Joseph Geliebter, Ph.D.
Holidays, birthdays, weddings, and
life-cycle milestones now serve to
highlight the profound changes that
have taken place in our city and our
country since last year. Many may find it difficult to celebrate at
a time when thousands of families are still grieving. Adding to
the unease is the specter of biological and nuclear terrorism
no longer a frightening plot of a science fiction novel, but a
terrifying new reality.
This special edition of The Comprehensive Network
Newsletter is intended to provide our caregivers and educators
with information that will help them cope with this national
tragedy. Our thoughts are with the nation as a whole, espe-
cially with our own administrative staff members and consult-
ants who were directly affected by September 11. We all need
to recognize the value of each day, each relationship and each
experience. One letter writer, commenting on the Portraits of
Grief that appeared daily in The New York Times in fall 2001,
wrote that she disagreed with Thoreaus statement that most
men live lives of quiet desperation; rather, she wrote, after
reading the biographies of the missing, she felt that most of us
live lives of quiet inspiration.
Our collective sense of reality and definition of normalcy
has changed. But day-by-day, our lives of quiet inspiration
go on. We at Comprehensive Network are especially proud of
our affiliated professionals who went beyond the call of duty.
On September 11 many stayed at schools late into the evening,
comforting children until they were picked up. Others
helped the City by volunteering at local hospitals and at
ground zero. Several of our nurses helped the City by
administrating flu shots to ground zero workers. By volun-
teering their services Comprehensive consultants lived up to
our motto, Where caring counts.
There are few careers as gratifying as your own, in the
healthcare and educational professions. You meet with heroes,
dailychildren and families struck by tragedy, disability, and
incomprehensible heartbreak who bravely acknowledge their
reality and then somehow reach beyond it. As professionals,
you know better than most that the subtle changes can
sometimes have the greatest impact. I have always been proud
of our profession; and today, I am prouder than ever!
by Leah Schlager
Dr. Geliebter and several Comprehensive staff members recently at-
tended a national mental health professional conference which focused on
Post-traumatic Stress Disorder (PTSD). One of the presenters, Dr. Judith
Guedalia, stood out from the rest because of her first-hand experience with
PTDS victims. The following is a digest of her presentation, A Neuropsycho-
logical View of Trauma and PTSD. Judith Guedalia, Ph.D., is Director of the
Neuropsychology Unit and Psychological Consultant of an ER Trauma Team
at Shaare Zedek Medical Center, Jerusalem, Israel.
Its four months after September 11th. Since then weve learned a great
deal about ourselves and the extent to which we feel threatened, both as a
nation and as individuals.
Although the initial acute trauma may have passed, some of us may be
experiencing what is referred to, in psychological terms, as post-traumatic
stress. In this phase, diagnosed at least a month after the event, the trauma-
tized are in a constant state of low level fear. This emotional, behavioral and
cognitive state is exhibited by either hyperarousal or numbing of responses,
intense emotional reactions, sleep problems, learning difficulties, memory
disturbances, dissociation, aggression against self and others, and psychoso-
These stress responses can be stirred
by experiencing stimuli from the body,
brain or environment. Visualization of the
trauma, sounds, smells or tastes that are
similar to the initial experience can be
traumatic and bring on any of the above
responses. The presentation of symptoms
may differ between men and women.
Whereas women are more likely to have
symptoms of numbing or avoidance and
accompanying mood and anxiety disor-
ders, men are more likely to have associated features of irritability and
impulsiveness and concurrent substance use disorders.
Similarly, children who suffer from abuse, neglect or other forms of
trauma may present symptoms that differ along gender lines. Whereas young
males may exhibit aggression, impulsivity, verbal abuse or combativeness
and are more likely to be referred for therapy, young girls often become
dissociative and depressed and are more likely to be ignored. Regardless, we
must recognize that children too suffer from forms of PTSD. The persistent
myth that children are resilient can be most destructive in preventing our
children from receiving the help they need.
WHAT ARE THE TREATMENT
OPTIONS AVAILABLE FOR PTSD?
The most effective tool for dealing with individuals that are exhibit-
ing signs of PTSD is short-term therapyprimarily cognitive behavioral
therapies. There are experimental techniques, like EMDR or hypno-
therapy that have shown signs of being beneficial in the treatment of
PTSD. Certain medications can also be useful in dealing with the anxiety
that accompanies PTSD. Dr. Guedalia stated, Research has demon-
strated Sertralines efficacy in the treatment of PTSD especially in women
and non-combat induced PTSD.
PTSD IN THE
AFTERMATH OF 9.11
Cont. on page 7
The persistent myth
that children are
resilient can be
Joseph Geliebter, Ph.D.
Leah Schlager, MA, MBA
Contributing Editors Deborah Eisenberg, MS, PT; Beth Friedlander, M.Ed.;
Mari Lazar; Darcy Wallen, CSW
Artwork - Page 1 Reprinted with permission from AMIT
magazine, Winter 2002 issue. www.AMITchildren.org
© 2002 Comprehensive Network, Inc.