People.com Archive Learning to Cope By L. Jay Koch and C.J. Peters Published on October 29, 2001 12:00 PM Share Tweet Pin Email Anthrax spores turn up in the mail of Senate Majority Leader Tom Daschle, and tours of the Capitol are halted. The 7-month-old son of an ABC News producer is infected by the deadly germ—possibly during a visit to the network’s offices in New York City. The bombing in Afghanistan intensifies, and the ground war looms closer. To a nation already on edge from the Sept. 11 attacks, it’s no wonder we are experiencing an unprecedented degree of apprehension. And yet experts say that as much concern as there may be, many of our fears are unfounded—and there are signs that Americans are finding ways to cope. Respondents to a poll on the PEOPLE Web site reflect both trepidation and calm. While not a scientific sampling, the results indicate that 36 percent of the roughly 2,500 questioned say they won’t fly at all or are very frightened of flying since the Sept. 11 attacks, and 63 percent say they are at least a little worried about a loved one being the victim of a biological or chemical assault. By the same token 58 percent report no trouble sleeping and 83 percent say their appetites have not been affected. The anecdotal evidence reflects the mixed picture. At the 110-story Sears Tower in Chicago, security has been beefed up considerably, but many workers remain on edge, fearing that their building could be a target. “I dread coming to work,” says Laura Skillom, 51, an insurance adjuster who works on the 20th floor. “I sit by a window and I’m constantly looking out.” By one estimate, the number of prescriptions for antidepressants was up 16 percent during the last two weeks in September over the same period last year. Yet health and government agencies point out that the threat of anthrax has touched very few lives and that the proper administration of common antibiotics has been effective in halting the bacterium. Also, added security measures have made buildings and airplanes safer. In fact, the number of air travelers has been climbing back steadily each week. Even the stock market, by Oct. 11, had regained much of its gut-wrenching losses. And there is hope the country can emerge stronger from the test. “Terrorism is like a contagious virus and we cannot accept it,” says Prof. Yonah Alexander, director of the Inter-University Center for Terrorism Studies and coauthor of the bestselling Usama Bin Laden’s al-Qaida: Profile of a Terrorist Network. “We have to show that we are not going to be intimidated. We cannot become Fortress America.” One of the best ways to avoid that is to continue trying to regain some degree of normality. “I’m not going to alter my life because of what the terrorists have tricked us into believing—that everywhere we go, we’re going to get hurt,” says explosives expert John Boyden of Pukalani, Hawaii. “Just be alert. Keep up with the news. You can be informed and not paranoid.” With that in mind PEOPLE asked seven experts like Boyden to provide their perspectives on the current fears, with practical hints for soothing jangled nerves. FLYINGNew airline security measures should bring a higher level of protection to American skies L. Jay Koch, 58, is a licensed clinical social worker in Kansas City, Mo., who specializes in treating people who fear to fly. Himself a former white-knuckle flier, Koch overcame his phobia and went on to earn a pilot’s license. Should people be anxious about flying now? People are experiencing fear. Hopefully it does not get to the point that it prevents flight. Because actually—and paradoxically—the threat now from flying is probably less than ever. To that extent the thoughts are irrational. Why are the skies safer now? Number one, the skies are pretty safe anyway. “When you think about it, you have 30,000 planes a day and four planes hijacked. As horrible as that is, the odds are not great. After the incident, all the measures the FBI, CIA and the airlines are taking make it even safer now. All this vigilance disrupts the strategies of the terrorists. They want areas where they will not be detected. I think all this taken together makes the probability that something else is going to happen much less. Why has flying always made people uneasy? That has always been the interesting paradox of flight. Even though it is extremely safe statistically, people perceive it to be risky. There are a lot of reasons for that. It’s partly because if you have an airline crash the world knows about it. The media are not covering every car crash. We don’t think about proportion and probability. Your odds are 11 million to 1 of being in a crash on a commercial airliner. What can someone do who suddenly starts having a panic attack on a plane? One way to block panic is not to get into rapid breathing. So hold your breath for two or three counts and then exhale. Then do it again. Also, you can talk to somebody, distract yourself from the scary thoughts you are having. If you tell people on an airliner that you are really a fearful flier and ask them to talk to you, they always will, especially in this climate. There are lots of cooperative attitudes right