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The Wisdom of Psychopaths
In this engrossing journey into the lives of psychopaths and their infamously crafty behaviors, the renowned psychologist Kevin Dutton reveals that there is a...
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Just watching television footage of the terrorist attacks of September 11, 2001, was enough to cause clinically diagnosable stress responses in some people who did not even live near the attacks—let alone the millions of people who did.
Like many other major disasters, 9/11 brought with it a host of psychological repercussions, one of the most severe of which has been post-traumatic stress disorder. PTSD is characterized by trouble sleeping, difficulty controlling anger, losing interest in activities, flashbacks, emotional numbness and/or other symptoms. If not treated, it can be debilitating.
But these reactions are not uncommon after a major disaster—and teasing apart post-9/11 disorders has been tricky for psychologists and researchers. "We tend to use the terminology of PTSD very loosely. A lot of people will have traumatic reactions but not necessarily PTSD," says Priscilla Dass-Brailsford of Georgetown University Medical Center's psychiatry department.
Researchers have been poring over the piecemeal collection of studies conducted over the past decade on the conditions of people after the attacks—how they felt and how well various treatments, and the passage of time, have helped them overcome mental afflictions. And from the literature, we are learning that old styles of early intervention, such as debriefing sessions, are not as effective as once thought—and that more often than not, people are incredibly resilient and can recover on their own and should be given the opportunity to do so.
"Research on 9/11-related PTSD has challenged the ways in which mental health researchers assess exposure to trauma," Yuval Neria, of Columbia University's psychiatry and epidemiology departments, and his colleagues wrote in a new paper published in the September issue of American Psychologist. Those in the mental health field have also borrowed research from other traumatic events to better understand the psychological wounds inflicted by the terrorist attacks. "Despite the fact that the exposure is different, the symptoms and problems are more similar than some people think," Neria says of PTSD sufferers from natural disasters or combat.
The exception, not the rule
During the week after the September 11 attacks, Dass-Brailsford was on one of the first trains to New York City, where she conducted debriefing sessions with a large financial company that had had offices in the World Trade Center. Many of the workers she spoke with in those sessions "were really traumatized," especially those who had been the last persons that friends or colleagues had spoken to before they perished.
But not everyone who was at the scene of any of the attacks on the morning of September 11 wound up suffering from PTSD or an other severe stress response. In fact, the majority did not. After traumatic events, such as 9/11 or Hurricane Katrina, "people expect the survivors or the victims to have PTSD, but that's not necessarily the case," says Dass-Brailsford, who also worked as a psychiatric first responder in the week after Katrina. Even if people experience occasional anxiety or stress having "perfectly normal reactions," she explains.
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9 Comments
Add CommentThank you for this article. The theme of resilience and stress reactions being a normal response to abnormal events is core to traumatic experience recovery in my professional experience as the mental health clinician over the past 25 years. I do wish to comment, however, that associating stress debriefings, designed originally to help first responders deal with events outside their usual response situations, and mental health crisis response should not be paired or compared. My clinical specialty for many years has been crisis response and longer term trauma recovery with individuals and groups from military combat members to abuse and hostage survivors , internment camp survivors and victims of crimes including family violence. I also am CISD advanced level trained and experienced. These techniques and their goals are entirely different. Each has merit in the correct context. I believe to repeatedly view CISD as a mental health response is erroneous and a disparagement of a technique that is much like a psychological autopsy, piecing together for responders and rescuers the mosaic of coordinated response so that their roles fit within a larger picture and their sensory and emotional experiences have a context of normal for them. The purpose of this is to quickly enable them to be on scene again without being brought to a standstill by evocation of neurosensory memory bringing them to a halt just when they need to be lightning fast in their work. The last piece of a CISD is to provide education for self-care and recommendations for support as and if needed without an assumption all are traumatized pathologically. With mental health crisis response the usual affected group is usually far more repeated trauma naive so that the sensory impact and resources for coping are not attuned. The type of response, whether individual or group is sensitive to this psychological exposure naivete and require tremendous cultural, generational and situational attunement. THe goals and techniques are completely different.
