Introduction

The recent horrendous terrorist attacks raise a lot of feelings and questions.

It is shocking and sobering to realize that we are all open to danger of mortal attack, whether it be flying on a plane or visiting in a building that is suddenly demolished – or even just walking on the street nearby.

The sharings on these pages address questions of fears, how to understand and deal with them, and possible ways to learn and grow through them.

As the greatest fear for most people is death, this discussion will open with a focus on this issue. Fears of being hurt, of other people dying, and of being unsafe will also be discussed.

Perpetrators of violence must be brought to justice. However, if that is only as far as we go in dealing with an atrocity in our lives, we miss opportunities to grow. We may also deal unfairly and injudiciously with others if we act without examining our inner motives behind our actions.

Similar cautions apply on national and global levels. Suggestions are offered for exploring our national responses to tragedy and our responses within the global community more deeply, so that we might understand and deal with roots of hatreds and the hurts behind them, with the hope of preventing further atrocities.

Every crisis, every challenge is an opportunity to grow. Practical suggestions are offered for dealing with stress, with anger and hatred, and with deeper spiritual awareness.

Immediate Responses
Emergency Contact Information:
http://europe.cnn.com/SPECIALS/2001/trade.center/contacts.html

Considered Responses

The attacks on the World Trade Towers and the Pentagon killed thousands of innocent people. We must ask ourselves, "How and why did this attack occur?"

We must assume that there is incredible hatred towards America and Americans. Who are the people with such hatreds? Why would they hate so much that at least four teams of people were willing to work for years in preparation for these acts of murder and to die themselves, taking thousands with them, in order to make a statement that we have yet to hear verbally?

What is wrong in our world that such a thing can happen?

Killing people is a way of making a statement that something is very deeply and seriously wrong. While we can only speculate on the specifics behind this heinous act, we must assume that the perpetrators feel they have no better ways to make their statement.

Seeing people killed touches us to our deepest core.
 

Why is death so upsetting when it is the one experience that every living person will someday have?

We feel anxious when we don’t know what to expect, and when we cannot control our lives. Death, either natural or traumatic, is a thing not fully known and is beyond our control. It is not surprising that there is a lot of anxiety around death.

In Western society we have distanced ourselves from death in many ways. We put our aging relatives in nursing homes. (In much of the world, the elderly are viewed as elders and given great respect.) They are taken to hospitals to die, often alone. (In other cultures, if the elderly – or any family members – are ill, family members stay with them in the hospital.) We hire morticians to tend to their bodies. (In other cultures it is considered a great honor to tend to the body of the deceased.) Even though we honor their passing at a funeral ceremony, we may choose never to see their body (viewed by the majority of the people of this world as a garment that the soul wears through a lifetime), once they have left it.

Death thus becomes an unfamiliar – to many, an unknown – direct experience in Western society. And what you do not know, you tend to fear.

The death of anyone else will remind you of your own mortality. This is probably one of the major reasons why we distance ourselves from death. Many doctors and nurses do this to an extreme. Death is fought at all costs. And when it is finally inevitable, I have too often seen these caregivers who minister to our health avoid going near the patient who is dying.

In other cultures, death is known from personal contact with the dying. It is not as frightening an experience to anticipate. In some cultures, there are extensive preparations for dying that help people to leave peacefully.

While death stands as a threat to cut off our life at any point, the fact that it is ever there makes the time we have on earth more precious.

Loss is Painful

Few of us are happy to have people who are close to us die. Even in cultures that are not death-avoiding and death-fearing like our Western culture, there are mourning rituals to help the bereaved deal with their grief and to honor the deceased.

You don’t have to be related to people who die in order to feel grief. You may readily identify with those who did lose someone close and may empathize with their loss and grief.

At another level, the loss of so many people at one time is a communal death, impacting our whole nation.

Stages of Grief

Be aware that grief has a natural course, running through several stages.

First, there is shock and denial – "Oh, my God!" "It can’t be true!"

