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After Shock

Psychiatrist Roy Lubit worked as a management consultant and teaches MBA students. But he’s spent the past two weeks at ground zero, counseling survivors and advising companies with traumatized workers. Here’s his advice on how to move beyond despair.

The past few weeks have been a sadly busy time for New York’s mental-health professionals. Roy Lubit, a psychiatrist who has been in the thick of it all, admits that his training didn’t quite prepare him for the sheer enormity of the pain he’s now trying to alleviate. “The work is not of a totally new sort,” he says. “But trying to help a large number of people briefly is different than helping a small number of people who have suffered from individual traumas over a longer period of time.”

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Nevertheless, Lubit has pitched in everywhere he can, working with survivors of the terrorist attacks on the World Trade Center. He’s also volunteered in the counseling center that the city set up for grieving families and has been leading meetings for companies in the city that did not lose any staff but that are still filled with traumatized workers. A forensic psychiatrist affiliated with St. Vincent’s Hospital in Manhattan, the closest trauma center to the collapsed buildings, Lubit brings the requisite medical credentials to his task. But he also did a two-year stint as a management consultant at PricewaterhouseCoopers and earned a PhD in political science from Harvard. This fall, he’s teaching a class on developing managerial skills for MBA students at the Zicklin School of Business, part of New York’s city university system.

Fast Company recently sat down with Lubit to get his perspective on how businesses should respond to employees’ emotional needs in the wake of such an enormous national tragedy.

Is everyone entitled to feel a deep, lasting impact from the terrorist attacks? Or should those who don’t live in New York or Washington and who aren’t personally affected just toughen up and stop thinking about it so much?

I’m not sure that “entitled” is a word I would use or choose, but it is important to accept that many people who were not physically threatened by the attacks have still been significantly affected by what occurred. A disaster like this undermines people’s sense that the world is a safe place and can leave them feeling vulnerable. Having a strong reaction doesn’t mean that a person is weak or has a significant emotional problem, just as a lack of problems doesn’t mean that someone is uncaring. Healthy, normal people have and will continue to have a wide variety of reactions.

Is the lingering emotional effect of the attacks grief or something else?

It’s not grief per se. The term in psychiatry is “acute stress reaction.” In the early days, people may have full-blown stress disorders, may experience feelings that the world is unreal, or may be in a daze. It’s as if things around them aren’t really happening — as if they’re watching themselves from the outside. Or they just feel numb.

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Are there other symptoms that are common for people to experience, even weeks later?

People without any preexisting emotional problems may still experience a wide variety of distressing feelings, such as the desire for withdrawal, intrusive recollections, thoughts about the disaster, anxiety, and jumpiness. People may feel despair and emptiness, causing them to question life’s purpose. Others may have nightmares or feel that they’re not safe anywhere. At a time like this, many people feel guilty about having any sort of pleasure. There may be a change in appetite, difficulty sleeping, or a loss of interest in sex. Some people may have trouble feeling warm, caring emotions and may become irritable, which can cause problems in their relationships with others.

Those are all normal reactions to an extremely abnormal event.

Few people felt good about returning to work and conducting business as usual in the days after the crisis. At what point should people who still feel uncomfortable working seek out help to deal with those feelings?

If people are still unable to maintain reasonable control of their feelings, breaking down in tears in front of their children or at work, then they should view that as a warning sign and seek additional support. People who have had prior problems with anxiety, depression, or other emotional disorders may find those disorders stirred up again.

We all know what we’re supposed to do to take care of ourselves physically. Are there preventative steps to take emotionally as well?

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There are several things people can do to take care of themselves and of one another. One is to take care of basic needs, the things that your parents and doctors have told you about for years. Eat appropriately and drink fluids. Lots of people have ended up in the hospital for dehydration over the past two weeks. Get plenty of rest, and don’t let yourself feel guilty about enjoying things.

People directly affected by the attacks may experience a sense of despair, hopelessness, and withdrawal. But some individuals may find themselves refocusing on things that will bring greater meaning to their lives. They may want to pay more attention to family and relationships or to place more value on their own time. Or they may want to focus more on work and seek to create something for the world that will leave a positive legacy.

Is it appropriate to talk about all of those emotions at work?

For some people, talking about the attacks and sharing feelings is very helpful. For others, talking will be too painful. We need to respect the different ways people deal with their feelings. Pressing people to talk about their feelings can flood them and be traumatic for them, making things worse rather than better. Also, telling people about your own painful experience in a very graphic way can flood them. It is important to remember that everyone out there has been traumatized and that everyone out there is vulnerable to being overwhelmed by what has happened and by repeatedly hearing about what has happened to others.

So should there be rules on when and where it’s appropriate for people to express themselves in the workplace?

I’m hesitant to suggest setting rules. We should all use common sense. If colleagues feel that they need to talk about things, then we should try to accommodate them but not let those conversations get overly graphic or upsetting to coworkers.

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I do recommend that people limit their TV watching to one hour each day. It’s not good for people to watch the buildings get hit by the airplanes, burst into flames, and fall down time and time again. Those images are being ground into people’s memories in a way that is not helpful.

What’s the role of leaders in an organization at a time like this?

Leaders serve a critical function at a time like this. They can support workers who need it by decreasing demands a bit and understanding that people are going to have difficulty concentrating. At some companies, productivity may not drop at all or may only drop for a short while. But for a few weeks, it’s better not to push people, particularly those who may not want to travel. This is a time to be tolerant and supportive rather than driving people intensively. Making them feel bad about themselves right now will just make them feel bad about the company too.

At the moment, the economy seems to be less stable than it was just a month ago. Should people express their concerns with one another about the health of the organization and discuss their fears about being fired?

Sharing one’s feelings and concerns is helpful for most people, but it should be done in a way that doesn’t cause others to panic. All of us need to take some responsibility for how we say things, the amount of emotion we pour out, and the words we choose. We also need to think carefully about the people with whom we share these feelings, because causing panic in others doesn’t just harm them emotionally — it can lead them to make bad decisions.

Ron Lieber (rlieber@fastcompany.com) is a Fast Company senior writer. Contact Roy Lubit by email (roylubit@adiglobal.com).

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