Coping with the Psychological Impact of the Attack on the U.S. Online Conference Transcript

Crisis therapist, Dr. Elizabeth Stanczak, talks about dealing with grief, dealing with loss, depression and feeling depressed, in light of the attack on the World Trade Center buildings and the Pentagon.

David is the HealthyPlace.com moderator.

The people in blue are audience members.

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David:Good Evening. I'm David Roberts. I'm the moderator for tonight's conference. I want to welcome everyone to HealthyPlace.com. I'm glad you had the opportunity to join us, especially under these difficult circumstances. These last few days have been traumatic for everyone.

Our topic tonight is "Coping with the Psychological Impact of the Attack on the U.S.." Our guest is trauma psychologist, Elizabeth Stanczak Ph.D., who is the Clinical Manager of Assured Behavioral Health in San Antonio, Texas. Dr. Stanczak has been a member of a Critical Incident Team and has expertise in critical incident therapy (crisis therapy).

First though, I want to make a couple of comments. Everyone here at HealthyPlace.com hopes that you, your family members and friends are safe. This is an enormous, and for many, an unexpected tragedy. We have our trained support group hosts on the site to help those who are having difficulty coping. They have done a wonderful job and have volunteered their time beyond anyone's expectations. It's really appreciated.

On our homepage: http://www.healthyplace.com we have a lot of information to help you cope. On the left-hand side of the page, there are videos and articles on loss and grief. While some may not pertain to your exact situation, the information contained there will apply to what's going on now. On the right-side of our homepage, under the heading "Daily News," you can read articles on the psychological aspects of dealing with the attack. As the horror of this event and the human aspects of the tragedy begin to settle in, some of you may feel depression beginning to takes its grasp. We have a lot of information on depression and how to cope with it in the HealthyPlace.com Depression Community. On the left side of the page, look through the sites, depression conference transcripts and online depression journals, diaries.

Good evening, Dr. Stanczak, and welcome to HealthyPlace.com. Today was a special day for me because for the first time I began to feel the emotional impact of what has happened. On Tuesday, I was amazed and caught up in the unbelievability of the attack on the United States and the images of the planes crashing into the World Trade Center buildings in New York City and watching the building crumble to the ground. It was surreal to me.

As the story progressed on TV today, I began to see and hear stories from people searching for their relatives and friends. One man on Good Morning America, told the story of how he and his wife were very close and how they would see each other off at the airport when they would fly on separate business trips. After saying goodbye to his wife at the airport in Boston on Tuesday morning, he went to work and later, to his horror, would discover his wife was on the plane that crashed into one of the towers. It was a very sad story. Diane Sawyer, the anchor on Good Morning America, was crying and I was in tears. My heart has been heavy all day. So the first question is -- is this normal?

Dr Stanczak: Good evening, and thank you for having me. First, I must say that I am not a "trauma psychologist". I am, however, a psychologist with training in crisis intervention.

Yes, it sounds very normal and healthy to me.

David:How would you recommend that most of us handle these feelings that we have right now?

Dr Stanczak: I think we must first remember that we are all different. Some of us may find solace talking with friends and family and some of us may need to seek assistance from mental health professionals.

David:How do you know when it's time to get professional help? I ask this because this could be a long, drawn out event, especially if we start retaliating militarily?

Dr Stanczak: If you start having thoughts or moods that interfere with your daytime functioning, problems sleeping that interfere with daytime functioning or problems interacting with close family members or friends, you might want to consider seeking help.

David: This being a mental health site, I'm wondering if extreme emotional events like this can produce stronger reactions in individuals who are already dealing with psychological issues like abuse, depression, self-injury, etc.?

Dr Stanczak: Most people do quite well when given the opportunity to grieve and will not need professional assistance. We tend to underestimate just how healthy and strong people really are and how much stress they can effectively handle. However, there will be certain cases where this additional stress will compound existing problems. Very few people will be involved in self-destructive behaviors, but many may feel overwhelmed by the additional stressors. In these cases, the individual should probably consult with a mental health professional.

David:What is your opinion about constantly staying tuned to the TV or radio for the "latest" events or constantly watching traumatic scenes repetitively?

