Surviving Collective Trauma: Between Loss and Renewal

Harriet Pappenheim, Emanuel Shapiro and Jean Owen

On Saturday, January 7, 2006 the Association for Psychoanalytic Self Psychology in New York City presented an all-day conference entitled "Surviving Collective Trauma: Between Loss and Renewal." As opposed to the usual focus on early individual trauma, this conference was focused on trauma as experienced within the family, community or nation. In the words of Harriet Pappenheim, LCSW, a member of the APSP Program Committee and a primary organizer of the conference, "APSP considered this subject of urgent importance since it is no secret to us in New York that there is another 9/11 disaster waiting to happen. If it does, mental health practitioners throughout our city will be part of the community's first line of defense in helping the traumatized. APSP felt it would help to prepare for such a future event by hearing from people who have worked with people severely traumatized by terror attacks."

Our featured presenter was Dr. Esther Cohen, who has done 30 years of clinical work with victims of war and terror in Israel. Dr. Cohen was a vibrant speaker, with the amazing ability to look straight into the heart of darkness, while always looking to encourage the tendrils of hope and renewal. Dr. Cohen's first presentation was "Changing Through Trauma: Multi-Modal Therapeutic Interventions with Survivors of Terror." Dr. Cohen began with an illuminating explication of the paradoxical ways of living that Israelis have learned to deal with chronic trauma: high vigilance combined with business as usual; intense celebrating and enjoyment as well as recklessness; caring and altruism as well as interpersonal aggressiveness, black humor and open public expression of sadness.

Her therapeutic focus was on resilience building, and on the appreciation of the incredible adaptability and growth of human beings, implying both respect for the defensive and coping mechanisms they employ. She spoke of preplanned protective measures like developing and strengthening communication and support networks. She stressed the importance of preserving continuities, such as keeping families together in their homes, crisis intervention, when possible, by familiar figures like teachers and counselors. She thinks that this priority was ignored here in the response to 9/11 and Katrina. Functional continuity is also important: the ability to remain active and helpful, continuing to fulfill one's usual roles. The therapeutic challenge is how to combine empathic understanding with the expectation for coping and continuity.

Dr. Cohen then presented a multi-modal framework for conceptualizing preventive and therapeutic interventions which takes into account belief systems, affective systems, cognitive systems, physiological systems, behavioral systems, reflective systems and narrative systems. How can the traumatic experience become part of one's life story?

Dr. Cohen's second presentation, "Soothing the Wounds of Trauma with Young Children and their Caregivers," was based on a research project in Israel. Play sessions with children from four to seven who had been exposed to the violence of terrorism (and a control group who had not been exposed) were videotaped, some of which were shown to the audience. The study found that, contrary to general belief, very young children are not immune to the effects of trauma. In the play sessions it was found that while the children typically reenacted the painful aspects of their experience, some showed unusual resilience and managed to soothe themselves successfully, for example with protective and care-taking activities. Others lacked self soothing mechanisms and some were so overwhelmed by anxiety and pain that they could not use play to process their experience. Parents were given the videotapes and follow-up work was done to help them understand and deal with their children's problems. If indicated, children were referred for therapy.

The discussant was the noted self psychologist Dr. Anna Ornstein, herself a survivor of the last century's greatest terror attack, the Holocaust. Dr. Ornstein was the perfect commentator as she, too, has always looked for the tendrils of hope and renewal in her work with victims of extreme trauma.

The afternoon featured a prestigious group of trauma specialists, organized by Emanuel Shapiro, PhD, reporting on their work during the aftermath of 9/11. Drs. Cohen and Ornstein joined the panel. Meg Kalman-O'Connor, LCSW, BCD, described her work as a counselor with a disaster medical team which enters disaster sites to provide medical relief to survivors. Richard Beck, LCSW, BCD, discussed how trauma impact requires the therapist to identify, manage and understand complex relational dynamics. Suzanne Lachmann, Psy.D, who counseled firefighters, fascinated the audience with her journey from her first days when her prospective clients left the room when she entered, to her full acceptance into their ranks. Jeffrey Kleinberg, PhD, an organizational counselor, found that by absorbing the trauma of their constituents, many organizations experienced ongoing pervasive stress that resulted in functional regression with a tendency toward insecurity, defensiveness, isolation, burnout, and attrition. Finally, Michael Andronico, PhD, led a widows' group involved with strengthening the widows' defenses to enable them to bear the powerful feelings of loss. Telling the stories of their lives and losses and having them witnessed was a reparative ritual involving the "healing of memories." The five presentations provided a perspective on the varying types of trauma work that can be provided following a major disaster.

To order audio tapes of this conference send a check for $20 to APSP - 215 E. 79th Street, Apt 13C, New York, NY 10021.

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