The 9/11 Attacks and Its Consequences on the Health

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Table of Contents

Abstract
Introduction
Literature review
Management of emotional aftermath of traumatic events
Psychological impact of the 9/11 attacks
Interventions to post 9/11 victims compared with the literature
Conclusion
References
Appendix

Abstract

Survivors of traumatic incidences may exhibit symptoms of stress and depression. The mounting menace of global terrorism has facilitated the need for scholars to research on the impacts of such traumatic incidences on the health of the victims. Natural disasters such as floods and earthquakes are also examples of traumatic incidences experienced by people across the world and they can equally cause mental and physical health complications. This research paper seeks to contribute to the available literature on the post-traumatic stress associated with the aforementioned forms of traumatic incidences by exploring the common effects that such occurrences cause to the survivors. The paper will analyse the 9/11 attacks and its consequences on the health of the survivors.

Introduction

Traumatic incidents are quite common in the contemporary times. Terrorism has been on the rise in the past few decades and it has increased the number of traumatic cases reported annually. Survivors of such traumatic incidences are at a high risk of suffering from stress and depression (Neria, DiGrande & Adams, 2011). It is estimated that roughly two thirds of people across the world pass through a traumatic experience in their lifetime (Ursano & Norwood, 2008). In the US, about one fifth of people are likely to experience a traumatic incidence annually.

Even though analogous global data is inaccessible, the data available indicates that a large proportion of people across the world have ever experienced a terrorist attack, mandatory relocation, or a crash, which is an indication that the general prevalence of experience to traumatic incidences globally is higher as compared to that of the United States. This research paper will explore the response by the community to traumatic experiences. The paper shall explore the health impacts of the 9/11 attacks and the response thereof by the affected communities.

Literature review

The consequences of natural or manmade disasters go further than just the material damage (Ysseldyk, Matheson & Anisman, 2011). Stress and other emotional disorders are likely to occur due to tragic incidences. The emotional tax can result in an extensive range of powerful, perplexing, and occasionally fear-provoking emotions (Neria, DiGrande & Adams, 2011).

It requires time to clear the wreckage and mend the physical harm of a disaster. Similarly, it takes time for victims of a traumatic incident to recuperate their emotional equilibrium and restructure their life (Victoroff, Adelman & Matthews, 2012). Research indicates that different people react disparately to traumatic events though there is a commonality in treatment. Literature is rich on the approaches needed to treat adverse emotional conditions. Listed below are some of the ways that can be used in the management of the psychological and emotional ailments arising from tragic incidences.

Management of emotional aftermath of traumatic events

Both natural and manmade disasters such as floods, earthquakes, terrorist attacks, and nuclear meltdowns are highly stressful and they equally affect both the victims and the bystanders (Ysseldyk, Matheson & Anisman, 2011). Such traumatic incidences may take away a person’s sense of security, thus making them vulnerable to stress and anxiety. Traumatic incidences affect both the victims and the bystanders equally and management of emotional disorders is thus inevitable (Eidelson, D’Alessio & Eidelson, 2003).

The management of the conditions commences with the recognition that different people react heterogeneously to disasters and other traumatic events. Avoiding repetitive thinking of the traumatic event and discussing the same with psychological experts and clergies may go a long way in fighting the resulting stress. The second way to manage psychological and emotional disorders emerging from traumatic incidences is through assuring the victims of their security (Ursano & Norwood, 2008). The victims have a tendency of assuming recurrence of the incidences, which instils fear among them.

The signs of stress among the victims of a traumatic incidence present themselves in numerous ways. Some people exhibit signs of anxiety, numbness, confusion, guilt, and despair. Such signs usually fade with time as the memories slowly fade. However, due to differences in response amongst different people, the signs may be more intense in some people than in others.

In such persistent cases, intervention by medical practitioners and religious leaders is essential (Ysseldyk, Matheson & Anisman, 2011). Such intervention is necessary when the signs of posttraumatic stress go for 6 weeks without getting better (Neria, DiGrande & Adams, 2011). Expert intervention may also be perpetuated by the inability of the affected people to attend to their routine duties, terrifying memories, nightmares, flashbacks, or suicidal attempts.

