One year later,
people affected by attacks still struggle with loss
The complicated journey toward healing
One year later,
people affected by attacks still struggle with loss
By jane waterhouse
Staff Writer
FARRAH MAFFAI Linda Dickinson holds her son, Patrick, at the Monmouth County Remembering September 11, 2001 ceremony at Brook-dale Community College. They lost Lawrence Patrick Dickinson, Patrick’s father and Linda’s husband.
Charles D. Brown III calls trauma "a normal response to abnormal events." And he should know. As the chief mental health administrator of the Monmouth County Department of Human Services, Division of Mental Health, Brown spends much of his time dealing with people in crisis.
He’s supported by a cadre of trained professionals known as the Disaster/Critical Response Team, a first-line respondent to any traumatic event that affects county residents. Domestic violence, addiction, natural disasters — they’ve seen it all. But when the smoke cleared from the World Trade Center after Sept. 11, 2001, Brown began to sense a change in the air.
"If anything, 9/11 destigmatized mental illness. People who lived ordinary lives — folks who went to work every day and came home to their families suddenly were saying, ‘I can’t sleep,’ ‘I’m not eating right,’ ‘I’m having trouble dealing with this.’ It’s given people permission to admit they need help," he said. "And I see that as an opportunity for the whole system of mental health care."
Brown said the procedures and services for dealing with widespread trauma were in place well before the events of Sept. 11.
"The county had already formed a Traumatic Loss Coalition comprised of mental health, school and community professionals who were prepared to help our resident youth," he said.
Traumatic Loss Coalition coordinator Dr. Mary Ann Cernak was quick to point out the difference between what took place on 9/11 and other critical events in the area.
"I’d been brought in to consult on disasters such as the Edison pipeline explosion and Hurricane Floyd, but while these events had a devastating impact, they were not the result of a deliberate act," she said.
Cernak went on to say that a study conducted by the University of North Carolina showed that people who worked and lived in the area of the World Trade Center experienced more trauma than those who worked at the Pentagon did.
"The Pentagon is a military facility. In New York, people were working in a neutral place and that only exacerbated the terror," she said.
But not only those on the scene were traumatized. Cernak explained that New Jersey’s proximity to New York, added to the great number of Monmouth County residents who commute into the city, brought the terror to every doorstep.
"As the event was unfolding — literally while I was watching the buildings collapse on television — I began work on an article called ‘The Human Response to Terrorism,’ which we immediately passed out to school superintendents and community leaders to give them some guidelines of what to expect," the doctor recalled.
She agreed with Brown’s assessment of trauma as being a normal response to abnormal events, but added, "It’s natural after an event like this that people will feel shaken up and kids will regress. If, however, a year later people are continuing to live in a heightened state of fear — if that child still isn’t sleeping in his own room — then we’re most likely dealing with post-traumatic stress disorder."
Cernak confirmed that the anniversary of 9/11 might stir up residual fear in many Monmouth County residents.
"But if a month later, fear is inhibiting their ability to function, then they should seek help," she said.
Providing kids with help is something that Risa Cullinane has been doing on an almost daily basis as director of The Source — a nonprofit, school-based youth services program located at Red Bank Regional High School, Little Silver. During the weeks following 9/11, she and her staff of trained counselors saw more than 170 teens.
Cullinane, who has been trained in stress debriefing, also is a member of Traumatic Loss Coalition spearheaded by Cernak.
"We offered 50-minute critical incident stress debriefings," she said. "We met in small groups, which are nonthreatening, and focused very specifically on the event — none of this ‘What happened to you when you were 10’ stuff. Kids hate that."
Cullinane believes that even the most guarded teenager is willing to share some information in a time of crisis.
"You begin by asking who they are, and where they were when the incident occurred," she explained, adding, "I often ask them how they felt physically at the time. They might say, ‘I couldn’t breathe’ or ‘I threw up.’ You don’t ask about what they’re feeling emotionally until later, when they’re ready to open up."
Although the majority of students who attended these stress debriefings hadn’t suffered a loss directly, Cullinane said they were still affected in an immediate and personal way.
"This event was different because we all witnessed it," she said. "The spheres of influence created a ripple effect — everyone knew someone who’d been lost — and with the nonstop media coverage, we saw the terror happening, over and over."
Experts say the constant repetition of horrific images from 9/11 can affect younger children in an even more dramatic way.
"When a 4-year-old sees video footage of a plane crashing into the World Trade Center on TV," said registered art therapist Cindy Westendorf, "the child thinks it’s happening again."
Over the past 10 months Westendorf has worked with 18 of the 9/11 families under the auspices of Amanda’s Easel, an art-therapy counseling program that operates in association with 180, Turning Lives Around, Hazlet.
"Trauma is stored in a nonverbal part of the brain," the art therapist explained. "Art is a highly effective way to reach that part of the brain, to tap directly into feelings and reduce post-traumatic stress symptoms."
Westendorf said the program is designed to take the grieving participants from their initial shock to self-repair.
"We have one dad, but it’s mainly women who lost their husbands in the twin towers," she said. "Their children are very young — we have one who’s only 3."
Parents and children are put in separate groups.
"These families are under incredible stress," Westendorf said. "Our first task is to get them to imagine their safe place. This gives them an image that they can refer back to, visually and mentally — a safe haven where they can retreat."
She encourages the children to engage in various types of play therapy, from expressive drawing and painting to puppet building and role-playing.
"Through the activities, I try to help them understand the change that has occurred in their lives," said Westendorf. "The older kids often feel overly responsible for their mom’s well-being. The little ones don’t understand the permanency of death. They keep asking when daddy’s coming back. That could continue for a very long time — three or four years usually."
As for the adults, Westendorf said that once they move past their initial trauma and shock, the real grief work begins.
"I often suggest that they create family photo albums or do portraits of their loved ones. I’ve been doing bereavement work for nine years, but working with the 9/11 families is different. The societal response … the lack of closure … and all the media attention …" the art therapist paused, grappling for the right words. "It complicates the grief."
Westendorf indicated that the Sept. 11 anniversary is a milestone in a journey that for these families is far from over.
"They all keep saying, ‘I just can’t wait until Sept. 12,’ " she said.