The Anniversary Dilemma

Anniversaries of tragedies can be difficult times for many people. For some, the anniversary date is a powerful reminder of loss. Family members and close friends experience the sadness, emptiness, and pain of a life which now only offers them a gaping hole in the fabric of life where there once was a vibrant and cherished person. For others, who may have tried to deny the tragedy’s occurrence, the anniversary may break through their defenses and produce unexpected grief and feelings of despair.

Some people believe that if they got through the first year after a terrible event happened the worst is over for them. They have lived through a year full of generally "awful firsts". For example, the first birthday without their family member or friend or the first Thanksgiving, Christmas, Hanukkah, or New Year may have produced poignant moments of pain for those left behind. Those poignant moments may pile up and produce their most serious impact during an anniversary time. The development of unexpected and intense feelings of grief can be overpowering for those who thought they had successfully denied their grief.

Still others see an anniversary of a tragedy as a milestone along the path to recovery. They hope that passing through the first anniversary will reassure them that a restoration of somewhat normal level of life activities is not only possible but that it is also close at hand. They realize that they have lived a whole year without their special person and they feel more confident that they can now make it through another. The doubts they once felt about their ability to survive without the loved one become less prominent.

Those who survived a tragedy, whether they were wounded or not, often find anniversaries bitter-sweet experiences. They are grateful that they lived through situations in which others perished, yet they feel intense guilt about the fact that others died. Intense feelings of terror and threat reverberate in their minds and hearts. Vivid dreams disturb their sleep. Anger and resentment toward those who caused significant changes in their lives predominate over calmer feelings. It is hard for anybody to feel the same around the anniversary of some significant tragedy.

Administrators of organizations, government agencies, and clergy in a wide range of congregations as well as family members and friends wonder what they should do to properly honor the memory of the dead while simultaneously alleviating the suffering of the living. ICISF has been asked for suggestions many times in the last few weeks as we approach the September 11^th anniversary of the brutal attacks on America. The suggestions which follow may be useful guidelines for those who want to know what to do to deal with anniversaries of tragedies.

1. Each individual may deal with the anniversary of a tragedy in their own way. The first rule of managing the anniversary of a traumatic event is that there are few hard and fast rules. Some people need to visit the site of the tragedy, or a grave or a memorial site. Some will go to a place of worship and pray for their dead. Others will visit those who have sustained injuries or they will bring together friends and family for a quiet meal. Some need to express themselves in a public manner with other people while others need to manage the anniversary in a very private manner. No particular method of managing one’s loss and grief is better than other methods. We all need to be understanding and tolerant of the methods people choose to deal with their grief. Their personality, culture and background may suggest to them different paths for the expression of their grief.
2. Public or private rituals can help people who are struggling with fear and loss. It is up to the individual to choose the rituals which will help the most. Many people need and choose a companion to accompany them through the rituals surrounding the anniversary. It is helpful to offer to go with someone if it appears that they may have to face the ritual alone. In some places a member of a local CISM team has been there through a ritual when no family member or close friend was available. If a person chooses to attend a ceremony by themselves, then that choice is respected.
3. Spiritually oriented memorial services can alleviate much pain. They should be carefully planned and presented. The more public citizens who are likely to attend, the greater the need for these services to be non-denominational.
4. Clergy or chaplain personnel can be instrumental in planning out the details of a religious or spiritually based memorial service. By the way, we should not overlook groups that have run memorial ceremonies for years. Concerns of Police Survivors and the Veterans of Foreign Wars have run such ceremonies and can be good advisors.
5. Grief seminars and other educational programs can help individuals or groups. Note: if both an educational program and a secular or spiritual memorial service are planned to be connected to each other, the secular or spiritual memorial service should go last. The reason is that educational programs tend to open people up and bring their pain to the surface. Spiritual and non spiritual memorial services tend to "re-box" the grief so that hope of recovery is enhanced.
6. Non-religious ceremonies may help people to face the loss of their loved ones. Non-religious ceremonies include the blowing of taps, twenty one gun salutes, speeches, military honors such as aircraft fly-overs, the reading of the names of the dead and missing, moments of silence, tolling a bell, the placement of empty chairs on a stage, candle lighting ceremonies, etc. It is not unusual for these ceremonies to be combined with each other or with prayers and other religious or spiritual ceremonies according to the needs and wishes of the families and friends.
7. When remains have not been recovered, the families and friends tend to suffer much more. They lack a sense of completeness of the loss. The anniversary often enhances the sense that the loss is truly not finished for them. Doubts remain about the reality of the loss of a loved one. This has certainly been the experience of those who have had loved ones lost at sea or dead within the earth as in a mining accident. No doubt, those whose remains were not recovered after the collapse of the World Trade Center will be sorely missed by their relatives and friends. The relatives often have a need to go as close to the area where there loved one was last known to be. They grieve their loss there.
8. It is perfectly acceptable for people to respectfully inquire about a person or a family or group’s well being during the anniversary time. The sending of cards, flowers, or memorial wreaths is acceptable according to cultural practices.
9. It is not unusual for people to experience behavioral changes for several weeks before and after an anniversary. Withdrawal, angry outbursts, emotional tirades, crying spells, overwhelming sadness, lack of attention to detail, loss of interest in school or work activities and poor treatment of friends, co-workers and family members are fairly common around anniversary times. Grief does not get processed according to some pre set schedule. For some, the intensity of their grief reactions gradually lessens over time. Some people have found that the second or third anniversary is much more difficult for them than the first. Never tell a grieving person that they should be over it by now. Never tell them that they just have to let go and move on. Those words of "advice" will cause more pain. Understanding, patience, and gentle support are most helpful during these stressful times around the anniversary.
10. People who are experiencing grief reactions around anniversaries should not be treated as abnormal. We ordinarily do not refer people who are experiencing normal grief reaction. Anyone, however, who is experiencing particularly intense, difficult, long-lasting or significantly disruptive grief reactions should be offered or encouraged to accept professional assistance. We refer to professionals when a person is stuck in overwhelming grief which is interfering with one’s ability to function normally in life.

