Dear Fellow American,

This handbook was initially written for doctors to assist them in helping their patients recover from the terrorist attack on America, September 11, 2001 It has become obvious that we all can benefit from the information within these pages. You will note some information directed at doctors. This information is intended for you too.

Dear Doctor and all Health Care Providers,

If you're like me, all of your skill and knowledge has been challenged by the aftermath of the terrorist attack. Hearts are broken in a new way. Sometimes our words leave us feeling helpless. We lack a paradigm with which to understand the pain and suffering, and sometimes we fall into tears along with our patients for we understand as little as they do.

Because of the urgent need for help, I have written this preliminary handbook. In this early phase of recovery from the attacks, I think we can now identify distinct phases of response to the terrorist attacks. By understanding these phases, you will develop the tools and insights for helping those who have, at times, been beyond our help. We stand in awe of their pain without words or techniques to alleviate the suffering.

May this work inspire you and your patients.

Dear Parent,

"Healing the Heart of America" is not just for doctors and other health care professionals. It is for you too. You will find it easy to understand the different stages we are going through following the terrorist attack. And you too will find the tools and techniques powerful in helping to ease the emotional wounds of your children... and in you. May this handbook lead to a deep healing for all.

With prayers for peace and healing,

Dennis Gersten, M.D.

Seven Stages in Recovering from Terrorist Attack

Why should we bother with delineating "stages" in recovering from the horrible events of September 11, 2001, a day that has changed all of our lives? There is great power in understanding. By realizing that our suffering and pain evolves through a series of stages, we can gain better control of our lives. We can each pinpoint where we are in our journey through this recovery process, taking solace in the fact that we are not alone. Almost all of us will experience at least six of these seven stages, to one degree or another.

1. Shock, Disbelief, Trauma.
People of all ages ask, "Is this real?" "This can't be real." "Is this the end?" The very foundation of our lives has been rocked.

What to Do

Listen. Listen. And Listen. Be open and willing to share your own personal reaction with others. And doctors, this is no time to hide behind our white coats and stethoscopes . . . or our psychiatric theories. This is the time to plunge into the moment, sharing the pain and confusion.

2. Emotional Barrage
Shock soon gives way to emotions from every end of the spectrum - anger, fear, sadness, pain, grief, mental confusion. And of course, "What will happen next? Will they blow up our bridges, schools, nuclear plants, reservoirs, and military bases?"

What to Do

Again, Listen, listen, and listen more. Do not rush to closure or dash to a quick solution. Dare to live with your own uncertainty, your own lack of understanding as to how this terrorist action could have happened. It is all well and good for parents to say to their children, "We love you. You're safe." And, of course, we need to be saying those words and hugging our children over and over again. But the fact is that those words will often not be enough to ease the pain of someone (all of us) whose world has just been shattered. The world will never be the same. Understand that this is real life with real pain in the world.

Do not rush to "diagnose" strong emotions. Strong emotions are part of life. Let life be lived and let emotions be expressed in an environment of safety and acceptance.

3. Disintegration
During the initial phase of terrorist attacks, along with shock, disbelief, and a pouring out of emotion, there is a more profound process taking place in many of us. Let me give an example. One woman who has made forty serious suicide attempts in life felt as if she had disintegrated along with the Twin Towers. This was no small stress. The outer world looked like it was falling apart. And for some, the inner world also totally collapsed. The center did not hold. This severe disintegration response is more likely to occur in those who grew up as victims of abuse or neglect. Their center was damaged and left incomplete, waiting for a solution . . . a long time ago.

What to Do

We'll get to that after a brief review of the seven stages. Doctors - allow yourself to feel vulnerable and uncertain. Let your love and humanity, your sense of spirituality rise to the surface to become your "clinical skills."

4. Re-integration into Love/Quantum Shift Phase I
Many have moved from self-concern and personal emotional turmoil to a feeling of unity consciousness, a love for America and all Americans. There is a renewed sense of spirit, God, focus, direction, and the value of life. Some have already embraced a love for all mankind. This is a gigantic quantum shift in how we feel and how we relate to our Creator and our fellow men and women.

