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of an Orderly World
He stated, Your confusion seems to be because your 'just world' philosophy of life cannot explain what happened in New York. You used to think that if you were careful, honest, and good, you could avoid disaster. But, the loss of your brother in the Twin Towers attack taught you that all your best efforts could not prevent the worst from happening. You saw others who were also innocent die or be unfairly injured. So, while you would like to believe that the world is orderly, and that good is rewarded and evil is punished, youve had experiences that contradict these beliefs. Because, you feel your brother was punished precisely because he was trying to be a good and competent person by going to work. So now its even harder for you to hold to your just world philosophy of life.
Certainly the loss of an orderly world occurred after the attack on the Twin Towers and the anthrax incidents that followed. Several of my anxiety disordered clients reported a fear of leaving their homes. Thus, their orderly world, so to speak, was rocked to its very core.
of a Positive Self-Image
A colleague treated a client who survived a fire in which his roommate was badly burned. He stated, I feel almost as if I had been exiled from my circle of friends for committing an unforgivable crime or as if I were carrying a deadly communicable illness; a part of me feels 'bad like I am a bad person,' scarred, diseased, or otherwise unacceptable. I should have been harmed in the fire as well. Did you treat a client following the Twin Towers attacks who suffered from loss of a positive self-image due to his survival when others did not?
My colleagues and I have found survivors of a trauma might even feel ugly - ugly as Dr. Frankensteins monster, regardless of how attractive they really are. It is an established fact that women with histories of sexual abuse often feel ugly. They believe they look ugly on the outside, because they feel ugly on the inside, or because ugly things have happened to them. Thus, post-traumatic stress reactions, such as depression, and other aftereffects of trauma can cause the loss of self-image and self-esteem. After the attack on the Twin Towers, as a nation, we suffered from loss of a positive self- image, that being terrorism cannot happen within our national borders. The idea we are not immune from attacks has forever changed our positive self-image as a nation.
and the Loss of Trust
Can your client trust going to the mail box, checking the mail and not contracting some form of a disease planted by a terrorist? Do you have a client that questions trusting his or her chances of going on an air trip, arriving, and returning safely?
There is another side to this coin: have you found the tendency for clients to automatically and completely trust others, after witnessing such a terrorist attack as September 11th or other trauma? For example, we have observed some combat veterans instantaneously trusting another combat veteran, without taking time to find out if they are indeed reliable. While in combat, a soldier could safely assume that members of his unit would treat him like family. Back in civilian life, the code of your blood is my blood may no longer operate. Trusting another soldier may have saved a soldiers life on the front lines; however, trusting all fellow soldiers implicitly might cause problems back home under non-traumatic situations. This trusting behavior was exhibited by New Yorkers immediately following the September 11th attack. Story after story was told of a more open and loving attitude in the city.
For trauma survivors, this fear of imminent danger often persists in post-trauma relationships that are not dangerous. A pervasive sense of doom is part of post-traumatic stress disorder and is related to depression, another common reaction to trauma. While expecting the worst makes perfect sense given the trauma survivors experiences, have you found friends and family members of your client labeling them as cynical, paranoid, or too negative, and find their non-trusting attitude oppressively burdensome?
Online Continuing Education QUESTION
2: What is part of post-traumatic stress disorder that is related to depression?
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