Thursday, July 07, 2005

London Bombings: Trauma and Recovery

Today during the morning rush hour, terrorists attacked the United Kingdom with orchestrated detonations that blasted three London subway systems and a crowded double-decker bus. Once again, we find ourselves gripped with a sense of horror. How do others live and breathe this hatred? Why are innocent people killed? Understanding evil and the motives of terrorism can help you move forward and heal.

Understanding Evil

As I have written before (Serani, 2004), the main conscious motive of terrorism is to destabilize a society and evoke mass reactions. Because terrorists are unable to achieve their goals by conventional means, they choose a chilling and merciless way to get the recognition they are seeking. Equally important to the effectiveness of the terrorist act are those who witness its wake. In this age of technology and 24 hour news programming, the accounts of shocking happenings are delivered with immediacy, and can be viewed, re-viewed, and revisited at the push of a button. Through the horror, the terrorist hopes that your basic security is seized, that your identity to community is shattered and that your coping and belief system will be gravely compromised (Butterworth, Clothier & Mellman, 2001; Everly & Lating, 1995; Herman, 1992; Hudson, 1999).

The unconscious aim of terrorism is to destroy objects, others and entities because they are sources of unbearable feelings of envy. The terrorist’s historical rage, grief, hopelessness, envy and dread congeal into the need to annihilate. The terrorist engages in violent acts as a result of experiencing hostility and helplessness over the lack of alternatives in his life. Feelings of inadequacy and deprivation that were intitially felt are now diminished because the terrorist finds a sense of potency, social status, potential wealth and a sharing of fanatical points of view in the terrorist group. Fueling the hatred and annhilation are other fanatical contructs: prejudice, authoritarianism, an unwillingness to compromise, a disdain for other alternative views. When the terrorist act occurs and victims are put through anguish, horror, cruelty and unspeakable loss, the terrorist transcends his own pain. The terrorist will deform ethics of religion, culture and society and will employ any evil means to reach such goals (Grand, 2000; Serani, 2004; Young, 2001). In doing this, the terrorist uses the defense of splitting (black-or-white thinking) so that he sees himself as altogether right, sanctioned by God, and the other as altogether wrong.

How to Cope

Well-being begins with psycho-education. Understanding what psychological trauma is and how it bears down on your biological, chemical and psychological makeup is the first step toward recovery. Psychological trauma is the unique individual experience of events or enduring conditions where you feel emotionally, cognitively, and physically overwhelmed. If you need to rest or detach in some way, do so. If you feel the need to be active and busy, do so. Whatever will help your body awareness and sensory awareness to slow down hyperarousal and reinstate safety and security is recommended.

Once the traumatic event is over it does not mean that your reaction to it will be over. The intrusion of the past into the present is one of the main problems confronting anyone who witnesses or experiences trauma. This is often referred to as re-experiencing. The re-experiencing may present as distressing intrusive memories, flashbacks, nightmares, or overwhelming emotional states. It is also important to know that witnessing crimes against humanity may raise anticipatory anxiety, where you are not only reeling from the trauma that just occurred, but are perched in a state of anxiety of what may come next. Though many of these symptoms are normal in the recovery process, if your trauma reaction does not abate within a few weeks, it would be wise to seek an outside consultation for further review.

News programming has moved from providing citizens with the information they need to be free and self-governing to programming that attracts ratings by exploiting their vulnerabilities. Drawing viewers to fear-based material is a marketing strategy as big ratings mean big revenues (Altheide, 2002; Glassner, 1999). Knowing that most news organizations work within this notion will help you realize that factual information may be clouded by sensationalism in news reports. Therefore, it would be wise to get information about current events by gleaning headline news blurbs, or reading updates on a home page or newspaper. Avoiding being glued to the television or engaging in high intensity group discussions as they may only serve to elevate anxiety and lengthen the arc of your traumatic reaction. The goal here is to find a sense of balance of what has occurred, where real facts counter unsubstantiated fear-promoting beliefs. Placing the terrorist act in a frame that allows you to stay connected to people and things, both locally and globally will help you flourish once again (Serani, 2004).

Interventions and Teachable Moments

Now that you have some understanding about terrorism, there comes the task of helping children understand it. Whenever a tragedy occurs children, like many people, may be confused or frightened --- and any time children are eager to ask a question, it is an opportunity for us to make it a teachable moment. It is important to know that when they ask questions, they are seeking two things -- understandable information and realistic reassurance.

As a parent, your answers should meet your child’s intellectual needs and emotional needs. The following recommendations are modified from the National Association of School Psychologists (2001):

1. Model calm and control. Children take their emotional cues from the significant adults in their lives. Avoid appearing anxious or frightened.

