Planning for the Anniversary of September 11, 2001

A Guide for Employees

Although five years have passed since the terrorist attacks on September 11, 2001, the effects still linger on for many. While for some people, the anniversary of 9/11 serves as a time to remember and honor those impacted by the events, others seem barely affected. Yet others are bombarded with strong emotions as they are flooded with reminders of grief and loss.

CIGNA Behavioral Health created this digest to help individuals prepare for the anniversary of 9/11, and to help them deal with any feelings that may arise as a result of the anniversary.

Common Reactions to Tragedy — What to Expect
People react very differently to a traumatic event such as 9/11. Not everyone will experience difficulties surrounding the anniversary. Those who were most directly impacted are more likely to experience emotional distress than those were not directly affected. People most likely to be affected:

• Were in actual physical danger or believed they were in danger at the time of the attacks.
• Lost loved ones as a result of the attacks.
• Witnessed other people killed or injured in the attacks.

However, because 9/11 was such a large-scale and tragic event, even those not directly impacted may have some difficulties dealing with their emotions surrounding the anniversary.

Some of the most common reactions that are experienced following a tragedy include*:

• Nightmares or flashbacks of the event.
• Physical reactions such as stomachaches, headaches, or nausea.
• Emotional distress (for example — social withdrawal, irritability, extreme sadness or fearfulness).
• Increased arousal or hyperawareness.
• Decreased sense of safety.
• Avoidance of anything associated with the event.
• Difficulty sleeping and concentrating.

*This list in not all-inclusive; symptoms differ by individual.

It is important to know that if individuals are experiencing any of these reactions, it does not mean they are "abnormal", or weak. Perfectly healthy and well-adjusted people experience reactions such as these as a result of exposure to a traumatic experience. The severity and duration of the reaction the individual has depends on a number of different factors. These include:

• Life experiences prior to the trauma.
• Personal resiliency and coping skills.
• Involvement/losses associated with the event.
• Physical proximity to the event.
• Type of help received following the trauma.

How to Deal with Intense Emotional Reactions to the 9/11 Anniversary
As mentioned earlier, some people may have more intense reactions surrounding the 9/11 anniversary than others. For example, they may experience panic attacks, crying, profound sadness, and/or confused thinking.

Because people have very different feelings and reactions to the 9/11 anniversary, how they can best deal with their feelings will also be different. Following are some tips that can be used to better manage the stress surrounding this anniversary. Keep in mind that not all of these strategies will work for everybody. It's important for everyone to find what works for them.

Helping yourself

• Acknowledge your feelings. By pretending they don't exist, it will only set you up for further upset in the future.
• Get some support. Talk to trusted friends or family members, or others who are in a similar situation and can provide you with support. Avoid withdrawing from others.
• Take care of yourself. Eat healthy and make sure to get plenty of rest.
• Keep yourself busy. This will help to distract you from focusing too much on painful memories.
• Take part in commemorating the anniversary (for example — donating to charitable organizations, helping others, taking part in family activities).
• Practice relaxation techniques.
• Find positive ways to release your emotions.
• Avoid the use of drugs and alcohol. While they may seem like a "quick fix", they only result in postponing and prolonging healing.
• Avoid or minimize your exposure to media coverage regarding the anniversary if you find it causes undesired feelings to resurface. Be aware that by exposing yourself to media broadcasting graphic images and emotional stories, you may feel as if you are "reliving" the event, and experience the same kinds of stress reactions you had to the original event.

Helping others
Employers and employees alike should be sensitive to the fact that others may have difficulty coping with the anniversary of 9/11. It's important to keep in mind that you may not be fully aware of the ways in which your co-workers were affected by the terrorist attacks. Below are some tips on what you can do to support your fellow co-workers.

• Be patient and flexible.
• Be tolerant of opinions that may be different than yours.
• Practice active listening if your co-worker expresses their feelings.
• Problem-solve with your co-worker around work-related challenges.
• Encourage them to contact their Employee Assistance Program (EAP) if they need further support.

