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Trauma, Revisited

As we approach the anniversary of the September 11 terrorist attacks which affected all of us, people in the country and around the world will be reflecting on that trauma. Trauma is a negative event of loss that overwhelms us, that sails past our best defenses and leaves us feeling victimized and temporarily helpless. It is usually sudden, taking us by surprise even if on some level we might have been expecting it. It damages us in a way that leaves us wondering if we’ll ever be the same.

Typically, anniversaries trigger vivid memories and feelings associated with the original event, whether positive or negative. For example, a wedding anniversary can bring back memories of young love, family, friends, and the anniversary of a graduation can recall feelings of self worth, accomplishment, and the joy of old friends. But the anniversary of something negative, like the events of September 11, can bring back feelings of insecurity, anxiety, depression, loss, and fear, sometimes with an intensity that mimics the reactions to the original event. These anniversaries can also remind us of every loss we ever had to face.

In my psychotherapy practice, I have observed clients having these feelings for weeks before the actual anniversary of a trauma. When one of my clients has trouble staying sober in recovery, feels a little extra “on edge”, sees old symptoms return, or something just seems a little “off”, I will ask if the anniversary of something negative is near — the answer is usually yes. This year, in early September, I will look for those signs in everyone. This time will require us to identify sources of support and be especially patient with ourselves.

The anniversary date of someone’s diagnosis of HIV can have a similar effect. I was diagnosed with HIV on Saturday, November 3, 1990. I can’t remember my cousins’ birthdays, but each November 3, I remember much of that day at the free clinic. I remember where I parked, whom I saw after my clinic appointment, where I ate dinner, and even the video I watched (“Tales from the Crypt”) that night with my best friend, trying to get my mind off of what I learned that day. All of this was nearly 12 years ago, and most weeks now I can’t remember what I had for dinner on Friday night by Monday morning. I’ve heard similar stories from my clients living with HIV over and over again; they all remember the date of their diagnosis.

I have a framed print on my bedroom wall that is a picture of a small portion of the wonderful NAMES Project AIDS Memorial Quilt. Occasionally, I look at my print and read the panels — not to depress myself, but to remember and honor people that I never knew who were the early fallen soldiers in the fight against AIDS. I wonder what they would think about the current fight against HIV if they were alive today. I think about the friends lost who aren’t on the print, but who are represented on the larger quilt today. I think of the many people who are gone, who didn’t have loving friends or relatives to make quilt panels for them; I think I mourn them most of all.

After September 11, when the country was gripped in fear, anxiety, and dreadful uncertainty, a friend of mine (also positive) responding to the national mood said simply, “Welcome to my world”—meaning that people living with HIV and those around them have been dealing with fear, anxiety, and uncertainty probably since the day they were diagnosed. But just as there is a response to terrorism, from military action to relief efforts to political negotiations, there is a response to HIV. Responses to trauma are called coping.

Coping with trauma, whether initially or when the feelings are re-awakened on anniversaries, involves rallying our resources. Americans coped with September 11 by renewing our commitment to each other as citizens, appreciating our police officers, firefighters, families and friends like never before, learning anew that life is precarious and should be savored every day. Similarly, coping with HIV involves rallying our family and friends, but also paying new attention to our personal health, recruiting our own “rescue” team of doctor, nurse, therapist, pharmacist, masseur, herbalist, clergy, and other supportive providers. It involves developing the tools for coping such as medication, lab tests, nutrition, exercise, self-esteem, social support, and spiritual renewal.

We can’t erase the day we were diagnosed. We can’t erase what happened September 11. But when the scab on the emotional wound is ripped off our hearts once again, we can fight back with our own personal coping – and heal a little more each day after. Just like the memorial planned for the site of the World Trade Center, or the AIDS Memorial Quilt, we recover by understanding that survival is possible, while honoring those who have been lost. Anniversaries can be a sad time of remembrance, but memorializing and renewing our commitment to our personal life goals with joy and meaning can support our recovery.

© Copyright 2008 – Ken Howard, LCSW

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