Secrets of the Strong-Minded: Can Children Be Made Resilient to Traumas Like 9/11?

September 28, 2014 Updated: September 29, 2014

Can children be made more psychologically ‘resilient’ to traumas like 9/11 – as well as the stress of everyday life? Emma Young meets a former school principal who believes they can.

“It was one of those perfect days. I think that’s what everyone remembers. And now whenever the day’s too perfect and the sky’s too blue, I think: what might happen?”

September 11, 2001. Lisa Siegman was in her first year as principal of Public School 3 (PS 3) in downtown Manhattan. Up on the fourth floor, the fifth-graders had a direct view down to the World Trade Center. “They had a perfect view of the towers,” Lisa says. “The kids saw people jumping. People were running into the halls of the school, just doubled over.”

PS 3 was far enough away to escape evacuation. But children from two other schools, PS 150 and PS 89, which were closer to the devastation, were sent there for safety. “People started converging on the school,” says Lisa. “We had parents wanting to take their kids, parents wanting to help; we had only two working phone lines.” By the afternoon the school had been identified as a potential site for a temporary morgue. Refrigerated trucks were lining up outside, along Hudson Street.

On what was just the sixth day of the school term, more than 5,000 schoolchildren and 200 teachers had to run for their lives. But kids all across the city were affected – from those who heard the non-stop sirens of the fire engines and ambulances to those in quieter neighbourhoods, who watched replays of the strikes over and over and over on TV.

By the end of that day the September 11th Fund had been established by two major local charities. Donations poured in. Money first went on immediate aid – hot meals for rescue workers, emergency cheques for victims and their families – and then funds were made available for programmes to help New Yorkers to recover. The damage wasn’t only physical, but psychological. Counsellors set up services in local churches, and psychiatrists came from around the country to offer their expertise and their insights. Thoughts turned to the city’s children – how would they deal with the stress and trauma?

Into the debate stepped Linda Lantieri. A former school principal in East Harlem and administrator with the city’s Department of Education, she had helped to develop social and emotional learning programmes for US schools, and was head of the National Center for Resolving Conflict Creatively, an organisation she’d co-founded to tackle school violence. Helping kids handle trauma and manage their emotions was Lantieri’s forte. She approached the Fund with her own take on resolving the problem: enhancing ‘resilience’ – a person’s ability to get through difficult circumstances without lasting psychological damage.

 

For scientists the concept of psychological resilience began in the 1970s with studies of children who did fine – or even well in life – despite significant early adversity, such as poverty or family violence. For a long time a person’s level of resilience was thought to be inherited or acquired in early life. This idea was supported by the often-replicated statistics on what happens after a trauma: while most people bounce back to normal relatively quickly, and some even report feeling psychologically stronger afterwards than they did before, about 8 per cent develop post-traumatic stress disorder, according to US figures.

The degree to which someone bounces back, or does even better – his or her resilience – has a genetic component. But “genes are not destiny here,” says Professor Dennis Charney, Dean of the Icahn School of Medicine at Mount Sinai, New York City. He bases this statement in part on interviews with people like Jimmy Dunne.

Dunne is a co-founder of the financial services firm Sandler O’Neill, which was formerly based in the South Tower of the World Trade Center. On 11 September 2001 he was out playing golf when he heard about the first plane crash. As further details emerged, he realised his colleagues were among those trapped above the burning wreckage. By mid-afternoon Dunne was on a train to Manhattan. He ran from Grand Central Station towards the small midtown satellite office where the firm’s survivors were gathering. About four blocks away he stopped running and started walking. “I remember thinking, as soon as I get there everybody’s gonna be looking at me, everyone’s gonna be looking for direction from me. I want to set a very different tone, one of total calm,” he said later.

Dunne told Charney that while he felt he was naturally quite pessimistic, “the moment I heard what the terrorists wanted, I decided to do exactly the opposite. Osama bin Laden wanted us to be afraid. I would show no fear. He wanted us to be pessimistic. I would be incredibly optimistic. He wanted anguish. I would have none of it.” His firm lost 66 of the 83 people who’d been working in its main offices, as well as its computer system and almost all of its records. Just six days after the attacks, it reopened for business.