5. Re-integration into Defending the Nation/Quantum Shift Phase II
The intense feeling of national love and unity eventually often gives way to a second phase of intense national unity. This Consciousness of Unity deals more with a need to protect the nation and the world from falling into a position of helplessness at the hands of terrorists. The US government is unified to do its best to clean the world of terrorism and most Americans share a feeling of defending our homeland. Many opinions may arise as to how we can remove the scourge of terrorism, but everyone is in agreement that something must be done, whether it be done through war, prayer or negotiations. The feelings of unity in love still exist, but the intent, emotions and consciousness have moved us toward a different kind of re-integration.

6. Action Steps
After we have tamed our emotions, struggled back to work, and tried to make sense out of our New World, many of us move into action. Action can be writing and sending letters and prayers. We think about our options, and debate the approaches that we, as individuals can adopt, and those that our nation will adopt. Action can be just getting back to work.

7. Lasting Transformation
Beyond feelings, action, and re-integration there is the possibility in this crisis for each of us to be transformed for the better. This will require effort for each of us. Effort to continue to love one another with the spirit of harmony. As families we can make the effort to make permanent changes, continuing to show and tell love every day. Re-examine your life and ask how you can make your world a better place . . . your family, your friendships, your neighborhoods. Let us not wait until the next major crisis to vow to make a lasting transformation in our lives.

Getting Stuck

For some, our natural emotions have become blocked, hardened, or denied. Some are experiencing signs of PTSD. One man I treat is awakened by nightmares of the terrorist planes flying into the Twin Towers. This scene has been shown so many times on TV it has become imbedded in our memory. Others are showing early symptoms of an emotional disorder, such as being too afraid to leave home.

When sadness lingers for months and turns into depression, we now have to shift our awareness from dealing with an existential crisis, a situation in which we ask, "How could God allow this tragedy?" - to dealing with a depressive illness . . . or a generalized anxiety disorder or a variety of psychiatric disorders.

We can get temporarily or permanently stuck in any of the seven stages. Realize that everyone heals in their own time and that there is no "correct" way to respond to the terrorist attack of 9/11. Most of us will move naturally through these stages, some getting stuck in one place or another, and then moving on. Each of us will require our unique time frame to deal with and integrate each stage.

By learning meditation techniques, deep breathing, and relaxing mental imagery techniques, you will begin to take the edge off emotions that have already become frozen in place and will break free from a "stuck" stage.

However, if you are still suffering immensely three to six months after the initial terrorist attack, consider psychiatric or psychological treatment to treat what could become a long-term emotional problem. Some may require psychotherapy and/or medication. There is no right way to heal. There is only "your way."

Healing those with a Wounded Heart

Healing at the deepest level is required in these extraordinary times. Search your own soul and become as clear as possible about your belief system. Do you believe in God? What is His/Her job description? Why do terrible things happen to wonderful, innocent people? Is there an after-life? If so, what is it? Where did all the dead go on the fateful date of 9/11/2001? When you have become clear and comfortable with your own spiritual beliefs, you become a powerful agent of change, a vehicle who allows his family and friends to also dive into life's most important and most difficult questions.

For many Americans, the core collapsed. The trauma lingers. What has happened? Psychologically, many theories may be offered. I will not be offering those here. Many have become disconnected spiritually, and they won't even know it until someone asks them about it. Some feel that their connection with God has broken, and that a feeling of Self and Soul are gone.

What to Do

Listen! But listen to the deeper aspirations of the human heart, the aching of the soul that does not know it has lost its mooring.

Identify past spiritual beliefs and practices. Many people may have forgotten them. Return to spiritual practices that have brought peace, comfort, and joy in the past. Just this simple reminder will help some begin to make the quantum shift into this new age, restoring their soul.

Ask yourself about meaning in your life. What were your goals, hopes, dreams and visions? Close your eyes and remember what keeps you going. Try to restore the vision of where you want to be going/doing in life. If you have no sense of meaning in life, do not be afraid to identify and admit it. Seek to know your personal truth . . . and then pray to find new dreams and goals.