Our thoughts and prayers go out to all who are suffering through an anniversary of a loss whether it is the attacks on America or some other painful experience. We hope for healing, peace of mind, and recovery for all who are in pain.

Jeffrey T. Mitchell, PhD, CTS
President, International Critical Incident Stress Foundation, Inc.

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By

Jeffrey T. Mitchell, Ph.D., CTS

August 20, 2002

About a week ago I completed an article entitled "The Anniversary Dilemma." It went out on ICISF’s web site. It was a set of guidelines for helping (but not over helping) communities, survivors, victims and bereaved to deal with the intensity of anniversary events, particularly September 11. ICISF, almost immediately, received many requests to put together a similar set of guidelines to assist those who had helped out in so many ways that they would be too numerous to describe here. This article is a response to the many requests that have come into ICISF.

1. For those who lost colleagues in a tragedy, the anniversary can be a very difficult time. The time period shortly after the loss is a time of shock, numbness and bewilderment. In the next few months the reality of the loss begins to set in. The person is missed and there are periods of distress intermingled with periods of relative calm. Grief, sadness and regrets are common. Generalized anxiety about one’s owns well being, specific fears and stress reactions are also common. Memories, dreams and thoughts of the dead person can intrude at any time. Frustration and anger over some aspect of the loss can also take up a person’s energy. As the anniversary approaches those feelings, memories, thoughts and dreams can become intensified.
2. An important anniversary is not a date so much as it is a period of time. Generally the anniversary period begins several weeks and sometimes a month or so before the actual date and trails off for several weeks after the anniversary date. Many people are surprised by the length of time that an anniversary of a significant event can take. Although uncomfortable and sometimes quite painful, the length of the anniversary period should not be surprising. Remember, the intensity of the feelings generated by an anniversary and the length of time the anniversary period lasts is usually in proportion to the importance of the person in your life. Look at discomfort at anniversary times as a personal tribute to the colleagues you miss so much because they were so important in your life.
3. For those who were involved in the search and recovery efforts at the World Trade Center the anniversary period can be particularly distressing because they were so caught up in the operation that they had to postpone much of their normal grief reactions. A delayed grief reaction does not mean that a person can escape his or her grief. There is a price to pay for the delay. In fact, most people report that they were surprised by just how powerful the grief was that overtook them at anniversary times. For a few, the grief reaction can be powerful enough to disrupt their work and home performance.
4. Around the United States and even in other countries, many people have attempted to use the emergency services and military personnel to express their shock and grief over the September 11^th attacks. That is natural. Those people represent the closest the general public can come to the "front lines" of the war on terrorism. They have made unwilling "heroes" out of emergency and military personnel. They focus their attention on them; wine them and dine them; give them awards and honors and include them in programs and ceremonies where they have been previously overlooked or even ignored. Many have cried on the shoulders of emergency personnel even when those emergency personnel may have had little or nothing to do with the actual search and rescue operations. Personnel in New York City, in particular, had to maintain that strong outer appearance for the people who came with flowers and candles to their police and fire stations. The public does not want their "heroes" to be sad and grieving. The public wants to cheer up fire, police, emergency medical and military personnel. They want to make them feel better. If they believe that they can be successful in that endeavor then they can feel more secure in this very insecure world. They want them to be strong and ready for action should it be necessary. Unwittingly, the public may have contributed to the delayed grief reactions that many operations personnel are now experiencing. There is no malice here. It is the best a frightened public can do. In the American Civil War the public cheered as soldiers paraded by on their way to battle and tied yellow ribbons around trees as they waited for the war’s end and the return of their soldiers. They are doing today what the public has done for thousands of years. They urge courage, strength and stamina in their front line protectors so they can feel safer in their own worlds. It is the best they know how to do. They mean no harm.
