Mark B. Borg, Jr. PhD
Borg, Jr., M. B. (2003). Observations from a World Trade Center Disaster Intervention. The Community Practitioner, 2 (1): 21-25.
RESPONDING TO THE IMPACT OF A DISASTER requires the collective resources of a community, whether it be a neighborhood, town, city, or organization. In this short paper I will present a brief case study of a community intervention that addresses some of the most common issues faced by community practitioners in the context of large-scale trauma. My emphasis here will be on personal/community/organizational resources especially social support and empathy as well as on the willingness to address the personal impact of a disaster on victims, their families and friends, and community practitioners.
The members of the multidisciplinary community crisis intervention team I belong to have expertise in areas ranging from public law to community and organizational psychology to psychotherapeutic treatment. Our consultations during a number of long- and short-term community interventions have primarily addressed the ways in which communities are impacted by acute and chronic trauma. In our work, we have observed that acute trauma often serves as a symptom that, if used skillfully, can help a community diagnose and increase its awareness of more chronic etiologies (Borg, Garrod & Dalla, 2001). The guiding principle that has evolved through previous and ongoing projects is to help communities develop collaborative solutions and strategies for working through trauma, both current and historical.
In the week following the September 11 attacks, we contacted the New York State Psychological Association to volunteer our services. We began a series of weekly meetings to determine what resources were required to sustain a long-term community intervention in response to the crisis. The following week we were contacted by the vice-president of a public service agency that works on housing issues associated with New York's mentally ill homeless population. She explained that 5 of the organization's 30 operational units were in the immediate vicinity of the World Trade Center, and that members of their staff were beginning to display dramatic reactions to the crisis. Many employees had resigned, and those who had not were refusing to commute to Manhattan from their homes in the Bronx, Brooklyn, and Queens; this was adding to the workloads and stress levels of those staff members who were willing to work on-site. The vice-president and her unit managers were concerned with the overall functioning of their organization in addition to the emotional well-being of individual employees.
The unit managers were dividing their time and resources between responding to their employees' stress-related symptoms and trying to maintain an acceptable level of performance in terms of client service. It became increasingly clear that at the same time the managers were dealing with traumatized staff members and organizational problems, they also had personal needs that were associated with the traumatic events of September 11. A number of unit managers had already been in contact with the vice-president to encourage the establishment of a forum to address the disaster's impact on their organizational community.
It was therefore suggested by the vice-president that the unit managers contact our team and make use of our services at times and in ways that they deemed appropriate. We in turn proposed a very general and flexible format for staff participation that reflected several of Zimmerman's (2000) criteria for organizational empowerment: a) staff-initiated decisions on how to organize and facilitate the intervention; b) shared responsibility for initiating, sustaining, and assessing progress; and c) shared leadership in facilitating the intervention and empowerment processes.
We received our first call two weeks after our last discussion with the vice-president. Since then, we have worked with various groups within the agency to identify means for collaboration in achieving their goal of re-connecting with each other and with the larger organizational community. The employees we worked with clearly viewed themselves as members of a community. Yet as much as they came together and helped each other during the weeks immediately following the disaster, many acknowledged a painful severing of affective ties as time wore on.
All 30 organizational units in Manhattan had put in requests for "crisis debriefing" immediately following the attacks. In addition to the 5 in the immediate vicinity of the World Trade Center, a single unit was located near the Empire State Building, which was also considered a prime target for terrorism; these 6 units requested more long-term intervention. Initially, the groups that were formed consisted primarily of African-American and Latino women. They later took it upon themselves to "recruit" their male co-workers, with moderate success. The stated goal for these groups was to understand the impact of the disaster on the organization as a whole as well as upon individual staff members. Much time was spent on identifying symptoms associated with Post-Traumatic Stress Disorder (PTSD). As part of our intervention team's standard approach, we told group members that they would eventually establish more specific goals and agendas as our work continued. One goal that emerged was for staff members to use their attack-related trauma to deepen awareness of the more chronic difficulties that their homeless and mentally ill clients lived with on a daily basis.