Dr Stanczak: Returning to a more normal routine is very important, however, it is human nature to be curious and to seek additional information. There is nothing wrong with being transfixed with the events as they occur, just as we were transfixed by the lunar landings.

David:One other question, what about our children? Should we let them watch everything on TV and how should we explain this to them, if at all, in your opinion?

Dr Stanczak: It is very important that the parents explain these events. In fact, it would be preferable to having them watch the TV. It is also important, to redirect the child to any positive aspect that can be identified, such as: focusing on the heroes who are searching through the rubble, or the victims successfully rescued. It might also help to have the child write a letter to either President Bush, the heroes involved, or even the group or groups that perpetrated this horrible act.

The important thing is to have the child express his or her feelings. Also, get them back into their normal routines as quickly as possible. They need to know what to expect in their day. Also, assure them that they are secure.

David:We have many audience questions for you Dr. Stanczak. Here's the first one:

majorca: Hi, I was in tower number 4 and saw the two planes go into the towers. Actually the second one went through all of our hearts. Then I evacuated the building but all I could do was stare at the towers in disbelief. When the towers came down, I had to run for my life. As I did, I helped people who were stranded or injured but still left many behind who never made it. I still feel the helplessness and haven't been able to sleep haunted by the images of the carnage. How can I get through this?

Dr Stanczak: Your feelings are very, very normal, and transient. You will never forget the events that have occurred. But, you will find that, with time, it will be easier to function more normally. I would be worried about you if you were not feeling these things. The important thing here is that you are having a normal response to an abnormal, horrific situation. Rest assured that all of America is having feelings similar to your, and that we are all frustrated by our inability to help more.

C.U.:I keep replaying the part when the plan crashed into the building, and although I only flew in air transportation once, in a small helicopter, after seeing that tragic event I'm scared to fly in an airplane ever. I'm only 16, but I will always remember the day I saw an event that left nearly 4,000 people's lives severely disrupted and left the country shocked and in disbelief of what has happened. How will I get over a fear of flying?

Dr Stanczak: First of all, this fear you have is probably transient. If it, for some reason, does persist, there are effective therapies that will allow you to overcome your fear. If you feel comfortable, I would encourage you to discuss these feelings with your relatives and friends. Incidentally, I would be afraid to fly in a helicopter.

luckysurvivor: I am having a terrible time with loss. I lost a job recently, then my best friend walked out on me and then this tragedy in NYC/DC- it's like more then I can handle and I am feeling a total emptiness almost hopeless now. Am I crazy?

Dr Stanczak: No, you're overwhelmed. Again, after what you have experienced, I would be worried if you weren't experiencing these feelings. I suggest taking some time to attend to your own needs. Seek recreation, companionship, and rest. If these uncomfortable feelings persist, for more than a month you might want to consider consulting with a therapist. I am sorry for your many losses.

oblivion1: I'm still in a state of shock not believing what happened. It's very hard for me to grieve and this makes me feel that I don't have a true heart. I have so many of the news papers but I have not read any of them. I can't watch TV anymore. I don't know what is wrong with me.

Dr Stanczak: There is nothing wrong with you. Each of us deals with extreme stress in different ways. This may be your way of dealing or coping. Again, it does not become pathological until it begins to significantly interfere with your daytime functioning. I suspect that, with time, you will find yourself becoming more involved in the events happening around you. Your shock is understandable and we all share it. I was in my car when I heard the news and responded by screaming "NO" repeatedly as if that would somehow change the horrific events. I then begged that it was a news error. I now grieve and cope by trying to assist others.

David:Some people, Dr., are extremely angry at all Arabs or people from the Middle East. Is that rational and is that healthy or unhealthy at this point?

Dr Stanczak: It is not rational, but unfortunately, it is normal. We are not always the rational, thinking beings that we think we are. It is human nature to stereotype even though stereotyping leads us to commit errors in judgment.

I would encourage those people to examine their bitterness and to focus on the positive circumstances surrounding this terrible event. I would also encourage those individuals to become involved in efforts to make the situation better rather than worse. For example, one of the first acts I performed was donating blood to our local blood bank.

