Mental mayhem
When you walk into a
restaurant, the experience
conforms to an established
routine: you sit down, you
order, the food arrives, then
you pay the bill.
Part of what distinguishes
traumatic events from ordinary
ones is they have no template,
says Dr Edna Foa, of the Center
for the Treatment and Study
of Anxiety at the University of
Pennsylvania. It’s partly this
absence of precedent that
explains the shock people
felt after September 11. “If
you don’t have a template for
interpreting information, then
it takes a lot more cognitive
effort for your brain to assign
a meaning to it,” she says.In the worst cases, your
mind simply shuts down, says
Rosemary Masters from the
Trauma Studies Center at
the Institute for Contemporary
Psychotherapy. “The brain
goes into pure survival mode.”
Which may explain Sarah’s
muted response. “My reaction
was to have no reaction,”
she says. “My mind was
immediately like, ‘You’re not
going to be able to handle this
right now, so we’re just going
to muffle everything’.”
That same day, Michelle
Ciulla, a magazine exec, was
working about three kays
north of Ground Zero. She
was standing on the roof of
her office when the Towers
fell. Someone handed her a
pair of binoculars and she saw
the silhouette of wreckage
falling. No – not wreckage.
People. “I’ve always really
regretted looking through the
binoculars,” says Michelle.
She used to be a heavy
sleeper. But ever since 9/11,
Michelle wakes up five times
a night. The daylight hours,
meanwhile, are overcast by
an impending sense of doom.
“It’s a feeling that something
cataclysmic is going to
happen that will change life
forever,” she says.
For most people, this kind
of reaction fades within three
to 12 months of the distressing
event, says Masters. “What
causes PTSD [as opposed to
PTS symptoms] is the failure
of the brain to integrate a
traumatic experience,” she
explains. If the experience isn’t
assimilated, the brain can’t
make sense of it and continues
to regard it with alarm. Fear is
then triggered whenever you
encounter something that
reminds you of the experience- loud noises, for instance, or
emergency vehicles. This is
O
10
YEARS
It takes this long, on average,
for someone with PTS
symptoms to seek help – a delay
with devastating effectsOnly recently has research begun to reveal
what many people intuitively know: you don’t
need to have suffered a personal loss to have
been traumatised by an attack. In the two
months after September 11, post-traumatic
stress (PTS) symptoms were reported by
17 per cent of the US population outside
New York. Even six years later, nearly one
in four passersby witnesses, like Sarah,
still suffered from PTS symptoms – a ratio
even higher, amazingly, than that for first
responders, according to a study conducted
by the World Trade Center Health Registry.
The findings fly in the face of conventional
wisdom, which holds that you can’t suffer from
post-traumatic stress disorder (PTSD) unless
your exposure to the harrowing event was
direct and immediate. As the Western World
witnessed in 2016, at least on the news,
terrorist attacks in Belgium, France, Germany
and Turkey – not to mention dozens more
throughout the Middle East – researchers
were bringing a disturbing truth to light: if
you witness a traumatic event, whether it’s
terrorism, an accident or a crime, your risk for
PTSD may be higher than previously imagined.why after a car crash, you
may find yourself dazedly
repeating over and over again
the story of what happened.
Sometimes the trauma leaks
out in nightmares. While
ordinary nightmares often
have bizarre, fantasy-like
content, PTSD nightmares are
usually graphic, video-like
replays of the traumatic event,
says Dr Kelly Bulkeley, former
director of the Dream Studies
Program at John F Kennedy
University in California.
The dream that terrorised
Michelle night after night was
stuck between an exact replay
of September 11 and a
mercilessly distilled version of
it. “It was like a black void,”
she says. “I could see people
standing in front of me, kind
of staggered, spread out. And
the people furthest away just
started exploding into flames.
And it was coming towards
me. I couldn’t move... I’d wake
up right before I exploded.”
The nightmares have faded,
but even today Michelle frets
about terrorist attacks on the
subway. Yet she has never
sought help. “I don’t feel like
my experience was bad
enough,” she says. “I felt
like my feelings were an
overreaction. There were
people who were really
suffering, and I just needed
to get hold of myself.”106