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.
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
(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.
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
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