Before 9/11 Charney and his collaborator Professor Steven Southwick at the Yale School of Medicine had been avidly studying people who’d experienced a trauma, looking for clues as to why some people are more resilient than others. Their interviewees include former American prisoners of war in Vietnam, serving members of the US Special Forces and their trainers, victims of sexual abuse in Washington DC, survivors of an earthquake in Pakistan, and later people who were hit hard by 9/11. “We started out with a blank slate,” Charney says. To the people who recovered well, they asked: “Tell us how you made it? What were the factors?”

As well as investigating psychological attitudes and mental strategies linked to resilience, Charney and Southwick have probed the neurobiology behind it. People whose bodies respond rapidly to a threat – with a surge of the stress hormones adrenaline, noradrenaline and cortisol – but who then recover quickly seem to cope better with stressful situations and jobs, such as working in the special forces.Could this drug make you mentally stronger?

More resilient people also seem to be better at using the hormone dopamine – which has a role in the brain’s reward system – to help keep them positive during stress. Charney’s team, along with colleagues from the National Institutes of Health, studied a group of US Special Forces soldiers. They found that the amount of activity in the reward systems of the soldiers’ brains remained high when they lost money in an experimental game, unlike in the brains of regular civilian volunteers. This suggests the system in resilient people’s brains may be less affected by stress or adversity. Each of the soldiers’ brains also featured a healthily large hippocampus (which as well as enabling the formation of new memories also helps regulate the release of the fight-or-flight hormone adrenalin) and a strongly active prefrontal cortex, the brain region dubbed ‘the seat of rational thinking’. This in turn helps inhibit the amygdala, the part of the brain that processes negative emotions such as fear and anger, allowing the prefrontal cortex to come up with a sensible plan to cope with a threat.

Through their research Charney and Southwick have identified ten psychological and social factors that they think make for stronger resilience, either alone or ideally in combination:

•        facing fear

•        having a moral compass

•        drawing on faith

•        using social support

•        having good role models

•        being physically fit

•        making sure your brain is challenged

•        having ‘cognitive and emotional flexibility’

•        having ‘meaning, purpose and growth’ in life

•        ‘realistic’ optimism.

Charney and Southwick are convinced that it is possible to develop these ten factors, and that this can lead to a positive change for generally healthy people in their ability to cope not just with a major trauma, but also with the day-to-day stresses of life.

Academic questionnaires to measure resilience do exist. They measure some of the factors that Charney and Southwick have identified. They’re decent tests, Charney says, but they haven’t yet been used to evaluate the extent to which a person’s resilience might be improved. Still, based on what he’s found out, Charney says that the extent to which these factors could be modified, in theory, is “a lot”.

For kids Charney’s first suggestion is ‘stress inoculation’ – getting them to learn that they can cope with a challenge and overcome setbacks, perhaps by playing competitive sport or through wilderness adventures. “I used this with my own kids,” he tells me. “I have five – four daughters and a son – and they like to say I got tougher on them.”

But Charney is also interested in another technique. It’s been shown in lab studies by other researchers to increase activity in the left prefrontal cortex. In theory this should allow people to recover more quickly from a negative emotion, in part by reducing inputs from the amygdala, as well as, studies suggest, by increasing activity in the brain’s reward system – all of which should boost resilience. Until recently this technique was relatively obscure. Now it’s everywhere: mindfulness. 

 

Mindfulness has its origins in the Zen Buddhist tradition, but its central ideas – involving attention and awareness – are secular. A modern explanation is that it means paying attention, on purpose, in the present moment and non-judgementally, to the unfolding of experience, moment to moment.

Lantieri believes that mindfulness and other fundamental stress-reducing strategies are vital foundations for the kinds of changes Charney talks about. “Many of the factors he mentions are internal strengths that can be cultivated through mindfulness – such as cognitive and emotional flexibility or facing fear. We can’t just tell people that it’s better to face their fear without helping them figure out how,” she says.