2. Reassure children that they are safe and (if true) so are the other important adults in their lives. Depending on the situation, point out factors that help insure their immediate safety and that of their community.

3. Remind them that trustworthy people are in charge. Explain that the government emergency workers, police, firefighters, doctors, and the military are helping people who are hurt and are working to ensure that no further tragedies occur.

4. Let children know that it is okay to feel upset. Explain that all feelings are okay when a tragedy like this occurs. Let children talk about their feelings and help put them into perspective. Even anger is okay, but children may need help and patience from adults to assist them in expressing these feelings appropriately.

5. Observe children’s emotional state. Depending on their age, children may not express their concerns verbally. Changes in behavior, appetite, and sleep patterns can also indicate a child’s level of grief, anxiety or discomfort. Children will express their emotions differently. There is no right or wrong way to feel or express grief.

6. Look for children at greater risk. Children who have had a past traumatic experience or personal loss, suffer from depression or other mental illness, or with special needs may be at greater risk for severe reactions than others. Be particularly observant for those who may be at risk of suicide. Seek the help of mental health professional if you are at all concerned.

7. Tell children the truth. Don’t try to pretend the event has not occurred or that it is not serious. Children are smart. They will be more worried if they think you are too afraid to tell them what is happening.

8. Stick to the facts. Don’t embellish or speculate about what has happened and what might happen. Don’t dwell on the scale or scope of the tragedy, particularly with young children.

9. Keep your explanations developmentally appropriate. Early elementary school children need brief, simple information that should be balanced with reassurances that the daily structures of their lives will not change. Upper elementary and early middle school children will be more vocal in asking questions about whether they truly are safe and what is being done at their school. They may need assistance separating reality from fantasy. Upper middle school and high school students will have strong and varying opinions about the causes of violence and threats to safety in schools and society. They will share concrete suggestions about how to make school safer and how to prevent tragedies in society. They will be more committed to doing something to help the victims and affected community. For all children, encourage them to verbalize their thoughts and feelings. Be a good listener!

10. Monitor your own stress level. Don’t ignore your own feelings of anxiety, grief, and anger. Talking to friends, family members, religious leaders, and mental health counselors can help. It is okay to let your children know that you are sad, but that you believe things will get better. You will be better able to support your children if you can express your own emotions in a productive manner. Get appropriate sleep, nutrition, and exercise.

11. Focus on your children over the week following the tragedy. Tell them you love them and everything will be okay. Try to help them understand what has happened, keeping in mind their developmental level.

12. Limit your child’s television viewing of these events. If they must watch, watch with them for a brief time; then turn the set off. Don’t sit mesmerized re-watching the same events over and over again.

13. Maintain a “normal” routine. To the extent possible stick to your family’s normal routine for dinner, homework, chores, bedtime, etc., but don’t be inflexible. Children may have a hard time concentrating on schoolwork or falling asleep at night.

14. Spend extra time reading or playing quiet games with your children before bed. These activities are calming, foster a sense of closeness and security, and reinforce a sense of normalcy. Spend more time tucking them in. Let them sleep with a light on if they ask for it.

15. Consider praying or thinking hopeful thoughts for the victims and their families. It may be a good time to take your children to your place of worship, write a poem, or draw a picture to help your child express their feelings and feel that they are somehow supporting the victims and their families.

Altheide, D. (2002). Creating fear: News and the construction of crisis. New York: Walter de Gruyter.

Butterworth, R., Clothier, J., & Mellman, T. (2001). America’s state of mind – Confronting PTSD, depression and anxiety in the wake of terrorism. Medical Crossfire, 2, 2-15.

Everly, G.S. & Lating, J.M. (1995). Psychotraumatology: Key papers and core concepts in post-traumatic stress. New York: Plenum.

Glassner, B. (2000). The culture of fear: Why americans are afraid of the wrong things. New York, Basic Books.

Grand, S. (2000). The reproduction of evil: A clinical and cultural perspective. New Jersey: Analytic Press.

Herman, J. (1992). Trauma and recovery: The aftermath of violence – From domestic abuse to political terror. New York: Basic Books.

Hudson, R. (1999). The sociology and psychology of terrorism: Who becomes a terrorist and why? Washington, DC: Library of Congress.

National Association of School Psychologists:

Serani, D. (2004). Expanding the frame: Psychoanalysis after 9-11. Bulleting of the Menninger Clinic, 68(1): 1-8.

Young, R. M. (2001). Fundamentalism. Paper presented at the Centre for Psychoanalytic Studies, University of Sheffield, England.