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After the Crisis

Natalia J. Garland

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Almost immediately after the September 11th attack, some New York City businesses were providing crisis debriefing for their employees. Some companies contracted with a mental health crisis firm known as C.M.I. (Crisis Management International Inc.). This firm is based in Atlanta, and is able to mobilize trained mental health counsellors nationwide in response to catastrophic situations. Each counsellor gets paid $640 to $800 per day. C.M.I. was hired by approximately 300 companies after the September 11th attack.

Single debriefing sessions are conducted with groups of 15 to 20 employees, and attendance is mandatory. Since debriefing is not therapy, there is no confidentiality as we usually know it, although C.M.I. states it is protective of their clients' names. The purpose of debriefing is to validate feelings and normalize reactions, provide education about stress, point out symptoms that might require further counselling, enable employees to return to normal work as soon as possible, and prevent more severe mental health conditions from occurring.

The founder of C.M.I. is Bruce Blythe. In the December, 2001, issue of Fast Company magazine, he was quoted as saying, "We focus on the human side of crisis. We bring order out of chaos. We want to keep people out of psychiatrists' offices and drug stores. That's our mandate."

There are three areas of concern which I would like to address in response to Blythe's statement. (1) The benefits of psychotropic medication in psychotherapy treatment. (2) The inherent value of psychotherapy, including long-term treatment, and including supportive therapy and personal growth therapy. (3) The likely reality that the September 11th horror will result in severe and/or ongoing stress for many people, including for some who were not even present at the actual site.

(1) If the goal is to keep people off psychotropic medication, then the underlying message seems to be that it is in some way wrong to be on medication, that medication is a bad thing. It seems to be implied that the survivors who need medication are somehow inferior to those who are getting along without it. That would be judgmental. People have different levels of mental health. Some people are going to have a more difficult time processing the events of September 11th and functioning in a nation on high alert.

Anti-depressant or anti-anxiety medication may be the path to alleviating symptoms and returning to work. For these people, the proper use of needed prescribed medication has to be looked upon as a good thing. People are not going to have hope for themselves, and will probably risk medication non-compliance, if mental health professionals have a poor attitude toward psychotropic medication.

(2) Therapy need not be regarded as something only for people who are traumatized. If the employees who participated in the debriefing sessions felt they benefitted from it, perhaps they could gain even more by continuing with a therapist of their choice. After the crisis situation and beyond emotional stabilization, there is still the necessity of day-to-day survival in a changed world and the quest for purpose and meaning. Especially for those who incurred the loss of family members, co-workers and friends, establishing renewed values and priorities could be facilitated by a good therapist.

(3) It would seem very likely that many people will require emotional and spiritual help as a consequence of September 11th. The terrorist attack was life-altering. Nationwide there are signs of patriotism, positive defiance, strengthened unity and identity as Americans. However, there is also tension, anticipation of the next attack, financial hardships, and a general human condition of grief. We will never forget. If some people need a helping hand, and if others can extend a helping hand, then together we will rebuild the self and the nation. (Written 02/04/02: bibliography available.)

Until we meet again..............stay sane.

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Copyright 2002 Natalia J. Garland