The 5 Stages of Fear and Lessons from 9/11

2018-09-12T00:20:45+00:00September 11th, 2018|De-Constructing Worldview|

Fear.

As a profound sufferer from migraines, I’ve always known the brain is complicated. Just ask my list of doctors who resorted to the eenie-meenie-minie-moe method to try to prevent them and, when that didn’t work, treat them.

So, it is not surprising that our brains act in paradoxical ways when confronted by a real or perceived threat. My Mom used to complain that I was too fearless for my own good. Climbing trees, jumping from 2 story buildings, eating yummy flavored children’s aspirin like M&Ms, and riding my tricycle down a street between 18-wheelers–well, you get the picture. I was impervious to danger or so the myth goes. But challenging oneself to dangerous feats and having it imposed are 2 different things. One is voluntary. The other is like stumbling into the den of a hot and bothered post hibernation grizzly bear. Scary as shit. This I know. I’ve experienced the defense cascade on more than one occasion. It all begins with that moment you know things are off and a whole lot of chaos is about to turn your world upside down:

  1. Arousal is the first stage in activating the defense cascade. The muscles tense, breathing, and heart rate go up in preparation for action. It can lead into the flight-or-fight response, but most often it leads to a type of freeze response in which the brain enters a curious state of immobility and hyper-vigilance or a state of attentive immobility. This is where you sweat, hyperventilate, and want to crawl out of your skin. It’s also the point at which you could swear you could hear someone coughing in the bedroom at the back of the house across the street. Your ears will never hear that well again. Before you actually are aware of the danger you face, your brain is already assessing the threat and mounting a physical response to meet it. The orienting reflex at this point helps slow the heart rate down and the breathing slows. I call this the sang-froid moment. When I was 10, I was left home alone with my little brother. Three guys tried to break into our house and I went through all these stages as we waited for the police to arrive who were actually looking for our house in the next town over. But as I weighed our options and waited, I understood we might be on our own for awhile. I swear my blood turned to ice water. It’s also the experience one has when watching a horror or thriller. I can imagine Sigourney Weaver’s look as the Alien moves in towards her. If she didn’t look, would the alien not see her?
  2. Fight or Flight is the potential second stage of the defense cascade. I say potential because the whole thing, paradoxical in nature, is subject to shuffling. But this is the stage at which you figure out whether you intend to run or stand your ground. I think Sigourney wavered on that. I would, too. Alien has some nasty saliva. Either way someone falls on this, it is deemed an active response because the body kicks in and there is a whole spectrum of brain action, voluntary and involuntary, that becomes involved. I won’t go into detail because the neurophysiological language is tedious even for this hopeless nerd.
  3. Freeze. Again. This time the fight or flight dynamic is put on hold.
  4. Tonic immobility. This particular part of the defense cascade is sort of creepy because there’s not a lot of the rational human mind involved. It’s like playing possum. Paralysis, collapse, dissociative dream state, trembling, defecating, amnesia, and changes in consciousness are responses to an inescapable threat. This particular step in the defense cascade is rarely portrayed realistically in the movies. In fact, the depth of this state is not understood by anyone. It is a place of such profound fear that the brain and, perhaps consciousness itself, shuts down. It is beyond the realm of the rational.
  5. Quiescent immobility. After the danger has passed, this is the state in which recovery begins.

Of course, we’ve all seen those movies in which the attacked has fought back, the attacker appears to be dead, the attacked collapses and lets down their guard, and the attacker then comes alive like nothing has happened and the whole defense cascade happens again. That’s where the fight is problematic in movies. Because the stakes are so high now that both parties become blinded by a profound aggression. The truth is, if there is an imminent threat, it is doubtful the attacked person would’ve put their weapon down after one blow. People in the throes of the fight response in the defense cascade are also under the influence of a part of the brain that has little to do with planning the next meal. In fact, they are capable of uninhibited, reckless, blind, unreasoned violence. They will use any weapon and inflict any wound. They will do whatever it takes to survive. And they might not stop when all reason should tell them their foe is dead.

Here’s the thing though. Animals get over it.

Humans don’t. That crazy hard-to-feed brain, the cerebral cortex, can’t easily shake off its trauma. Post-traumatic stress disorder.

