Terrorist attacks in New York and Washington have shattered our sense of safety and have evoked strong feelings of vulnerability in us all. When events of this magnitude occur we respond in one of two directions.  We may experience either a great deal of distress and arousal, or extensive denial and numbing.  Some people fluctuate between those two extremes, and don't understand what's happening to them.  Those people who are experiencing the arousal and distress will often show physical signs.  This reaction is normal and happens to people who don't have any preexisting psychological difficulties. People usually need a mixture of supportive help, nonjudgmental general conversation, and attention to their immediate signs of physical and psychological distress.  Below is a series of things that anyone can do to become a source of mutual support.  

Take an inventory of your own reactions. Find a way to be sure that you are calm and able to focus on other people. If you are not able to do this it is understandable.  

Acknowledge that some unusual and/or crisis event has taken place. Most individuals will experience feelings of anxiety, worry, sadness, anger, confusion and most significantly fear as a result of a traumatic event. Talk with others. Ask people how they are doing and what would be most immediately helpful to them. Ask them to describe their immediate physical reactions, such as rapid breathing or racing heartbeat, this can be a useful way of helping people to start to talk about the impact of the events upon them.
 

Explore ways of coping that have been helpful in the past. During other situations of great distress what has helped you to calm down? Ask others what has worked for them. Provide reassurance that the current arousal and distress will be time limited.

Set useful limits in gathering information about the tragedy. While noting the reality of the crisis event, emotionally vulnerable persons should limit the time they revisit or repeat the events by repeatedly seeing it on TV or hearing it on the radio. The goal is to get information but not get overly aroused and stuck in the repetitive details of the tragedy.  People can be re-traumatized by excessively over-viewing the events.  If you notice someone getting progressively more upset by continuous attention to the news try to help them recognize that they need to limit the amount of their exposure, and try to help them shift their focus to calming themselves down. 

Take care of yourself!  People need to anticipate that over the next few days they may have difficulty sleeping, nightmares, stomach aches, or find themselves forgetful or inattentive.  This is the usual way that the mind and body tries to integrate overwhelming, irreconcilable information.  Good self-care is paramount, such as practicing calming methods, i.e. deep breathing, meditation, etc., making sure to eat regularly, not drinking alcohol, and getting regular exercise.  

Normal functioning may not be possible. People need to know that they will not be functioning at their usual levels but it will be helpful to try to maintain as much continuity and normality as is realistically possible.  

Anticipate the needs of children. Adults can model the ability to openly admit to and discuss their own reactions while recognizing that such events do eventually return to a more stable and secure state. Parents should expect that their children might seek closer contact than usual. Although this may seem like clinginess or reverting to younger-type behavior, it should be allowed.  This will include needing more reassurance before falling asleep and being very concerned about the whereabouts of their parents.  Specific information and availability is most important.  Facts should be given to children on an age appropriate basis.  While the impulse to offer blanket reassurance to children is understandable parents should first attempt to find the nature of their children's worries and fears before trying to reassure them.  

Helping those who have been directly exposed.

Provide the individuals with a safe, secure, and familiar environment. Pay attention to whether or not you are picking up indications of shame, blame, or helplessness, as these are indications of more complicated reactions and professional help should be sought.

Acknowledge that such feelings are normal. It is the event that is unusual and chaotic, and that their feelings and thoughts are acceptable and understandable. 

Encourage affected individuals to express their feelings, thoughts and dreams openly and assure them that none of these experiences are foolish or silly. Open expression is important. If a person wishes to remain quiet or silent, provide the opportunity for them to talk by indicating a willingness to listen when they are ready to speak. 

Directly connect the person's feelings and reactions to the actual external crisis event. This allows the person to establish some understanding of their reactions and to connect the event with the feelings of chaos and confusion. 

Reassure the affected persons that they are secure and safe. Remind them of the love and support systems in their life and assist them in returning their world to some degree of predictability. Minimal time should be directed towards analyzing or explaining why such events happened. 

JFS is here to help you and your family.  We have professional therapists with expertise in crisis intervention ready to address you and your family's individual needs.  Call toll free 1-877-537-1818.

Sources:  Dr. Robert Abramovitz, Chief Psychiatrist at the Jewish Board of Family and Children's Services and Ruth Rales Jewish Family Service of South Palm Beach County.
 
 

HELPING CHILDREN COPE 
WITH A TRAUMATIC EVENT
September 2001

In light of Sept. 11's  horrifying events parents face the challenge of helping their children cope with the trauma and feel safe again.  A child's view of the world as a safe and predictable place is temporarily lost during a trauma or disaster.  Just as we adults have trouble understanding the damage, injuries or death that can result from an unexpected or uncontrollable event so do our children. An adult's response can help a child to recover from a trauma faster and more thoroughly.  As an adult you will need to cope with the disaster in a way that will help the child avoid developing a permanent sense of loss and to give children guidance that will help them reduce their fears.  

To help you help your children, we have listed some common reactions to a traumatic incident and some guidance as to how to address them.  

How might Children react?

Fear and anxiety: Children are afraid that the trauma will happen again and that they or their family will be injured or killed.  A child's most central fear that he or she will be left all alone.  These fears are very real to a child even if they seem very exaggerated to adults.  Children may also be distracted and have trouble concentrating.

Regressive Behavior: Children's fear or anxiety may cause them to act younger than their age (i.e. thumb sucking, bedwetting, fear of strangers, clinginess, decreased independence for older children).  This regression is not intentional and children may not be aware that it is occurring.

Bedtime Problems: Children may develop nightmares, may be fearful of sleeping alone, be afraid of the dark or may have difficulty falling or staying asleep.

Physical Reactions: Some children have stomachaches, headaches, nausea, eating problems or other physical symptoms of distress.

What can I do to help a child?

Keep family routines: Maintain regular meals, activities and bedtimes.  Children should stay with people who feel familiar and comfortable to them.  This allows a child to experience more security and control.

Indulge special needs: Allow a traumatized child to be more dependent on you for a period of time following the trauma.  This may involve more holding or hugs than usual or permission to be clingy rather than socially outgoing.

Talk about what happened: Children express their feelings in different ways - some will be numb, withdrawn and unable to talk about the event.  Others will experience intense spurts of sadness or anger and recognition of what has happened, and other periods of denial when they act as if the event has not occurred.

Your words and actions can provide reassurance.

When talking with your child be sure to present a realistic picture that is both honest and manageable.

Children from frequently targeted groups

Certain groups, such as Jews, have been historically persecuted. Children from these groups may have stronger reactions to traumatic events because of this history.  Their sense of security may be particularly threatened and they may focus on the event happening again, someone being injured or killed, being separated from their family, and being left alone.

When an event happens in a familiar place or involves a familiar mode of transportation

Even an earthquake, terrorist attack or plane crash thousands of miles away can seem very close to home when it is reported on the news. Let your child know the facts about these types of disasters. Millions of people get on airplanes everyday and arrive safely to where they were going. Simply because we see things on the news, doesn't make it any more likely they will happen to us. You may even want to talk with your child about the many people who are working to help those affected by disasters.

Sources: American Red Cross and FEMA.