By Sue Landry
InteliHealth News Service

Terrorist attacks in New York and Washington on Tuesday shattered this nation's sense of safety, throwing people across the country into a kind of collective grief tinged with fear and anger.

People are scared, anxious, tense. Children may have trouble sleeping, and if they do sleep, they may have nightmares. Co-workers may be edgy and snappier than usual. Anger may cause people to lash out.

It's as if the nation as a whole is and will be experiencing a level of post-traumatic stress syndrome, says Jacqueline Olds, M.D., child psychiatrist at McLean Hospital and Massachusetts General Hospital, associate clinical professor of psychiatry, Harvard Medical School.

"In our own feelings, we have to appreciate how traumatized we are and that there are ways in which we are not going to take safety for granted for a long time," Dr. Olds says. "We are a traumatized nation. This will cause flashbacks for a long time."

What happened is "total horror," says Joseph A. Rogers, president and CEO of the Mental Health Association of Southeastern Pennsylvania. "They've hit the heart of our country in many ways. We are all connected to New York and our capital and the fear is great."

The nation seemed to come to a halt as word of the terror in New York began to spread just after 9 a.m. People remained glued to televisions, radios and Web sites as the extent of the terror unfolded. Two planes slammed into the World Trade Center towers in New York, a plane crashed into the Pentagon in Washington, and a fourth plane crashed in western Pennsylvania.

As hundreds of firefighters and police rushed to help victims at the World Trade Center, the two towers collapsed in gigantic piles of steel and concrete and glass, sending clouds of choking smoke billowing through streets blocks away. Uncounted numbers of people died.

The grief and fear, of course, are most intense for people who have friends or relatives who died or are unaccounted for. But others will be feeling a wide range of emotions that could last for several days, said Martin Franklin, Ph.D., clinical director of the Center For The Treatment And Study Of Anxiety at the University of Pennsylvania School of Medicine.

"I don't think you need to necessarily know someone personally to empathize and feel the loss and to feel that scared," he said. "I think people's sense of danger right now is intensely heightened and I think that's extremely common after something like this. Collectively, it wouldn't be surprising at all if people feel really scared and threatened for a while and also if they feel really angry."

What people are feeling in the wake of this tragedy represents the early stages of grief, says John Fairbank, Ph.D., associate professor in the Department of Psychology at Duke University and the Department of Psychiatry and Behavioral Sciences at Duke University Medical Center.

"I look at the folks around me here, it's a range of feelings from disbelief to denial to anger," says Fairbank, who is immediate past president of the International Society for Traumatic Stress Studies, Chicago.

"I know that I'm numb. I think that's a fairly common reaction," he says. "I'm aware of the fact that this is really horrible, and I'm not reacting to it yet. I would imagine that at some point it's going to hit me that a member of my family could have been in that building or on that plane."

The intensity of the feelings could be worse since people, not nature, caused Tuesday's disasters.

"The research seems to show that the reaction to human-caused trauma tends to be worse than when it's an act of god," Fairbank says.

That fact also will lead to anger, sometimes intense.

"I think there's a fury in America about the idea of somebody using our planes to collapse our buildings," says Harvard's Dr. Olds.

Americans, she says, are good at dealing with disasters, like hurricanes and fires. But this is different. " One of the psychological goals of terrorism is to make sure that Americans don't feel so invulnerable and I think that has been achieved. This right-angle turn has occurred so that Americans no longer have that sense of invulnerability."

The anger that people are feeling has no target because we don't know who the terrorists are yet. Because of that, "people may sort of get mad at other people in their environments," says Franklin of the University of Pennsylvania. "There's going to be sort of a sense of hyper-vigilance about threat. I think it's important in something like this that we all realize that people are going to be tense and that we cut the other person some slack."

In the coming days, weeks, and even months, the nation will be going through a grieving process, not unlike the grief someone goes through when a loved one dies.

"We do know how people have responded to other disasters. There is both an individual sense of fear, loss and grief, and a collective reaction — a collective narrative that's being written right now," says Joshua Miller, Ph.D., associate professor at the Smith College School for Social Work. "Inevitably, we'll move from the initial reactions to a sense of sadness and mourning, perhaps depression, both individually and collectively."

Not everyone will react the same way. Some may feel the need to be glued to the television and talk to family and friends. Others may want to be alone. Many may feel the need to get away. All that is normal, Rogers says.

"We live in such a high-paced, media-rich environment that things like this build, one upon the other," he said. "We get immediate pictures of the horrors as they unfold.

"You get glued to the TV," he said." The pictures are very real and they make a real impact on the body and the emotions." So, people should feel they can take a break. "They have permission to shut the TV off. Go hug a loved one, read a book."

For more information on posttraumatic stress disorder, click here. InteliHealth staff writers Lisa Ellis and Stephanie Whyche contributed to this story.