Often there is wishful bargaining: – "Please, God, don’t let it be true!"

This stage may last from minutes to a few hours, perhaps to a day or more when verification of the personal tragedy is delayed. If the fate of a potential victim is not confirmed, denial may be prolonged, with hope against waning hope that the person you know (knew?) and love (loved?) has survived, perhaps in a hospital somewhere, unable to communicate.

Next, when it is verified that this person who was alive only a short while ago is alive no longer, there is the stage of horrible pain of realizing she or he is no longer there. The pain tends to come in waves, like a storm, stronger at first, waning in intensity over 6-12 months. Strong waves often recur periodically over one or two years, particularly on occasions when you miss this person who was an important part of your life. Anniversary dates such as birthdays, holidays, and the day of their passing on may be difficult for several more years.

Mixed with the pain there are often two other feelings.

Anger can come in spurts or may be prolonged. You may be irritable for no apparent reason, snapping at friends and family or at grocery clerks, other drivers, or telephone solicitors. While your anger may be justified by their actions, when you look back on it, or when others observe it, you may become aware that there is an excess of rage – coming from your grief reaction.
Feelings of guilt are common, over words or actions that you wish now you had or hadn’t expressed when this person who was suddenly taken from you was still alive.

The last stage is one of resolution, accepting the inevitable and finding your way to a new life that does not include this person who had been a part of your routines, your pleasures, your challenges, and your special occasions.

Stress and Post-Traumatic Stress Disorder (PTSD)

Stress hormones are released when you are threatened. Your mind and nervous system reflexes are more tense and alert, your heart races to make more blood available, and your muscles are charged up for confrontation. If you are able to respond competently, as when confronted in a wrestling ring by an equal opponent, the physical exertion and the struggle of the contest put the stress hormones to good use.

If you are a victim of or witnesses to violent circumstances that are beyond your control, with no possibility of dealing with them physically, much less competently, you may feel overwhelmed and your hormones will still be flowing, your nervous system and muscles tensed and ready for action.

When you experience severe stress that you are unable to resolve or adequately deal with, then residues of stress responses remain undischarged in your body, in your mind, and in your heart. A common experience is to have a near accident while driving. Your whole system is jarred and left with no way to discharge the tension. You may be shaking when you get out of the car, despite the fact that no harm was done and no physical injury occurred.

Such stresses can leave scars in your mind, heart, and biological energy fields. These may lie, unnoticed, in the depths of your being, or may be disruptive to your life in various ways.

If the PTSD is severe, you may have any of the following symptoms:

You may find that you can’t concentrate, can’t remember simple or even important things, are hyper-alert for no immediate reason, or are insensitive to your environment. Your thought processes may be "mushy" and confused, and you may make mistakes that are unusual for you to make. You may lose track of time.

Your body may respond with tiredness and weakness, or various tensions might manifest as poor coordination, a tight chest, nervous stomach, racing pulse, or other forms of body complaints.

Your emotions may reflect these stresses as anxiety, agitation, unusual fears, or even panics, emotional instability and irritability. All the feelings associated with grief can come in spurts and waves, including moodiness, depression, crying spells, anger and guilt. Emotions may surface in response to anything and everything.

You may feel like eating less or might comfort-eat. You might have more of an urge to smoke, drink, or use other chemical relaxants. Activities that normally give you pleasure may be unsatisfying, such as your sex life. Sleep onset may be delayed, and sleep may be restless and interrupted by dreams or nightmares.

How can we deal with our shock and grief after a terrorist attack?

Being upset is normal when we grieve. Be aware that you are likely to feel upset – not only when you hear news of the tragedy, but at any time during the day or night. You might be jarred by any stress into responding with an excess of emotion.

Be patient with yourself. Be patient with others around you who are processing their own grief.

Accept that you may feel out of sorts, may have difficulty concentrating, and may not feel up to doing things you normally do without thought or question. Tasks that require thought and concentration may be difficult or impossible to do for several days; longer if the impact has been stronger. You may find it helpful to take periods of time to do manual work or to exercise, in order to discipline your mind away from dwelling on what is upsetting, as well as to work off excess nervous energy.