During the first six months, intervention team members facilitated one 90-minute group session/week with each of the six units. Average group size was 30, with each session facilitated by 4 practitioners. The group size demanded that we use a combination of large- and small-group formats to examine the impacts of the disaster on individual group members, organizational units, and the overall organization. After approximately three months, average group membership fell to 15 and the number of practitioners was reduced to 2 per group. The staff members told us that they considered themselves to be the representatives of their respective units. The groups were considered diverse in terms of age, ethnicity, and organizational roles (e.g., managers, receptionists and secretaries); as the intervention continued, they became increasingly balanced in terms of gender.
In the first few meetings, many participants described their experiences with emotional breakdowns, with several reporting numerous instances of "unbearable" feelings that were made more intense by their need to provide support for their traumatized clients. For many employees, those demands created a sense of "overload" that preceded breakdown and a need to completely remove themselves from their work environment and consider quitting their jobs. As mentioned above, some of these emotional breakdowns were the result of the workers' chronic sense of daily trauma that was not associated with the September 11 attacks, and therefore the acute terrorist-related trauma actually encouraged staff members to reconsider the empathy they held for their clients' predicaments.
Those staff members who continued to work with our team developed community focus groups based on the goal of reestablishing connections among themselves as well as within the larger organization. Due in part to their collective self-identity as members of a community, staff members were able to tap into aspects of their large-group identity that they had historically relied on for support. They were thus empowered to reestablish their bonds with one another and with their clients, and to some extent establish new bonds with the intervention team members.
Many participating employees found that the intervention process allowed them to confront the impacts of the disaster by helping them create a sense of safety and support within their work environments. This in turn led to the creation of forums wherein they could implement self-defined and mutually supportive solutions to problems associated with the crisis. Group members acknowledged a sense of mutual support in the recovery processes of others as a key factor in their own recovery efforts. The original members of the focus groups were willing to voluntarily initiate and lead similar efforts in other organizational units.
Throughout the intervention, employees have voiced a need for each other and a realization that healing required interpersonal support. As this sentiment developed during group meetings, intervention team members became increasingly aware of the same need among ourselves as we planned our next steps. We discussed how our own sense of collaboration helped us become more aware of the ways that we were impacted by the September 11 attacks. We became increasingly aware that any success in empowering agency employees required that intervention team members become acutely aware of our own reactions to the tragedy. Similar to the unit managers, we were in the position of performing our own job duties while dealing with the personal impacts of a traumatic event. Exploring our own experiences in team meetings reminded us of the need to sustain a critical stance toward our efforts in creating and maintaining and occasionally losing and re-establishing a sense of collaboration among ourselves as well as with members of our respective groups.
After one year, the six groups decided to collaborate on a monthly forum for ongoing discussions of the issues they had raised as well as to perform some outreach work with others who had been affected by the disaster. In addition to encouraging participation by other employees in their organization, group members invited their own clients to discuss their experiences of acute and chronic crises. Group members also scheduled a number of retreats and workshops to share what they had learned; one event was attended by survivors of the Oklahoma City bombing, who described the ways that they and their similarly traumatized organizations dealt with that event. Intervention team members continue to serve as voluntary consultants as needed, and have been invited to participate in the forums and retreats, but for the most part it is the group members themselves who are responsible for managing these projects.
An important area of resistance to the intervention was apparent in both the organizational groups and our own intervention team: the difficulty of giving up our roles as practitioners, facilitators, and helpers long enough to acknowledge our own reactions to the traumatizing event. The agency's overriding purpose is to give help to the homeless and mentally ill, and the guiding principle of the intervention team is to give help to communities undergoing some form of change. Therefore, it was easy for everyone involved in this project to step into the role of "helper" and to dismiss their own support needs as part of their personal and professional/occupational lives. Intervention team members speculated that much of the attrition that occurred early in the project was tied to the use of customary organizational and care-giving roles as defenses against the emotional impacts of the tragedy.
