Monday Morning Crisis Quarterback

We're continuing to look at the ways American society is manifesting behaviors indicative of PTSD in the wake of the 9-11 attacks. Today's topic is the third cluster of symptoms, "Hyper-Arousal." People with PTSD are, in many ways, in a permanent state of fight or flight. They are overly alert and on guard. So are we.

People with PTSD have at least two of the following symptoms:

Difficulty falling or staying asleep. It's somewhat difficult to judge how much of America's current sleep deprivation has happened since 9-11.  It is certainly well documented that on average we don't get enough sleep. What's more, we don't value sleep as a society. Few people work in places where the boss will tell you not to come in if you're tired. In fact, we don't consider exhaustion do be a legitimate reason to take a sick day -- that's faking. More and more, our institutions function on the assumption that we are awake at all hours. Congress works into the wee hours of the morning. The funniest television is on past 11. The announcement of the death of Osama bin Laden was made late at night even though it had happened hours before -- couldn't it have waited until the morning? We assume no one is sleeping, and we may be right.

Irritability or outbursts of anger. I talked at some length about how angry we are as a society in yesterday's post. Everything is a place to draw the line, make a stand and stand our ground. You're either with us or against us, with us or with the terrorists. Comparisons between politicians, political parties, grassroots organizations and the Nazis are so common we're not even surprised anymore when someone makes them.

Difficulty concentrating. Let's face it. The American public has the attention span of a flea, with apologies to all the hardworking fleas out there. The "news cycle" is getting shorter and shorter and it is easier and easier to push a big story out of it. We can't stick with a substantive news story for more than a day. A mass shooting or a celebrity wedding, sure, but not hunger, poverty, public policy or the wars. We're on to the next.

Hyper-vigilance. Consider this. The risk of a terrorist attack on American soil was no different on September 12, 2001 than it was on September 10, 2001. Does that even seem possible to you? It barely does to me. What changed on September 11 was not the risk, but our knowledge of the risk. And since then, we're constantly looking for the next one.

You can make a reasonable argument that we should be more vigilant than we were before. We were naive, and now we know. We're smarter than we were. The thing is, we're not only vigilant in smart ways. We are constantly trying to prevent whatever plot was the last one, successful or not. We take off our shoes, put up with backscatter screening and don't carry liquids on planes because those steps might have prevented a previous attempt, not because we have any reason to think anyone's going to try them in the future.

We profile Arabs and Muslims horrifically. A report that came out in the last couple of days indicates that the Mall of America has been reporting people, two thirds of them non-white, for such suspicious and sinister behavior as forgetting their cell phone at the food court or pacing outside the bathroom while they wait for a companion. This isn't just a lesson learned, it's hyper-arousal.

What's more, we seem to also be defending against entirely imagined threats. The fact, for example, that Sarah Palin said that Paul Revere was telling the British they weren't going to be taking away our arms was not just wrong, it was weird. There's a segment of society that has been obsessed with the idea that the government, or more specifically the Obama administration, is trying to take their firearms. We're more than two years into Obama's term, and not one gun control measure has been proposed. We're afraid of being unable to defend ourselves and sure that that's what "they" want, but it's not based in reality.

Exaggerated startle response. Last year, a major international terrorism scare was triggered by someone shipping watches that were taped together. A plane was grounded because a man was putting on tefillin, the leather boxes with straps that Orthodox Jewish men wear when they pray. We're a little bit jumpy.

A couple of years ago, I was flying from Washington, DC to Detroit with my family. There are four of us, so it often winds up that the two kids sit with one parent and the other sits alone. On this occasion, I was alone. The man sitting next to me put his bags in the overhead compartment and sat down. I wasn't paying much attention. Then he spoke to me, in good but accented English: "My name is Ahmed. I am a dentist from Toledo. You are safe." How jumpy must the average member of the traveling public be around Arab men on planes that Ahmed felt he needed to say that before I even registered him at all?

