NEWSWEEK: When something like this happens, what kind of emotions can it trigger?
David Spiegel: Well certainly it can, will—and it did in me—trigger memories of 9/11, and you wonder, “Is it another terrorist attack?” It tends to get you back in the frame of mind that you were in when 9/11 happened, so it’s a lot of anxiety and insecurity and wondering what’s going on. It’s a recognition of how vulnerable you are. It does give you the feeling that you’re not safe anywhere, and I think it understandably makes people anxious.
Is there any way for a person to stay calm or not freak out when something like this happens?
That wouldn’t be the way I’d approach it, frankly. There are times when you shouldn’t be calm—our anxiety, our arousal systems are there for a reason. You know, we’re not very big or strong or fast creatures, and so when we’re threatened we need to get ourselves aroused to respond, to get out of harm’s way. So, there’s nothing wrong per se with being anxious when a situation like this happens, it’s more, what do you do about it? What I tell people is not, “Don’t be anxious.” It’s how to be anxious. It’s how to worry. And if you worry in a way to further address what’s going on and to figure out what to do about it, that’s a constructive thing.
Is it sometimes better not to watch coverage of these types of events on TV?
Well, obviously you’ve got to know something. But I think it’s better not to overdose on it. I’m a physician. I’ve seen a lot of blood and gore. I’ve worked in emergency rooms, but there came a point after 9/11 when I could not watch the plane hit the World Trade Center anymore. I just couldn’t stand to watch it—so I turned it off. Too much of what we get in these emergencies is these intense visuals of horrible things happening and not enough information about what to do, how to respond, what it means.
What’s the effect of that?
You’re just getting repetitively exposed to something that leaves you feeling even more helpless. The essence of trauma is helplessness, and what you want people to do is find something they can do about the situation.
Would you say people sometimes underreact in these types of situations?
A lot of times people underreact. I mean, if you saw the film about 9/11, these poor firemen in the building, they didn’t get it—they thought they were there to get people out of the building, to put out the fire. It took too long for them and their commanders to realize those buildings were going down, and all they could do was get the hell out of there. And a lot of people died in the World Trade Center because instead of saying, “This is a horrible situation, get the hell out,” they were told to go back up to their offices. In general, it’s not that we get anxious, it’s that we don’t get anxious enough when we ought to be.
What’s the main thing people should remember in dealing with the stress of a tragedy like this?
I think the main thing is that this is understandably upsetting. It’s horrible for the people it happened to, and it stirs up memories for everyone. The fact that people are made anxious by this is not by itself a bad thing. If you find yourself overwhelmed, if you can’t stop thinking about it, if you can’t sleep if it gets to the point where it’s really impairing your ability to function, then you may need some help in dealing with it.
What should people tell their children in this case?
It scares children, and to pretend there’s nothing wrong or to hide it from them is a mistake. Kids have very keen antennae for emotion. The best thing to do is just to sit down with them and help them make sense of it at a level they can understand, depending on their age. But it’s OK to say, “Mommy and Daddy are worried about this, too, but we’re going to do everything we can to protect you and here’s what happened.” Make them a part of what’s going on.
For someone who suffers from PTSD after 9/11, what can something like this do?
Well if you’ve had PTSD in the past or if you still have it, you’re at higher risk for getting it again even with a lesser trigger.
What are some of the symptoms of PTSD?
There are three classes of symptoms. The first are what are called intrusion symptoms, things like nightmares, flashbacks, feeling as though it’s happening all over again. It’s intrusive thoughts—you can’t get it out of your mind. You know, you want to go do something else but you can’t stop thinking about it. The second are what are called avoidance or numbing symptoms. You find that you are trying to keep yourself from thinking about it, you avoid going to places that remind you of the traumatic event, you feel numb, you can’t enjoy things you used to. And some people have literally trouble consciously remembering aspects of the event. The third type are what are called hyperarousal, irritability symptoms. You find yourself being irritable, you jump at a loud noise, you’re restless, you don’t sleep well, that kind of thing.
Tell me about your findings when you studied the posttraumatic stress levels in people after 9/11.
We found that people who were emotionally open, cognitively flexible and socially supported did better. So if you were less trying to sort of pretend everything was fine and act like you weren’t angry, fearful or sad, if you had people around you, if you had bigger social networks where people would let you talk, you did better. If you were flexible, if you were willing to say, “This causes me to rethink my goals and values in life”—other than people who just wanted to go back to the way it was—tended to do better.