Reply | Report Abuse | Link to thisBest regards,
Aliceann Carlton, LCPC
For a thorough debunking of the 2002 JAMA paper, point by point, see
Reply | Report Abuse | Link to thishttp://www.psychologytoday.com/blog/the-skeptical-sleuth/201109/september-11-2001-did-americans-suffer-virtual-trauma-television-co
and
http://www.psychologytoday.com/blog/the-skeptical-sleuth/201109/after-911-the-mental-health-crisis-never-came
PTSD is a terrible thing. I have a friend who just returned from Iraq and he was suffering from PTSD. We try to help him but he is half the man he was.
Reply | Report Abuse | Link to thisAlvin, you are right and I am sorry for the loss of the friend you knew before his Iraq experience. This article is really trying to redefine what is acute stress and a normal and expected reaction and what is post-traumatic stress which persists and becomes debilitating over time. I take issue with the concept that there is less PTSD than the author and cited sources are presenting because whatever it is defined to be, a person exposed to such emotional and neurosensory impact is forever changed and will never be the same. So what is happening in the United States now is an effort to "neutralize" horror and turn it into something a resilient mind can survive. That's a "well duh" sort of claim as most of us who grew up with children whose parents were in Nazi death camps learned very quickly. It's like watching a sturdy tower collapse and then rebuild itself, sometimes haphazardly and sometimes with sand rather than stone and morter. I am literally stunned by the lack of inclusion of first responders and family members in the 9/11 NYC Memorial as the trauma was shared by all at ground zero, and by the entire country where the ripple effects still wash over the consciousness of citizens, fueled of course by a warmongering leadership for some years. To say that an acute stress reaction and post-traumatic stress problems are normal reactions to abnormal events is accurate, to say many "get over it" is partly accurate, to say that life resumes as normal for most people is inaccurate unless you also posit that "normal" is the adaptation to hypervigilance, hypersensory or hyposensory acuity, flashbacks triggered by normal life events many years after the experience, and relationship changes so profound many are ruptured or badly strained for ever.
Reply | Report Abuse | Link to thisI did not think about 9/11 disaster much in past decade but after bin ladens death its having an impact on my mind.Its like iam being lifted to a new state of mind.
Reply | Report Abuse | Link to thisHi,
Reply | Report Abuse | Link to thisMany years ago I fought in Vietnam.One of the things that often bothered me was I would wake up often thinking I was back there.It went on for years.
I did have a problem with depression .My kindly therapists recommended Recovery Inc.I have been going for several years now and have setbacks only whe I didn't practice their method.
Dr. Low the founder of Recovery Inc.has a saying about memories.The brain knows very well how to forget.All you have to do is not keep reviewing the past.Don't work up the past,it's outerenviroment and we can't control it.
My mental health is most important to me.That is why I continue going to Recovery Inc. meetings and practice.
John,
Reply | Report Abuse | Link to thisThank you for your service and sacrifice. Also, you are to be commended for your continuing work to deal with your PTSD.
My father was WWII veteran who fought at Gaudal Canal. When he was in his early '80's he was still waking up from nightmares screaming "Japs, Japs, Japs."
My father was always on edge. Some said he was a rage-aholic, but in my early adult years after reading about PTSD in children of alcoholics, I realized why my father was the way he was. My family was horrible. Because of my father's condition, by mother and the 4 kids were all abused emotionally and physically, to the point that we suffered PTSD ourselves. Few seem to realize the devastation that occurs not only to our Vets, but to their family members as well.
Those interested might appreciate the work of the Climate Institute who are looking into the effects of natural disasters on mental health. You can read more about the Climate of Suffering at www.climateinstitute.org.au
Reply | Report Abuse | Link to thisThose interested might appreciate the work of the Climate Institute who are looking into the effects of natural disasters on mental health. You can read more about the Climate of Suffering at www.climateinstitute.org.au
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