|Coping With The Aftermath
by Avram H. Mack, M.D., Richard J. Frances, M.D. and Jeffrey
P. Kahn, M.D.
The September 11th attacks have had a profound emotional
effect on New Yorkers, Washingtonians and all Americans. Some
of us were there. Everyone was confronted with frightening images
and information through television and the press, with consequences
on their personal lives and with fears of ongoing danger.
How can we get through this awful event, these terrible emotions,
this fearful time? How can we comprehend this tragedy, return
to a semblance of normal life and adapt to the way our world
has changed? While everyone will have a different reaction,
there are four steps that many will find helpful and that may
prevent psychiatric complications.
First, take an inventory of all of the large and small ways
that your life has been touched by loss, inconvenience, unpredictability
and change. Be sure to include effects on your family and others
close to you. At the same time, take note of other changes you've
experienced recently. And don't overlook any positive events
in your life, because they can be especially stressful at a
time like this.
Second, recognize that these changes can stir up powerful feelings
of grief, fear, anger, uncertainty, guilt and preoccupation
with the disaster. Reach out for help and talk about these feelings
with people to whom you feel close. Family, friends, colleagues,
neighbors and clergy are having some of the same feelings that
you are, and most will find discussion as helpful as you will.
Some people will find it too hard to talk just yet, so be available
without pushing too hard.
Third, after taking a personal inventory of the way your life
and your feelings have been affected by this disaster, find
practical ways to cope with change and distress. Your ordinary
coping mechanisms have not left you. Keep occupied with problem
solving, work, family, prayer, exercise, movies, music and more.
The goal is to focus your energy in positive directions, and
give your mind a respite from troubling emotions without trying
to deny those feelings. If you've had some problems before,
it is important to make sure you are getting good help now.
Fourth, after having benefited from the help of family, friends
and others, reach out to help those who have not yet become
aware of how their lives have been changed by this tragedy.
Helping is more than a coping mechanism: it makes you feel better.
Within a few weeks most people will find that their most intense
emotions come under control. But recovery may be more difficult
for people with greater losses, prior traumas, other life problems,
fewer social supports, a history of commonplace anxiety, depression,
or addiction disorders, or for those who are faced with the
emotional dilemma of tragedy combined with positive changes.
Signs of greater distress may include ongoing sadness, hopelessness,
anxiety, irritability, fearfulness and changes in sleep, appetite,
concentration, impulsivity and abuse of alcohol or drugs. Sometimes,
severe distress needs more than just your support. While you
shouldn't try to be an armchair psychiatrist, you can help people
seek evaluation by a psychiatrist or other mental health professional.
These tragic events remind us to pay attention to our own and
others' feelings and emotions, and the importance of reaching
out to each other.
Dr. Mack, the author of Concise Guide to Alcoholism and Addictions,
is a resident physician in child psychiatry at Columbia-Presbyterian
Medical Center and a trustee of the American Psychiatric Association.
Dr. Frances is the medical director and CEO of Silver Hill Hospital,
New Canaan, Conn., professor of clinical psychiatry at New York
University Medical School and founding president of the American
Academy of Addiction Psychiatry. Dr. Kahn is president of Manhattan-based
WorkPsych Associates, providing a range of services to corporations
and executives. He is past president of the Academy of Organizational
and Occupational Psychiatry and teaches at the Weill Medical
College of Cornell University.
Newsweek. Used by Permission.