Jewish World Review June 28, 2002 / 18 Tamuz 5762


By Dr. Abraham Twerski, M.D. | Basic trust is an essential for normal functioning. It is difficult to conceive anyone living a normal life without a sense of trust. We cross the street or drive through an intersection because we trust that motorists will not drive through a red light. We take a malfunctioning automobile to the mechanic because we trust that he knows how to repair an engine. We travel on an airplane because we trust that the pilot knows how to fly it. We consult a doctor when we are sick and take the prescribed medicine because we trust that the doctor knows his diagnosis and treatment and that the pharmacist dispenses the medication that the doctor ordered. We can go on an on, enumerating the many facets of daily life that are based on trust.

The feeling of trust begins with the first people that care for us when we enter the world. The intensity and reliability of these early relationships determine how firm a sense of trust we develop. But whether we have a greater or lesser degree of trust, it is a feeling that accompanies us through life. Without trust, life would be virtually impossible.

Trust gives us a sense of safety and predictability. It is usually strong enough to survive some challenges, as was evident in the incident of the mother and child at the pediatrician. The doctor approached the child with a vaccination needle to immunize the child. The child's trust in his mother was strong enough that he could dismiss her collaboration with the doctor to hurt him as an anomaly which did not disprove her love for him. To the child, the world was still a safe place to be.

Because the patterning of our sense of trust in G-d and in other people follows the trust we have in our parents or caretakers early in life, early experiences that foment distrust can undermine our relationship to G-d and to other people. As we noted, traumatic incidents may be walled off and barred from our awareness. If they emerge at any time, they can undermine our relationship to G-d and to significant others.

Traumatic incidents that were experienced at the hands of any person that was trusted can seriously disrupt subsequent relationships. People who were abused or molested in childhood may not be able to develop trusting relationship with a spouse, employer, a superior or a friend. They are haunted by suspiciousness. They may feel that there is no one to whom they can turn for security.

Even the closest and most caring person cannot protect a person from a tornado or a terrorist attack. However, those who have a basic sense of trust may feel some security in their relationships to others and to G-d. Everyone who witnessed the collapse of the World Trade Center was shaken. Some people, however, were shaken to their very core.

With no firm sense of trust, the feeling that they had early in life that the world is not a safe place was resurrected and reinforced. The anxiety of being at the mercy of an unpredictable world was virtually paralytic. Those who had a basic sense of trust were able to maintain their equilibrium, and even some who were at the scene and felt the world caving in on them were able to help others escape.

Some people who were at Ground Zero miraculously survived. Some of these people may feel guilt and shame because they think that they should have tried to save others. Others who were supposed to be at the World Trade Center that day had a change in plans. Some of these people developed feelings of guilt for having survived while others died.

People may react to trauma with contradictory feelings. They may isolate and withdraw, yet they may crave the comfort and support of other people. This may result in a fluctuation between avoiding people and clinging to them which can be confusing both to them and to others.

The loss of control and loss of trust incident to trauma can impact on the basic structure of oneself, with feelings of inferiority and incompetence which can impair their function. Unfortunately, any impairment of function intensifies the sense of inadequacy, resulting in a vicious cycle. Early treatment of Post Traumatic Stress Disorder (PTSD) is important in preventing progression of the condition by this self-reinforcing cycle.


Post Traumatic Stress Disorder (PTSD): A very real condition
Helping our kids deal with trauma
The Creator helps those who help themselves
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 Send your comments by clicking here.

© 2002, Abraham J. Twerski, M.D.