PTSD. That’s the writer in me. But, it’s also personal because I sometimes wonder if we don’t have a collective form of it. A form of trauma that we pass down to the generations after us. A cycle of storytelling that retells a form of it everyday in the media.

The world as we know it under attack.

“Liz, you need to come up here.” Helen’s voice urged me to come quickly. Laced with concern, I assumed something was amiss at the inn. Helen managed our 28-room inn. I worked in my shop, The Iron Rooster Gift Shop and Boutique, performed operations management at the inn, and oversaw the renovations every year. It was September. A particularly beautiful time of year in the Berkshires. The kids were back at school and the weather was resplendent. It was 8:46 a.m. in the morning.

I closed the shop which was not due to open until 10 a.m. anyway. The chores could wait.

The walk across the parking lot was short, but I vividly remember it. The air was warm, the breeze gentle, the sun benign, the sky clear and blue. It was the most exquisitely perfect day.

It is that exact memory that woke me this morning and filled me with anxiety. The same anxiety I feel every year at this time. A monsoonal rain poured a deluge outside the window and added to my sense of unease. I cancelled my plans to drive 1 1/2 hours away to Austin. It reminded of another time when palpable fear caused me to cancel another drive far into the Berkshires.

But, on that beautiful day at the inn, the lobby and cafe were filled with people watching television.

“A little commuter plane hit one of the Towers.” Helen said.

That didn’t make sense. How could that be? The Towers ruled the sky. No one could miss them.

At 9:03 a.m., it made sense. The second tower was hit by a jet and everyone in the building knew we were under attack. The moment of attentive immobility. I began to take stock of who I knew was trapped in New York City. My father-in-law was supposed to be in the Towers. My brother-in-law? I wasn’t sure. Friends who survived the attack in 1993 who still worked there? The same questioning surrounded me. People began to make phone calls. Outside the day was immeasurably beautiful. Inside, fear gnawed at our collective sanity.

9:37 a.m., the Pentagon was hit. I felt another blow. Did it hit the area in which friends of mine worked?

9:42 a.m., all flights were grounded, but the graph on the TV showed them coming down gradually.

9:59 a.m., the South Tower collapses.

10:07 a.m., United Airlines flight 93 crashes in Pennsylvania.

10:28 a.m., the North Tower collapses.

It was like a clock tower ringing. Boom. Boom. Boom. The blows kept coming.

I’m not sure we were ever the same after that.

Perhaps it is PTSD that is compounded everyday by the barrage of horrifying news. Gun violence, mental illness, desperation, opioid addictions, fractious politicians, storms, flooding, fires, etc.

It is important that we look at that fear. “Unlike animals, which generally are able to restore their standard mode of functioning, humans often are not, and they may find themselves locked into the same, recurring pattern of innate responses….The process of shifting the neural patterns is the necessary first step in unlocking the trauma response, breaking the cycle of suffering, and helping a person adapt to, and overcome, past trauma.” (Kozlowska K, Walker P, McLean L, Carrive P. Fear and the Defense Cascade: Clinical Implications and Management. Harvard Review of Psychiatry. 2015;23(4):263-287. doi:10.1097/HRP.0000000000000065.)

By the time I was able to account for everyone in my circle (miraculously did not go to the Towers that day, were badly injured, or did not survive,) I was so grateful to be alive. I never truly took stock of how a sense of fear had settled into my gut. For weeks afterwards, military planes flew over us regularly. One flew so low, it knocked everything off the shelves in my shop and shattered all the breakables. There were constant reports of persons of interest loitering around and breaking into reservoirs in our area that provided the drinking water for New York City. We lived with a plan for evacuation that the kids carried with them to school and plastic sheeting in which to cover our basement windows in case of a dirty bomb. And every weekend, our town filled with shocked and bleary-eyed refugees from the City.

It has been 17 years since that fateful day, but the fear does not dissipate so easily. I constantly think of the millions of people, especially children, in the world who live in a constant state of terror or in the throes of the defense cascade.

There but for fortune? Maybe.

I light a candle every 9/11 and say a prayer for Lindsay Stapleton Morehouse, for every other person who died, and for all the amazing first responders, many of whom gave their lives to give us back our sense of security.

 

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