So, we've established that we're all acting in very PTSD-congruent ways. But why did 9-11 do this to us in a way that the Kennedy assassination, the Oklahoma City bombing or the Challenger disaster did not? I'll be looking at that tomorrow.

Yesterday I shared the idea that America, as a society, is manifesting symptoms of PTSD. There are three sets of these symptoms, and today we'll be looking at symptoms of numbing. People with PTSD go to great lengths to avoid and/or numb themselves to feelings and experiences related to the trauma.

Specifically, to be diagnosed with PTSD, there must be at least three of the following symptoms present:

Efforts to avoid thoughts, feelings, or conversations associated with the trauma. Traumatized people often come across as angry. It's not that they don't have a right to be angry at the people who traumatized them. But they're often just angry all the time at everyone. Anger is a very effective defense mechanism against other, more uncomfortable feelings.

If there's one thing Americans are, it's angry. You need look no further than Capitol Hill. We don't just disagree, we think the other side is a threat and evil. We are locked and loaded. And we're rude.

So, what feelings are we avoiding? Fear. If you think back to how you felt on September 11, you weren't mad. You were horrified, and you were scared. Pretty quickly, you were sad. If someone had asked you if you were mad at the people who did this you would have said yes, but anger was not the primary emotion.

The thing is that fear doesn't feel good. It feels weak. So does sadness. Anger feels strong. So we stick with anger -- at each other, at other countries, at whomever. Do you remember that feeling of togetherness we all had right after the attacks? Have you wondered why we can't seem to get it back? Because we came together in fear and in grief, and as much as we might like togetherness, we don't want to go back and feel those things again.

Efforts to avoid activities, places, or people that arouse recollections of the trauma. There was a contingent of people who got mad at President Obama for visiting Ground Zero after bin Laden was killed. They said he was politicizing September 11th (and I would argue that ship sailed a long time ago, but let's put that aside).  But Obama didn't go there to give a speech or do a victory lap. He went to lay a wreath. He went to acknowledge grief. That's a no-no.

Inability to recall an important aspect of the trauma. There are certainly things about 9-11 that none of us will ever forget, but here's a test question: Following the September 11th attacks, what was the stated motivation of Al Qaeda for attacking the U.S.? If you said something like, "They hate us for our freedoms," you're not alone -- that is our dominant societal narrative. It was started by President Bush the same week as the attacks. And, if I may be so bold, it's wrong. At the time of the attacks, Al Qaeda wanted the U.S. to withdraw its troops from bases in Saudi Arabia, which it considers sacred ground. We forgot the motivation for the attack almost as soon as it happened.

Markedly diminished interest or participation in significant activities. This is a tough one. "Significant activities" for individuals are easier to define. However, I'm struggling to remember the last time it seemed like everyone was having a joint experience -- like the last episode of M*A*S*H, or even the Superbowl. Is it me, or is it just harder for us to all decide that something, other than a disaster or trauma, is important these days?

Feeling of detachment or estrangement from others. We know who our allies are in official terms. But what foreign country do we as Americans truly respect as partners these days? I can think of no one. We have become a very lonely country in a lot of significant ways. You can blame politics or policies for this, but it's also the manifestation of a gut feeling that no one really understands us.

Restricted range of affect (e.g., unable to have loving feelings). As discussed above, our primary societal emotion is anger. We don't feel joint happiness or pride anymore. We don't "put aside politics" for any common purpose. We want Congress to compromise, as long as they don't compromise on the things we want. We have lost the ability to have mixed emotions, and changing one's mind about something is weak. This is what a restricted range of emotions looks like -- anger and black and white thinking with no nuance.

Sense of foreshortened future. There is a conventional wisdom in America that the United States is no longer a superpower, or that we won't be one for much longer. Polls show we believe America is headed in the wrong direction. Every new law or policy (passed or just proposed) on both sides of the aisle is met with doomsday scenarios about how it will mean the end of America as we know it. It's one thing to say you don't like an idea, and quite another to think we can't survive it. We don't, as a country, feel very confident about our future.