One can also look at how this event has brought us together as a nation. Still strong, still wonderful. We should also recognize and be thankful for the tremendous support we are receiving from the world community.

David:Here's the next audience question:

HPC-Karen: As a HealthyPlace.com support group host, what are the things we can do to help users who come to the site?

Dr Stanczak: First of all, assure people that their feelings are quite natural and normal. Do not try to force help upon those who do not want such help. Recognize that people are much stronger and healthier than we sometime give them credit. Also, some types of help may actually be harmful. We don't want people thinking they are sick. And we certainly don't want to make them sick. Our assistance should be sought, and specific to the individual in need. Encourage people to resume as normal a lifestyle as possible. If indeed someone needs psychological help provide them with a referral. I also encourage the chat rooms and the support offered therein.

David:Here are a few audience comments on what's been said so far this evening, then we'll continue with the questions:

C.U.: When I heard about all this, I wasn't mad at the Arabs, I was mad at what they did. They killed a lot of people and they probably are going to get themselves hurt soon too. In this fighting between countries NO ONE IS A WINNER everyone loses something, and it causes "massive destruction".

Ny: My feelings are that standing alone we are weak but by standing as one, it will show that we are a strong nation and that we will prevail and not let anyone perform acts of terrorism on anyone again.

bunnyears: I feel anger at the people here in this USA that are not caring about this.

confussed1980: I am dealing with being raped and when I saw the news of what happened, I completely freaked.

HPC-Whiteswan: My condolences to you all who have lost a loved one.

bunnyears: I have tried to cry but the tears don't come. I go to work, but then I just sit there.

Dr Stanczak: You may not be able to cry, and you may not be able to focus on your work, but I commend you for thinking and trying.

DAwn.Marie: I do not understand why this had to happen.

David: Here's the next question:

Clover Imp: Although my boyfriend was unharmed in the World Trade Center tragedy, I still suddenly feel like I am going to lose him. I call him many times a day just to make sure he's okay. Also, even though I am afraid of him leaving me, I've started pushing him away. What do you suggest to stop this?

Dr Stanczak: You're having some irrational thoughts, just as all humans do. I would consider short-term consultation with a therapist who employs cognitive behavioral therapy. You can contact your State Psychological Association for a referral.

Liser217: I am personally scared of war. Even more so, there is talk of the end of the world. Do you think this is hype or is it a reality?

Dr Stanczak: Hype. Being a prior Military Intelligence Analyst, I find it highly unlikely that the world will end. As for war, there will most likely be some action taken to show the world that this will not be tolerated or go unpunished. This is my personal opinion. By the way, everyone is either afraid of war or a liar.

David: Here's an audience comment:

annibelle: What makes me sad is that the same people who consider this a tragedy only seem to want to extend the tragedy with retaliation and ultimately: war

majorca: Dr., do you have any advice for New Yorkers as to what else we can do to cope with the aftermath of this tragedy and while we wait to hear about our missing loved ones?

Dr Stanczak: Good points!

About the aftermath, I have been watching the news and think that New Yorkers have amazing stamina and patience, even though they may not recognize it.

The anxiety of being in limbo may at times seem unbearable. However, we all manage somehow to muddle through until the crisis is resolved and life returns to as normal as possible. I wish there was more I could say. God bless you!

Ny: I am having a really hard time discussing this with my children. They just don't understand what has happened or why I am crying when I talk to them about what has happened to the United States. I'm just not exactly sure on what I should and shouldn't tell them.

Dr Stanczak: First of all, it is hard for adults to understand, it makes no rhyme or reason. Thus, naturally, children will have a hard time making sense out of the recent events. The best you can do is to be a resource for them to come to when they have questions and then to answer those questions to the best of your ability. The children will take our lead. We, as adults, will demonstrate to them how they can respond. We, therefore, try to present the best role model we can.

DAwn.Marie: This has been very triggering for me. How can I get back what has been lost from this, my feeling of safety? I am scared to leave my house. Is this normal?

