911 Anniversary

We all know how important anniversaries are, whether they be birthdays, weddings, national holidays, or personally important deaths. Especially when deaths and losses are involved, the first-year anniversary will be important psychologically.

Similarly, September 11, 2002, the first-year anniversary of the huge terrorist attack on our nation, is likely to effect all of us in an emotionally powerful way. Many businesses, both in the New York area and nationally, whether directly or indirectly affected by the attack, are planning a day off or brief workday events. It is important for all of us to anticipate how one might react, so as not to be caught off guard, and to know what is a normal reaction and what may not be.

Surely, there will be a lot of media stories to remind us of what happened. These stories will inevitably evoke emotional reactions and memories that will be similar, to some degree, to how each of us reacted on September 11, 2001 and the days after.

By its very nature, successful terrorism is likely to produce fear and panic in those even only distantly or marginally exposed. If one suffered a personal loss directly related to the tragedy, whether that be people or work-related, the reaction will likely be more intense. On the other hand, one may have also experienced unusual experiences of generosity, caring, and courage. Those, too, may be recalled. But it is usually the painful memories that come back unwanted and unexpected.

A normal reaction includes not only feeling sad, but also other emotions, including anger, horror, panic, guilt, and relief. Intense memories of exactly what one was doing when hearing of the attack are likely. Nightmares are possible. Normal functioning may be impaired. These reactions can occur in people who wanted to forget and felt they were "over it."

What may be abnormal is if these reactions don't start to remit after a few days. Having no emotional reaction or strong memories may also be a warning that one's reactions were so painful that they had to be buried as much as possible. Delayed reactions to trauma are not rare, especially if there has been other prior trauma in one's life, which may be psychologically connected.

We also know that treating such post-traumatic stress disorders as soon as possible is the most helpful, whether the trauma is from terror, auto accidents, rape, fire, or natural disaster. If one suffers from a depressive or anxiety disorder, those symptoms are likely to intensify.

Here is a simple 9/11 Anniversary checklist:

* Expect a similar, although less intense emotional and mental reaction to what you experienced last year. This is normal.

* These anniversary reactions may persist beyond a few days and interfere with one's usual functioning. This may be abnormal and suggest getting professional help.

* Those already suffering from a psychiatric disorder are likely to find some of their symptoms temporarily getting worse.

* Caring for others and being involved in community projects related to September 11 can be helpful.

* Watch television and read stories about September 11 only to the degree that you continue to feel emotionally comfortable.

* Parents and teachers should expect, and should try to elicit the reactions of children, and should offer realistic reassurance about their safety when necessary.

This first year anniversary of September 11 also gives us a reminder of the need to prepare for how to respond to possible future terrorist attacks or other disasters, either locally or at a distance. The nature of terror makes it impossible to predict where an attack will take place, or what the nature of it may be. Recently, at a conference sponsored by the U.S. Department of Health and Human Services, the Substance Abuse and Mental Health Services Administration, and the Center for Mental Health Services, attempted to prepare mental health workers to handle the psychiatric sequellae of trauma, including the need to interface with other health and human services. A strong emphasis was placed on the need for all local communities to have coordinated planning among healthcare, social services, police, firefighters, clergy, schools, media, and major businesses.

We may also want to personally consider making a September 11 resolution, as we often do at the New Year. The resolution could be to make special efforts to demonstrate the same kinds of unusual caring and concern that people showed for one another immediately after the tragedy. There are some indications that the national and local outpouring of affectionate concern and practical help mitigated the expected mental health damage in the New York area following the attacks. Perhaps such a resolution will cause something good to come from the bad.

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