There are those with "dream-anemia." The spirit of creativity, of dreaming was emotionally beaten out of them at an early age. But that happened to many of us by third or fourth grade. Realize that everyone can learn to dream, learn to want something that matters. There is no one who is hopeless. Let everyone know that and know that yourself.

Avoid dogma as you struggle to deal with your suffering. Avoid saying things like, "God will take care of this." For many, that phrase will fall on deaf ears and you will lose the opportunity of helping others. While you may be clear about your spiritual beliefs, do not allow your beliefs to dominate the spiritual or religious approach of others. Of course, with your children explain life's deeper questions through the eyes and ears of your personal religion. For doctors and other healers, this word of caution: By remembering the unity of man and that the core of all the world's great religions is the same, it should be easy to set aside your personal religion and spiritual beliefs. Just remember to love God and treasure service to those in need. That is the best way you can allow your own spirituality to become a true healing presence.

As a healer . . . or a parent, trust your own spirit, your God within and your God without. Allow your spirituality to be your foundation. Your genuine heart-to-heart contact with others is the starting point. And it will take you beyond your own frustration in the face of this terrible tragedy. You CAN help. You can help yourself and shine a light on the suffering of those around you. We must help each other.

Tools and Techniques

Now that you have allowed yourself to experience and talk through the full range of emotion and have had the chance to "stage" your progress through this universal shock, you may want to try some of these simple techniques. But, remember that attention to your own spirituality is the foundation upon which you can now add tools and techniques.

  1. Close your eyes. What makes you feel safe and happy? Visualize in your mind a person, place, or thing that has brought feelings of safety and happiness. Be specific. Perhaps, it is the image of hugging a special Teddy Bear. Perhaps it is the image of your mother tucking you into bed at night, kissing you on the cheek, and saying, "Sweet Dreams." Bring out the details of this image and then repeat it whenever you feel a need.
  2. If you could imagine everything different right now, what would that look like? Picture that. See it. Hear it. Touch it in your mind.
  3. Allow an image to emerge which represents the qualities you are seeking, whether it be peace, certainty, or safety. That image can be animate or inanimate, human or animal, or an object of any size, shape or color. As an example, you might visualize a Crucifix given to you by your grandmother, or the sword of Sir Lancelot . . . or anything at all.
  4. Remember that America is like one great big family. Families go through sad times and happy times. Sad times always pass. This sad time will also pass. We just don't know when.
  5. What do you really have faith in? Think about it and visualize whatever that is. It could be God, Mom, Dad, an old oak tree, your pet dog, your husband or wife.
  6. Where do you gain spiritual rejuvenation? Walking by the ocean? Fly fishing in a stream in Idaho? Laying in a meadow in the high Rocky Mountains? Going to church, synagogue, or a mosque? Go there in your mind whenever you need to.

Deepen Your Spiritual Connection
- The Maypole Imagery -

Each of you has your own religious and spiritual outlook, your own way of praying, your own way of connecting with your form of God. The technique called "The Maypole," adds a sense of spiritual immediacy and closeness to your current beliefs, and will only add to that connection. You can do this by yourself. Doctors can teach their patients. And parents can teach their children. Here's how it goes:

"Close your eyes. Take a couple of deep breaths to relax. Now visualize a maypole, a pole with a number of colored ribbons attached to the top. At the top of the maypole visualize your Hi C, Higher Consciousness, God, or Spiritual Being. This Spiritual Being could be obvious, such as Jesus for Christians. Others may visualize a ball of loving, intelligent light.

In your mind, walk up to the maypole. Grab one of the colored ribbons and then walk back to where you were.

Now, imagine that God sends feelings of peace down your ribbon into you. Let that feeling run through your body, from head to toe. Then imagine that God is sending his divine love down the ribbon into you . . . filling you from head to toe. Allow yourself to experience each feeling fully. Imagine God sending feelings of protection down the ribbon into you. Finally, ask God to send any other kind of feeling, emotion or experience down the ribbon into you.

When you have fully experienced this connection and have absorbed all the love, peace, protection and other qualities you want and need from God, let go of the ribbon. Take a few deep breaths and open your eyes when you want to."

