Since September 11th many individuals and groups have tirelessly given of themselves to help the nation deal with a terrible tragedy. A number of them have nobly served in working with people affected by other disasters.

As the counselor (or other service provider) interacts with the victims it becomes easy to lose sight of the effects of the trauma on themselves. Seeing and hearing the consequences of the disaster on the victims, hearing detailed accounts with the resulting pain, and observing traumatic scenes can often take a silent toll. Counselors can and do become traumatized themselves. The effect is compounded if one has witnessed the event as many of us did, repeatedly, on television and radio or if one has been through other traumatic events.

Effects can be similar to those observed with the individuals one works with. Depression, anxiety, dissociation, withdrawal, agitation or irritability or a sense of being overwhelmed can occur. One may begin to isolate from one's support system and intimate relationships. Alcohol abuse, or other compulsions or addictions can exacerbate. Self-care can deteriorate. Along with the effects, sadly, can be a guilt or belief that it is not okay to be feeling the way he or she does. The counselor may think "after all I didn't go through what they went through". It's important to realize that the feelings are valid and just as important and deserving of being addressed. To help others we need to first to take care of ourselves, if we are drowning with someone we first need to get to shore in order to help them out.

We need to find someone to talk to- someone who is able to hear and understand. If we talk to someone who changes the subject or is unable to tolerate the discussion it doesn't mean that it is not important or deserving- it just means we need to talk to someone else. Sometimes a therapist may need to be considered; we may need to "practice what we preach". Taking time for ourselves to do something we enjoy things we used to (even if at first we "act as if we enjoy it), taking time off, getting involved in our religion, watching comedies, attending support groups, relaxation training, yoga and other strategies may be helpful. It is imperative that we find what works for us.

Those of you who have helped in this and other disasters deserve our thanks....and deserve to take care of yourselves.