For three weeks, millions of residents in this area lived with the random sniper attacks. Until the arrest of two suspects on Oct. 24, many residents avoided areas and activities that were normally part of their daily routines. Now the community is returning to normal. But for some people "normal" has been changed forever.
The people of Jerusalem can identify with what D.C. area residents experienced. Whether terror comes in the form of anthrax-laced letters, sniper attacks or suicide bombings, the effects are the same. People feel vulnerable, afraid and anxious. For some, these incidents sow the seeds of long-term problems. This is especially true for children and adolescents.
The Israel Center for the Treatment of Psychotrauma in Jerusalem has worldwide experience in treating both children and adults. Our post-Sept. 11 work in the United States began with a New York City social service provider, and now, in partnership with the CDM Group in the District, we are bringing our expertise to groups nationwide. From our experience, we have identified three key points of which parents, teachers and health professionals should be aware:
* Children are extra vulnerable to trauma. Don't believe those who say children cope with crises better than adults do. In the aftermath of the shootings, be especially alert to children who are too quiet. Only by reaching out can you uncover their true state of mind.
At our treatment center, the focus has been on helping children step away from a traumatic event in order to let their natural coping mechanisms take hold. One way to do this is to have the adults in their lives reassure them that they will be taken care of, regardless of what happens. This reassurance takes the form of both family conversations and visible safety procedures.
For example, in Israel, after every terrorist incident, teams of school personnel and adult volunteers implement a standard response that includes taking physical security measures, checking on the whereabouts of students and preparing classroom activities.
* We must be ready to deal with the long-term trauma experienced by terrorism's survivors, witnesses, first responders and the general population -- especially if they are young.
Most people can deal with emergency situations: Survival mode focuses them on the danger and how to deal with it. But some people will continue to be afraid after the danger has passed. They may keep their feelings quiet because they are ashamed that the traumatic event affected them so much. Many will be unable to sleep or eat; some will be afraid to leave home. Those who continue to have trouble functioning four weeks after an incident may be diagnosed as having post-traumatic stress disorder, which is characterized by nightmares or flashbacks, severe sleep disturbances, extreme sensitivity to sudden noises, continual physical alertness, depression and aggressive behavior.
Untreated psychological trauma can manifest itself in violent and aggressive behavior or substance abuse or in other physical and emotional health problems.
* From our experience, 80 percent to 90 percent of children and adults adjust to trauma and go on with their lives. Nonetheless, we must find ways to augment their natural coping mechanisms.
We encourage adults to talk to children about what is happening. Clearly, this is a conversation for parents to have with their children; but it is also a conversation for teachers to have with their students. We have held workshops to teach educators how to discuss violence with their students.
Americans are resilient and optimistic, but on Sept. 11, 2001, they entered a world in which uncertainty and the potential for death and destruction are always present. No one can fully anticipate the next traumatic event, but we can be prepared to deal with its physical and psychological consequences. In so doing, we will be balancing caution and concern with the need to continue living our lives.
-- Danny Brom
is director of the Israel Center for the Treatment
of Psychotrauma at Herzog Hospital's
Latner Institute in Jerusalem.