profile

to identify areas where coping mechanisms are well-developed, and

areas that might be developed. "We don’t talk about strengths

and weaknesses," says Dowd. She feels the words carry too heavy

a load of responsibility in a climate where everyone is already

overloaded.

People with well-developed personal coping systems might, for

instance,

have a good sense of humor, or might be able to think of both

positives

and negatives that come with change.

trends

in professions, the direction in which a company is headed, and how

roles within the company are shaking out.

ancestors, and perhaps even to the philosophy her grandmother’s peers

may have embraced, Dowd declares: "We can’t do everything

ourselves

anymore. We can’t possibly be independent." Instead, it is now

important to know where to go for help, who to seek out as a mentor,

and what resources are offered by the company and by the community.

resources, individuals are in a position to make changes that will

position them to move easily through a shifting work landscape. But,

warns Dowd, it is not a good idea to try to change too much at one

time.

entire life in 48 hours," Dowd says. "We try to offer

bite-size

suggestions."

Top Of Page
Post-Traumatic Stress

We had it all figured out. Life was allowed to hand

us varied ups and downs, but never any real derailments. Those

wrenching

disasters were supposed to happen to the others — those separated

from us by distance or time. Then came September 11th and our

protective

illusions burst. We not only mourned the tragedy that did strike,

but we confronted a new anxiety about the future.

Now we face a national psychological, medical, and even legal cleanup.

"Moving Past Trauma: Coping after 9-11" on Tuesday, February

5, at 5 p.m. the Princeton Plasma Physics Laboratory explores how

the cleanup can be achieved. The panel will explore post-traumatic

stress disorder (PTSD) and substance abuse, then discuss the medical,

legal, and management issues involved. Speakers include psychiatrist

Naomi Vilko, a PTSD specialist; attorney Steven Berlin

of Buchanan Ingersoll PC; and addiction treatment specialist Arnold

Washton. Call 609-987-7112 or register via E-mail at

carpenter@blpc.com Attendees are required to bring a photo ID.

Even while the World Trade Center stood proud and tall, approximately

one third of Americans were victims of limiting mental health problems

severe enough to qualify for medical treatment. This is actual,

extended

impairment, the American Psychiatric Association hastens to add, not

just feeling blue. In productivity loss, early death, paid disability,

and substance abuse, this illness costs our nation an estimated $113

billion annually. The Domenici-Wellstone amendment to the 1996 Mental

Health Act proposed to broaden mental health insurance coverage.

Congress

recently killed the amendment.

"The Domenici-Wellstone amendment," explains Berlin,

"following

on the heels of the 9-11 disaster brought a lot of necessary light

to a long ignored problem." The bill, aimed at fixing the

disparity

between mental and physical health care insurance payments, stated

that neither insurance companies nor employers with more than 50

employees

could categorically limit mental health payments. "But since

December,

with the economic downturn, no bill that puts a greater burden on

employers is greeted fondly," Berlin says. "Nonetheless it

is a disparity that must be repaired."

"Count on it, psychological trauma will prove the greatest loss

— in human or cash terms — to come out of the September 11th

debacle," warns Vilko, who initiated the February 5th seminar.

"Our trauma-induced downtime and costs have just begun to

soar."

Vilko, a native New Yorker, took her undergraduate degree at Barnard,

then received her psychiatric training at the New York Medical

College.

For the past 22 years, Vilko has maintained offices in both Princeton

and New York, where she specializes in post-traumatic distress

disorder

and substance abuse. She is on the staff of Princeton Medical Center

and has taught at Robert Wood Johnson Hospital. Her son, an investment

banker with Deutsche Bank, barely escaped from the 9-11 attack.

"There is nothing vague or categorical about post traumatic stress

syndrome," insists Vilko. "It is delineated by three clearly

recognizable symptom groups." First, flashbacks and nightmares

occur, usually only for the most immediate victims. Secondly,

withdrawal

moves in. The victim doesn’t go out, avoids trains and public places,

and fails to communicate. The third symptom, hyper-arousal, Vilko

witnessed clearly on the subway immediately following 9-11. A single

jerk or sudden loud noise sent several crisp-suited business folk

crashing to the floor in expectation. "It was exactly the kind

of behavior one so often sees in disturbed Vietnam vets," says

Vilko.

Post-trauma stress symptom is an old and familiar disorder. While

the syndrome only came into official terminology in the l980s, it

pre-dates World War I shell shock. "A lot of it came to our

attention

after Vietnam, in the form of substance abuse," says Vilko.

Self-medication

via drugs and alcohol can typically reach 50 percent among traumatized

males.

"But 9-11 is unique," says Vilko, "because, unlike

Vietnam,

we can catch the problem before the victim is beyond control."

The events were seen by millions on television. After a month, the

initial symptoms of PTSD were evident in most sufferers. A blended

treatment of medication and psychotherapy has proven quick, relatively

simple, and very effective in most cases.

The problem now becomes getting people in need to receive the

necessary

treatment, without waiting. First, we face overcoming our societal

block concerning any mental problem. Victims of flying bricks get

immediate bandaging. Victims who faced the trauma of flying body parts

should just buck up, we say, and not lower themselves like wimps to

seek any psychiatric aid. Secondly, most people fear mind-altering

medications. But Pfizer’s Zoloft and the new Paxil are reducing the

stress amazingly well with virtually no side effects.

Conversely, stalling off treatment plants a costly time bomb in

victims.

As indicated by Holocaust victim analysis, post-traumatic stress

disorder

creates a chemical imbalance not only in the victim, but passes the

imbalance on to succeeding generations. The initial cost may be

hidden,

but comes due in succeeding generations.

Berlin agrees that the victims of 9-11 need immediate treatment, but

he feels that "in the first knee-jerk gush of sympathy after the

World Trade Center bombing, companies with the best of hearts adopted

some terribly wrong methods." Typically, mental health problems

in the corporate community have been handled in group sessions. While

this has some merit by addressing the problem, it frequently delays

treatment.

"You would not invite all those who had suffered back trauma out

on the loading dock to come in and talk the situation over," says

Berlin. "You’d get the individuals some fast, one-on-one,

professional

help. The same should be done with those facing emotional trauma."

The Americans with Disabilities Act linked with the New Jersey Law

Against Discrimination form a united barrier protecting workers

afflicted

with physical or mental handicaps. Legally, an employee who is

disabled,

perceived as disabled, or who has a disabling history (e.g. recovering

from substance abuse), must be able to return to his job without

prejudice.

His employer must also make reasonable accommodation for his

disability.

This baffles most employers. The legal ramifications of handling

over-stressed

workers are vague, but the spirit is common sense. "Treat them

as a worker returning healed from a broken leg," advises Berlin.

"It may be counter intuitive, you may want to walk on eggshells

around them, but use common sense and react normally."

The scope of the explosions of September 11th may be comparatively

minor when set against the air raids of hundreds of cities during

World War II. But this one certainly struck hard into the national

psyche. Not because we were unprepared or weak; if anything we had

taken too great a refuge in our strength. Our trauma, collective or

individual, did not spring suddenly from the destruction alone. Rather

it is layered heavily upon a lot of other problems we had not quite

gotten around to addressing. Let us hope we can use this event to

address them now.

— Bart Jackson

Corrections or additions?

— the web site for U.S. 1 Newspaper in Princeton, New Jersey.