Rick. A. Myer, Ph.D.,
Associate Professor, Director of the Center for Crisis Intervention and Prevention
Holly Moore, M.S. Ed.
Duquesne University
Pittsburgh, PA
On September 11, 2001 three commercial airliners were used as missiles to ram the World Trade Center and Pentagon while a fourth crashed near Pittsburgh, PA in a failed attempt to smash into a building in Washington, DC. Approximately 3,000 people died, numerous others were injured, hundreds of children lost parents, and thousands of others were traumatized. Around the world people watched the events unfold in real time, many of whom also experienced traumatic effects. The belief system of Americans was shattered. We knew attacks could happen, but believed these attacks were limited in scope and impact, however this attack changed that. Because of the magnitude of the attack, people found themselves afraid to do even the most ordinary activities; commute to work, take vacations, and so on. Everyone was trying to make sense out of what happened, but found this task difficult at best and impossible at worst. It was like trying to fit a square peg into a round hole.
Our experience involved providing crisis intervention with employees of a multi-national corporation located in a building adjacent to the World Trade Center. Using a holistic approach (Marby, 1998) for interpreting the experience four critical issues emerged. Each played a role in providing services. The overall goal of the intervention was to restore a pre-crisis level of functioning to those affected by the event, minimize the chance more severe psychological problems would develop, and as we discovered, to help the corporation itself to return to a sense of normalcy. An important aspect was the dynamic relationship among the issues. None stood alone, and recognizing this reciprocal impact was important as the intervention process progressed.
The first and most critical issue was to be aware that one event resulted in multiple crises. As individuals reacted with various levels of intensity to the attack so, too, did the organizations, businesses, and corporations. A safe assumption is that people in the vicinity of Ground Zero as it has come to be called had a crisis after seeing, hearing, and smelling what happened that day. However, the various businesses that were housed in the area also experienced a crisis. Survivors of ground zero also found that their families had another crisis. Many family members were reported to be angry with the survivors for not contacting them. This reaction confused survivors who asked why their families were not more supportive and understanding. The answer is that family members had another crisis. The people at ground zero had one crisis while the family had another. Both had difficulty understanding and accepting the others reactions.
The second issue concerns the perspective used to understand the problems being experienced. A natural tendency for most clinicians would be to utilize diagnosis to classify survivors' reactions. This method would help in communication among professional human service workers and suggest treatment strategies that might be helpful (Hohenshil, 1996). Any number of diagnoses would fit, Acute Stress Disorder, Post Traumatic Stress Disorder, and Adjustment Disorder. Many of the family members of the employees also met criteria for a diagnosis including those mentioned above as well as others such as Separation Anxiety Disorder and Generalized Anxiety Disorder. However, diagnostic labels were limited in the ability to capture the experience of the people in this situation.
Another way to understand the employees was to liken them to refugees. Refugees are people, many of whom experienced a trauma, who have been forced from a location, usually their homes, but in this case their place of work, to another location not of their choosing (van der Veer, 1998). This description corresponded well with the experience of these people. They were forced from a well known location and had to relocate in other parts of the city. Friends were separated, working relationships altered, and familiar procedures changed. They were now in unfamiliar surroundings having to learn new routines. The cultures of these locations were also different; from being in the one building in the financial district of lower Manhattan to being scattered throughout the area in five locations, none of which bore resemblance to their former building.
A third issue was that the intervention process required an organic approach. As needs surfaced, the intervention had to adjust in response. Although Mitchell's (1997) Critical Incident Stress Debriefing was utilized initially, this model proved inadequate to meet the needs of survivors. Concerns regarding the effectiveness of Mitchell's model have been for raised incidents such as September 11th (Stuhlmiller & Dunning, 2000). In our experience, more effective strategies involved contact that was regular and continued, but not constant. Therefore in addition to meetings requested by individuals and groups, and consultation with management, accessibility and visibility were key elements. This approach provided a "security blanket" for people. At times, this approach incorporated a "walking through" strategy that involved strolling through the building. A primary focus of the intervention was to assist people to recognize strengths and accomplishments. Generally, this intervention was most helpful after a level of trust had been established by listening to people tell their story several times.
A fourth issue concerns the need to balance the role of crisis intervention worker and crisis management consultant. This situation is not unique in the area of consulting (Dougherty, 1990), yet it became increasingly complex to handle as management requested input regarding decisions that impacted the lives of employees. The balance between these roles required recognition of the role we were in at a particular moment and corresponding ethical responsibilities. A particularly thorny problem after being on site for several months was not becoming over involved, or going "native". To do so would compromise the objectivity of the intervention and recommendations made to management.
References will be provided at the presentation.
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