Speak with others to share and vent your feelings, as well as to have a sense of where they are with their emotions. This is really important with family members, particularly children. Let you children know about your feelings, so they can understand their own feelings better. Reassure them about the realistic likelinhoods of anything happening to them. Pont out that caution is wise, but fear and panic are not necessary, and if these start to creep in and take over, there are ways (discussed below) to deal with anxieties.

While it is helpful to have the latest news, constantly viewing scenes of disaster and its aftermath can be traumatizing, particularly to children. You may choose to limit the amount of time you or your children spend in watching or listening to news coverage.

Keep your focus on the human side of what is happening. Not all Arabs or Muslims are terrorists. Don’t villify Afghanis, Saudis, or other foreigners. (Why didn’t we suggest profiling after the Oklahoma bombing?)

Working at Deeper Understanding of Your Responses to the Stress

Why do some people have more serious reactions to a stressful situation than others?

People who cope better may have more or better support systems, greater self-confidence or other qualities or life experiences that have prepared them to deal with this stress.

If you are among those who are stressed by the attacks, you may have been impacted more severely by the images of the attacks, so graphically portrayed by our media. People who have severe reactions may be more sensitive, tired, or stressed with other problems, so that the terrorist attack was a "last straw" that pushed them beyond the limits of their resources to cope.

Often, people who have severe reactions are responding not only to the current stress. They have had one or more severe emotional traumas previously, often buried in their unconscious minds. These may quietly fester below conscious awareness, hidden away after the original hurtful experience, because the stress at that time was too much to bear. Burying it in forgetfulness was the best that could be done at the time, in order not to suffer the hurt, anger, guilt, shame, or whatever other feelings the experience engendered.

When another stress comes along at a later time, the unconscious mind wants to unload the old hurts that it has had to spend a lot of energy to hide from conscious awareness. So the unconscious mind may start dumping some of the buried feelings from the old traumas, catching a ride on the feelings roused by the current trauma. The unconscious mind wants to unload these but isn’t sure it’s safe to do so, since it wasn’t safe at the time these feelings were originally buried. Sometimes, the unconscious mind really opens the floodgates, and old memories come tumbling out in their entirety. At other times, your only clue they’re there may be an excessive reaction to the current stress.

If you are open to self-examination, a serious stress like this can become a wake-up call for you to examine what inside you is responding to it, and to clear yourself of your negative emotional responses to current and old traumas, using some of the approaches detailed below.

On a national level, a terrorist attack may collectively stir many buried hurts and angers that are outside our conscious awareness. Our unconscious minds may seize on this opportunity to discharge some of the old angers at a convenient target – the terrorists – while not revealing the actual source of the excess angers from past hurts. You might find yourself angry with people who resemble the terrorists. It is not uncommon for people of the same cultural or religious background as terrorists to be targeted for persecution in fear and revenge. (Remember how we treated the Japanese Americans in World War II.)

Dealing with New and Old Traumatic Experiences

There are several counseling techniques that are potent and rapidly helpful for dealing with stress and symptoms of PTSD. These are presented for health caregivers who might wish to integrate them in their practices for stress management. People needing help with stress are advised to seek help from a health care professional for guidance in the use of these techniques. Resources are listed after each approach.

Eye Movement Desensitization and Reprocessing (EMDR) was developed by Francine Shapiro, PhD, an astute psychologist in California. She found that people experience a dramatic relief of anxieties when they alternately stimulate each side of their brain by moving their eyes back and forth from right to left. Alternately stimulating the cerebral hemispheres by tapping on either side of the body is easier, and produces the effects.
Research shows EMDR is potently effective in relieving symptoms of PTSD, even when it is severe – such as from traumas of Vietnam War veterans.
With adults, it is strongly recommended that EMDR should be done only during sessions with the therapist. This is to prevent being overwhelmed by intense emotional releases that can occur during treatment. I found that younger children rarely have such intense releases, perhaps because they had not kept their hurt feelings bottled up for as long a time, or perhaps because their emotional defenses are not as strongly developed.
This was very helpful, for instance, with nightmares, when traumatic memories were stimulated by current stresses, or where excessive angers erupted.
See: www.emdr.com for more detailed explanations of this method, research references, therapists, and more.

