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FEAR AND WAR
Over the past two decades, the world has witnessed an
increasing number of disasters involving massive exposure of the
population to radiation, chemical toxins, or other hazardous agents.
Terrorist acts such as that on September 11, 2001 create apprehension
about possible further attacks, perhaps with biological or chemical
weapons. The term "ecological disaster" is used to indicate these
incidents, which are often followed by widespread fear of future adverse
health effects. Concerns or worries about health tend to facilitate the
appearance of medically unexplained symptoms or syndromes. This mental
health component has received relatively little attention in the
disaster literature (Havenaar, Cwikel & Bromet, 2002).
Murphy, Wismar & Freeman (2003) examined stress reactions to the
events of September 11, 2001 among African-American college students not
directly exposed to the attacks. Within 3 days of September 11, 219
undergraduates (78.3% women; aged 18-32.9 yrs) completed self-report
measures assessing stress symptoms and other reactions to the attacks.
The results indicated that many students experienced a variety of stress
symptoms and distressing thoughts and feelings in response to the events
of September 11, including academic problems, concerns about family and
friends in the military, and fear about war. Most students were highly
distressed by specific attack-related news reports and images. Anger
toward persons of Middle Eastern descent was not frequently reported.
Later college year and having parents not currently together were
predictors of overall stress symptom severity as assessed by the
Posttraumatic Stress Disorder Checklist. Later college year also
predicted academic problems after September 11.
Panic and fear appear to have different functions. Starcevic, Kolar, Latas, Bogojevic & Kelin (2002) assessed the impact of real danger on several aspects of panic disorder patients' psychopathology and level of disability. Their results suggest that there is no relationship between panic attacks and real danger and lend support to the notion that panic attacks and fear induced by real danger are different phenomena. Fear interrupts the continuum of memory. Examples of situation-specific amnesia, including severe depression, crimes of passion, disasters, war and child sexual abuse suggest that emotional memories may implicate amygdaloid circuits. In extraordinary circumstances we may ask ourselves to recall far more detail than in normal circumstances (Kopelman, 2000).
Therapists have unique skills that are desperately needed in the prevention of and recovery from violence, war, and terror. They can heal, teach people how to hear and transform, and listen. Recent acts of terrorism and violence on U.S. soil have left citizens, politicians, and professionals asking similar questions. Why did this happen to us? What can we do to keep this from happening again? Witty (2002) provides one answer to those questions by calling for greater involvement of systemic therapists in violence prevention and intervention at home and abroad. Conflict resolution theory, steeped in realism, modernism, and a structural perspective of change, dominates conflict analysis abroad even though it has been largely ineffective. Structural changes in government do not address the fear, anger, and destruction of human relationships generated by war and terror. The transformation of the root causes of war, violence, and hatred lies in integrating the analytical and transformational perspectives of conflict resolution and systemic therapy, particularly the narrative deconstruction of hate, with existing structural problem-solving models.
Fear and Children
The potential for war is a pervasive threat to the
security and family structure of children in military families and can result in anticipatory anxiety and other expressions of distress. For children living in war zones, they can express acute distress from various traumatic events through emotional problems that are not usually recognised. Thabet, Abed & Vostanis (2002) assessed the nature and severity of emotional problems Palestinian children (aged 9-18 yrs) exposed to home bombardment and demolition during the Al Aqsa Intifada and age-matched controls who had been exposed to other types of traumatic events related to political violence. They completed self-report measures of post-traumatic stress (PTS), anxiety, and fears. Significantly more children exposed to bombardment and home demolition reported symptoms of PTS and fear than controls. Exposure to bombardment was the strongest socioeconomic predictor of PTS reactions. In contrast, children exposed to other events, mainly through the media and adults, reported more anticipatory anxiety and cognitive expressions of distress than children who were directly exposed. Thabet et al (2002) suggest that health professionals and other agencies coming in contact with children who have been affected by war and political violence need to be trained in detection and treatment of emotional problems due to acute stress from traumatic events.
