Aftermath Part III: Living in a Radically Changed World

A year ago the Boston Marathon bombings shook our worlds. The media has given us glimpses of the lives and recovery of people directly affected by the event. Not everyone is “all the way back”, and we should not expect that. But we have seen enough to confirm that people are built for this. We reconstruct our worlds all the time, usually in minor ways, but almost everyone is challenged by a radically changed world sometime in their lives. Meeting that challenge is part of our essential competence as persons.

Nonetheless, world reconstruction is a complex and difficult task. Last year I wrote about what do you do when it’s your world that needs reconstruction. Now let’s look at how we can be useful in helping another person reconstruct their world.

When the Event is fresh we predictably first see people struggling to come to grips with what was lost. This often entails shock, denial, grief or mourning. This is trauma, and one goes through it as best one can, at one’s own pace. Supporting someone through this seems to call essentially for compassionate listening and simple human kindness. Assurances and attempts to make sense of it all at this point are usually more comfort to the giver than the recipient. A person has to recognize and acknowledge how things no longer are in order to turn to how things can and will be from now on.

Now we arrive at the aftermath: through the paralyzing trauma, and ready to proceed forward. How do we help someone from here?

First we must recognize what has changed. Yes, my world has changed – in some shockingly significant way it is no longer the world I once lived in. But my place in the world has also changed. Who I once was, I no longer am; who I am now, I’m not sure how to be. The core reconstruction task is to acknowledge the world as I now find it to be, while finding a way of being in that world where I can confidently be who I now am.

To illustrate, let’s consider some entirely hypothetical individuals whose worlds changed dramatically when the Boston Marathon bombs exploded. (They are amalgamations of events and reactions reported by actual survivors; hundreds of other examples could have been chosen and each would be different in important, specific ways.)

  • John is the father of a runner who had just crossed the finish line when the first bomb detonated. In the noisy smoke-filled moments afterward he thought he was experiencing a flashback to Vietnam where he served as a medic. He rushed in to help whomever he could; he saw a foot lying in the street, and then he saw his son Ken unharmed, running back toward the finish line.
  • Karen was running her fourth Boston. She was just short of the finish line when the first bomb exploded. She felt a powerful blast and sharp pains in her left leg. As she fell screaming to the ground she saw her running shoe a few yards away with her foot in it.
  • Alison was at mile 24 when the word came to stop the race. She heard that two bombs has exploded near the finish line. She was stunned, disbelieving; as more information arrived she realized that if she had not spent 10 minutes helping her training partner work out a leg cramp, she would have been approaching the finish line when the bomb exploded.

Four people, four very different situations. But what they have in common, indeed what everyone directly impacted by the bombing have in common, is this: they now all live in a world where mortal, terrifying danger can appear in an instant, without warning. What before was a mere possibility has become real for them – and it will remain so. They all are living in a radically changed world.

Who they are – their place in the world – has also changed, and this is where the greatest differences show up:

  • Karen’s place changed most obviously. Her injuries, in particular the loss of her left leg, required hospitalization, surgeries and months of healing. Before the event she was an emergency room physician ( she chose the specialty largely because it allowed her the time to train and race). Her world had been a place in which mortal, terrifying danger can appear in an instant, without warning – she saw that every shift – but it had been a world where these things happen to other people. Her place shifted to “I’m a person to whom terrible things can and do happen without warning.” Danger now is as real to her as the chair she sits on.
  • John already knew how dangerous the world can be from his time in Vietnam. But he now lived in a world where that kind of thing can happen here, in his own town. He found himself in a constant state of anxiety for the safety of his family and the people around him; his place became “I’m a person who sees horrible things happen to the people around me, and there’s nothing I can do about it.”
  • One might assume that Alison would be the least effected, since she was not actually present at the bombing site and nobody she knew had been injured. But unlike Karen and John, Alison’s world had been like most people’s – a world in which sudden terrifying danger was something she saw on the news. She knew it was possible for such things to happen to her, but it was a remote possibility, not something she took into account in her day-to-day life. But now she saw clearly that she had avoided personal tragedy by the most whimsical of chances – a friend she was running with developed a leg cramp and asked for her help. What if the friend hadn’t cramped? Or had just dropped out? Or had told Alison to go on without her? Alison’s world was now a place where “Unthinkable things can happen to me and, unless I’m very lucky, will happen.” Alison is a novelist with several published books; she has a highly developed imaginative capacity for taking possibilities and making them real. She now looked around her and felt danger lurking in everything.
  • Ken was horrified by what he saw as he ran back toward the finish line. He also felt a strange exhilaration as he realized he was unharmed. He saw directly that the world was a capriciously dangerous place; he also knew suddenly that “I’m a person whose destiny protects him.” When the second bomb exploded, he sprinted toward the smoke and noise to help out. He felt like he could run another marathon if he had to.

