Attacks on Civilians & the Process of Grief

From Nice in France to Kabul in Afghanistan, media has been packed with shocking assaults on innocent lives. Both as direct victims or indirect observers, these attacks have widespread effects on our mental health. How do we take in, process and ultimately find closure through the grievance of such heart-wrenching losses?

In her 1969 book “On Death and Dying”, Elisabeth Kübler-Ross proposed that, humans from all walks of life experience grief and mourning. But, unjustified violence complicates this process. Intense levels of media coverage and the public’s concern over terrorist attacks also increase general levels of stress by acting as a reminder of feared outcomes. In this post, I highlight the Kübler-Ross model of grief and loss to explain the emotional storm the community of humans might be experiencing in the face of recent news: 

1. Denial

Lasting even for few seconds, the first reaction to the news you get from your media outlet might be to deny the reality of the situation – a state of shock. It is a normal reaction to rationalize the shocking impact of devastating emotions. Whether achieved by turning off the TV (or keeping it on even through repeating news) and tuning in to your favorite happy music: denial for some of us is the first line of defense that preserves the integrity of one’s nervous system through buffering the shocking news. We block out the words and hide from the facts to allow them in slowly. This is adaptive! Grant this person the space and nurturance they need to move past their denial and avoid minimizing a situation that is already intense and equally unacceptable. The recent attacks on civilians are sudden, unexpected and unaccounted for, leaving more grieving individuals in a state of shock and denial. 

2. Anger

As the heartbreaking reality re-emerges in our consciousness, we find ourselves threatened by the ongoing and random terror; the intense emotion is warded off from our vulnerable core, redirected and expressed instead as anger. Anger is a complex emotion that can run wild aiming at random targets like total strangers, ideologies, extremist and radicalizing groups, and even inanimate objects. Some reports indicate that the purchase of firearms is on the rise in the aftermath of attacks on civilians which accounts for wishful self-protection through preparing to respond to rage by anger. The warded off anger may bring about polarization on one extreme, reinforcing an “us vs. them mentality”; and, on another end, compassionate feelings expressed to ameliorate the devastation experienced by the victims and their relatives. Clearly, the implications are widely different.   

3. Bargaining

As the anger subsides, feelings of helplessness and vulnerability re-emerge in an attempt to regain control. This is a weaker line of defense to protect us from the painful reality.

• If only security and police were more rigorous…
• If only their government had not accepted so many refugees with unknown backgrounds…
• If only we had not attacked those countries in the name of democracy…

Secretly or openly, we may resort to or even doubt our beliefs in higher power in an attempt to prevent the inevitable, achieve inner peace, find an object to release our anger upon, or in search of an ultimate wisdom that is unavailable to the rest of us, but could answer our numerous “why” questions.

4. Depression

Helpless sadness is a depressive state marked by a pervasive feeling of inadequacy in restoring what has been lost. Knowingly or unknowingly, we harbor worries about the emotional costs ahead of us. We may secretly feel relieved that we were safe, but feel selfish too, similar to the survivor’s guilt phenomenon. This phase may be eased by authorities offering reassurance, yet the experience of depression is more subtle and, in a sense, perhaps more private. It is our quiet defense against witnessing senseless madness. It is sensible to feel sad for up to two weeks before the condition worsens to clinical depression.  

 5. Acceptance (or numbness)

As long as there are valid reasons to foresee more unexpected attacks on civilian lives, reaching acceptance might also mean submitting to the attackers. Framed differently, it also means better preparation. The sudden and unexpected nature of recent events makes it difficult for us to see beyond our anger or find meaning to replace our sense of denial. The political backlash deepens the gap to reach probable peaceful resolutions, feeding a polarizing effect of us versus them. As time goes on, we gain relative calm through withdrawal, distractions, or other coping strategies.

Whether attacks are carried out by a terrorist or a severely mentally ill, this is not a period of happiness but numbness, desensitization and anger. Allowing in different perspectives for the sake of gaining additional insight helps us view the current events under more realistic lights, un-skewed by media propaganda. And withstanding the real struggle to find personal meaning amidst the brutal news might just be our only path towards reaching acceptance and cultivating inner peace moving through a state of chaos.    

To our profound awakening, 

Dr. Hessam

The Pharmacy of self-love

In the mediated age of technology where so many signals and networks compete for our attention, we still own the world’s first and most advanced pharmacy: our brain.

