Disaster and Trauma In detail please explain the disaster to the class.

September 11, 2001 is remembered for the unforgettable incident of suicide attacks against different targets in the United States carried out by 19 militants of Islamic extremist group al-Qaeda by hijacking four airliners. Two airliners crashed into the towers of World Trade Center, a third one hit the Pentagon, while a fourth one rammed into a field in Pennsylvania. The attacks, often referred to as 9/11 in American date format, resulted in extensive death and damage, which generated major U.S. wits to contest terrorism and define the presidency of George Bush. Around 3,000 people, including more than 400 firefighters and police officers, were killed in these attacks (History.com Staff, 2010). Residents of 78 countries lost their lives at the site. The following day, President Bush stated, "Freedom and democracy are under attack," (p. 1) while, leaders from around the world declared 9/11 as the attack on civilization itself. (State.gov staff, 2002)

b. Discuss the loss of the people who experienced the disaster (Physical, Emotional, Familial, Community, and Material).

Terrorist attacks usually involve an "extreme and powerful threat" and perhaps actual damage to the emotional and physical integrity of one's self and others and can encompass injury and death. These attacks can also include the damage to resources like jobs or homes, as witnessed post-9/11. Many will be affected psychologically and emotionally. However, not just the civilians but many rescue workers were also affected, in the prolonged aftermath of the attacks, as they experienced it first-hand (Jordan, 2005, p. 342).

People exposed to the attack are at a higher risk of developing PTSD, as Brewin (2004) defines, (1) a failure of usual adjustment to a traumatic event, (2) coming across with acute fear, horror and helplessness at the time or later, (3) in part it is a common response to any hostile event, and (4) in part it is a particular response including reminiscence (i.e. flashbacks) and identity (i.e. alienation) (p. 342). While others, according to Kessler and colleagues (1995), might experience panic disorder, substance abuse, major depression or generalised anxiety disorder; or as Yehuda (2002) says, "somatic symptoms and physical illness such as hypertension, asthma, and chronic pain syndrome" (cited in Jordan, p. 342). According to a study, in United States, 44% of people were facing at least one PTSD symptom (out of five), in the first 3-5 days post-9/11 attacks (Jordan, 2005, p. 345).

While, another study by Freedman reports that when people are incapable of assimilating their experience and attributing a meaning to it, then clinicians are encountered with a conundrum: that when, how and whether to intervene. Some typical signs of failure to regain an emotional equilibrium include: distancing from others, seclusion from family, withdrawal, emotional solitariness, failure to relate to usual feelings, dominance of a sense of loneliness and hopelessness, and a loss of association and purpose. Any addition to these prospective symptoms would be "emotional numbing," labelled by Bloom and Reichert (1998), as an acute form of detachment. However, they suggest that this detachment may not be recognized as people may function on numerous levels simultaneously in this state -- "step across part of a torso" and carry on "to get the job done" (p. 377) -- they may look as if managing well. Though, their capability for normal communication could be reduced or even lost (Freedman, 2004, pp. 387-388).

Nonetheless, along with other losses, another study by Human Reproduction (2006) based on more than 700,000 childbirths in New York amid January 1996-June 2002, illustrates that the birth sex ratio dropped to below one in January post-9/11, i.e. its lowest level. One concept is that the trauma of the attacks, to the women in their second and early third trimesters of pregnancy, caused uneven loss of male foetuses, thus dropping the chances of a male birth (Dobson, 2006, p. 516).

c. Based on the loss highlighted above please explain to the class how you believe these individuals feel.

An upgraded way to separate the physical and mental health, in the wake of a disastrous event, is through the difference between mental and somatic health. The medical term somatic comes from the Greek word soma, meaning "the body." Therefore, the successful enactment of mental functions in relation to thought, behaviour and mood, denotes mental health, while any variations in performing those functions is labelled as mental disorders (Ritter & Lampkin, 2012, p. 7).