Given the emotional impact of traumatic incidences to both the survivors and bystanders, it is imperative to assist the victims to regain their sense of normalcy (Jhangiani, 2010). Even though stress responses may seem excessive, and thus result in distress, they normally do not turn out to be chronic predicaments. The majority of victims of traumatic incidences get well from even modest stress responses in between 6 to 16 months after a gory death incident.

Victims of traumatic incidences should be encouraged to involve themselves actively in their daily chores. Active involvement in such tasks will help to divert the attention of the affected and help fight stress (Eidelson, D’Alessio & Eidelson, 2003). Research regarding psychological responses to terrorism is continuing in a bid to come up with effective ways of dealing with stress that befalls most people after traumatic incidences. Researchers and medical experts have proposed the use of cognitive behavioural therapy in the treatment of stress and post-traumatic stress disorder (PTSD) due to trauma.

Psychological impact of the 9/11 attacks

Numerous researches have been conducted in New York to establish the actual experiences of victims of the attacks (Jhangiani, 2010).Researchers of the post 9/11 attacks response reveal that most survivors of the attack exhibited signs of stress and anxiety (Pollard, 2011).

The Journal of Traumatic Stress, which preceded the 10^th anniversary of the 9/11 attacks, revealed the psychological experiences of the survivors. The journal’s publishers based their information on a research conducted on college students and observed that even persons not directly involved in the attacks suffered from stress and depression (Neria, DiGrande & Adams, 2011).

This observation is a clear indication that such traumatic incidents affect both the directly involved persons as well as bystanders. Research conducted in New York by Ivy Tso, a psychologist, revealed that close to 40% of the city residents had signs of stress and anxiety (Jhangiani, 2010). The research further revealed that 8-10 percent of the city residents exhibited symptoms of PTSD, which is a secondary effect of stress. Just like the Journal of Traumatic Stress, this research was conducted on university students situated in Boston (Pollard, 2011).

Conventionally, most people who suffered from psychological disorders after the 9/11 attacks did not come from New York. It is reported that watching news on television caused stress and anxiety to a great number of individuals not at the site of terror. The most common type of psychological complications that came due to the 9/11 attacks is the PTSD, which presents itself in different ways including troubled sleep, uncontrolled tempers, and emotional numbness (Ursano & Norwood, 2008).

Interventions to post 9/11 victims compared with the literature

Conducting debriefing sessions

Debriefing sessions refer to guidance conducted by psychologists in which the victims of disasters are afforded a chance to express their feelings concerning their conditions (Walsh, 2007). Debriefing has for a long time been the first step in the management of stress-related ailments in the US and the 9/11 case was not an exception. Persons who were either directly or indirectly involved in the New York’s incident were afforded a chance to speak of their experiences (Jhangiani, 2010).

The assumption behind conducting debriefing sessions is that the victims feel encouraged when they share their experiences with fellow victims. Even though the topic on the effectiveness of debriefing sessions in treatment of psychological and emotional disorders has stirred heated debate, it has been used in the management of stress in the US for quite a long time. Debriefing sessions conducted by the US psychologists are consistent with the available literature that suggests the effectiveness of the same in the treatment of psychological conditions.

Active involvement

Active participation and commitment to one’s daily chores may help to reduce stress and anxiety among the affected individuals (Galea, Nandi & Vlahov, 2005). Generally, the pervasiveness of PTSD has a tendency to decline progressively in the months and years after a distressing incident (Walsh, 2007). This scenario was true for the Americans who suffered from stress following the 9/11 incident. Individuals who were actively involved in their day-to-day tasks quickly recovered from the condition. A study conducted in New York, “the attacks’ site, indicates that the rates of PTSD amongst the wide-ranging population reduced from estimated 5 percent in the year of attacks to about 3.8 percent in a period of two years” (Ursano & Norwood, 2008, p. 74).