now, that we are all in this together. BIOTERRORISMRx for anthrax: knowledge, calm and common drugs As former chief of Special Pathogens at the Centers for Disease Control in Atlanta, Dr. C. J. Peters provided the inspiration for virus hunters portrayed in the 1995 film Outbreak. Now a professor of pathology at the University of Texas Medical Branch in Galveston, Peters, 62, assessed the threats posed by bioterrorism. What is anthrax? Anthrax is a dangerous bacterium that was first documented in 1876. It can survive for decades in the soil, but sunlight will kill it quickly if it becomes airborne. Until recently, when it evidently fell into the hands of terrorists or criminals, it was mainly a risk for animals who ingested contaminated soil and, in rare cases, people who worked with diseased animals or animal products. With anthrax showing up in mail around the country, should we avoid opening letters? No, because we have a system that’s already saving lives. If you find a powdery substance in a piece of mail, put the letter or package down, leave the room, wash your hands and call 911. Hand-washing will keep the anthrax spores from floating into your lungs. You can contract the disease by touching spores, but inhaling it is more dangerous because it spreads from your lungs to other organs. If you’ve been exposed, there are antibiotics—Cipro and even penicillin—which, taken promptly, will keep you from getting sick. Concern for children has heightened since a 7-month-old baby in New York City contracted anthrax. How do we protect our kids? I think we should bear in mind that the child was probably exposed at his mother’s workplace. The threat to children shouldn’t be overstated. All of the anthrax incidents so far have occurred in offices and mail rooms, not in homes, schools and parks. An anthrax vaccine exists, yet it isn’t available to the public. Why? It was not economically viable, and there was never thought to be a compelling public health need. Only one lab produces the vaccine, and it has been shut since 1998 because of safety and quality control problems. And vaccines can cause side effects, such as allergic reactions, that are risks in themselves. For now we can deal with anthrax in the mail without vaccines. How can terrorists get their hands on anthrax or other deadly germs? Some are not terribly hard to obtain. There are veterinary labs in every state that have samples of the anthrax bacterium for research. Someone could just steal some. Smallpox, which is another serious threat, is kept under lock and key at a lab in Russia and one in the United States—as far as we know. But secret stashes are thought to exist elsewhere in the former Soviet Union and perhaps in other countries as well. The danger would be if they put those supplies to use or sold them to terrorists. Weren’t millions of Americans vaccinated against smallpox as children? We stopped vaccinating people in the early ’70s. To remain immune, you need a booster every 10 years. The Centers for Disease Control keep a limited supply of vaccine in case we need it again. Should we worry about our food and water? Water treatment plants remove almost all infectious agents, so I think the public can rest assured that tap water is safe. As for food, we have a lot of protections in place already—inspections, state regulations, that sort of thing—so that a food-borne terrorist event would be detected, traced and dealt with. Are there extra precautions people can take at home? Again, I’d stress that the threat of anthrax exposure has been in the workplace. Unless that changes for reasons we can’t yet foresee, our homes are safe. CHILDRENHonest answers and open ears can help keep kids secure Dr. Flemming Graae, 52, director of child and adolescent psychiatry services at New York Presbyterian Hospital in White Plains, N.Y., has long treated small patients with big worries. After Sept. 11 he and his team offered counseling and evaluation to 25 children, many of whom had family members inside the Twin Towers. What are children likely to be feeling now? Kids always react to a traumatic event like this in terms of the immediate risk to themselves and their loved ones. It’s “Can they drop a bomb on my house?” We should be reassuring and honest, and we should continue to maintain family routines. What warning signs might indicate a child is having trouble dealing with anxiety? Increased difficulty in falling asleep and in separating from a parent, more headaches and tummy aches that don’t have a clear cause, more difficulty in concentrating. Also, the questions they ask can offer clues. A child might ask, “What happens to people when they die?” An expression like that is clearly, “Am I safe? Is my family safe?” What about teenagers? Some teens may have trouble with homework while some may have more problematic behavior such as drinking or fast driving if they’re feeling anxious. We might also expect them to be more vocal and expressive of their views. How can parents help kids cope? We should tell our children that bad people did these things and that many people are making sure that this will never happen again. We want to tell them that their houses