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Will Americans be okay?
Rising out of the white noise buzz of op-ed pieces, web logs and dinner-table discussions is a singular question: Will America ever be the same following the September 11 terrorist attacks?
PHOTO: Owen Egan
In all likelihood, no.
Change is inevitable, be it narrow (air travel regulations) or wide of scope (U.S. foreign policy). But as once caustic talkshow hosts choke back tears, another question presents itself: Will Americans ever be okay again? Psychiatry professor Duncan Pedersen thinks they will.
The director of McGill's Psychosocial Research Division is in high demand of late. His five-year research into the effects of terrorist violence on a population's health has attracted much media interest. His fieldwork focuses on the ongoing impact of Peru's Shining Path guerilla revolution on five highland communities of indigenous people -- a world away from lower Manhattan, but not without similarities.
"It's not only the [direct] victims and survivors who are to be measured and assessed," Pedersen says. "You have to look at the overall context; the larger and long-term effects of [the terrorist attacks] are tremendous. We're going to see all kinds of psychological effects, and social and economic effects."
As rescue costs soar and stocks drop, the astronomic economic impact is already without question. The psychological effect, however, is yet to be fully understood. Research indicates that 20-25% of people directly exposed to the attacks will experience symptoms of post-traumatic stress disorder.
With symptoms including anxiety, flashbacks and paralyzing numbness, it isn't difficult to foresee the wide-reaching toll PTSD will take on individuals, families and workplaces.
Many World Trade Center and Pentagon victims and rescue-workers will require long-term PTSD treatment, but Pedersen is careful to offer some much-needed perspective.
"It is important to take into account that 75% of the population [directly exposed to terrorist acts] remains 'normal,'" he stresses. "We're beginning to learn about the biological and psychological responses that make a large number of people resilient to PTSD. We know that of the 25% of people who experience PTSD, many have had prior exposure -- in their infancy or childhood or adolescence -- to violence and abuse, be it a physical attack, an armed attack, a rape, an automobile accident. They have experienced symptoms as a consequence of this exposure, and will tend to repeat those symptoms when exposed again."
Many TV viewers watched "the attack on America" unfold in real time, lending the catastrophes an extra sense of immediacy. The gruesome images of doomed airplanes and falling bodies have since become inescapable and, for many people, impossible to shake off. However, without downplaying the horror or tragedy of the attacks, Pedersen warns of overstating the lasting psychological impact on the bulk of the population.
"People watching it on television are not true witnesses," he explains. "Psychological effects will be very different for people who have been at ground zero than those for people like you and me who are removed from this scenario.
"Some traumatologists call this 'secondary' trauma, not 'primary' trauma, but I really question these labels. We have a lot of trouble differentiating between emotions and pathological conditions. I think it's a mistake to turn a set of emotions that people [watching the attacks from afar] express -- grief, sorrow, depression -- into pathological conditions."
Pedersen further warns of a sinister agenda that goes beyond mere sensationalism or misdiagnosis. "It's not an innocent mistake," he says. "It's in the interests of the pharmaceutical industry to enlarge the market for consumption of antidepressants or other drugs that claim to have a direct beneficial effect for those exposed to traumatic events.
"If you look at the experience of Rwanda, where you had the carnage of one million people in just a few days, the response from Western countries was aid -- food, supplies -- but at the same time they also flooded the country with trauma counsellors who went around to cities and small towns administering pharmaceuticals.
"Responses such as this are completely unnecessary."
Drugs may not be necessary, he says, but people are. "We have learned, and this is very important, the significance of social support -- that is, family, friends, or another closely tied network that you communicate with on a daily basis, with whom you exchange emotional support. Institutions such as churches and religions are also very important supportive mechanisms. Those who have access to intense, and high quality, exchanges occurring within these networks do tend to have much less risk for traumatic scars."
Pedersen believes that, despite lacking a pre-existing "state of readiness" present in countries regularly threatened by terrorist violence, the U.S. is no less equipped to survive. He also points out that many Americans living in inner cities are confronted with a different kind of violence "every day of their lives. To live in an American city is not to be protected, or to necessarily live in a very peaceful environment."
Americans, in other words, will heal.
"Certainly they will," asserts Pedersen. "But it's also certain they will have to change their way of life." He believes foreign policy revision is a crucial step toward creating the necessary "feelings of security in the population" and alleviating constant fear of terrorist retaliation.
Referring to George W. Bush's "justice will be done" address, Pedersen adds, "On the contrary, this constant drumming of war only leads to insecurity."
Healing is neither quick nor easy, but Pedersen does offer a small piece of advice: turn off the TV.
"The media constantly marshals the same images of terror," he explains, "bringing the conflict into your living room. I have deliberately avoided watching CNN. Some of my friends are walking away from the television, preferring to listen to the radio to avoid these images.
"What we are seeing is not reality. Human suffering is a condition that the media has expropriated, used and commercialized. We have to reflect on this commercialization of human suffering; it's something that I'm not willing to accept that easily."