror, when you encounter a reminder of the attacks?
3. Do you avoid reminders, for example, places, people, memories or discussions related to the attacks?
4. Do you feel excessively "on guard" and/or have an exaggerated startle response?
5. Do you feel depressed with insomnia, poor appetite, and marked difficulty coping with daily activities?
6. Do you believe that you would be better off dead or that you should have died with someone who died in the attack?
7. Are you preoccupied with guilt about things done or not done at the time of death of a loved one?

If you have answered yes to questions 1 - 4 you may be experiencing PTSD.

If you have answered yes to questions 5 - 7 you may be experiencing Bereavement.

Both are treatable problems, not signs of personal weakness.

If sharing your experiences with family, friends or discussion groups does not relieve the distress, there are various effective treatments available.

1. Cognitive therapy:
   Helps you change the thought patterns which maintain the state of immediate trauma.
2. Behavior therapy:
   Helps you overcome your panic by teaching you how to gradually giving up your avoidance behavior.
3. Eye movement therapy (EMDR):
   Is another modality which has been found especially helpful in the processing of traumatic memories.
4. Group therapy:
   Short-term groups to provide support, sharing and understanding are excellent resources as well