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FROM THE EXECUTIVE DIRECTOR Joseph Geliebter,  Ph.D. 2 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 Thoreau’s 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, daily—children 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! Sincerely, 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. It’s four months after September 11th. Since then we’ve 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- matic reactions. 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 therapy—primarily 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 Sertraline’s 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 most destructive in preventing… Editor-in-Chief Joseph Geliebter, Ph.D. Managing Editor Leah Schlager, MA, MBA Contributing Editors    Deborah Eisenberg, MS, PT; Beth Friedlander, M.Ed.; Mari Lazar; Darcy Wallen, CSW Contributing Writer Elisheva Schlam Photo Editor Ivan Norman Credits Artwork - Page 1 Reprinted with permission from AMIT magazine,  Winter 2002 issue. www.AMITchildren.org © 2002 Comprehensive Network, Inc.