and their communities are safe. And we can help our kids do certain practical things, such as taking up a Sept. 11 collection that will allow them to channel their anxiety. What should parents do to help older kids, who may be in school away from home? Be more available and in contact, listen to their opinions about what they’re hearing on I the news and help them find ways to manage I their own distress. Should we tell children about anthrax? We have to give them some practical information about what anthrax is to minimize their imagining catastrophes. But we need to say that only a very few people are affected; it’s not going to happen everywhere. Should parents let kids watch the news? For younger kids, I wouldn’t let them watch news programs except occasionally and in a very supervised kind of way. For older kids a certain amount of watching the news and talking about it is appropriate. Many parents are wondering how to handle Halloween this year. I think it’s best to tone down the scary images. And parents may wish to limit their trick-or-treating to neighbors they know. But Halloween is a normal, fun part of our culture. We don’t have to take away the fun. Should families have an emergency plan? Yes. Reassure your kids that the likelihood of anything happening is very small but that it’s good to be prepared. Make sure you have ways to contact each other. Make sure children know your numbers by heart. Have a backup plan for where your child should go if you’re not home. How do you explain to kids the concept of a war on terrorism? Help them understand that the country needs to defend itself because of this awful event. And explain that all of us can help our country by simply being good to each other. ANXIETYIn a suddenly scarier world, don’t get worried sick A specialist in acute anxiety disorder and posttraumatic syndrome, Dr. Paul Ragan is an associate professor of psychiatry at the Vanderbilt University School of Medicine in Nashville. Ragan, 46, served as a Navy psychiatrist in the Gulf War. Is the nation as a whole suffering from acute anxiety as the result of the terrorist attack? A large segment of the nation is. Because of electronic communications, all of this gets into our living rooms and we can’t help feeling anxious. This attack occurred out of the blue—that is what strikes the most terror. What are the signs of acute anxiety? You may have intrusive memories of the event—you play it over and over in your head and can’t get to sleep. Or you have nightmares. There can be a physical response: an increased heart rate, dry mouth, dilated pupils, intestinal disorders. You can have shortness of breath, a tightness in your chest, difficulty swallowing, even tremors. At what point should a person seek help? The symptoms may be so severe that they interfere with your relationships and your ability to function. Someone might become so fearful that they can’t leave the house or enter a high-rise. Also, be on the alert if you resort to destructive behaviors—increased drinking, for instance. If a few weeks after the terrorist attack your symptoms aren’t toning down, you may have reached a stage that requires therapy. But if there continue to be new frightening events, like the anthrax scare, then high levels of anxiety will be normal. How can people ease their anxieties? Talk about them, at churches, in social groups and especially with the family. People who are the most isolated are the most at risk for developing persistent anxiety disorders. Writing—poems, letters, in a journal—is also helpful. Try yoga or meditation to relax. An active person may need to be out running, dancing or climbing rocks. Or else try to do something you think is constructive—such as giving blood. Can watching the news heighten our anxiety? It depends on the individual. People who are especially sensitive may need to limit TV. But if the news is disseminated responsibly, it’s essential, whether it provides us with the signs of anthrax or quashes rumor and panic. BOMBSWhen it comes to explosives, alertness—and common sense—goes a long way Vietnam veteran John Boyden, 60, has built a reputation as a pioneer in his field, both as the former head of UXB International—the leading explosive-ordnance disposal company he cofounded in 1983—and as the author of technical manuals on explosive removal and safety. What is the likelihood of becoming the victim of a bombing? Very, very slim. Terrorists aren’t targeting the residential areas where most of us live or the places where most of us work. It’s the high visibility places, important landmarks, where they can make an impact. If they were mailing out letter bombs to homeowners, they’d probably blow themselves up more often than anybody else. Are bombs difficult to spot? Bombs can be in any kind of container or package. People should watch for anything out of place or unusual. For example, a car or truck that’s parked in a spot where it normally wouldn’t be for long periods of time, or there’s a package in a building and you don’t know how it got there. In your own small work area if you see something—say, a big briefcase or box—that doesn’t belong there, then you should become