Getting Past The Trauma

A 200-foot-long plywood wall at Pier 94 stands as an impromptu symbol ofgrief. It is covered with photocopied sheets, each one displaying a photograph depicting a highlight of a person's life: a graduation portrait or a wedding picture or a vacation snapshot. Thousands of pictures, every one of them portraying a person who died in the September 11 attack on the World Trade Center in New York.

"Something this huge is incredibly difficult to process," says Margaret Pepe, an officer of disaster mental health at the Red Cross. The psychological toll is enormous: 1,600 mental-health workers contacted more than 57,000 people in the first three weeks after the attack. And the magnitude of the disaster challenges our understanding of grief. "Grief moves through shock and denial and anger," says Pepe. "But here in New York, the sheer scope of it is slowing the process down. It is taking a lot longer to go through shock and denial than we see in other types of disasters." In fact, reports showed a dramatic rise in drug and alcohol abuse in the months following the attack.

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Although the victims' families can't shake off shock and numbness, the rescue workers--firemen, National Guardsmen and volunteers from across the country--have quickly moved on to anger. For them every day at work is like a funeral, having to return to the horrific scene and see comrade after comrade pulled from the rubble. "Here, the rescue workers have been working nonstop every day at the site with constant exposure to the trauma of finding body parts. What we have known about acute stress--studies about functioning under stress--we have to put that knowledge aside. It just doesn't apply here."

Allen Russell, a Red Cross social worker from Atlanta, is on the last day of his two-week assignment. He is exhausted, his eyes red and watery. His voice occasionally quivers when he speaks. "We have seen the normal expectations of reaction to trauma magnified. The enormity of it sucks the energy out of you," he says while thinking about the people he has counseled.

"I try to use humor as a way of starting a conversation," says Maura Cain, a licensed professional counselor from Alabama. She works at one of the respite centers for rescuers on the very edge of Ground Zero. "If I see someone sitting alone, I'll say, 'Are you really going to eat all that?'"

But reaching a worker on the edge of shock is not always as simple as making a joke. "Making contact challenges every bit of creativity you have; sometimes they simply can't talk,' says Russell. "They just need someone there to be a witness to their grief so that they can cry."

THE RED CROSS LIMITS ITS mental-health workers to just two weeks at a disaster site. Even so, the toll is obvious on the faces of those volunteers about to head home. To disperse the accumulated burden of grief, the Red Cross provides counselors for the counselors. But there are also more informal consolations. "We are a pretty demonstrative group," explains Russell. "We monitor each other all day and give a hug or pat on the back. It's the only way you can get through it."

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