The study also established that most people who were directly involved in the attacks including the first respondents had soon recovered from the condition. Conversely, rescuers who immediately retired after the incident exhibited serious signs of PTSD. In reference to a research published in the Public Health Reports, about 22 percent of firefighters retirees who were directly involved in the 9/11 traumatic incident continued to experience stress three and seven years following the incident (Norris, Stevens, Pfefferbaum, Wyche & Pfefferbaum, 2008).

Security assurance

As noted earlier, providing assurance of security to the affected individuals is another way of fighting stress among the victims (Jhangiani, 2010). Victims of traumatic incidences tend to worry more about the recurrence of the incidence than their current condition. Assuring the affected of their security is a major achievement in the fight against stress-related conditions. The 9/11 incident led to the killing of the Al Qaida’s leader, Osama bin Laden. His death was a major boost to the fight against stress amongst the 9/11 incident as the victims were rest assured of their security.

Treatment

Following the bill passed by the congress, the US government was compelled to afford treatment to the affected individuals. The James Zadroga 9/11 Health and Compensation Act set aside 4.3 billion dollars to cater for the treatment expenses for the victims of the tragic incident (Dimen, 2002). Even though the bill covers government officials who include firefighters, police officers, employees of the New York City medical examiner’s office, it was a major step towards fighting stress-related illnesses among the 9/11 victims.

Conclusion

Coping with both natural and manmade disasters can sometimes be disturbing as it may have negative impacts on the subjects. The impacts not only affect the survivors, but also by the rescue teams and clinicians. Research into the impact of traumatic incidences on the victims indicates certain commonalities in individual response to traumatic cases of different nature and it suggests that by comprehending these partly conventional patterns of response, patient outcomes could be improved. The available literature emphasises on the need to increase disaster awareness coupled with preparedness and prevention.

References

Brown, M., Beutler, E., Breckenridge, N., & Zimbardo, P. (2007). Psychology of terrorism. New York, NY: Oxford University Press.

Dimen, M. (2002). Day 2/Month 2: Wordless/The words to say it. Psychoanalytic dialogues, 12(3), 451-455.

Eidelson, J., D’Alessio, R., & Eidelson, I. (2003). The impact of September 11 on psychologists. Professional Psychology: Research and Practice, 34(2), 144 -150.

Galea, S., Nandi, A., & Vlahov, D. (2005). The epidemiology of post-traumatic stress disorder after disasters. Epidemiologic Reviews, 27(1), 78-91

Jhangiani, R. (2010). Psychological concomitants of the 11 September 2001 terrorist attacks: A review. Behavioural Sciences of Terrorism and Political Aggression, 2(1), 38-69.

Neria, Y., DiGrande, L., & Adams, G. (2011). Posttraumatic stress disorder following the September 11, 2001, terrorist attacks: A review of the literature among highly exposed populations. American Psychologist, 66(6), 429 – 46.

Norris, H., Stevens, P., Pfefferbaum, B., Wyche, F., & Pfefferbaum, R. (2008). Community resilience as a metaphor, theory, set of capacities, and strategy for disaster readiness. American journal of community psychology, 41(1-2), 127-150.

Pollard, J. (2011). Seen, seared and sealed: Trauma and the visual presentation of September 11. Health, risk & society, 13(1), 81-101.

Schein, A., Spitz, I., Burlingame, M., Muskin, R., & Vargo, S. (2006). Psychological effects of catastrophic disasters: Group approaches to treatment. Binghamton, NY: Haworth Press.

Sundelius, B., & Grönvall, J. (2004). Strategic dilemmas of biosecurity in the European Union. Biosecurity and bioterrorism: biodefense strategy, practice, and science, 2(1), 17-23.

Ursano, J., & Norwood, E. (2008). Trauma and disaster responses and management. Arlington, VA: American Psychiatric Publications.

Vázquez, C., Pérez-Sales, P., & Matt, G. (2006). Post-traumatic stress reactions following the March 11, 2004 terrorist attacks in a Madrid community sample: A cautionary note about the measurement of psychological trauma. The Spanish Journal of Psychology, 9(1), 61-74.

Victoroff, J., Adelman, R., & Matthews, M. (2012). Psychological factors associated with support for suicide bombing in the Muslim diaspora. Political Psychology, 33(6), 791-809.