Dr Stanczak: Just like the questioner above, you are experiencing some irrational thoughts which are shared by all of us. It is important for you to first recognize that these thoughts are irrational and to replace them with a more rational view. This is hard for people to do on their own and they often consult with a psychologist.

true: I have a eating disorder and the only thing this has done for me is trigger me big time. I'm not sure why?

Dr Stanczak: This is your response to stress and loss of control. You should consult with your therapist about the best way to re-establish more normal eating habits as soon as possible and to help you deal more appropriately with this increase in your stress level.

David:We have a couple of people from overseas who have questions, Dr. Stanczak:

jen seven: Although I live in Australia, I have been deeply affected by this tragedy. However, I have a medical condition which means I can't cry (no tears) and I don't know how to deal with my feelings.

Dr Stanczak: I think you're doing it very well. You are participating in a group activity, you are communicating your thoughts and feelings, and your are supporting your fellow humans in America. No tears required. Thank you so much for being there, I feel better just knowing you're with us!

bumblebee34: I am from Australia and I feel so distressed with the events in the US. So sad. I can't keep the TV off, I'm just watching it all day and I've been having nightmares. I don't know what to do, I'm not coping and I suffer from depression as well.

Dr Stanczak: First of all, your feelings are normal. Many of us are experiencing the exact same things. Rest assured that these phenomena are transient and that you will feel better in the future. It takes longer for some of us than others. The word Depression is used in various ways, if you feel that you are suffering truly a clinical depression, I encourage you to consult with your mental health care provider. Best wishes.

David:Here's an audience comment from a visitor from the UK:

bluechickpea: Just a comment. I am from the UK, and although this doesn't affect us in the UK nearly as greatly as it does the people in America, I really feel that I and all of us in other nations around the world can't do enough to help and support America at this time. I just wish I personally had enough words to say to people who have been left devastated by this tragedy, but from the UK to America, we all send our thoughts and prayers.

Dr Stanczak: Thank you for your support. Just your kind words and thoughts provide more comfort than you can ever imagine.

HPC-Whiteswan: I'm from Canada and I also experience flashbacks of my own abuses. The situation triggered many emotions during the past few days

Barbs: After seeing all this on TV Tuesday, I had nightmares that night about my past abuse. How am I supposed to live with this tragedy occurring in real life while reliving my abuse at night?

Dr Stanczak: It is not uncommon for stressful events to aggravate existing unresolved problems. I would encourage you to bring this issue to your mental health provider, as I really can not offer psychotherapeutic services over the internet. Good luck to you!

membee: I feel guilty about my mental illness when others have loved ones who've died. What should I do?

Dr Stanczak: You are experiencing what is commonly called "survivor's syndrome". There is nothing to feel guilty about. If these feelings persist you should discuss them with your therapist. However, I know that many of us have re-evaluated our problems and concerns in light of recent events.

David:To those in the audience, we also welcome your comments on our special bulletin board called "Tragedy Support-Attack on the U.S."

Thank you, Dr. Stanczak, for being our guest tonight and for sharing this information with us. And to those in the audience, thank you for coming and participating. I hope you found it helpful. We have a very large and active and very caring community here at HealthyPlace.com.

Thank you, again, Dr. Stanczak, for joining us tonight.

Dr Stanczak: Thank you for allowing me to participate tonight. I have been honored by your invitation. Good night.

David: Here are a few extra audience comments that came in late. I thought I'd post them for all to see.

Liser217: Just wanted to say goodnight everyone. Keep hope in your hearts. And have faith in each other.

majorca: In the name of all New Yorkers I want to thank those of you who pray for us and who have had us on your mind since the tragedy occurred. I also want to thank those of you especially who have donated blood or similar or who have volunteered in any way. I think NYC is showing not only our fellow Americans but also the world that we are one, that we can cope with even the worst scenario and that we are indeed the beacon of freedom and of hope. Let's all unite together as one nation.

David: Good night.

Disclaimer: We are not recommending or endorsing any of the suggestions of our guest. In fact, we strongly encourage you to talk over any therapies, remedies or suggestions with your doctor BEFORE you implement them or make any changes in your treatment. What occurs in this conference is by way of information and providing helpful ideas for dealing with situations; it is not intended to provide you with psychotherapy or medical advice.