The use of children in combat situations is another source of fear, distress, and long-term trauma among those involved. Armed combat in childhood is a form of child abuse. de Silva, Hobbs & Hanks (2001) interviewed 19 former child soldiers (aged 16-24 yrs) using a standard questionnaire. Reasons cited for recruitment included: volunteered, hatred of enemy (revenge), virtue of being a freedom fighter (martyrdom), and as a means of supporting their family (economic). One child was abducted, 7 joined for fear of the 'enemy' abducting them, and in 5 a family member was killed by the 'enemy' or their own group. The children were involved in manual labour, guard duty, front-line fighting, bomb manufacture, setting sea/land mines and radio and communication. Fifteen were trained in firearms and fourteen in self-destruction. Twelve children attempted to or did run away and eleven refused to obey orders or argued. This led to various punishments, including kitchen duty, beatings, imprisonment, blackmail or death threats. A majority of the children felt sad and emotionally upset when they remembered their mother and family. de Silva, Hobbs & Hanks (2001) conclude that children's involvement in war, whatever the 'justifications' may be, should always be considered as forced, as they cannot truly comprehend their action in war. The responsibility must be taken by the adult caregivers. They suggest that firm international agreement on guidelines for the lower age limit of recruitment of children into armed forces should be required.
Fear and trauma among children can also occur as a result of vicarious exposure to traumatic events. Using telephone interviews with a random sample of 314 Dutch children between the ages of 7 and 12 years, Valkenburg, Cantor & Peeters (2000) investigated (a) the prevalence of TV-induced fright, (b) whether the fear-inducing capacity of different types of TV content (interpersonal violence, fantasy characters, war and suffering, and fires and accidents) is associated with the child's age and gender, and (c) how boys and girls in different age groups cope with their TV-induced fears. Ss were given open-ended questions about TV fright, the TV-induced fright scales, and questions dealing with the frequency with which they used various coping strategies to reduce fear from TV. Thirty-one percent of the children reported having been frightened by television during the preceding year. Both children's TV-induced fears and their coping strategies to reduce such fears varied by age and gender.
There are a number of suggested techniques for helping children who have been exposed to such severe traumatric events as war. Indirect methods, such as games or play seem to be more effective ways for children to communicate their feelings. For example, Herman (2000) examined the use of board games to teach effective ways of communicating, dealing with conflict and feelings of anger, and fear. Four games were designed as part of the curriculum for use with 112 fourth grade children at Vladimir Nazor School in Slavonski Brod, Croatia who were experiencing the trauma of war. They found that over repeated game playing, there was improvement in dealing with anger, conflict, and fears by the children who were using the games. Interviews supported the game as an effective way of teaching communication, and alternative ways of coping with anger, conflict, and fears.
Fear And Other Cultures
Fears can sometimes be transferred from older sources to newer or different ones once the original has been eliminated. Murray & Meyers (1999) used the collapse of the Soviet Union to test the hypothesis that some people are psychologically predisposed to "need enemies." The findings from the 1988-1992 Leadership Opinion Project (LOP) panel data show that those respondents who had been highly suspicious of Soviet motives before the end of the cold war are more likely to view other countries with suspicion and to perceive the international environment as dangerous after the Soviet collapse. There is no evidence that people have actually transferred old fears about the Soviet Union onto a replacement enemy. China is the country most frequently named as the US's main adversary following the cold war, making it the most likely object for the transference of hostility. However, even the most ardently anti-Soviet respondents do not exhibit greater fear or animosity toward China after they have lost their old enemy. However, it is possible that the need to have some sort of "enemy" has been transferred to Al Queda and Saddam Husein's Iraqi regime.
Culturally relevant approaches toward healing are important considerations when developing and implementing interventions within a culture not one's own. For example, among Somalis in Ethiopia, war-related distress is not interpreted in a medical framework aimed at healing. Rather, such violence is predominantly assimilated into the framework of Somali politics, in which individual injuries are considered injuries to a lineage or other defined group. The dominant emotion in this context is not sadness or fear, but anger, which has emotional, political and material importance in validating individuals as members of a group sharing mutual rights and obligations (Zarowsky, 2000). Before advocating trauma-based models of war-related distress, researchers and practitioners should consider whether a medical framework would do better at helping individuals and communities to deal with distress and reconstruct meaningful lives and relationships in circumstances of long-standing collective violence. It is important to consider culturally relevant approaches before proceeding in any response.
In another example, Hinterhuber, Hartmann, Stern, Ross & Kemmler (2001) investigated attitudes toward warfare in the former Yugoslavia among refugees and emigrants. In 1995, 283 Serbs, Montenegrins, Croats, and Bosnians (mean ages 32.0-37.8 yrs) from the former Yugoslavia completed surveys concerning: (1) feelings, values, political attitudes, and assessments of contemporary history; (2) attitudes to the then ongoing war; (3) prejudices; and (4) perspectives for the future. Results show that almost half of Croat Ss were happy when Yugoslavia started to disintegrate. The Serbs predominantly felt grief, followed by fear and uncertainty.