Tomorrow I'll look at the third cluster of symptoms -- hyper-arousal. Later in the week, we'll examine why 9-11 impacted us this way when other things didn't, and at what kind of "treatment" we might recommend for our traumatized society.

Today, the White House announced that President Obama has decided not to release photographs of Osama bin Laden's dead body. As reported in the press, there was some disagreement over whether releasing them would be a good idea. One view was that it would convince people that he is actually dead. The other was that it would "inflame" his followers, in part because it might be seen as an act of disrespect.

I actually don't have any opinion about whether either of these arguments is true. I was interested, however, that, at least publicly, a third issue was not being discussed. These pictures are described as "gruesome." What effect would seeing them have on your average person on the street?

I myself don't really need to see "gruesome" images. Just as I felt triggered by listening to audio of people screaming on 9-11, I find certain kinds of images very disturbing. Over the years, for example, I have studiously avoided the video of people jumping out of the twin towers. I don't need to see it to understand what happened, but seeing it is too vivid for me. It takes me from the reasonable point of needing to understand others' trauma to being traumatized myself.

Now, it's perfectly reasonable to say that we don't censor the press to protect Naomi Zikmund-Fisher from objectionable images. If I don't want to look, I won't -- just as is the case with the 9-11 videos. This relies, however, on media outlets handling the images in a manner that acknowledges that not everyone wants to see them, or wants their children to see them.

I vividly remember the day more than 4 years ago when I hooked up my laptop to a projector to show a website to some kids, opened my browser (which had CNN as its startup page) and was confronted by -- and confronted my students with -- a picture of the Virginia Tech shooter aiming a firearm at the camera. I had some explaining to do to some parents, and I wished CNN had made it just a tiny bit harder to see those pictures.

This is a free society, and we don't censor our press. If my sensibilities, or even the sensibilities of a lot of people, were the sole issue, the pictures of bin Laden should have been released. The President has decided not to, and I know that a lot more went into that decision than whether they would be traumatizing to the average American. This is a good occasion to remember, however, that sensory input -- sights, sounds, smells, tastes and feelings -- can trigger very strong emotional reactions, much more intense than just hearing about a traumatic event. While we shouldn't prohibit them, we should be careful about exposing people to them by accident.

Yesterday, I shared with you my thoughts about explaining Osama bin Laden to children. I was apparently not the only person worrying about this. Time ran a piece which began,

President Obama certainly wasn't taking the sensibilities of West Coast children into consideration when he made his stunner of a speech Sunday night.

Parents in the Pacific time zone found themselves scrambling to explain the news in real time, and some of them were pretty unhappy about it.

While I certainly understand the problems of trying to explain this stuff to kids -- that's why I wrote yesterday's piece in the first place -- I will admit to feeling a little frustrated with those who would make this complaint. If there was one thing we all should have learned from 9-11, it is that live television is unpredictable. Anything can happen at any time. Part of being a parent is recognizing this and using it to make decisions about whether your children can watch TV, and whether you will choose to watch things live. Part of being a parent is also realizing that kids will inevitably ask about things we'd just as soon they not know about, and we have to answer the questions when they come.

In addition, speaking as someone from the east coast, Obama's speech didn't start until way past my bedtime. If he had waited until every kid in the country was asleep, he wouldn't catch a whole lot of adults, either. News happens when it happens. If you don't want your kids to see it, don't turn on the news.

That having been said, I have been somewhat appalled by what some media outlets have chosen to run in their coverage of bin Laden's death. Yesterday afternoon I was listening to "Here and Now," a public radio show from WBUR in Boston. They had the usual talking heads discussing the implications of bin Laden's death, which was all well and good. At the very end, the host said that his death also brought us "back in time" to 9-11. They then proceeded, with explanation of what each clip was, to play the audio of the second plane hitting the World Trade Center (complete with screaming), audio of someone who died in the towers on the phone, and audio of a very frightened voicemail message left by someone who died.