One chronic problem we face as modern living mammalians may be our chronic perception of situations as threatening that are not. Raised cortisol levels due to chronic fear lead to depression by draining various neurotransmitters that play vital roles in our ability to experience life with joy. 

In many of our daily experiences, we trade resources like time and money for services that we expect to be of high quality. Trading is a form of exchange that also takes place in our body’s most advanced organ as it produces different chemicals in response to what we provide it with and how we interpret the world. We give more credit to external circumstances than we do to the impact of our continual interaction with our own brain through self-criticism or self-kindness.

Kindness directed at own self is not a New Age concept!

As mammals, we are our own healers when we soothe our own pain by the mere touch of care. Our built-in caregiving pharmacy starts its operation by triggering our hormonal system to release oxytocin. It has been titled by researchers the “hormone of love and bonding” because its magic begins before even we are born. The strength of mother-infant bonding after birth is predicted by the levels of oxytocin measured in pregnant mothers. As adults, we might not readily realize how much we judge our social relationships based on our oxytocin’s levels. Research has shown increased levels of this hormone give rise to feelings of trust and connectedness that also promote the ability to feel warmth and compassion for ourselves as well as others.    

Oxytocin overrides stress!

It counteracts the increased blood pressure and elevated cortisol due to stress; as a result it reduces emotions associated with anxiety and fear. When you are feeling frustrated at the airport security check or feeling timid at a party (because there is no alcohol), it is because anxiety and relaxation cannot coexist in the same moment (for any of us), and their chemical arsenals in the brain never overlap, rather counteract one another.

Researchers at the Multidisciplinary Association of Psychedelic Studies (known as MAPS) investigate psychedelic-assisted psychotherapy for the treatment of mood and trauma disorders. Their research has shown that MDMA (also known as the drug party Ecstasy) simulates the actions of oxytocin to quickly and effectively reduce or eliminate persistent anxiety disorders. Again, there is evidence for activation of same brain regions that aside from feeling calm and compassionate, Oxytocin in prefrontal cortex enables us to accept our differences through empathy for self and others. Through drugs or positive practice, there are noteworthy implications here for our mind-body health outcomes in time. For example, practicing relaxation techniques coupled with self-kindness successfully neutralize emotions associated with anxiety and fear. Now, Xanax does the same thing but with unwanted short- and long-term side effects.   

The pharmacy of self-criticism 

The experience of physical and emotional attacks influences the oldest part of our brain: the amygdala in the limbic system, an almond-shaped structure responsible for the emotional processing of our experiences. Mammalian evolution celebrates its selection of the amygdala's protective function to search for threats in the environment; and so to mobilize our body to protect itself. As the fight-or-flight response is triggered, the amygdala sends signals that raise the blood pressure along with the blood levels of adrenaline and the stress hormone cortisol. This activates the body’s energy systems to quickly confront or avoid a threat. unnecessary activation leads to feelings of depletion and exhaustion. Fortunately, this can be reversed to restore well-being.    

Research has also identified different parts of the brain involved in processing the signals produced by two conditions of self-criticism and self-reassurance. In one study, participants were asked to choose their reaction to a job rejection letter for the third time in a row in either a reassuring or a self-critical way. The group of participants who focused on personal setbacks engaged in self-criticism and experienced activation of the lateral prefrontal cortex and dorsal anterior cingulate. These brain regions are also responsible for processing errors and solving problems. Participants who showed understanding toward themselves, on the other hand, activated left temporal pole and insula, which are areas of the brain associated with processing positive emotions and loving kindness. One implication signifies the long-lasting advice that we function significantly better when we approach ourselves with affection as valuable human beings who are worthy of love, instead of seeing ourselves as a problem to be fixed.

Today's problem & Solution

Our life experience in this day and age has changed tremendously. Yet, our brains process threats and kindness similar to how it did thousands of years ago. The experience of warmth and tender care towards yourself changes your body as well as your brain. Self-love offers us the calm and secure inside sanctuary where we no longer function from a place of fear. Once we relate to ourselves with greater self-understanding we can see through the ego-serving distortions of reality better - and to approach dreams with the essential confidence to actually achieve them.  

How often do you give yourself a long hug after a mistake or failure?

ps., please pardon any errors you find in this post. today I honor my thoughts that want to just rush out and lay on the keyboard. 

Dr. Hessam