Mindfulness practices play a prominent role in Lantieri’s programmes for both adults and kids. Just before 9/11 Lantieri completed a series of intensive retreats, learning contemplative practices, including mindfulness – which involves meditation but also a conscious attempt to be ‘in the moment’, a strategy used by some psychologists to help people manage depression and anxiety.

After 9/11, to best help the city’s kids, “I knew I had to start with the adults – with the teachers,” Lantieri says. The adults in a child’s life can have a huge influence, she says, and if they’re not coping they can’t be expected to adequately help the kids. She put forward a proposal to the September 11th Fund and it was accepted.

In September 2001, as New Yorkers began to clear away the physical debris of the terrorist attacks, Lantieri developed her Inner Resilience Program (IRP) for teachers. Working with them, she developed a suite of tools for use in the classroom, to help children cope not only with serious traumas, like the terrorist attacks, but also with more everyday stressors, from exams to poverty to conflict in the home. These include exercises designed to improve conscious awareness of the body and how to calm it down, in part to tackle stress and anxiety, and in theory to boost long-term psychological resilience.

 

We’ve been stuck in Manhattan rush-hour traffic for an hour, but now we’re on the FDR (the Franklin D Roosevelt expressway) speeding uptown, towards East Harlem. “Tom, the traffic angels have come to our aid,” says Lantieri down the phone. “We’re like at 103rd already, so we’ll be there by 20 after.” At 119th Street we turn off. The car stops by a complex marked with a Costco sign. “People come and park here and do their shopping,” says Lantieri, as the vehicle comes to a halt. “They have no idea they’re right round the corner from kids living in incredible poverty.”

Public School 112 is right across from the Costco. A rectangular block of a building, it’s three storeys high with diamond-patterned security gratings across the windows of the first two floors. Above the entrance, painted in uneven rainbow-coloured letters, are the words “Live your dreams”. Higgledy-piggledy kids’ paintings adorn the front walls. There are robots, a princess, something that might perhaps be a crocodile. Waiting inside is Tom Roepke, one of the teachers. He and Lantieri hug, and he leads us up to a kindergarten classroom.

It’s a bright, welcoming room, the walls plastered with artwork, an alphabet, a number chart. There are circular tables with little chairs, and two Apple iMacs on a low desk by the wall. Roepke goes and sits cross-legged on a rug in a circle with 14 kids.

He places a folded cloth down in front of him, and slowly, deliberately, opens it. “A chime!” cries one little boy. Roepke nods. In a quiet, warm voice, he asks the kids to put their hands on their bellies and take a few deep breaths. Everyone obeys. He strikes the chime, and the kids listen attentively to the clear, pure sound. At last, when the echo finally dies away, they all raise their arms very slowly. No one giggles. No one fidgets. They’re only five or six years old, and they’re fully engaged.

Roepke puts on a baseball cap. “I’m going to take you on a journey,” he says quietly. “We’ll cross a bridge, and take nectar from our pockets with our fingers. A butterfly may land on your finger. If something happens on the trail, what could you do to calm yourself down?” A girl puts one hand up and the other on her lower belly. “Yeah,” says Roepke. “Let’s practise. Low and slow.” He breathes deeply, three times, and the kids follow suit. Then he unfurls a long canvas strap.

