Dear NESTTD Members and Supporters:

It is tragic and ironic that the events of the last month have brought trauma onto center stage in the lives of Americans. Historically, we have been here before: it seems to take a tragedy of national and international scale (a Vietnam war, for example) to raise popular consciousness about traumatic experience. Even though women and children in homes and families still constitute the highest risk group for exposure to trauma, it takes being traumatized directly or vicariously as a nation to make it real. Now, as we all experience heightened hypervigilence, fears about going with our normal daily activities, traumatic stress responses to a multitude of reminders of the trauma, a sense of a foreshortened future, more difficulties sleeping and eating, and a higher baseline level of hyperarousal, we share as a community and a nation what trauma survivors have been living with for years.

When I sat down to write my last President’s Column, I wrote of events in the trauma treatment microcosm: coming back after the summer, fall events in the world of trauma professionals, and the like. Now I write with the awareness that events are happening in the macrocosm that affect all of us personally and professionally. At our NESTTD quarterly meeting, Girvani Leerer opened the program by reading ISSD’s response to the World Trade Center terrorism and then asked for a moment of silence for all those touched by the disaster, whether as victim, witness or rescuer. I know that, for many of us, the opportunity to immediately put knowledge and skills to use in helping with the psychological recovery of those directly affected has been a deeply moving way of feeling less impotent and more useful. Seeing the experts in our field educating television news audiences about trauma or being asked ourselves by colleagues and friends to offer expertise helps in a different way: we now have a role to play outside our individual offices within the larger community. Living with the personal experience of vicarious traumatization, noticing the bi-phasic pulls toward both avoidance and preoccupation with the trauma, experiencing firsthand how therapeutic dissociation functions to enable us to carry on with our lives as usual: these phenomena bring our professional world directly into our minds, bodies, and homes. However each of us has been touched by what is happening in the world, however we are coping with fear and trying to find peace within ourselves, however we are learning to live in a world that no longer feels assured and safe, however our own earlier life histories are being activated by what is happening, we are experiencing firsthand what it is like every day for the trauma survivors with whom we work—because, even if we were not before Sept. 11^th, we, too, are now trauma survivors. And, hopefully, we are bringing the same thoughtfulness, compassion and respect to taking care of ourselves that we bring to taking care of others.

But there is another side to all of this that I want to also articulate in this space because I was very aware of it at the September Quarterly Program. Trauma and tragedy also have a way of enlarging our perspective, deepening our spirituality, and bringing us together as a community. At the meeting, I was aware of not only how many people came to hear Claire Frederick but also how many stayed to break bread together afterward. It seemed as if people made an even greater than usual effort to connect with each other: conversations were animated and it was harder for the President to interrupt! In my practice, I see some trauma survivors who have been re-traumatized by the terrorism but even more whose perspective on what it means to be "safe" has profoundly changed since September 11^th. For many traumatized adults who have chronically felt "unsafe" in their homes and neighborhoods, with loved ones as well as strangers, it is suddenly clearer that, within their homes and communities, they have been safe, remarkably safe. Seeing the survivors and loved ones left behind by the World Trade Center tragedy, their losses raw and fresh, has helped to more clearly place their losses in the past—painful and sad but long ago and far away. Ironically, the knowledge that the ongoing threats to safety are now outside the family, not inside it, has enabled them to be more grounded and committed to their lives in the here-and-now, less troubled by traumatic intrusions. One of my DID patients, "Annie," took on her first job in two years the week after the terrorism. Despite the stress of returning to work and adjusting to a new work setting, she has been more grounded and more confident in differentiating past from present experience and child selves from adult self than at any time in the four years I have known her.

On the other hand, I have also noticed that those who have been more vulnerable to re-traumatization in the past few weeks are, not surprisingly, those whose past traumatic experiences have involved disaster, sudden death, community and political violence or displacement: the survivor of a family suicide, the adult child of Holocaust survivors, an adult who witnessed political violence in Colombia as a child in the 60s, an adult whose family chronically lived like itinerant displaced persons, the victim of a stalker who assaulted and raped her, and survivors of guerilla or terrorist activity in South America and Israel. Although these old experiences have generally been less intrusive on a day-to-day basis than traumatic experiences of familial abuse tend to be, they are now strongly activated and "right there." In that paradoxical way that trauma work illuminates the best and the worst in human nature, the deepest human suffering and the resilience to bear it and to grow in spite of it, I see ourselves and our patients growing into this experience: the suicide survivor drawing comfort from knowing firsthand that the bereaved families will somehow get through this as she did; Annie finding new ability to grow now that she has found the present; we as therapists finding strength or vulnerabilities we did not know we had; learning to live with a sadder, scarier but more realistic sense of our own safety. As one of my patients said, "We have always been either 100% safe or 0% safe at any given moment in time, and we still are."

president@nesttd.org