Emotional Freedom Technique (EFT) was developed by Gary Craig. In EFT you tap or press a finger at a series of acupuncture points on your face, chest and hand, while reciting an affirmation. Because it works more rapidly than EMDR and does not evoke intense emotional releases, it can be used as self-healing. (Affirmations are described below, under the Hybrid technique.) See extensive discussions and a broad range of problems that have been helped by EFT at www.emofree.com. Gary Craig is a true pioneer in the arena of stress management.

The Wholistic Hybrid EMDR-EFT (WHEE) is much briefer than EFT and I find it works just as well as the longer series of EFT points. With WHEE you alternate tapping the ends of your eyebrows across the bridge of your nose, while reciting the EFT affirmation.

Here is a generic affirmation (from EFT): "Even though I have this [anxiety, panic, fear, etc. – be specific when filling in the blank], I completely and totally love and accept myself and know that God loves and accepts me unconditionally [or use whatever positive suits you best at the time of use].

Prior to doing this self-healing technique, it is helpful to assess how strong the negative feeling is that you want to address. The most commonly used is the Subjective Units of Distress Scale (SUDS), where you rate it on a scale from 0 (not bothering you at all) to 10 (the worst it could possibly feel).

After tapping for a few minutes, check the SUDS again. It will usually go down. Repeat until it is zero. Then you can replace the negative that you have released with a positive affirmation, simply stating the positive as you tap until it is at a maximal SUDS strength.
If the numbers don’t shift after you’ve tapped, you can give yourself a gentle massage on the releasing spot, located just below the collarbone at its midpoint. No affirmation is needed here. Then return to tapping.

Alternatives to tapping on your forehead are to tap on your right and left at any other part of the body. A method that appeals to children is cross their arms so that their hands rest on each biceps muscle, alternating tapping on each arm with their hands. This is also self-comforting just as a hug.
Children respond particularly well to these approaches.

A deep breath following the affirmation facilitates emotional releases.

Holding your other hand over your heart center (chakra – at the upper third of your breast bone) while you tap or touch your eyebrow points deepens the effects.

There are many other variations on these Meridian Based Therapies (MBTs), often called Energy Psychotherapies. See discussions on some of these at Gary Craig’s site, http://www.emofree.com/eftcous.htm

The principles behind these therapies are enlightening. If you consciously pair a strong positive against whatever negative you are challenged with, while calming your mind, you can weaken and eliminate the negative.

The Sedona Method may appeal to adults and is an even faster approach. This involves simply asking yourself whether you are prepared to let go of your problems and then inviting yourself to do so (with a structured series of questions that are trademarked by the Sedona teachers - (www.Sedona.com). I find that younger children don't respond as well to this approach.

Giving yourself permission to let go of a fear or other negative can release it.

In other words, there is no need to run away from hurt or angry feelings, and certainly no need to vent them on others. You can competently deal with your negative feelings and eliminate them.

More on these approaches (for therapists) can be found at Articles/Selfheal.htm

Larry Lachman, PsyD, who consults on dealing with cancer posted the following helpful sites:
GriefNet aids people working through loss and grief issues of all kinds. You'll find 37 e-mail support groups and an area where kids can help each other deal with their emotions.
www.griefnet.org

The Trauma Information Pages is a huge portal to all things online having to do with emotional trauma and traumatic stress, whether following individual experiences or a large-scale disaster. Browse through a directory, or search with keywords.
www.trauma-pages.com