One by one, the kids cross the imaginary bridge. All the time, Tom talks in an animated near-whisper, encouraging and guiding them. “Be careful of that bridge. It’s a little shaky… Pay attention to your breath as you’re going. Slow, low breaths.” The class teacher offers tips, and praise. “Watch your feet… Good, Makari, you’re being so careful and calm.” The kids are calm. But when they’re all at the other side, a few start to chatter. “Anybody excited?” asks Roepke. They nod. “Me too. What can we do to calm down?” As one, they put their hands on their bellies. Immediately, the room goes silent. They breathe. Roepke puts his finger in a pot of imaginary nectar and holds it up, and the kids do the same. They whisper about what they’re seeing. Roepke says: “Now one, two, three… Watch them go…”

Eyes still closed, the kids talk happily about where their butterflies flew off to. “Mine landed on a tree,” says one. “Mine went to planet Earth!” says another. Roepke passes round imaginary bottles of water. “Everybody’s thirsty. But don’t gulp it,” he says. “Feel it going down your throat.” Obediently, they pretend to drink, all apart from one little girl, who asks, “You got any soda?”

Through the butterfly hunt the kids learn two concepts crucial to Lantieri’s programme: how to connect with the body – to be ‘mindful’ of the physical signals of stress and excitement – and strategies to combat this. Lantieri recommends other exercises, such as more structured meditations and progressive muscle relaxation, which might be used during ‘Peace Time’, a defined period in the school day that slows the pace – helping the kids to calm down after the lunch-break, for example. Peace Time acts as a space in the curriculum for kids to learn ways to help themselves. The main goals are to teach students how to calm themselves when they’re upset, relax their bodies and minds, and help them pay attention, whether that’s in class or at home. 

 

Meditation and relaxation techniques may help with acute stress. But there’s also evidence that, when practised regularly, they can help the body become less reactive in a stressful situation, boosting resilience to stress and anxiety disorders. Mindfulness meditation isn’t the only form that’s been shown in lab studies to increase activity in the prefrontal cortex, as noted by Dennis Charney in his neurobiology research.

According to studies conducted at Harvard Medical School, transcendental meditation (which involves the repetition of a mantra) and yoga can also initiate what’s sometimes called the relaxation response.

This is the physiological opposite of the fight-or-flight stress response. It’s controlled by the parasympathetic nervous system – the branch of our nerve network that calms us down after a stressful event – lowering our heart rate and reining in stress hormones. People who can calm down quickly, whose parasympathetic nervous system response is quick and effective, cope better physically and psychologically with stress. Meditation seems to be capable of improving its activity, as does exercise.Stronger body, stronger mind

Lantieri advocates setting up a ‘Peace Corner’ – a part of the classroom (or even the home) with perhaps a cushion and a few stress-releasing tools, such as paper and pencils, a music-player with recordings of sounds of nature, and a water bottle filled with glitter in solution for the kids to up-end and watch while breathing slowly. In the kindergarten classroom of PS 112 this is a chair with a sheet of paper on the wall that reads “Peace Corner Choices: Sit and Breathe. Read a Book.” After the butterfly hunt a few of the children talk about what they like to do in the Peace Corner or during Peace Time.

“You can draw your mother or your dad or hearts or your dog or you can write ‘I love my mom’,” one girl says.

The class teacher asks the kids when they might go to the Peace Corner. “If you’re scared or you’re nervous,” says one girl. “Or if you miss your mom and you’re crying.” A boy sitting near us says, “If someone died in your family, you could go to the Peace Corner.” There’s silence for a few moments. “Does that help you?” the teacher asks. The boy nods. “Yes.”

The idea, Lantieri explains, is that children learn that when they’re feeling sad, anxious or angry, or even excited, they can go to the Peace Corner to calm down. It’s not for the teacher to send a child there if they’re misbehaving. “A child is never told to go to the Peace Corner,” says Lantieri. “They learn to take themselves. This is about building self-regulation.”

Lantieri’s programme for teachers also includes a strong focus on methods for calming down. It involves weekend retreats, which offer yoga, workshops on stress management and conflict resolution, and introductions to mindfulness and other types of meditation, as well as opportunities for teachers to talk about the meaning of their work.

There are also day courses and workshops. Teachers might have a massage, or join a session in which they are read a poem and asked to relate to a line as a way to encourage them to talk through issues that are concerning them. Lantieri also runs monthly meetings that enable local school administrators to come together, to take part in a meditation, use some of the other techniques taught in the retreats, or just to talk, without judgement.

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