Dar, Kimhi, Stadler & Epstein (1999) studied the effects of military service during the Intifada on veterans from a kibbutz background. 184 Israeli Defense Forces veterans (133 males and 51 females) from a kibbutz background who had served in the occupied territories during the Intifada (1992-1998) were retrospectively asked in a semi-structured questionnaire how this service had affected them. The results showed some common themes: (1) service in the "territories" deepened Ss' understanding of the Israeli-Palestinian conflict, but also increased their fear and hatred of Arabs; (2) most Ss did not develop a new political position but were firmer in their original "leftist" position; (3) only a few Ss based their position on support for the Palestinians' rights or suffering focusing mainly on a generally utilitarian consideration of the Israeli side's needs; (4) in order to cope with the conflict between their military duty and the internalized values of their kibbutz education, Ss either sought shelter behind army orders or compartmentalized their humanistic values and military duty; and (5) Ss regarded their military service during the Intifada as a most difficult experience but leaving only a situational, temporal psychological imprint.
Cultural values, exposure to traumatic events, civilian or military status, attitudes, history, prejudices, politics, education, and other variables all play a role in the experience of and effective responses to fears due to war situations.
Fear and Nuclear Threats
Not since 1945 has the world experienced nuclear
warfare, although there has been the threat of nuclear terrorism and a
large number of nuclear/radiological accidents. Most people fear a
nuclear/radiological threat even more than a conventional explosion due
to their inability to perceive the presence of radiation with the
ordinary human senses and to concerns about perceived long-lasting
radiation effects. Studies of radiological accidents have found that for
every actually contaminated casualty, there may be as many as 500 people
who are concerned, eager to be screened for contamination, sometimes
panicked, and showing psychosomatic reactions mimicking actual radiation
effects (Salter, 2001). Data from the Hiroshima and Nagasaki attacks revealed widespread acute reactions such as psychic numbing, severe anxiety, and disorganized behavior, and later there were chronic effects such as survivor guilt and psychosomatic reactions. Such responses would likely be common in any future nuclear/radiological accident, terrorist attack, or warfare.
Conclusions
The response to 'new security' risks requires
significant changes in public behavior, and the legitimization of
unpopular government policies. Public education is one means of achieving this. The need is reflected in initiatives such as environmental
and development education, health promotion, and the public
understanding of science. Current strategies are often based on
commercial advertising, but mass communications theory does not directly
encompass influencing perception, which is necessary to create awareness
of the new 'invisible' risks. Recent evolutionary brain science is
providing new insights into our species perception deficits, which can
inform a more effective approach to public education. Williams (2002) places risk within the context of the post-Cold War 'global security' agenda. He proposes a theoretical framework--'brain lag'--to explain perceptual deficits. It draws on theories of information, adaptation and denial, and an understanding of the human senses including time-scale-latency. He proposes fundamental areas of evolutionary perception: fear and
disgust, number perception, and cheating. This leads to a core concept
for public education about new security risks, 'enhanced difference', and a set of hypotheses that can be applied to text or image. Whatever approach, fear remains a potent motivator of behavior. It is one that is consistently utilized for control and is manipulated by others for maximum effects. Helping those traumatized by fears is a major task for psychologists and others attempting to help them readjust to the world and to achieve a level of equilibrium.
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REFERENCES
Dar, Yechezkel, Kimhi, Shaul, Stadler, Nurit & Epstein, Alek (May 1999). Imprint of the Intifada: Response of kibbutz born veterans to military service in the West Bank and Gaza. Megamot, Vol 39(4), pp. 420-444. Publisher URL: http://www.szold.org.il
de Silva, Harendra, Hobbs, Chris & Hanks, Helga (Mar-Apr 2001). Conscription of children in armed conflict--a form of child abuse. A study of 19 former child soldiers. Child Abuse Review, Vol 10(2), pp.
125-134. Journal URL: http://www.interscience.wiley.com/jpages/0952-9136/
Havenaar, Johan M., (Ed), Cwikel, Julie G., (Ed) & Bromet, Evelyn J., (Ed) (2002). Toxic turmoil: Psychological and societal consequences of
ecological disasters. Series Title: Plenum series on stress and coping. New York, NY, US: Kluwer Academic/Plenum Publishers. xiii, 279 pp.
