How does one respond in the face of national trauma?

Jerusha Detweiler-Bedell, assistant professor of psychology

Hello everyone, and welcome. In our panel, we are transitioning from the more political to the more personal reactions to the events of September 11. Because I am sure that each and every one of you in this room was affected in a personal way by the recent events, I will now turn to how we cope with and make meaning of national trauma. I am speaking to you as both a clinical and health psychologist, and what I have been observing over the past week and a half are the various ways in which people cope with a tragedy of a size that our nation has never seen before. Specifically, how is it that we, as people living in the United States, cope with a trauma of this magnitude? From the previous panel we've heard that losing perhaps 6,000 lives may be small in the big scheme of things, but in our own country this is a disaster that no one has any real experience dealing with. Most of us in this room were never taught how to cope particularly well with something of this magnitude. So my question is this--how is it that on September 11 most of us managed to get out of bed, come to class or to work, reach out to people around us, look for support, and in effect, cope with the fact that our lives had been changed forever? In part, the reason we all have the ability to cope is not that we have learned it, not that anyone has taught it to us, but that it is biologically and evolutionarily rooted in our body.

Go back for a moment in your mind to the morning of September 11. Think about where you were when you first heard the news. Think about what you felt in your body. Do you remember your heart pounding? Did you feel dizzy, nervous, or tearful? Did you have trouble getting dressed? Did you lose your appetite? I was about to eat a bowl of cereal that morning when my neighbor came over and told me to turn on the television. I ate no more than a bite of that cereal. What was happening to most of us during the moments when we first found out about the events at the World Trade Center and the Pentagon was our body's stress response. Our body knows this stress response very well because it's biological; it's "preprogrammed" within us. Our racing heart, our feelings of dizziness, and our lack of appetite: all are our body's very natural and adaptive ways of coping with stress. One of the terms for this phenomenon is the "fight or flight" response. When faced with such terror and confusion, with such an immense threat, our bodies automatically respond as if they were about to fight, to combat whatever the terrible threat is, or to flee, to get away, to escape, to find a zone of safety. On that morning, and perhaps throughout that day, many of us felt the fight or flight response. But what about the next day, September 12? Did any of you get a rush of fear when you heard the fighter jets flying overhead? I know I did, and I know that colleagues in my hall did as well. We gathered together nervously looking out the window as we heard those sounds overhead. And it was scary. Our body again mobilized. The stress responses flooded our system because we again thought we were under threat. We didn't know whether we needed to fight or flee or take cover. But again, we experienced a natural, biologically based response to a potential threat.

Beyond our bodily reactions lie our emotional and physical memories of these events. Earlier, when I asked you to remember where you were on September 11, I imagine that many of you were able to recapture the emotions, to reexperience some of those sensations. The reason we can vividly recapture these feelings is that our body is also preprogrammed to hold onto upsetting memories in vivid detail, for as long as possible, so that we can better protect ourselves against future harm. How many of you have images that flash through your mind before you fall asleep at night? Some vivid image from the media, perhaps of one of the World Trade Center buildings collapsing, perhaps of the people who were leaving the World Trade Center covered with ashes. These are terrible images. They stick with us because, again, it is our body's way of protecting itself by reminding us of the horrors that happened so that we can take steps to protect ourselves in the future.

There is a third domain of coping that is perhaps not as biologically based, but certainly evolutionarily adaptive, and that is seeking out other people. Seeking out social supports through contact with friends and family is a natural human response. Many of you probably spent a week ago Tuesday on the phone or on e-mail trying to get in touch with loved ones, just to make sure they were OK. Many of you talked about these issues in classes or with your friends or coworkers. Many of you gathered together, as we in the Lewis & Clark community gathered, to share our concerns and sorrows. Again, this is a response that is very adaptive. It is a way of coping that you were never explicitly taught, but that is a part of each of us. When we are under stress, it makes a lot of sense to gather people around us, to look for people similar to us, and to join together to support one another.

I have been discussing three ways of coping: our stress response (called the fight or flight reaction), our vivid emotional and visual memories, and our need for social support. These are all ways of coping that are extremely adaptive. None of us had to learn to implement these responses to cope with what happened on September 11. But are these entirely good reactions? What I'd like to argue, as a health psychologist, is that our automatic responses may be adaptive to a certain extent, but eventually they can backfire. And perhaps they are even backfiring right now for many of us. First, what about that stress response our body has? What about the flood of adrenaline and stress hormones that coursed through our bodies when we heard the news of September 11? Did it take long for us to calm down? When we went to bed a week ago Tuesday, did we let go of all our worries, all our concerns, and all our fears? Most likely, the answer is no. As humans we have the ability to visually represent, rehearse, and relive the tragedy of September 11th. And I'll tell you, that process is exhausting. Our bodies are physically exhausted by living and reliving these memories. We need to be aware of the fact that being in the fight or flight response over a long period of time can be very stressful for our bodies. Over time, if we continue not to eat properly, not to get the right amount of sleep, not to relax, we may be causing irreversible damage to our bodies.

