Attack on the psyche

Avoid breakdown by talking about tragedy

Can I get a cigarette off you? Yeah, sure. It's hard not to smoke today.

"I know. I thought I had quit, but ...

But the World Trade Center towers have been destroyed. The Pentagon is in shambles. More than 5,000 Americans are dead or missing.

It's noon Tuesday, Sept. 11. The girl takes the cigarette and fades back into the shadows of her booth at Manuel's Tavern.

"Fucked up, says a mustachioed, middle-aged businessman sitting at the bar. His tie is undone, his dress shirt unbuttoned at the top. "This is so fucked up.

Halfway across the state, an 85-year-old great-grandmother who's lived through Pearl Harbor, World War II, Korea, Vietnam and the Gulf War cries hysterically — not out of sadness, but out of fear, though she's tucked away on a farm outside Montezuma, Ga. She's not in danger, but she realizes her sense of security — grounded in the overwhelming might of America — has been vulnerable all along and she didn't even know it.

A 28-year-old architect leaves his office in Little Five Points around 10:30 a.m., when the second tower collapses. He goes home, to the place where he is surrounded by familiar, comforting things.

These reactions have been repeated thousands, perhaps millions, of times around the country, and are telling of how the entire nation reacted. Whether we've acknowledged it, we're all suffering psychological trauma similar to what a victim of a violent mugging experiences after an attack.

Post-traumatic stress is defined as responding with fear, helplessness and horror after witnessing a traumatic event, says Barbara Rothbaum, director of Emory University's Trauma and Anxiety Recovery Program. That's how terrorism gets its name — and its power.

"For good or bad, the images on the television turned us all into witnesses of what happened — we all witnessed the deaths of thousands of people, and we know it could have been us, Rothbaum says.

"These people were sitting on planes and in their offices, which are supposed to be safe things to do. That is why, in some ways, we have all been victimized. It was so unpredictable, what's to say it couldn't have been Atlanta? What's to say it won't be next time? This has opened up a whole future of possible horrors for people.

Post-traumatic stress manifests itself with three distinct sets of symptoms.

Some people have nightmares. They even think about the disaster so often they daydream about it.

Others have difficulty sleeping and can't concentrate on their work. They are irritable and at times irrationally angry.

The third — and most damaging — set of symptoms is called the "avoidance and numbness reaction, according to Rothbaum. Those people don't want to talk about what happened; they cut themselves off from others because of what Rothbaum calls "an exquisite sense of vulnerability.

"Americans are not very good about talking about negative things. For a lot of people, it's easier to escape back to their normal lives, she says. "But if you don't process this by talking about it and focusing on it, it will come back to haunt you. And it's possible you'll come down with a full-blown case of post-traumatic stress disorder. It feels like something from the past is haunting you, yet at the same time it's still part of your present.

Rothbaum says post-traumatic stress victims can go through phases of each set of symptoms.

That might explain the blank, subdued faces at Manuel's during the lunch rush Tuesday, and a spirited condemnation of Muslims overheard at the Euclid Avenue Yacht Club that evening, where two separate tables merged together so the new-found friends could share in Arab-bashing without having to yell across the room.

The following day, a friend distilled her apprehensions in an e-mail message: "To me, the whole world seems more fragile. Is there anyone or anything in this world that can protect me or comfort me? I was thinking yesterday that if [my husband] and I are lucky enough to have a baby, he or she will be born after Sept. 11, 2001. That fact alone will define his life in many ways. Will he trust the way we did? Will he demand freedoms the way we did? Will he even understand how the world used to be, before Sept. 11, 2001?

For some, the healing begins in confronting and coming to terms with an uncertain future.??