However, regarding the feeling of victims of 9/11, one therapist recalled to Karen Seeley, Columbia University researcher, that her walk into a local fire station unveiled the number of people in shock, the bad shape they were in, a lot of PTSD, their...

Her mere suggestion for their time off from work made the firehouse lieutenant understandably impatient as he does not have others in the need of the hour. Talk therapy, practical assistance and medication were offered to others who were trying to shift temporarily from their house in the pain of the shock. Children, on the other hand, who witnessed awful sights as buildings falling, bodies coming down and heard screams, were having nightmares (Burkeman, 2011).
d. Based on the perceived emotional reactivity of the individuals as outlined above, please tell the class what these people would need in order to start the healing process.

Interaction and conversations between therapist and family members, also amongst multiple families, began initially at a slower pace but gained momentum soon and became livelier. Connections began to occur through the similarities and differences of people's way of viewing loss and coping with it. The therapists considered it important to hear the losses of each family member and understand their attempt of making sense of it. This mutual appreciation and respecting cultures continued in the second hour of family meeting with multiple family groups. There was no judgement about right or wrong, normal and abnormal, except for the life threatening ways of coping with it. Some decided to wait for the information; while others for a funeral without a body; there were those who had to improve tolerance for family members with conflicting views. Trust and human connections developed because of explicit conversations, thereby forming a bond between the therapist and all families. Therefore, in this broader framework of human connectedness, the healing initiated (Boss, Beaulieu, LaCruz, Wieling & Turner, 2003, p. 459).

Similarly, as asserted by Madrid, the therapist, offering therapy in such a situation is unethical. One can only offer what is now called psychological first aid; the term had not been coined then. They just sat with sufferers, allowed them to talk, and perhaps prepare them a bit for their further visits to recognise the symptoms of trauma, later (Burkeman, 2011).

e. Based on the perceived need highlighted above please share with the class what types of services you would provide if you were a member of the emergency response team.

The recovery can be defined in two ways: firstly, through outcomes, as people with major psychiatric disability are able to completely overcome or cope up by living with psychiatric signs and dysfunctions. Consequently, it often results in accomplishing significant life goals as independent living or full-time service. Secondly, recovery is recognised as a process. As such, few essential processes such as hope and well-being have been re-established by recovery into rehabilitation (Corrigan & Lee, 2013).

A study by NilamadhabKar reveals that current literature discloses strong evidence that Cognitive Behavioral Therapy (CBT) is an effective and safe measure for both acute and chronic PTSD along with other traumatic experiences in children, adolescents and adults. Presently, expert consensus panels and numerous treatment procedures recommend using trauma-focussed CBT. Numerous other procedures of therapies have been compared with CBT, namely problem-solving therapy, psycho-dynamic therapy, acupuncture, supportive psychotherapy, present-centered therapy, hypnotherapy and structured writing therapy, etc., for treating PTSD. However, most dependable comparison has been with EMDR (eye movement desensitization and reprocessing). A methodical review after 23 clinical trials regarding the effectiveness of CBT recommended that remission rates of CBT are better than EMDR or other therapies. Both trauma-focussed CBT and EMDR are widely used in treatment of PTSD, but studies show superiority of CBT over EMDR (Kar, 2011).

A vital element of recovery as a process is enablement. The power to act on decisions is a must for people, which can yield an optimistic future that reproduces their personal objectives (Corrigan & Lee, 2013). Accordingly, a mental health project funded by government, Project Liberty, was formed instantly after 9/11 to help its victims recover from their unsteady mental health. Psychotherapists experienced extreme difficulties in treating innumerable victims and their families. All psychotherapists shared and experienced same emotions as their clients. Each new client and every recounting retraumatized the psychotherapists. Various programs and classes seem not enlightening enough for the psychological community as many of the psychotherapists felt unskilled. Many of them questioned the significance of traditional psychotherapy, considering all therapy sessions and all the theories of psychology taught as dysfunctional. This question encouraged research regarding the psychological impact of 9/11 and effective treatment for…