Walsh, F. (2007). Traumatic loss and major disasters: Strengthening family and community resilience. Family process, 46(2), 207-227.

Ysseldyk, R., Matheson, K., & Anisman, H. (2011). Coping with identity threat: The role of religious orientation and implications for emotions and action intentions. Psychology of Religion and Spirituality, 3(2), 132.

Appendix

Fighting stress and fear among the victims of traumatic incidents can be an arduous task. The mounting menace of global terrorism has facilitated the need for scholars to research on the impacts of such traumatic incidences on the health of the affected. Natural disasters such as floods and earthquakes are also examples of traumatic incidences experienced by people across the world and they can equally cause mental and physical health complications (Eidelson, D’Alessio & Eidelson, 2003).

The most affected persons are those directly affected by the incident such as the injured. Others such as rescue teams and healthcare providers are secondary parties and they can equally suffer emotional trauma. The media has been accused of increasing the fear and stress among individuals and citizens of various countries, since most media stations air news accompanied by graphic pictures and at times, they are disturbing.

This essay explored deeply how victims of traumatic incidences, whether primary or secondary are affected emotionally by such frightening incidents. The paper also explored possible strategies that may be used in treatment of severe conditions involving stress. The paper examined matters ranging from the scientific basis of posttraumatic depression response to the psychosocial and illusory structure of terror and other calamities ranging from unsystematic acts of aggression to warfare. The research unveils certain similarities in human reactions to disasters of varying magnitude and it holds that comprehending these partly conventional patterns of response can greatly affect patient outcome.

Based on ample examination of the available literature, the paper suggests that disaster intercession strategies should stress on the acknowledgment of the emotional impacts of trauma as well as preparedness and prevention. The majority of victims of traumatic incidences get well from even modest stress responses between 6 to 16 months after a gory death incident. Victims of traumatic incidences should be encouraged to involve themselves actively in their daily chores.

Normal emotional responses to traumatic events

Traumatic incidences instil fear and anxiety on the victim. The effect on the affected can be either short term or long term. Signs of emotional hardships may present in a number of ways to both the Survivors and bystanders, viz. shock and disbelief, fear of recurrences, sadness especially if the incident resulted in deaths, and lastly a feeling of helplessness (Eidelson, D’Alessio & Eidelson, 2003). Immediate symptoms of fear after a traumatic event include trembling, cold sweats, pounding heart, and rapid breathing (Jhangiani, 2010). If stress and emotional imbalances are not managed in time, they may result in complications in the end.

Inasmuch as traumatic incidences affect communities negatively, it may also have some positive results in some cases. A case in point is the 1974 tornado in Xenia (Neria, DiGrande & Adams, 2011). The majority of survivors in the aforementioned case admitted that they had learnt new and innovative means to handle similar cases in the future. Disasters are also said to bring a community together in pursuance of a specific goal, which, in most cases, involves executing strategies aimed at deterring the recurrence of similar incidences.

The two examples given above indisputably demonstrate positive impacts in the aftermath of a traumatic incidence. The aforementioned idea has been alluded to as ‘posttraumatic growth’ by a section of scholars and it is analogous to the popular benefited response described in the combat trauma prose (Jhangiani, 2010).

The September 11 attacks

The 9/11 attacks define terrorist attacks that occurred in New York in the wake of September 11, 2001. The gory incident that Al Qaeda, which is a self-confessed terrorist group, claimed responsibility and it left over 3,000 people dead including both civilians and security officers and properties worth billions of money destroyed (Ursano & Norwood, 2008). The attackers were on a suicide mission and they accomplished it through crashing four planes, viz. the American Airlines Flight 11, United Airlines Flight 175, American Airlines Flight 77, and the United Airlines Flight 93 (Jhangiani, 2010). Each of the four planes was used to bomb a specific business building, thus causing great damages.

