February 16, 2011
By Staff Reporter
Though certainly suffering from a loss of credibility, it’s good to be reminded at times what the peace process has been all about: the ending of violence. Sadly, the aftermath of 35 years of Troubles will be with Northern Ireland for a long time to come.
Last week, David Bolton, director of the Northern Ireland Center for Trauma and Transformation in Omagh, Co. Tyrone, came to New York to meet with a group of senior managers and clinicians from emergency and health organizations who dealt with the aftermath of the Sept. 11, 2001 terror attacks to take them on a weeklong working visit to Northern Ireland where they will talk shop and compare the treatment of victims scarred by violence and trauma.
Bolton, a trim figure with a soft Fermanagh accent, was born in Dublin but raised in the watery county. He had his first experience of post-trauma support work in November 1987 with the Enniskillen Memorial Day bombing, which killed 12 people and left hundreds injured, many with scars that cannot be seen anywhere on the body — they are scars on the mind, inflicted on the inner person.
Bolton’s next major experience was an air crash in January 1989, when a plane carrying mostly Northern Irish-born travelers back home, crashed and killed 34 people.
Then there was Omagh, Aug. 15, 1998 — the worst individual incident in the Troubles, coming cruelly on the heels of the Good Friday agreement.
Bolton, a man who knows trauma intimately, describes the Omagh effect as follows.
“Omagh gouged huge shockwaves through our entire community with over half the cases of PTSD from the street where the bomb exploded,” he said. An unusually large number of people witnessed the explosion or the torn-apart bodies afterward, he said.
“Any terrible incident in our lives, whether terrorist-related or not, can lead to a range of symptoms that are now characterized as Post Traumatic Stress Disorder, or PTSD,” Bolton explained.
“This group of symptoms make people very sad and exhausted all the time,” he said, referring to such symptoms as flashbacks of the traumatic event; avoidance characterized as avoiding the area where the trauma happened; drinking heavily to forget; and a state of aggressive anxiety.
“A third of people who experience some form of PTSD go on to live chronically unhappy lives,” Bolton said.
The field of study itself is now so advanced it attracts the interest of New York’s finest health managers, such as director of the Fire Department of New York’s counseling unit, Malachy Corrigan to Northern Ireland. But for 30 years, it languished, he said, for 30 years of “immobilization” as the Troubles raged on.
A recent report by the Department of Health for Northern Ireland touched briefly in its third chapter on the long-term effects of the Troubles on people’s health is “not clear” and “poorly understood.”
That said, the report then noted, using Omagh as an example, that truly debilitating PTSD was likely to be rife amongst the population, with children especially vulnerable.
The report then cites another example of severe and enduring PTSD: Enniskillen, where significantly poorer levels of mental health existed among those affected by the bomb continued for years afterwards.
In particular, people referred to their horror that such an event as the Enniskillen bombing could happen in what researchers collectively referred to as a “low-violence” town.
They referred to their horror, Bolton continued, when they overcame a natural Northern Irish reticence.
“We would hear of warped, utterly misshapen lives, only after people finally found it intolerable to live with,” Bolton said. “And then it was only with the words, ‘I am really sorry to trouble you, but . . . ‘ “
Bolton’s knowledge of the various research into PTSD across Northern Ireland leads him to suggest a figure of one in four people with possible long-term mental illness: 375,000 people.
How is this illness being treated?
Bolton spoke of how cognitive therapy techniques are being coupled with creating situations in which individuals are given methods that allow them to monitor their own symptoms — giving them power over their lives again, in a sense.
In counseling, people often describe their witnessing of the most horrific events in a deadpan way, Bolton explained, which seems like a full description.
Often, however, they are slipping over what experts in the field call the “hot spots.”
“So we slow the telling way down,” Bolton said. “We place a huge emphasis on making the patient feel safe. Someone, for example, might tell you vividly of their experience of Sept. 11, ‘I was at such-and-such a street,’ and it sounds detailed, but they are actually leaving out huge amounts of detail. These are the hot spots.”
Bolton is a gentle man, a professional whose care and concern comes out frequently in conversation. But he remains just as concerned for the fate of Northern Ireland as he was before anyone ever heard of the peace process.
“Especially now,” he said, “when we are more divided than ever,” referring to the fact that Protestant and Catholic communities are even less likely to intermingle with each other than ever before. And who knows what miseries will be uncovered in the years ahead, as further study is done into the true depths of the hurt on people of 35 years of Troubles?
How does Bolton himself cope? With a smile, he said: “We don’t take our own strengths for granted. But home — home is earthing for you. Connecting you back into ordinariness.”
Ever the professional, he adds: “I wish I knew after Enniskillen what I now know after Omagh.”