Dealing with fears — The Fear of Flying
Because airplanes were involved in the 9/11 terrorist attacks, many Americans feel hesitant about flying. The following are some points for those who fly to keep in mind:

• Know that it's normal to be afraid of flying in the wake of terrorist attacks and ongoing threats. However, make sure to remind yourself that the federal government and airline industry are going to great lengths to ensure your continuing safety.
• Consider alternatives such as teleconferencing, video conferencing, on-line meetings, or travel by car, bus or rail. Along with avoiding stress, you may also save yourself some money.
• If you do fly…
  • Accept your feelings of anxiety. Don't fight your feelings, but do resist negative thinking. Don't dwell on thoughts or images of the worst.
  • Bring something to keep you occupied — for example, a book, laptop, or portable DVD player.
  • Don't delay getting back into the air. It won't get any easier, and may get harder as a result of avoidance.
  • Relax. Take slow, deep breaths if you begin to feel nervous. Repeat something reassuring to yourself, such as, "I must relax, I'll be okay, I've done this many times before."
  • Give yourself extra time at the airport, taking into consideration extra security measures so you don't add to your anxiety.
  • Keep in touch with loved ones frequently while traveling — to calm both you and them.

Finally, if the fear persists despite your best efforts, seek the help of a mental health professional. A call to your Employee Assistance Program (EAP) is a good place to start.

Helping Children Cope
The events of 9/11 reminded many of us that the world is not always as ideal of a place as we may like it to be. Particularly for young children, this reality may have come as quite a shock. Perhaps you are wondering what you can do to help your child to maintain loving and compassionate qualities in the face of continued violence in the world. Following are some suggestions:

• As the anniversary approaches, limit your child's exposure to broadcast news media. It can be confusing for young children to repeatedly see images replayed — they often don't comprehend that it's a replay, and may react as if it were happening anew.
• If your child has questions, answer them honestly. Talk to your child about what they are seeing.
• Encourage your child to learn about people from different cultures. You can help your child develop empathy by exposing him/her to other ways of life and points of view. Teach your child not to discriminate.
• Share stories about the heroes and volunteers that have helped out with the 9/11 tragedies with your child. Remind your child that not all people are "bad", and that those involved in terrorist attacks were a small, non-representative group of individuals.
• Give your child the opportunity to help others. One person can make a difference, so help your child come up with ways on how they can help out in your community.
• Reassure your child that you they are in a safe and loving environment.

Moving Away from Stereotyping and Towards Respect
Since 9/11, we have seen and heard reports in the media about an increase in incidents of discrimination and intolerance based on people's religion, ethnicity or national origin. Continuing events in the Middle East may have increased this trend.

It's important to keep in mind that the events of 9/11 were committed by a small group of individuals who are in no way representative of all people within their ethnic group. We must be vigilant to keep our dignity, tolerance, and sense of fairness during these difficult times.

When conflicting opinions on political, religious, and cultural issues are deeply felt, it can lead to stereotyping and expressions of anger, hostility, and even violence. When expressed in the workplace, the result is unsettling for everyone, and it can seriously disrupt the workflow and culture of an organization.

Below are some guidelines to ensure that anger is not expressed in inappropriate ways, and that employees and customers are not discriminated against, intimidated or offended:

Guidelines for Respect in the Workplace

• Recognize that it is natural for employees to have a range of strong emotions about these events. These can include everything from disbelief and sadness, to anxiety and anger. Practice tolerance for others and keep in mind that how they were affected by 9/11 may be very different from how you were affected.
• Acknowledge that it is normal for employees to want to discuss their feelings and opinions with their co-workers. However, any such expression must be within the bounds of appropriate workplace behavior.
• Do not take part in inappropriate communication such as discriminatory remarks or actions, graphic descriptions of revenge; or any other activities that could be considered to be offensive or in poor taste.

Although anniversaries of traumatic events can bring about a flood of unwanted feelings, they can also be a positive way to acknowledge your feelings and to commemorate those who were involved in the event.

The important thing is to be able to find a way to express your feelings in a way that works for you — perhaps by observing the national moments of silences, by talking about your feelings with others, or by keeping yourself busy. If you or someone you know is having difficulty dealing with emotions surrounding the anniversary of 9/11, contact your mental health provider or your Employee Assistance Program (EAP).

This material is provided by CIGNA Behavioral Health, Inc. for informational/educational purposes only. It is not intended as medical/clinical advice. Only a healthcare provider can make a diagnosis or recommend a treatment plan. For more information about your behavioral health benefits, you can call the member services or behavioral health telephone number listed on your healthcare identification card.

CIGNA Behavioral Health, ©2006