Is It Ten Years Already? Seems Like Yesterday.

November 22, 1963—I am nine years old, home sick from school, watching television when the news flashes across the screen that John F. Kennedy has been shot.

April 19, 1995—I am sitting in my office reading reports, when a co-worker tells me to turn on the radio because of the Oklahoma City bombing. Who can forget the sight of that fireman holding the infant outside the federal building? 

April 20, 1999—I am working with teenagers at the Denver Children’s Home when another child tells me that two students attacked other defenseless students at Columbine High School right here in Colorado.

September 11, 2001—driving into work, my car radio informs me that a plane has hit the World Trade Center. I arrived at work shortly after the radio announcement and turned on the television to watch in disbelief as the towers collapsed.

Images of all of these events have been seared into my memory. I viewed the events multiple times on those historic days, the same way I find myself drawn to look at a car accident on the highway. They scared and angered me and yet I couldn’t turn away. When something in our environment is perceived as threatening it is difficult to disengage. Each of these events altered my perception of the world and my personal sense of safety and security. Memory researchers call these “flashbulb” memories. Memories of events that are highly emotionally significant that the brain records them more vividly and we believe we recall them more accurately then other less significant events.

That day—September 11, 2001—normal activities were not an option and I wanted to make contact with people I cared about. Everyone I interacted with shared what they were thinking and how they were personally impacted. Our cognitive templates didn’t account for such catastrophes. When threatened, our biological directives cause us to seek proximity to each other and begin circling the wagons.  It is amazing how tragic events seem to draw people closer together. We all shared something painful and we all felt soothed by our relational connections. However, when we huddle together that means everyone outside the circle is a danger.  Nobody wants to say anything that might get them kicked out of the circle. In times of danger, we must present a united front to our perceived enemies.

Although these events have many things in common, our response to them is what creates the difference. The message we received in those earlier events—before 9/11—was that the actions of disturbed individuals resulted in a terrible disaster.  However, the world was still good. The rituals, the funerals, the grieving and healing helped put meaning to the overwhelming, unimaginable experiences.

Something of a different magnitude occurred on 9/11 and changed forever the way we think, feel and behave when it comes to safety and protection. The world on that day was divided into good and evil. Our only hope of survival was to defend ourselves. As a nation we had to seek out and destroy the threat before it destroyed us. Survival was, and still is, at stake. Laws were quickly enacted and policies implemented that were designed to protect us but in reality generated increased anxiety.  Every time we travel we are reminded that the world is an unsafe place and that danger is ever present.  It is as if the very strategies that were initially put into place to keep us safe became the obstacles to healing and moving forward.

In some ways Kennedy’s assassination, the Oklahoma City bombing, and Columbine created an acute stress response, but 9/11 resulted in an entire nation suffering from Post Traumatic Stress Disorder. The diagnostic criteria for PTSD:

Exposure to traumatic event in which both the following were present

• Experienced, witnessed, or was confronted with an event or events that involved actual or threatening death or serious injury, or a threat to the physical integrity of self or other
• Response involves intense fear, helplessness or horror

The traumatic event is persistently re-experienced in one (or more) of the following ways

• Acting or feeling as if the traumatic event were recurring
• Intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event
• Physiological reactivity to exposure to internal or external cues that symbolize or resemble the traumatic event

Persistent avoidance of stimuli associated with the trauma

• Efforts to avoid activities, places, or people that arouse recollection of the trauma
• Efforts to avoid thoughts, feelings or conversations associated with the trauma
• Diminished interest or participation in significant activities
• Restricted range of affect
• Sense of foreshortened future

Persistent symptoms of increased arousal (not present before the trauma)

• Hyper-vigilance
• Exaggerated startle response
• Irritability or outburst of anger

Duration of disturbance more than one month

The ongoing anxiety generated by 9/11 changed the world and shattered our assumptions. The speed in which we enacted new laws and shifted power to one branch of government and eliminated certain liberties, without understanding and debating the long term impact of those decisions, suggested the level of threat we felt we were under.  The openness to go to war with a country that was not even connected to 9/11, because it presented a potential threat, suggested how reactive we were. New homeland defense measures were funded and continue to function ten years later. Our profiling of a group of people that triggered memories of the traumatic incident suggested our efforts to avoid these individuals at all costs. I don’t think we monitored the whereabouts of all white middle class teenagers after the Columbine incident. No exaggerated startle response was necessary because we portrayed those two teenagers as troubled youths, unlike other teens.

