Thursday 13 September, 2001
Coping with post-traumatic stress disorder
Many people who experienced the attacks targeting the USA's financial and military centres in New York and Washington will be feeling shock, disbelief and anger at the events which have occurred; and some will suffer longer-term psychological effects.
BBC Science looks at what causes these effects and what can be done to alleviate the trauma.
Post-traumatic stress disorder
Shocking events often produce a psychological condition known as post-traumatic stress disorder. This follows well-defined patterns, involving strong memories of the event, flashbacks and nightmares.
People can often function “normally”, then find that a small event triggers the memories, resulting in depression, anxiety attacks and sleeplessness. Such symptoms can persist for years.
In an interview with BBC News Online, Dr Matthew Friedman, of the US Department for Veteran Affairs, explained that the experience can be like living through the original event a second time. In his opinion post-traumatic stress is ‘like a psychic time machine.’
Psychological triggers
Many World War II veterans have found it impossible to escape their experiences. In Turkey, following the 1999 earthquake, as many as 60% of adults and 95% of children in the area showed symptoms of stress disorder.
The people most likely to be affected in New York and Washington are those at the heart of the disaster, people who survived the falling buildings and those working for the emergency services, left powerless to help as they too became caught up in the unfolding disaster.
| 'Being told you are lucky to be alive can cause additional distress, through the knowledge that other people are dead.' |
|
And much later, when life returns to “normal” memories can be triggered by the slightest detail reminiscent of the event.
When Margaret Searle, a clinical psychologist, recently spoke to BBC News Online she described how the memory works by associations. She said:
‘The memory for an event is distributed among various sites and the process of remembering involves the creation of a variety of connections… A memory can be called up by a particular sound, sight or a particular smell.’
Emotional first aid
The kind of help that people receive immediately after the disaster can determine the severity of their illness and how long it lasts.
According to the psychiatric journal Harvard Medical Health Letter, typical treatment involves:
‘Patients being helped to think about the trauma without intrusive reliving and exercise self-control without avoidance and emotional numbing.’
In short the advice from psychologists specialising in post-traumatic stress disorder is that people need to talk about the events and how they are feeling.
They say feelings of guilt, anger and emotional distress are normal; but internalising these feelings and not discussing them actually makes the bad memories stronger, leading to a higher chance of suffering the disorder in the long term.
Therapists
Emergency psychological counseling is already being offered in New York.
The problems now facing therapists hearing the stories is to remain calm and collected whilst listening to horrific accounts; a difficult task when many may themselves have lost friends and loved ones.
But as the Harvard Medical Health Letter is at pains to point out:
‘Therapists have to avoid both over commitment and detachment. They should not identify themselves with the patient or see themselves as saviours.’
|  |  | | | Survey of PTSD |  |
| | The National Comorbidity Survey (NCS) interviewed a sample of 8,098 Americans aged between 15 and 54 years old.
Its results indicate that men are twice as likely as women to suffer from post-traumatic stress disorder at some point in their lives.
From their survey, conducted between 1990 and 1992, the most frequently experienced traumas were:
Witnessing someone being badly injured or killed
Involvement in a fire, flood, or natural disaster
Involvement in a life-threatening accident
Combat exposure
Source: The National Centre for PTSD website. |
|  |
| |
