Jewish World Review June 14, 2002 / 4 Tamuz 5762



The Creator helps those who help themselves



By Dr. Abraham Twerski, M.D.

http://www.jewishworldreview.com | A friend of mine who lives in New York, told me that on September 11, after she had seen the horrific scenes of the World Trade Center attack, she went out to the shelter of her backyard and began to weed her garden. This was not uncaring, cold and callous. "I felt I had to do something that I could control," she said.

To be indifferent to the plight of others is inhumane. I know my friend to be a caring and sensitive person. Her reaction of weeding her garden was not to distract her from the tragedy of the calamity that killed 3000 people. Rather, it was to help her re-orient herself and to help her find her bearings.

Despite the Simon and Garfunkel song: "I am a rock, I am an island" none of us can afford to see ourselves as an island. There is a famous story of a group of people traveling across a lake in a rowboat. One of the individuals took out a drill and started drilling a hole in the bottom of the bottom under his seat. The others jumped up and wrestled the drill from his hands. "Hey, you can't do that," the man with the drill shouted, "I am entitled to do whatever I want under my own seat!" The analogy is clear. Whatever we do in our shrinking global society does affect neighbors, friends, relatives and fellow employees.

We must learn to empathize with the pain and suffering of others. However, those of us who have and are experiencing trauma have to learn ways of coping with adversity so that we can continue to live productively. Just as empathy is a responsibility and an obligation, so too, taking personal responsibility for our trauma reactions, is a personal kwhich I like to call "challenges".

One of the possible effects of a trauma is a loss of personal control. Persistence of this feeling can result in a severe curtailment of normal behavior. If a child falls off her bike, she must pick herself up and get right back on the bike. If you have been in a car accident, it is actually therapeutic that you thereafter continue to drive. Refusal to drive is a delusion of control: "If I don't drive I won't be in an accident". If you allow the effect of the accident to frighten you away from driving, even for a few days, it may be difficult to resume driving.

If our sense of having a grip or "handle on life" is shaken by trauma, we should do something to regain our composure. When we are traumatized by loss of control it is important to realize that this is not a complete loss of control in all areas of life. There are things we can and do control.

Nearly every mother has tried the following "psychological technique" at the dinner table. The mother, urging her child to eat her green peas, says something like: "Think of all the poor children who go hungry and would love to have that food." Now imagine the child, in an ironic psychological technique of her own says: "Mom, if I do eat my green peas, will those poor children no longer be hungry?"

A good rule of thumb in life is to think about our proposed course of action and say to ourselves: "In what way is this act going to be useful?" Giving up is not useful. Failing to eat our green peas will not be useful. Refusing to venture outside after the World Trade Center attack would not be useful. Crawling under the covers and being afraid to face the world, would not be useful or purposeful. Despair is not useful. There is nowhere to go to "give up". The only alternative is to push on with life.

Healthy Behaviors. It is important to engage in healthy behaviors. We should eat well balanced meals and get enough rest. We should exercise. Appropriate recreation is healthy. The cancellation of baseball and football games in the immediate aftermath of the World Trade Center attack was appropriate. This was a time when we should not have been diverted from feeling the grief of the thousands whose lives were shattered. However, the games had to resume at some point. The games resumed but with a sobering realization of their value as recreation….and that they should not be taken too seriously. Our values have changed.

The various ceremonies at Ground Zero and other rituals to remember the tragedy are appropriate, but they should not overwhelm or paralyze us. They should give us pause to reflect and to prioritize our values. This type of self reflection will contribute to our collective and individual character growth.

There are two main ways in which one can cope with the fear of an attack. In some situations, being aware and alert, can help. For example, in Israel one must be suspicious of packages that are unattended. We promptly report these to the police. People are cleared away and traffic is stopped until the package has been removed. The knowledge that everyone is alert can diminish the anxiety about this particular type of danger, although it does not help in other types of dangers, such as anthrax scares. The fact that the public is being alerted about how to handle mail that is suspect is helpful. However, this "problem-solving" approach does not really diminish anxiety significantly.

Another approach is "diversion-relaxation". When there is nothing more to be accomplished by "problem-solving" then the added pressures of anxiety are counter-productive. For example, some people in Israel are painfully aware of the dangers of terrorist attacks on buses, yet they have no choice-they must ride the buses. Worrying about a possible attack is not going to help, so they divert themselves by reading, or closing their eyes and thinking pleasant thoughts (Forsythe, C.J. & Compas, B.E. (1987). Interaction of cognitive appraisals of stressful events and coping. Cognitive Therapy & Research, 11,473-485). The proper attitude should be: "save the worrying for where it is useful."

Don't over expose yourself to news broadcasts. On September 11 and the next several weeks, people were glued to their televisions and watched the graphic footage of the planes hitting the towers again and again. This added nothing to their knowledge but it did accentuate the impression of the trauma.