The first two were crashed at North and South towers respectively, while the last two were crashed at the Pentagon and Washington, D.C respectively. Al-Qaida, the allegedly involved group, denied responsibility at the time only to change later and say that it had been involved in the attacks. The motive behind the attacks was to compel the US to withdraw the support that it had accorded Israel and the subsequent withdrawal of its troops from Saudi Arabia (Eidelson, D’Alessio & Eidelson, 2003). In addition, the group required the US to withdrawal its sanctions against Iraq. Records indicate that about 125 American troops perished in the incident (Ursano & Norwood, 2008). The attacks caused trauma amongst the survivors, families, and other bystanders.

A new kind of psychological first aid

Up to the time of the 9/11 attacks, the US had in place a strategy that emphasised the importance of conducting critical incident stress debriefing to get insight on the people’s psychological feelings after a traumatic incident (Schein, Spitz, Burlingame, Muskin & Vargo, 2006). However, the strategy has drawn criticism from psychological experts who have alleged that the sessions only serve the purpose of increasing stress amongst the affected victims.

The opponents of the debriefing sessions also cite brevity of such sessions in providing effective solutions to the stress that befalls most people after such incidences (Sundelius & Grönvall, 2004). Due to the issues raised by critics, the US has dropped the so-called critical incident stress debriefing in favour of ‘psychological first aid’ (Vázquez, Pérez-Sales & Matt, 2006). The psychological first aid is an extension of the critical incident stress debriefing and it allows not only the victims of traumatic incidents to participate in the talks, but also their relatives (Brown, Beutler, Breckenridge & Zimbardo, 2007).

What is Trauma?

Trauma can well be understood from different perspectives including physical harm or injuries inflicted on a person or a group of persons. Emotional trauma is a psychologically excruciating, appalling, nerve-racking, and every so often life-ominous occurrence (including viewing events) that may engross bodily injuries. Emotional trauma does not only appear when physical injuries occur, but it can also appear devoid of such injuries. Instances of emotional trauma comprise natural calamities, bodily or sexual violence, and terror campaign (Sundelius & Grönvall, 2004).

Natural disasters, for instance, typhoons, earthquakes, and droughts can cause deaths and wipe out homes or entire communities. The aforementioned calamities may cause solemn bodily and psychosomatic injuries. Violent acts directed at a person or a group of persons may also cause trauma among the affected. The 9/11 attacks are just examples of the most serious traumatic events in the contemporary world. Mass assassinations in institutions of higher learning and physical/sexual attacks are other common types of traumatic events across the world (Ursano & Norwood, 2008). Research indicates that such distressing events terrorise a community’s sense of security and they can influence a person’s judgment.

Effects of such traumatic incidences can be either instantaneous or deferred. Responses to trauma vary in sternness and they cover an extensive range of actions and reactions. Infants with inborn mental challenges, who have had traumatic experiences earlier in their childhood, or whom their guardians have neglected may be more responsive to trauma (Eidelson, D’Alessio & Eidelson, 2003). Recurrently experienced reactions amongst infants after a traumatic event include diminished trust and increased panic of similar events.

After a trauma, the victims may exhibit varied responses. The responses are more likely experienced by first-hand witnesses of the events as well as bystanders (Eidelson, D’Alessio & Eidelson, 2003). Many responses can be from individuals, places, or objects linked with the traumatic incidences. In some cases, responses to particular incident may vary greatly from one person to another.

People are generally astonished that responses to trauma can go for longer periods than expected. It may require weeks, months, and sometimes even a year or a period longer than that. Traumatic responses can be less severe if interventions are made in time. Such interventions include help and support provided by relatives and close friends.

The support of family members and friends comes in handy during this period. Unfortunately, such people are untrained in the areas of deadline with psychological trauma, and thus they end up complicating the situation by adopting ‘get-over-it’ attitude. This approach is flawed for traumatized individuals, as they might end up becoming more stressed. Therefore, the fact that family members are helpful and their support is indispensable, they should watch what to say to victims of trauma.

The majority of psychologists have argued that individuals, cluster, or family-based counselling sessions are supportive and they cite the Eye Movement Desensitisation and Reprocessing (EMDR) as the most effective form of therapy (Ursano & Norwood, 2008). Some scholars have also suggested the use of Internal Family Systems (IFS) therapy in providing care and support to the affected groups. The most important aspect of the aforementioned therapeutic methods is connection and support to the victims.

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