5. Avoidance is very common around anniversary times. Some people, especially those who have recently entered into a delayed grief reaction, will do everything they can to avoid ceremonies and programs associated with the anniversary. They fear that they will be overwhelmed by such ceremonies. Such fear is natural. In some cases attendance at a ceremony will be mandated by the organization. Do the best you can under those circumstances. Keep in mind that ceremonies can help to move the healing process along and do not necessarily have to overwhelm if a person has a positive attitude. A positive attitude is one that looks at attendance at a ceremony as a way to honor the memory of those who have been killed or wounded. In some cases people will be given an option regarding their attendance at an anniversary ceremony. People should consider attending very seriously before making the decision. There may be hidden benefits to attendance.
6. If a person decides that they cannot attend an optional ceremony their decision needs to be respected. Every person deals with their loss in their own way and on their own time frame. Remember, many of you who helped out got wounded internally yourselves. You may need time to heal and sometimes people cannot face anniversaries very well when they are feeling the pain of their wounds.
7. Do not be talked into doing things which go against your internal feelings. For example, I was asked to be a speaker at a memorial program on September 11. My internal sense said that the organizers were going in the wrong direction. They wanted to invite every emergency person they knew (and many they did not) to the ceremony so that "heroes" would be on site during the program. The anniversary is not about us. It is about those who died or were wounded. It is about their families. It is about the losses America has suffered as a nation. I was very concerned with their approach and said no to the invitation even though there was considerable pressure being exerted on me to comply.
8. Some people need to be in a quiet place away from others and they need to reflect on their personal experience of the loss. Others will choose to be around friends and family. Others prefer to be with their coworkers. A few people want to attend every ceremony or program that is available in their area. Some simply want to go away. They are worn out by a year full of reports about the tragedy. Others choose to work and keep busy. Some want to talk about it, others do not. There is no one way to deal with the pain of an anniversary. Choose your best personal plan.
9. Do not be afraid to tell those you care about that you love them and that you care for them. We are in a war and just about anything may happen. Even if we were not in a war, just about anything can happen.
10. Look out for one another. If someone you work with does not seem themselves or they are hurting, please offer a listening ear and a kind heart. A little listening goes a long, long way.
11. Spend time with friends and family, love your children and care for them. Read, think, pray, play. Do anything that works for you. An anniversary of a tragedy is a significant occurrence. Remembering, grieving, feeling, honoring the dead and wounded are all important aspects of our lives. Likewise, growing, rebuilding, looking forward and participating in daily life are also important. Anniversaries should be lived through with dignity and honor. They should not become emotional swamps that swallow us and cause us to cease living healthy and productive lives. We do not honor the memory of our dead by ceasing to live own ourselves. We honor them by choosing to live life better because of them.
12. For those who have worked directly with the tragic events, they hold membership in a special club. Their memories may be somber around the anniversary. They should not forget, however, that they have had the privilege of working side by side with some of the finest people the world has to offer. They should entwine those positive memories of team work and personal sacrifice in with the sad feelings generated by the anniversary period. You and they have given gifts and each has received gifts by the work you have done in the aftermath of the tragedy.
13. People may need a referral for additional support if the distress they are encountering during the anniversary period overwhelms them and causes them to dysfunction on the job or at home. Look out for your colleagues who are having a really hard time during an anniversary period. Get them to CISM services or to counseling if that is necessary.
14. Remember, the most important people in our lives have made us laugh and they made us cry. Honor them all by the quality of the lives you live. Thank you for all you have done to reach out to others in times of need. Please use this reflective time around the anniversary to contemplate but not get bogged down in the past while simultaneously resting and preparing yourselves for the future. No doubt, there is yet far more to contribute.

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