We should, of course, be aware of what is happening. Listening to one morning and one evening news report will provide us with sufficient information to remain informed. Resist the urge to hear or see the hourly news. This urge is no different than the urge to scratch an itchy rash even though the doctor has told you that scratching may aggravate the condition.

While the responsibility of the media is to provide information, the business of the media is to make money. The competition for listeners and advertising revenue is fierce, and sensationalism is the bread-and-butter of media fortunes. Sensationalism may be good for the media, but it is bad for us.

Do not watch a newscast (or other television shows, for that matter) during mealtime. It is not conducive to healthy digestion, nor is it conducive to communication and family bonding during the meal. It is also advisable not to watch the late night newscast; it can disturb sleep. Don't worry about missing anything important. It will really not make any difference if you get the news a few hours later.

At a time of stress friends are invaluable. Strengthening friendships and relationships will alleviate the stress and anxiety of being alone. There is truth in the maxim: "A joy shared is doubled; grief shared is halved". The various community gatherings and the widespread display of the flag to demonstrate our solidarity are anxiety reducing measures.

Traumatic events may interrupt our established routine. It is important to re-establish a regular and consistent schedule. If you don't have an orderly daily schedule, now is an opportune time to create one. Mealtimes, sleep, work, study and other regular activities should conform to a schedule. And don't forget to schedule some spontaneous fun.

During times of increased stress and anxiety, major life decisions should be avoided, if at all possible. Anxiety may impair our perception and judgment. Decisions made under stress are often regretted. The impatience and irritability that often follow trauma may cause one to implicate one's marriage or one's job as contributing to one's emotional discomfort. A time of stress and anxiety is not the right time to, leave a marriage, quit one's job or relocate. If major decisions appear to be necessary, they should only be made with much discussion and guidance from competent advisors and counselors.

After experiencing a trauma, give yourself time to heal! You may think that because you have strong willpower you should be able to control your emotions. You may become impatient with and have unrealistic expectations of yourself. The saying: "Time can do what the intellect cannot", is valid.

Don't have anxiety about anxiety. Some say that the goal of terrorists is to create panic and to paralyze the country. While there are some negative effects of anxiety, there is no reason to fear that it will bring us to our knees. During World War II, London was subjected to severe "blitz" bombing every night in the Battle of Britain. People spent many nights in air raid shelters. The danger was real, and there were grounds for anxiety, but England survived.

The anxiety reducing power of prayer is widely recognized. After the attack on September 11, people of all faiths held special prayer services. One might ask, "Why turn to G-d? After all, He let the disaster happen, didn't He?"

Let me illustrate the answer with a story. In a pediatrician's office, a mother was holding her one year old infant who was jolly and playful. When the white clad doctor appeared, the child emitted a loud cry of anguish and held onto mother for dear life. He remembered how he twice suffered pain when the white clad person jabbed him with a sharp needle.

When the mother took the child into the treatment room, he kicked and screamed. When she restrained him so that the doctor could give him the life-saving immunization injection, he fought the mother, kicking and biting her.

The child was no doubt bewildered. "Why is my mother, who loves and protects me, collaborating with this horrible person who always hurts me?" The child had no way of understanding the purpose of this painful procedure.

The doctor left after administering the injection, and the child promptly embraced the mother, whimpering in her arms. But why did the child turn to his mother for security? Wasn't she the one who had turned against him and joined with the enemy to hurt him? Yes, indeed. Nevertheless, the child knew that his mother loved him and would protect him, although he could not make any sense of her complicity in hurting him.

When disaster strikes, we may be angry with G-d. But after the acute assault is over, we, like the infant, turn to the One Who we believe loves us, and ask for His protection.

I attended a meeting of recovering alcoholics, where each person spoke briefly about how sobriety had improved his or her life. The very last speaker said: "I have been sober for four years, and I wish I could tell you that my life has improved. My company downsized and I was let go. I have not been able to find a job. My wife divorced me and took custody of the children. I was unable to keep up the mortgage payments, and they foreclosed on my house. Last week the finance company repossessed my car. But I can't believe that G-d has brought me this far, only to walk out on me now".

Sometimes we may feel abandoned by G-d, but the very fact that we exist is testimony that He has not abandoned us.

Previously:

Knowing what to expect
Psychological fallout in the shadow of terrorism
Self-esteem in the face of world terrorism


Abraham J. Twerski, M.D. is a psychiatrist and ordained rabbi. He is the founder of the Gateway Rehabilitation Center in Pittsburgh, a leading center for addiction treatment. An Associate Professor of Psychiatry at the University of Pittsburgh School of Medicine, he is a prolific author, with some 30 books to his credit. He has recently launched a new 12 step program for self esteem development www.12steps2selfesteem.com Send your comments by clicking here.

© 2002, Abraham J. Twerski, M.D.