As the acute crisis evolved into a more chronic state of concern over such ongoing incidents as anthrax scares, potential terrorist acts in such enclosed spaces as subway stations, and increased police activity, the sense of urgency associated with service-oriented intervention work began to subside. This change occurred despite our professional recognition that trauma treatment requires long-term patience, persistence, and collaboration (Herman, 1992; Tedeschi, Park & Calhoun, 1998; van der Kolk & McFarlane, 1996). Problems associated with long-term intervention include time and resource (mostly financial) commitments, maintaining emotional investments in goals that require delayed gratification, and uncertainty about the changing compositions of organizations and communities. To this list of issues we must add the need for practitioners to commit themselves to maintaining clear connections with their own experiences of trauma, especially if they are impacted by the same events that affect their clients (Borg, 2002a).
Our intervention efforts have been influenced by the work of Harry Stack Sullivan (e.g., 1940, 1953), especially his idea of participant-observation and his commitment to supporting the indigenous resources of individuals an idea that we have expanded to include the internal resources of communities and organizations. Although Sullivan's interpersonal/cultural theory was specifically designed for use in clinical treatment, we believe his model can be adapted and applied to organizational and community settings (Borg, 2002b; Borg et al., 2001). I contend that when collaboration serves as a framework for community crisis intervention, practitioners are better equipped to confront the above-described tendency to hide behind help-giving roles and to look instead at the ways they have been touched by a traumatic event. By sustaining our own channels of giving and receiving support, members of my intervention team were able to maintain a process in which group members eventually created their own agenda. In the absence of such awareness, there would have been greater potential for the help-giving role to be used as a defense against the sense of frailty that everyone in this project experienced when the towers fell.
In the current context of fighting a "war on terror" and considering the possibility of a military invasion of Iraq, we believe that forums of the type described in this paper are a timely response to the needs of individuals and organizations facing trauma-induced stress. These support systems seem as relevant to us now as they did last September, even though the initial acute crisis has evolved into a much more chronic form. In this particular instance, community intervention work entailed creating and maintaining collaborative processes, tapping into indigenous resources, and sustaining participant-observer stances within our own team, between our team and the organization, among members of that organization, and between organization staff and their own clients. One of the best lessons that emerged from this intervention concerned the efforts of both the helpers and the helped to acknowledge the effects of a traumatic event.
Borg, M. B. (2002a). The Avalon Gardens Men's Association: A community health psychology case study. Journal of Health Psychology, 7(3), 345-357.
Borg, M. B. (2002b). The psychoanalyst as community practitioner. Psychologist-Psychoanalyst, 22(2), 26-34.
Borg, M. B., Garrod, E., & Dalla, M. R. (2001). Intersecting "real worlds": Community psychology and psychoanalysis. The Community Psychologist, 34(2), 16-19.
Herman, J. (1992). Trauma and recovery. New York: Basic Books.
Sullivan, H. S. (1940). Conceptions of modern psychiatry. New York: Norton.
Sullivan, H. S. (1953). The interpersonal theory of psychiatry. New York: Norton.
Tedeschi, R. G., Park, C. L., & Calhoun, L. G. (Eds.) (1998). Posttraumatic growth: Positive change in the aftermath of crisis. Mahwah, NJ: Lawrence Erlbaum.
van der Kolk, B. A., & McFarlane, A. C. (Eds.) (1996). Traumatic stress: The effects of overwhelming experience on mind, body, and society. New York: Guilford Press.
Zimmerman, M. A. (2000). Empowerment theory: Psychological, organizational, and community levels of analysis. In J. Rappaport & E. Seidman (Eds.), Handbook of community psychology (pp. 43-64). New York: Kluwer/Plenum.