Manager’s Journal: Good Grief: Don’t Get Taken by the Trauma Industry

The Wall Street Journal, October 15, 2001

By Sally Satel and Christina Hoff Sommers

Did the Sept. 11 attacks on New York and Washington trigger a national mental health crisis? Many psychiatrists, psychologists and grief counselors think so. They warn that the nation faces an epidemic of depression and post-traumatic stress.

Companies are being deluged with offers from grief counseling firms insisting that their services are vital for the well-being of all employees. The president of the New York Psychiatric Association says that many who watched televised images of the planes flying into the World Trade Center can expect psychiatric problems. Another psychiatrist cautions that witnessing the disaster on TV plus worrying about more conflict “add up to a critical public health challenge for our country.” And, said the president of the National Mental Health Association, “What our country really needs — now more than ever — is a complete mental health infrastructure.”

The good will of these professionals and firms — Crisis Management International, International Critical Incident Stress Foundation, Corporate Counseling Associates, and COPE, Inc., to name a few — is not in doubt. But they exaggerate their own importance. Many individuals — chiefly those directly affected by the atrocities — may well have been traumatized to the point of needing therapeutic intervention. The nation as a whole has not. And managers should avoid the impulse to jump on the bandwagon and automatically contract with crisis counselors to show their sensitivity.

It is true that the attacks filled all of us with powerful, even overpowering, emotions. But as the renowned psychiatrist and Holocaust survivor Viktor Frankl pointed out, “Suffering is not always a pathological phenomenon . . . suffering may well be a human achievement, especially if grows out of existential frustration.” In other words, suffering is often ennobling and strengthening. It is in this spirit that Time writer Lance Morrow recently wrote, “For once, let’s have no grief counselors standing by with banal consolations, as if the purpose, in the midst of all this, were merely to make everyone feel better as quickly as possible. We shouldn’t feel better.”

Nor do all of us need therapy. When asked if he wanted counseling, Richard A. Grasso, chairman of the New York Stock Exchange, replied sharply, “No, I don’t need it. My counseling is this: that Monday morning 9:30 bell.” A story in the New York Times reports that even most school children in New York City are resisting counselors’ attention. “The students are saying, ‘Can’t we just do math?'” according to Dr. Ricky Greenwald from Mt. Sinai Hospital’s Child Trauma Program.

This is not to deny a legitimate place for mental health experts in the tragedy’s aftermath, but their work is primarily local in scope, not national. Epidemiological evidence tells us that between 10% and 25% of those who confront harrowing, cataclysmic experiences — barely escaping death at ground zero, for example — may well develop clinical post-traumatic stress disorder (PTSD) within three months. Symptoms can include marked withdrawal from society, intense re-experiencing of the event (relentless nightmares and waking images), crippling anxiety and phobias. Cognitive-behavioral techniques and medications for PTSD are tested and effective.

Unfortunately, other interventions employed are far less reliable. Practitioners who call themselves “debriefers” are ubiquitous in New York City. They are part of a trauma industry that blossomed in the wake of the Oklahoma City bombing and Columbine shootings. Many saw their job as getting victims to express their feelings about the event — to cry and relive it as vividly as they could.

The worst debriefers can be so intrusive that a group of 19 psychologists sent an open letter to their professional colleagues cautioning that, although “our instinct is to help, it is imperative that we refrain from the urge to intervene in ways that, however well-intentioned, have the potential to make matters worse.” The signatories, among them some prominent specialists on the psychological effects of trauma, cited studies showing that certain crisis intervention techniques that emphasize the release of emotions and reliving the event had either no benefit or were actually harmful because they impeded recovery.

The best bet for managers is to learn the early warning signs of serious mental conditions — not-for-profit mental health agencies can teach them what to look for — and then to refer employees in need of treatment on a case by case basis.

Yet the experts abound. New York City Schools Chancellor Harold O. Levy commissioned a mental health tip sheet from “leading child trauma experts” that he distributed to the city’s 80,000 teachers. Among the pointers: “Avoid cliches such as ‘Be strong.'” But why? Strength and courage are exactly what the country needs. The shadowy enemies we face are difficult to engage. However, their beliefs and intentions are clear enough. They abhor our devotion to a Judeo-Christian ethic, our commitment to Enlightenment principles of human dignity, individual liberty, and resulting economic creativity. With terrorist enemies, we need a clear, forceful response — not therapeutic intercessions.

In a 1943 address at Harvard University, Winston Churchill praised his American allies: “How fortunate it was for the world that when these great trials came upon it there was a generation that terror could not conquer and brutal violence could not enslave.” The good news is that just such a spirit of resolve turns out to be very much alive in America today, despite decades of moral drift.

The sensationalizing mental health professionals and journalists have mistaken the mood of the country. Americans do, indeed, feel a new and dismaying vulnerability, but that feeling should not be confused with helplessness, panic or the need for therapy on a grand scale. What we need — and thankfully seem to have — is a morally galvanized and focused citizenry, not a population turned inward on its alleged psychological fragility.

Dr. Satel is a psychiatrist and Ms. Sommers is a philosopher. They are scholars at the American Enterprise Institute.

(See related letter: “Letters to the Editor: We Simply Respond To Pleas for Help” — WSJ Oct. 25, 2001)