Sandra Bloom, Past-President of the International Society for Traumatic Stress Studies and author of Creating Sanctuary: Toward the Evolution of Sane Societies and co-author of Bearing Witness: Violence and Collective Responsibility, states that under severe stress, a leader rapidly emerges within a group. The process is a combination of the needs of the group, individual characteristics of the individual leader and the demands of the moment. Under these conditions humans become more suggestible to the influence of a persuasive leader who represents the best defense for the clan and has the function of binding the group’s anxiety. Decisions are made quickly with input that is colored by a pressure to conform to standards of group cohesion (Neither Liberty Nor Safety, pg. 9). 

This tenth anniversary of 9/11 is an opportunity for our nation to heal from our wounds rather than just defend ourselves from possible future threats. Research over the past decade has shed light on how exposure to life threatening adverse events changes how an individual, an organization or even an entire nation  perceives, processes, stores, retrieves and acts upon environmental stimuli that has become associated with a traumatic event.

Trauma-sensitive approaches to helping victims heal suggest that our country must find a way to redefine our definitions of “safety” and integrate our past traumatic experience into a coherent narrative that can be used to navigate a healthier vision of the future. As a psychologist who works on a daily basis with victims of trauma, I am looking to leaders who are:

• Committed to creating an environment of physical, emotional, social and moral safety, so that we can engage our higher brain regions in advancing innovative and creative solutions to the complex problems confronting our world.
  
• Communicating clearly about actual probability of a threat and not scaring people with the possibility of an attack.
  
• Determined to look inward for the solutions rather than blaming others. In some respect we are a developmentally very young nation that needs healthy, attentive, attuned, responsive caretakers to both sooth us and challenge us to express our optimal potential.
  
• Capable of reflecting upon the decisions that were made under imminent danger and evaluating the need for elimination or modification of those decisions.
  
• Willing to shift our resources away from protection toward policies of optimal growth.
  
• Open to engaging in honest dialogue about what lead up to the attack and how we reacted. This dialogue is designed not to point fingers and blame, but as a way of beginning to integrate our experience, learn from the past, and begin to create a brighter future.
  
• Ready to invest in educating our citizens about the benefits of developing healthier relationships within families and communities. Work on supporting the development of adaptive coping strategies to deal with potential threats and challenges rather than short term solutions.
  
• Motivating individuals to not only remember the tragic events but to encourage them to perform some positive, caring action in their community.

Terrorism comes in many forms and in all walks of society.  The symbols of the collapsing towers and the loss of 3000 valuable lives can serve to awaken all of us to the terrible fear and pain children in our country face every day. Millions of children are abused neglected and exposed to violence in their homes and in their communities each year. In a 2004 longitudinal study of 768 New York City teens, reported in Applied Development Science (Vol.8, No.3) and sited in an article by Tori DeAngelis (Monitor on Psychology, September, 2011), the authors compared the rate of mental health problems among those exposed to the 9/11 attack with those teens who had experienced or witnessed community violence but were not directly exposed to the attack on 9/11. These youth are exposed to assaults, domestic violence, bullying, and murders were far more likely to experience a mental health issue than those exposed to the isolated event of September 11, 2001. True Homeland defense must not exclude those most at risk.  Take this tenth year anniversary to find a way to get involved in  your community to improve the quality of life for someone more vulnerable than yourself and making the world a safer place.

“The role of elders in any society is to determine what experiences we want our children to be exposed to with enough repetition that it gets passed onto the next generation.” Dr. Bruce Perry, ChildTrauma Academy