The National Mental Health Association presents Time for Reassurance, advising that the unfolding tragedies can naturally cause children and adults to feel confused, afraid, angry or powerless. The site also lists nationwide resources that can provide help.
www.nmha.org

Child-related aid
Traumatic stress experts at ParentsTalk offer advice on helping children cope with emotionally difficult situations. A user-friendly list on how to recognize signs of stress in kids and what steps to take. www.parents-talk.com

ACCESS - AirCraft Casualty Emotional Support Services - stands ready to help when the initial shock of an air disaster subsides and the natural grieving process intensifies. Volunteers who have survived or lost a loved one in an air crash provide peer support.
www.accesshelp.org


University of South Dakota - Disaster Mental Health Institute Website.
Contains short booklets on coping with disaster that can be printed from the
website.
http://www.usd.edu/dmhi/Pubs/availability.html

National Association of School Psychologists. Coping with a nationaltragedy. Has several resources including Helping Children Cope with Tuesday's Acts of Terrorism.
http://www.nasponline.org/NEAT/crisis_0911.html

National Institute of Mental Health Website. A comprehensive section entitled Helping Children and Adolescents Cope with Violence and Disasters. Contains more in-depth information on Trauma, PTSD, etc.
http://www.nimh.nih.gov/publicat/violence.cfm

David Baldwin's Trauma Information website. Disaster Mental Health Handouts.
http://www.trauma-pages.com/pg5.htm

Red Cross Brochures
(Available at your local Red Cross Chapter or through the APA Practice
Directorate's Disaster Response Network Office at 1-800-374-2723)
When Bad Things Happen
Helping Children Cope With A Traumatic Event
Helping Children and Cope with Disaster - ARC 4499

Why would anyone attack thousands of innocent people, with the obvious intent of killing and injuring as many as possible?
There has to be enormous hate behind these terrorist acts – hate which is so great that people will die to vindicate their feelings. It is clear that hate of this magnitude was present in enough people to bring down four airplanes, killing as many people as they could when they extinguished their own lives.
We must assume there is a wish to hurt and frighten the American people.
The terrorists have succeeded to some degree in this way. I hear many friends and acquaintances saying, "I’m nervous now when I go out anywhere." "This could happen anywhere, any time." "I don’t feel safe."

I lived in Palestine turning Israel 1945-1949. My family home was in Jerusalem during the Israeli War of Independence. I slept in the basement many a night during shooting, shelling and air raids. I still shudder a little when I see a war film from that period. The decrescendo whistle of incoming shells reminds me of my terror as I waited to hear whether the explosion would be far away or nearby, hoping the house upstairs wouldn’t be destroyed, hoping it wouldn’t cave in on me – despite my parents’ reassurances that the basement was safe.
I lived again in Israel during the Yom Kippur War in 1973. My apartment in Ashkelon, on the Mediterranean coast just north of the Gaza Strip, was directly under the flight path of an Israeli air force runway. Our dishes would rattle in the cupboards as jets roared just a few hundred feet overhead on their way off to missions in the nearby Sinai.
I was in Israel during the Munich sports massacre, and later during a period of street and bus bombings. Because Israel is a small country, we all were personally acquainted with some of those who were killed in terrorist activities. There was outrage, pain, grieving, and calls for revenge.
I had to ask myself, was it safe to go out in the streets? To ride a bus? To let my daughters play in the streets? To visit my elderly father in Jerusalem?
Our family decision (and that of many of our friends and colleagues) was to live life as usual and not to let the terrorists achieve their goals of making us fearful, of diminishing the quality of life. This was not easy to do in Israel, which is a small country surrounded by hostile countries, dependent on outside support for survival. There were many times when we reeled from repeated terrorist attacks, on the borders and within the country. But life went on and we more than just survived. The terrorist threats led us to value life? all the more and be thankful for all the positives that we had in our lives. Nothing was taken for granted. So, although we lived with more tension, and sometimes struggled with grief, the terrorist attacks actually achieved the opposite of their intent – we were more appreciative and thankful for life.
A decade later I was living in London during the period of IRA bombings, and had to revisit these questions, coming to the same answers and resolve to not let terror be a part of my life. Caution to not go where a bomb might be likely – Yes. Limiting my activities – No.