How can we help these people reconstruct their worlds? It should be obvious that no “one size fits all” method will work. There is no set procedure, no series of predictable steps to help them acknowledge the world as they now find it to be, while finding a way of being in that world where they can confidently be who they now are. But we do know some things:

  • To help me reconstruct my world, you must live in the world I live in. To be more exact: I must see you acting in the same world I act in. Your place in that world – what you do and how you do it – may, indeed probably must, be different from mine, but it must be clear to me that you see the world I see. This is usually established through shared or similar history: it takes an addict or someone who has lived with addiction to get what addiction is like; parents whose children die often say that only other such parents understand what they are going through; you have to have been there when the Event happened to share the world that results. Boston Strong is a community if you were there; otherwise it’s just a t-shirt.
  • Sharing the world establishes your eligibility – it gets you into the game – but you won’t be of much use unless you also act from a place in that world they do not share, but want to. Yes, you are an addict – and you also live in a world where you have been clean and sober for 5 years and are genuinely humble and self-respecting. Yes, you know this is a world in which mortal, terrifying danger can appear in an instant, without warning – and you relish your life and the world you live in while taking sensible precautions.
  • In short, to be useful in helping someone reconstruct their world, you must live in their world and occupy a place in that world of greater behavior potential they aspire to. Bluntly: you can’t help someone reconstruct their world into a world you do not yourself inhabit. You can’t help an addict reconstruct their world while you yourself are using. You can’t help reconstruct a loving, intimate world unless you actually live in one. As the flight attendant says: “Secure your own oxygen mask before helping others secure theirs.”

Granted that you are eligible to help, what can you actually do that is useful? What you do depends fundamentally on the person and their circumstances. But here are some guidelines:

  • Deal with the real, not the true. People act on what is real to them in the present moment, which is only moderately related to what they know to be true about the world. Before the bombings Alison knew that the world was a dangerous place where a terrorist act could potentially occur, but that potential fact was not part of her present moment reality – she did not feel the danger and did not act on it. All that changed in a few moments. Danger became real. Alison lost that comfortable ease that accompanies being and feeling secure in the present moment. Reconstructing her world is not a matter of convincing her that this was a rare event, not likely to recur – she already knew that to be true. What she did not know before was that she was someone to whom such things in fact happen, that in her world danger is real – but now she knows that, not theoretically but directly. No amount of reassurance or factual information will change that. For months Alison stayed in her home, too terrified to go out except for emergencies.
  • Engage the Actor. Alison’s best friend Susan is a holistic healer and yoga teacher. Except for the day after the bombing they never talked about Alison’s fears. Instead, once she realized how stuck Alison was, Susan took Alison for long walks in the woods, reminding her to breathe deeply and allow herself to quietly observe the light and shadows playing among the leaves. For some time Alison remained tense and fearful, startling when a bird suddenly launched into flight, but over time her tension subsided until one day Alison said to her friend: “This is so beautiful. I feel safe.” Susan replied: “Yes. You are protected.” Alison continues to have moments of anxiety, but she says to herself “I am protected” and it usually calms her. For influencing how people are in the world, actions clearly speak louder than words. Engage in actions where what is clearly real for you is what they aspire to, and give them an opportunity to engage along with you. What they do, what they are in action, becomes real to them. It can become part of their radically changed world.
  • Inhabit the world as they need it to be and engage with them in that world. As she stared at her severed foot lying on the pavement, through the shock and pain Karen had a strong realization: “This is not going to stop me.” As soon as she regained consciousness after her first surgery she reached out to a friend, the best orthopedic surgeon she knew, and asked him to take charge of her recovery. Even before she could be fitted with her first prosthetic leg Karen joined a support group of amputees, many more grievously wounded than she, who were working to regain their mobility and their lives. She aspired to run Boston again (after getting back to her job in the ER). All around her she saw people who had accomplished their goals, returning to work and participating in their sports while accepting only the minimum accommodations actually required; one of her physical therapists had a prosthetic leg similar to the one Karen was fitted for. Being part of this group was all the help Karen needed to reconstruct her world and her place in it. Six months later she returned to the ER, working her way carefully into a full schedule, and in March 2014 she joined a large group of people who had been injured in the bombing in running Boston again. Her time sucked, but she finished the race.

Not everybody comes all the way back: John still attends a PTSD group at the local VA hospital, where a combination of medication and supportive therapy helps him through his recurring nightmares and occasional flashbacks.

And some come through seemingly better than ever. John’s son Ken says: “It’s like I had been asleep and the bomb woke me up. I am here to make a difference and there is no time to waste.” He quit his job at Best Buy and enrolled in an emergency medical technician’s course, intending to become a first responder.

Worlds change, sometimes radically – but so do people. It’s in our core competence as persons.

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