Monday Morning Crisis Quarterback

Yesterday on NPR, there was an interview with Adel Idris, a Libyan man who recently escaped after being imprisoned for nine days during the current unrest in Libya. Mr. Idris describes some horrific things that he witnessed, including the torture and rape of other prisoners, and hearing the screams of women in the night. The reporter describes Idris' behavior during their interview:

He spoke to NPR for several hours about his experiences, his hands shaking, switching between broken English and Arabic. . . . . He stops talking and stares into the distance. He does that a lot during his narrative.

Later in the story, Idris describes the Libyan authorities' use of dogs on the prisoners:

What he do with me there with his dogs, I don't give up - never to give up. I not cry. I not scream. Not. [He begins to cry.] It's the first time I cry now.

What Mr. Idris describes is truly horrible, but his reaction to it is not surprising. He is exhibiting all the typical symptoms of someone who has been through a traumatic event.

When you take a class in Critical Incident Stress Management, one of the things you learn is the typical symptoms of normal, adaptive post-traumatic stress and how to distinguish them from warning signs of more serious problems. Not surprisingly, shaking and crying are on the "normal" list. In addition, "1000 yard stare" is listed as a typical symptom that is not, in the short term, of particular concern. From the description, it sounds like Mr. Idris is exhibiting a 1000 yard stare. What may seem less intuitive is the idea that someone could be stoic throughout such an ordeal, not cry while it's happening, and then cry while describing it. In fact, however, not only is this a common reaction, it's a good sign.

When I teach these classes, I encourage students to think of a traumatic incident as though they were a wild animal being attacked by a tiger. Their reaction, during and after the attack, is critical to the survival of the species. When the tiger first pounces, they exhibit some combination of three reactions -- fight, flight or freeze. Most of us have heard of "fight or flight" and it seems to make sense -- fight off the tiger if you can, run away if you can't. But freezing is also an adaptive response. In some cases, it may prevent the tiger from seeing us, if we can manage to blend into the background. And if we can't fight or run away, convincing the tiger we're already dead may save our life.

You will notice that crying is not one of the options in this scenario. That's not to say that no one ever cries at a moment of great danger, but this is not, in fact, an automatic response. Crying is triggered by a realization of what is happening, but fight, flight and freeze are triggered automatically, before our rational mind knows what is happening. Even a few moments later, when we realize the tiger is attacking, our full energies are dedicated to survival. We literally don't have the resources, in many instances, to cry.

Once the attack is over, our priority, from an evolutionary standpoint, is making sure we either avoid or survive the next tiger attack. This causes us to respond fearfully to sights, sounds and experiences that we associate with the attack, even if they are pretty irrelevant. If we smelled flowers right before the attack, after all, then that smell might signal that another attack is coming.

Imagine, however, that we didn't experience the attack as particularly bad, or that we blocked ourselves off from realizing how bad it really was. That might sound good, but it would be dangerous, because we would not be on the lookout for the next pouncing tiger. If humans ever exhibited this trait in large numbers, it's likely it was bred out of the gene pool a long time ago.

In order to avoid the next tiger attack, we need to know that tiger attacks are bad. That means that all the reactions of fear and distress which we avoided during the attack itself because we were trying to stay alive are critically important in helping us learn. So, when the attack is over, we cry when when we remember it. We shake. We can't concentrate, so we stare off into the distance.

So, Mr. Idris' tears are normal. But more than that, they are healthy. They mean that he is, in some way, in touch with how he feels about what happened to him. And while there are many more factors that go into determining how quickly and well people will heal after a traumatic event, we do know that isolating yourself from the painful feelings is a risk factor for Post Traumatic Stress Disorder down the line. So I applaud Mr. Idris for his bravery, his escape, and his tears, and I hope that Libya soon has many fewer reasons to cry.