Even when you are not directly affected by terrorist attacks, you may feel anxious when you know that getting on a plane, going to a big city, or that visiting any public place could be dangerous. This is a normal reaction, but you don’t have to suffer with it. You can use the approaches described here to stop these reactions.

How can we respond to the perpetrators of these atrocities in New York and Washington DC?
The perpetrators must be brought to justice. Law and order require that there be rules and that transgressors of society’s rules should be prevented from repeating their crimes. This could require drastic measures with terrorists.
There are several dangers inherent in our responding with force.
We could act as the terrorists did, "leveling Afghanistan" – as some have suggested, taking innocent lives in the process of hunting them down. This would be a tragedy for us as well as for the victims, as it would mean that the terrorists had brought us down to their level of disregard for human life. It would also serve the aims of the terrorists, by creating further ill will against the US.
Will attacking Afghanistan stop terrorism? What consequences are going to be adequate to deter people who are willing to die, fighting for their cause?
Are we going to avenge their terroristic acts by terrorizing them? This may release some of our angers (from their actions and from other sources) but is likely to intensify the motivation of the terrorists to repeat their attacks. Are we going to escalate to terrorize their families? Their towns? Their countries?

The futility of revenge
My father was born in Cairo, son of a Jewish tailor who emigrated from Lithuania in the early 1880s, finding business better in Egypt and life freer of religious persecution. Speaking Arabic, my father worked as an administrator in Arab education in Palestine under the British, continuing eventually as Vice Minister of Arab education after the State of Israel was established.
I grew up hearing both sides of the Israel-Arab conflict. I heard from Israelis that is it impossible to trust Arabs, who basically want to wipe Israel off the map. I heard from Arabs that is impossible to trust Israelis, who occupy their lands and deny them their sovereignty. I saw Israeli children taunting and cursing Arab laborers who were hired in Israel to do menial jobs that Israelis would not want, such as construction labor and garbage collection – and their parents stood by and did nothing to restrain them. The local rabbi, inspecting the construction of a new synagogue, was questioned by Arab laborers, "Why do you lock up the construction materials overnight?" They shook their heads in wonder at his response that the materials would probably disappear overnight if they were not in a secure space. "How could anyone even think of stealing from a house of worship?" they asked. Family members of Israelis who had been attacked by Arab terrorists came to me for treatment of their post-traumatic stress disorders.
These were just a few of the surface manifestations of personal and cultural wounds that had been festering over several generations. Revenge generates more violence and more revenge.
I learned that in cultural conflicts, as in the marital and family conflicts I am trained to treat, there are always two sides to any disagreement. My experience with resolution of interpersonal discords is that compromises work best and last longest. Solutions imposed by one side or the other breed resentments and do not hold for long. So it is with national and cultural disputes. When anger, hatred, distrust, and desires for revenge are the motivating forces, striking back is an appealing option. This will only generate further terrorist attacks, with endless counterattacks. The Arab-Israeli conflict is a clear example of this endless vicious circle.

Personal responses to the attack
Risk assessment
If we look at the actual risks of being hurt in a terrorist attack, they are very small. Even if there were further attacks, the chance that you would be involved is infinitesimal.
If we look at the relative risks, you are far more likely to die from a side effect of a medicine properly prescribed by your doctor or of a medical error in a hospital than from a terrorist attack. At a conservative estimate, over 100,000 deaths occur every year as a result of negative reactions to medications that are properly prescribed and as a result of medical errors. Medications are everywhere. Terrorists are not.
Yet the fact remains that we are more stirred and fearful of terrori

 
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Copyright © 2004 Daniel J. Benor, M.D. Reprinted with permission of the author, P.O. Box 76 Bellmawr, NJ 08099
www.WholisticHealingResearch.com   DB@WholisticHealingResearch.com

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