Most of us seem to getting back to life more or less as usual, while watching the further developments of the investigation into the Marathon terrorist incident and noting the remarkable spirits of those recovering from injury.  Yet, all it takes is a walk through Copley Square, or a news item such as the one indicating that the attack might otherwise have occurred at the July 4 concert, to bring back memories of how that day unfolded and transformed an occasion of joy to one of horror.

Some of us will react in a stronger and more prolonged way than others.  Post-Traumatic Stress is a term coined in the aftermath of the Vietnam war, when some veterans, years afterward, continued to react as if they were in the midst of combat.  (Such syndromes were previously called “battle fatigue,” “shell shock,” etc.)  Clinicians later realized that they saw a similar constellation of symptoms among people who had endured or witnessed traumatic or abusive experiences in childhood.  Post-traumatic features include:

• Hyper-vigilance and exaggerated startle response;
• Intrusive images of the events (in nightmares or while awake);
• Intense distress when exposed to cues representing the event;
• Feelings of detachment or unexpected anger or tears;
• Avoidance of thoughts, feelings, people or places associated with the trauma;
• Problems with concentration and memory

For some or possibly most people, these phenomena begin to fade within a month or so.  For others, they may persist, or even surface years later.  As you might expect, the condition is generally more severe when the traumatizing circumstances continue over time, e.g., a child whose sexual abuse went on for years, or a solder in continuous combat for months or years.  Although we are currently dealing with the events of one day (or a week, depending on how you look at it), we are also dealing with echoes of other attacks dating back at least to 9/11, and with our sense of not knowing what to expect next, and when.

We are also grieving for those whose lives were lost.  Most of us did not know them, but it feels now as if they are part of our extended family.  You have probably heard of the so-called “stages of grief” (which in reality vary greatly among people): denial, anger/guilt, sadness/despair, acceptance and hope.  Acceptance are hope are hard to find, yet ultimately there is no other healthy choice.

Both post-traumatic and grief reactions are normal in the short run.  They become clinical concerns when they persist over a period of months or years, or if they severely interfere with daily functioning.  Even normal reactions, however, frequently cannot be handled solely through avoidance or “stiff upper lip.”  Most of us need to talk to each other repeatedly about what we’ve experienced and how we feel about it.  But different people make their way through this process at different rates of speed; they should be invited but not forced to talk, and their feelings should be heard and accepted, not judged or “fixed.”  And not everyone is ready to listen, either.

We have seen on many occasions that trauma and loss can actually bring about some positive results, and, as the President and others have noted, that was evident in Boston right away.  Our confidence to face any challenge has been bolstered.  Our values may turn away from the superficial and toward what is truly important.  We may better appreciate our friends and family and realize that we are “all in this together.”  Perhaps we more fully experience and appreciate each day.  Finally, the aftermath of a catastrophe may actually help us finding meaning in what we choose to do, personally and in our profession.  May we all find new perspective and inspiration.

The events set in motion on Patriots’ Day not only dropped a catastrophe into our lives but suddenly shook up our view of our city, our Marathon, and ourselves in relation to them.  We find ourselves returning to some of the understandings that we underlined in September 2001.  Assimilating such a radical change in our understanding of ourselves and the world can be personally and collectively disorienting.  Although the process of adjusting to an altered reality is not entirely subject to deliberate and conscious management, there are some recommended ways to deal with it.

Beyond returning to a sense of normalcy, the ultimate goal is also to empower ourselves as individuals and as communities to be a force for healing.  While depressive symptoms are normal following any significant loss, positive action is one of the most effective antidotes.  As we have already seen, it enables many people to live heroically amid extremely adverse and dangerous circumstances, deepening rather than dulling their sense of humanity and compassion.  Here are some additional strategies to help us move beyond feelings of sadness and powerlessness:

• Respect your own feelings and your own process of adjustment.  As intrinsically social beings, most find it helpful to share their reactions and feelings with others.  Talk with friends and family.  Journal, talk to a counselor or clergy person, write a letter.  Stoic avoidance or denial of feelings can result in physical, psychological or behavioral symptoms later on.  Everyone experiences tragedy differently, so don’t expect yourself or anyone else to recover in the same way or at the same rate.
• Remember that no feeling is either good or bad; it is simply data about how something is affecting you.  How you express the feeling, however, can be helpful or harmful.  For example, most of us are likely to experience some level of anger in reaction to these events; anger is infused with energy that can be directed constructively, while of course thoughtless, destructive venting of anger makes one a participant in the same negative energy from which terrorism itself derives.  (Unexpressed anger is thought by many to fuel depression.)
• Take extra good care of yourself and those nearest and dearest to you.  Stressful events, especially catastrophic events, impose strains on the mind and body that can be mitigated by adequate sleep, healthy diet, appropriate exercise, social interaction, quiet time, prayer or meditation, and laughter.
• Take time to re-evaluate what’s important to you.   Re-order priorities and modify your life accordingly.  Reach out.  Enjoy time with family members.  Mend or strengthen relationships.  Seek professional or clerical help if necessary.
• Balance your need for news and information with activity that permits a complete change of focus and mood: listen to music, play with the kids, ride your bike, walk in the woods.
• Find ways to make a difference in your daily routine.  Show kindness and patience in how you drive, treat strangers, interact with family or co-workers.  Volunteer to help in local services, i.e., Red Cross, shelters, literacy programs, Big Brother or Sister.
• Educate yourself; be involved in democratic processes, support sound national policies that serve American values and promote peace, truth, justice and understanding rather than violence.
• Utilize spiritual resources.  In a broad sense, this can include a faith community, 12-step program, meditative practice, etc.  Devoting time to such activities, states of mind, and connectedness to community has been shown to be beneficial to physical and mental health.  The familiar 12-step slogan “One Day at a Time” can be particularly helpful in getting through periods of high stress and change.

The process of adjustment to a major life disruption, though it varies in form among individuals, is a universal human experience.  It permits a psychological restructuring, eventual acceptance, and ability to move forward creatively and constructively, often with greater compassion, a broader vision of self, and a stronger commitment to one’s role in the world.

God grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.

Here is an article from the Oklahoma Bar Association to inspire you to notice and avoid an overabundance of professional stress.  At LCL, of course, stress of various kinds, and its impact on lawyers’ functioning, is our focus, so part of taking care of yourself may be remembering that we’re here.