As simple as this technique seems, tens of thousands of people have utilized its power, with great success. You do have the right to an intimate relationship with God or a Higher Power. In this time of national crisis, we need to be able to draw upon all the resources we can. By allowing yourself to connect with the Ultimate Source of peace, love and protection in such an immediate and quick way, you will be better able to move through the pain and confusion we have all been suffering from . . . and you can find your own temple, synagogue or mosque anytime you need to . . . by looking within. As a medical doctor, I have used this technique as part of the work I do for nearly fifteen years. It works.

Let Your Breath Help in the Healing

Proper use of your breath will also help you quickly cope with painful emotions. Most Americans breathe shallowly, and we breathe from high up in our chests. When Western Man first met the Native Hawaiians and sat down to eat with them, the Hawaiians noticed that Western Man did not appear to be breathing at all. They named us "Haoli." It does not mean "white man." It means "He who does not breathe!"

Here are two simple ways to temporarily modify your breathing. "Normal" breathing actually increases stress and anxiety. By learning these simple deep breathing techniques, you can allow painful feelings to be more easily expressed and then released. And you will learn how to relax quickly.

  1. For 30 seconds take slow, deep breaths from your abdomen. Put your hand on your belt or waistline. When you breathe from your abdomen or diaphragm, your hand should move and you should see your abdomen rising, then falling. If you don't see this happening, you're still breathing from high up in your lungs. As you take these deep breaths, let yourself experience any emotions, weak or strong, or even overwhelming. You can breathe into the pain. After 30 seconds, you will feel more relaxed and more in control.
  2. Inhale slowly to the count of 4. Hold your breath to the count of 4. Exhale slowly to the count of 8. Repeat this cycle several times.

Experiment with both types of breathing and then start practicing with one or both, using them as part of this program of tools to help you find lasting solutions for the wounds of terrorism.

We Are One

What you feel is no different from what others feel. And Parents, you can use these tools on yourself. They will help heal you and your children. We are ONE in this crisis. As you can now see, these techniques, tools, and spiritual approaches are for the young and the old. They are for all of us. They will help us all heal. I pray they help you heal.

A final word about the seven stages of response to overwhelming terrorist attacks. People may not go through those stages sequentially. Many people will be experiencing several different stages at the same time. Hopefully now you will feel confident in sorting through the complexity and will aim high. Trust that the human condition is such that we are built with incredible versatility and resilience. Convey that to others.

And always feel you are united with the consciousness of America, not working alone. We are all working alongside our brothers and sisters.

Godspeed for your uplift - for doctors and their patients, parents and their children... and for you. May all children everywhere benefit from this advice, not simply surviving this trauma, but becoming stronger than they were before. A war is fast approaching and we must be prepared for the emotional needs of our fellow Americans.

Peace in the Heart - for You, your Kids, and the World

Please do not relegate your emotional survival to the realm of emotions and psychology. Take this time to ask yourself what is deeply important in your life. Treasure and share your family every day. Pray or meditate on the meaning of life, and the purpose of your life. Find things in yourself that need to change and take this tragedy as an opportunity to let go of old habits that no longer serve you. Many will feel guilt for what they didn't do or couldn't do September 11th. Let go of guilt. That is what terrorists would like you to feel. Rise above that.

Let your feelings and emotions come and go. Experience them without judgment. We all feel very much like you. Keep this perspective: your connection with your Creator, your Source is your connection to a meaningful life. Let emotions pass through you like clouds passing through the sky. Keep your eye on the sun shining through that sky. Unify your family in love. Let our nation unify as one big family. Let us pray that one day the world will unify in love.

These are my hopes, prayers, and medical prescriptions for you. - Dennis Gersten, M.D.

©2001, Dennis Gersten, M.D.

Permission is hereby granted to all to copy "Healing the Heart of America." Individuals are hereby granted permission to make copies, to send out via e-mail or transfer in any other form. If you would like to link to this document in text or PDF format, link to any of the following addresses:

Pass along the information any way you can. These tools can help millions of Americans, not to mention those around the world whose hearts have broken along with ours, and who now unite with us to create a better world.

Contact Information:

Dennis Gersten, M.D.
1020 Second Street, Suite C
Encinitas, CA 92024
Tel: 800-211-5215
Tel: 760-633-3063