I cried. Then I got mad. Don't get me wrong, I certainly understand that this weekend's events bring back memories of 9-11, and to some extent they will trigger any unresolved trauma we all have. But wasn't the memory enough? Did we really need the extra boost of some vivid sensory input? Did we need to invade the privacy of dead people just one more time? Were they afraid we wouldn't remember unless they retraumatized us? And if you're worried about the sensibilities of children, would you want your kids hearing that with no warning at all?

9-11 is unique in our collective experience because it was a trauma for almost everyone in the country. That means that, in planning what to broadcast, you have to treat everyone in the audience as a trauma victim. You wouldn't force the victim of a shooting, for example, to listen to the audio of the incident without a good reason. We all deserve a little less sensationalism and a little more respect for how raw this still feels.

* The artwork on this post, like yesterday's, comes from the FEMA website and was created by a 5th grader at Chagrin Falls Intermediate School for the 1st anniversary of 9-11.

I can trace my expertise talking to children about traumatic events directly to the night when my 3 year-old daughter asked, as I was tucking her into bed, "Why is everyone singing the 'Bless America' song?" It was September 14, 2001. We had been at a previously scheduled party, and at 7 o'clock we spilled out in front of the house, lit candles, and sang.

This was the first of many questions my daughter would have about 9-11, then and many times in the years that followed. We tried our best to answer them in an age-appropriate way. We wanted to give her answers that were honest and respected the question, but not overwhelm her with frightening information. I like to think we did a decent job.

This morning, when my husband told our daughter that Osama bin Laden had been killed, she reacted with disbelief. "No way. Osama bin Laden, gone?" To her, the bogey-man had been vanquished. Then her brother piped up. "Who's Osama bin Laden?" My husband responded, "It's hard to explain."

My son will be 6 this week. As much as bin Laden was the bogey-man of my daughter's early childhood, he was completely irrelevant to my son. That by itself is amazing.

In our house, "It's hard to explain" really means, "Go ask Mommy, she's good at this sort of thing." So it fell to me. I wanted to give an honest answer to an honest question. But I knew the answer would be potentially scary, and so I wanted to make sure the answer removed any danger as much as possible from my son's experience.

Here's what I said:

A long time ago, when your sister was little -- she was 3 -- some very mean people attacked our country. The man in charge of the mean people was named Osama bin Laden. We wanted to catch him and arrest him for what his people had done, but we couldn't find him. We looked for him for almost 10 years. Then, yesterday, our soldiers found him in the country of Pakistan. They tried to arrest him, but he didn't want to go. He shot a gun at the soldiers, and they shot guns back, and he died.

For today, this answer satisfied my son. I know from his sister's experience that it will not satisfy him for long. Inevitably, he will eventually ask why the mean people attacked us, and what they did. We will tell him that they were angry at our country because they didn't like that our government had soldiers in a part of the world they believed was holy, and they stole planes and crashed them into buildings. In his sister's case, it took her many, many years to realize that there were people on the planes that were stolen. By then, she was old enough to not translate that into an abject fear of flying. Hopefully my son will be, too.

I'm sure my son is not the only little kid asking this question today. I'm sure my husband is not the only parent at something of a loss for how to explain the situation. If my explanation can help you talk to your own kids, please feel free to borrow. I've also heard very good things about the books The Day America Cried and The Little Chapel That Stood for discussing 9-11 with little ones.

We owe our children honest answers to honest questions. If we don't give them that now, who will they be able to turn to when the next bogey-man comes along?

* The artwork on this post was created by a 5th grader at Chagrin Falls Intermediate School in Chagrin, OH for the 1st anniversary of 9-11, and comes from the FEMA website.