Where Were You on 9/11?

Last week marked the 20th anniversary of the horrific September 11th terrorist attacks on the World Trade Center and the Pentagon. Twenty years later, many people are still traumatized. That date is seared into our brains as a national trauma.

Not all stress is bad. Examples of positive stress are a wedding and having a baby. Tolerable stress is that in which we have adequate support and resources to cope. Toxic stress, or trauma, is an experience that overwhelms us, sometimes making us feel like we are in danger. Trauma results from prolonged exposure to stressful and adverse experiences that we are not confident we can overcome.

Studies conducted after 9/11 suggest that those who experienced the attacks and those who repeatedly witnessed the events on television and in newspapers were at greater risk of developing long-term psychological problems.

Symptoms of post-traumatic stress disorder (PTSD) are the most common mental disorder of the 9/11 attacks. According to one study, up to 20% of adults directly exposed to the disaster or injured in the attack had PTSD symptoms. Ten years after the attacks, 15% of the participants in one study reported depression and 10% reported both depression and PTSD. Stress and exposure to the attacks increased the risk of developing substance use disorders or caused relapse among people who previously had a substance use problem.

And while the majority of people have recovered in the years since, many survivors still experience symptoms. People who are more at risk for psychological distress have experienced prior traumas, or unemployment, or lower-income, or housing insecurity. They are far more likely to continue to struggle with mental illness over the years compared with others.

Trauma is a type of stress. It can be personal or public. “Trauma is an inescapable stressful event that overwhelms peoples coping mechanisms”, according to Bessel Van der Kolk. Trauma can result in an emotional response to a terrible event. Personal trauma can arise from sexual assault and/or abuse, neglect, witnessing, or experiencing domestic violence. Public trauma can arise from a natural disaster, terrorism, war, or community violence.

Trauma can be acute, caused by a single traumatic event that causes extreme emotional or physical stress. But it can also be chronic, arising from repeated and prolonged stress such as domestic violence, physical or sexual abuse, neglect, or combat experience. Chronic trauma can result from a buildup of multiple traumatic experiences throughout one’s life. And it can be complex. Complex trauma describes the problem of children’s exposure to multiple or prolonged traumatic events, often of an invasive, interpersonal nature, that negatively impacts a child’s development.

I recently attended a workshop presented by Trish Caldwell, MFT/LPC, with Recovery Centers of America. She posted a chart about Developmental Plasticity that explains the brain’s ability to change in response to experiences and the amount of effort such change requires. The bottom line is that the older we get, the more difficult it is for the brain to adapt to stress and trauma. Adults may need multiple treatment modalities and lengths of treatment to achieve lasting success. Younger people tend to be more resilient.

So, what does trauma treatment look like? Trauma therapy is a form of therapy that can help you deal with the emotional response caused by a traumatic event. The role of the therapist is to help the person make sense of their situation and teach strategies and coping skills. Its focus is on emotion regulation.

If you suffer from long-term negative effects from 9/11, or any other trauma, help is available.