concerned. But leave it alone. Don’t disturb it, don’t pick it up. What if you think you see a bomb? Call 911. Let the authorities know about it and get out of the area. Every case is different, so you have to use common sense. But let’s say you’re in an airport lobby or waiting room. If you see a bag sitting there by itself with no one around it, and you think it’s a bomb, don’t start screaming for them to evacuate the entire airport. Just tell the security people and let them check it out. Should people be worried about taking mass transit? Personally I don’t consider using mass transit a concern. You probably have a higher risk of getting run over while crossing a street on a green light than you do of being hurt by a bomb while taking mass transit. Don’t let these people get the best of you. Get back to your life. BUILDINGSHigh-rises often have more safety features than smaller structures Carol Ross Barney, 52, is chief architect of the federal center soon to be built in Oklahoma City to replace the Alfred P. Murrah building destroyed in 1995 by explosives planted by Timothy McVeigh. Should we feel safe in high-rises? The threat to a high-rise isn’t necessarily any greater than to a three-story building. People in tall buildings might even have an advantage or two. For example, most high-rises have sprinkler systems that have been designed to keep you safe until you can be rescued. People should be able to get out in a very short time. In that sense the World Trade towers performed pretty well—up to a point. Can most office buildings withstand bombs? It depends on the size of the bomb, the age of the building and how it was built. We saw the Murrah building collapse, but on the other hand the first time the World Trade Center was bombed, in ’93, it withstood the blast. The construction techniques required in very tall buildings often make them more resistant to movement. How can you make buildings safer? In the Murrah building, a major danger was flying glass. We can make windows that stay in the frame rather than shatter. Then there is the issue of collapse. In Oklahoma City one major column was hit, and thebuilding fell in on itself. You can design buildings so that even if you remove a major structural member, the building will stand. But can you avert all dangers? You can design your house to protect yourself from tigers in the backyard, but do you really want to? Is this really going to happen in your lifetime? You have to figure out what’s realistic. You could build a building that resists all blasts, and it would have no windows. It would be a terrible place to work. The problem isn’t the structure, it’s the situation. In New York, the danger wasn’t the buildings or the plane. It was the people on the plane. RUMORSDon’t fall for frightening tall tales. There are ways to help tell fact from fiction Have you heard? An Afghan immigrant warned his American girlfriend not to fly on Sept. 11 and not to visit any malls on Halloween. That tale—utterly baseless, according to the FBI—is “one of the standard kinds of rumors that will come around in a situation like this,” says Princeton University English Prof. Elaine Show alter, 60, who studied past and present panics for her 1997 book Hystories: Hysterical Epidemics and Modern Media. How do rumors like the terrorist’s girlfriend story get started? We really don’t know. These stories are very hard to track down. But human beings have a strong need to make sense of what happens to us. For example, the idea of a girlfriend being spared credits the terrorist with humanity. In that sense it is a comforting story. But if she existed, you’d see her on the news. How can we tell which rumors to ignore? Know how to read critically. What you look for in any rumor is attribution and evidence. Look for anonymous sources, for unattributed quotes, for sweeping generalities. Those are the top three signs that a rumor has no merit. What should we do when we hear a rumor that contains a warning? Check newspaper and TV news Web sites. They’re constantly updated, and they have been very thorough. If there’s a rumor that authorities believe warns of a real danger, they will tell the media. They won’t be telling a local hairdresser. There are also some good Web sites that investigate rumors. The Internet is both the poison and the remedy—on one hand, rumors are very quickly circulated there. On the other hand, they’re quickly detected. But the media have at times reported rumors that turned out to be wrong. People still need to evaluate what they hear. What’s the evidence? If someone is being quoted, what credentials does this person have? It is perfectly understandable that the media will bring in a wide range of people to comment. But the viewer needs to consider who they are. Do terrorists use rumors as a weapon? They don’t necessarily plant them, but they do profit from them. Terrorists want to demoralize and destabilize, and they want people to distrust authority. Rumors can have all those effects. Right now confidence in government is a necessity for our society—and for fighting back. Updated by Flemming Graae, Paul Ragan, John Boyden, Carol Ross Barney, and Elaine Showalter