What about our thoughts? What about our vivid images that continue to flash through our minds? These images, if they stay with us and are played over and over again in our heads like a broken record, can also be terribly damaging. Humans have the ability to ruminate about events, to think over and over again about something without escape. Those people who are haunted not only by memories, but also by flashbacks, nightmares, poor sleep, and changing emotions, develop posttraumatic stress disorder, or PTSD. Here is something you may not know: Even among those who were at the World Trade Center, among the survivors of this tragedy, among the rescue workers who are currently recovering bodies, not one of them has developed PTSD from this disaster--yet. Why is that? It is a completely academic reason. No one can be diagnosed with posttraumatic stress disorder until a month after the traumatic event. In the short term, a diagnosis called acute stress disorder may characterize the reaction of people who witnessed the events, people who are among the rescue crews, and people who lost friends and family, to name a few. A subset of those people (estimates are between 25 and 50 percent) will develop posttraumatic stress disorder. In one month's time, one month from September 11, some people may not be able to escape these haunting memories, may still have flashbacks, may still experience emotions ranging from anger to fear to terror, may begin to avoid memories or reminders of the events. These individuals will be suffering from PTSD. When we think of those most at risk for developing PTSD, we should think of the survivors, but we should also think of the rescue workers and the family and friends of those who were lost; we should also think about the media, about the people who were on the scene taping these horrific images, about the people who took photographs during those first hours. These individuals also saw things that were horrific, and they too are at risk for developing posttraumatic stress disorder. In sum, these vivid visual images can come back to haunt us and can permanently change the lives of some people who were affected by the tragedy.

And what about the social supports that I mentioned earlier? Can seeking out social support also backfire? I told you that it was a good thing that you reached out to others, that we came together as a community at Lewis & Clark. It was a good thing that we sought out social support because we need an in-group; we need people who are like us to support us. However, in order to have an in-group, you also need an out-group. Does an in-group exist without someone or some group on the outside? No. If an in-group necessitates an out-group, we can better explain why there is so much pressure among people in our country to "declare war" against an enemy. Having an out-group helps to explain why some people are mistreating not only Arab Americans and Muslim Americans, but also Arab and Muslim people around the world. Being attracted to similar others during times of tragedy may bring us together, but at the same time, it creates a problem: namely, the creation of an out-group, "the other."

So how can we use our body's natural responses without having them backfire? I have three ideas, and I will end on this note. First, in terms of our body's natural stress response, I encourage everyone in this room to remember that we need time to relax; we need time to let go of some of our stress responses. Because the fact is, we are all ready to fight or flee right now, but that reaction is not particularly helpful. You may have heard people talking about "going back to your normal routine." Even at Lewis & Clark, classes weren't canceled on September 11, and we tried to maintain some of our routine. Our community leaders and members of the media may tell us that routine is beneficial because we need to "put on a good face." They tell us that we need to say to the world, "We can survive this horror." However, I'd like to suggest that routine is also important because it's familiar to our bodies, it's soothing, and it's the best way to take care of ourselves physically. Routine is critical if we want to break out of the fight or flight response.

In terms of dealing with those vivid images and the memories that might plague many of us, you might think that my recommendation would be to avoid those images; turn off the television; avoid the newspapers; erase all the bad memories. In fact, I am going to tell you the exact opposite. Do not avoid the images; do not avoid the conversation about September 11. Avoidance is one of the symptoms exhibited by individuals who develop posttraumatic stress disorder. They try to insulate themselves from reminders of the traumatic events. Instead, I encourage you to address these events in a personal way, perhaps by writing about them or by coming to forums like this to talk about and think about them. Don't avoid them.

And lastly, how do we deal with the idea of in-groups and out-groups? How do we prevent our country from "declaring war" on an unknown enemy? First, I encourage you to talk to people about your experiences, your culture, and your background. Second, expose yourself to as many different perspectives about the events of September 11 as you possibly can. As humans, we have the ability to discuss upsetting issues; we have the ability to think through terrible events; and we have the ability to be creative problem-solvers. Finally, we have the ability to try to be reasonable and rational even in the face of such unreasonable and irrational events. Thank you very much.