Herman, Patricia (Sep 2000). Children and the trauma of war: Exploring the use of games in transforming attitudes and behaviors. Dissertation Abstracts International: Section B: The Sciences & Engineering, Vol 61(3-B), pp. 1637.
Hinterhuber, Hartmann, Stern, Milan, Ross, Thomas & Kemmler, Georg (Oct 2001). The tragedy of wars in former Yugoslavia seen through the eyes of refugees and emigrants. Psychiatria Danubina, Vol 13(1-4), pp. 3-14.
Kopelman, M. D. (Oct 2000). Fear can interrupt the continuum of memory. Journal of Neurology, Neurosurgery & Psychiatry, Vol 69(4), pp. 431-432. Journal URL: http://jnnp.bmjjournals.com/
Murphy, Ronald T., Wismar, Keith & Freeman, Kassie (Feb 2003).
Stress symptoms among African-American college students after
the September 11, 2001 terrorist attacks. Journal of Nervous & Mental Disease, Vol 191(2), pp. 108-114. Journal URL: http://www.jonmd.com/
Murray, Shoon Kathleen & Meyers, Jason (Oct 1999). Do people need foreign enemies? American leaders' beliefs after the Soviet demise. Journal of Conflict Resolution, Vol 43(5), pp. 555-569. Publisher URL: http://www.sagepub.com
Salter, Charles A. (Dec 2001). Psychological effects of nuclear and radiological warfare. Military Medicine, Vol 166(12,Suppl 2), pp.
17-18. Publisher URL: http://www.amsus.org/
Starcevic, Vladan, Kolar, Dusan, Latas, Milan, Bogojevic, Goran & Kelin, Katarina (2002). Panic disorder patients at the time of air strikes. Depression & Anxiety, Vol 16(4), pp. 152-156. Publisher URL:
http://www.interscience.wiley.com
Thabet, Abdel Aziz Mousa, Abed, Yehia & Vostanis, Panos (May 2002). Emotional problems in Palestinian children living in a war zone: A cross-sectional study. Lancet, Vol 359(9320), pp. 1801-1804.
Valkenburg, Patti M., Cantor, Joanne & Peeters, Allerd L. (Feb 2000). Fright reactions to television: A child survey. Communication Research, Vol 27(1), pp. 82-97.
Williams, Christopher (Jul 2002). 'New security' risks and public educating: The significance of recent evolutionary brain science. Journal of Risk Research, Vol 5(3), pp. 225-248. Publisher URL: http://www.tandf.co.uk
Witty, Cathie J. (Oct 2002). The therapeutic potential of narrative therapy in conflict transformation. Journal of Systemic Therapies, Vol 21(3), Special Issue: Reflections in the aftermath of September 11. pp. 48-59. Journal URL: http://www.guilford.com/cartscript.cgi?page=periodicals/jnst.htm&cart_id
=547216.21319
Zarowsky, Christina (Sep 2000). Trauma stories: Violence, emotion and politics in Somali Ethiopia. Transcultural Psychiatry, Vol 37(3), pp. 383-402.
To search for books on disasters and disaster mental
health topics, leaders, leadership, orgainizations,
crisis intervention, leaders and crises, and related
topics and purchase them online, go to the following url:
https://www.angelfire.com/biz/odochartaigh/searchbooks.html
RECOMMENDED READING
by Gina Ross
Book Description
In The Media's Role in Secondhand Trauma, the author proposes a collaboration between the media, helping professionals, and trauma researchers to stem the tide of trauma. The media, Ross suggests, can use its influence to promote messages of peace over violence and be used as a tool in the restoration and rebuilding of wounded psyches, communities, and nations. Convincing media professionals to apply healing tools to their own lives can create positive cycles that will benefit everyone.
Additional Readings at: Terrorism and Stress in the search engine. Also try looking here for Psychology and Terrorism.
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Contact your local Mental Health Center or
check the yellow pages for counselors, psychologists,
therapists, and other Mental health Professionals in
your area for further information.
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George W. Doherty
Rocky Mountain Region
Disaster Mental Health Institute
Box 786
Laramie, WY 82073-0786
MENTAL HEALTH MOMENT Online: https://www.angelfire.com/biz3/news
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