Terror & trauma: New pain for past victims

She was just 15 years old when she saw her cousin gunned down by Iraqi authorities, and her brother nearly died after being shot in the chest. For daring to oppose the regime of dictator Saddam Hussein during the Gulf War, she was thrown into prison.

“There is no safety in Iraq,” she says. “You could be shot any time and not know who did it.”

But the terror didn’t end — not completely, anyway — when she and her family fled to Syria in 1997 and then emigrated to the United States 14 months ago.

Sitting in the windowless office of her therapist in Dearborn, Najlaa (who asks that only her first name be used) talks about how deep her emotional wounds run, and how difficult it’s been for them to heal.

She’s not alone.

In January, the Arab-American Community Center for Economic and Social Services (ACCESS) opened this clinic to help refugees who’ve settled in this area deal with the psychological trauma suffered under repressive regimes.

For the counselors treating these people, a stressful job grew even more difficult following the terrorist attacks of Sept. 11. Since then, calls for help have jumped dramatically as the traumatic events of that day and the uncertainty that has followed in its wake have awoken old nightmares.

Even before the World Trade Center towers fell, escaping the past was difficult for people such as Najlaa.

Her doctor referred the mother of four to the center about six months ago, when medication failed to relieve the migraine headaches that tormented her.

Her therapist, Husam Abdulkhaleq says that before he started working with Najlaa, she would not leave her home except to shop for food, and didn’t trust anyone outside her family. The counseling was beginning to help. The headaches lessened, as did her nightmares. She began learning English. Then terrorists attacked America. Since then, Najlaa’s anxiety has grown worse, and the crying spells that were beginning to fade have become more frequent.

What makes her story even more distressing is that, compared to others seeking help in the same office, Najlaa is relatively well off.

“This is not as dramatic as other stories,” says Abdulkhaleq, a Palestinian who came to the United States from Israel in 1985, “Sometimes they make you cry, they tell you things that are unbelievable.”

From imprisonment to torture to seeing family members murdered, the people coming to Abdulkhaleq for help have suffered through all sorts of terrible hardships. What has helped Abdulkhaleq keep going is that, since the Psychosocial Rehabilitation Center opened in Dearborn in January and he started working there, many of his clients had begun to heal. Some smiled more, isolated themselves less; the flashbacks and nightmares subsided.

But last month’s terrorist attack retraumatized many of his patients, erasing much of the progress many had made. And Abdulkhaleq, who has been helping his clients rebuild their lives, must begin again.

Starting over with his patients is not all that has made Abdulkhaleq’s job tougher. Many want to see him — and the other two therapists on staff — more often. Abdulkhaleq, who saw four or five clients a day before the terrorist attacks, now sees between seven and nine a day as well as handling the attendant paperwork, staff meetings and training, and other job responsibilities. Asked how long the overworked therapist thinks he — and the center, which has a growing list of patients waiting for services — can keep up this grueling pace, Abdulkhaleq answers: “I don’t know.”

Starting over

While Abdulkhaleq is in a staff meeting, a client who does not have an appointment waits to see him. When his meeting ends, Abdulkhaleq explains to the elderly gentleman that he doesn’t have time for him today. But the troubled fellow insists that he needs only 10 minutes and the therapist concedes.

Abdulkhaleq says that it’s common for clients to pop in the center without an appointment.

“I face walk-ins everyday, more often since what happened in New York,” he says.

Many of his clients, like the man who dropped in unexpectedly, don’t have anything specific to discuss with Abdulkhaleq.

“They just need to make contact,” he says.

But not everyone is eager to come to the center. An Iraqi woman, who Abdulkhaleq says was “making huge progress,” rarely leaves her home since the terrorist attack. He has scheduled four appointments for her, but she has only been able to make one.

“She has panic attacks and can’t sleep,” he says.

Abdulkhaleq’s goal is to help his clients feel safe again, which he attempts to do by assuring them that America is a peaceful country. He says that creating a safe environment is the first step of this therapeutic process. And if he can’t accomplish this, he can’t help them.

The first few days after the terrorist attack, many clients were afraid to leave their homes and failed to make appointments at the center. In fact, ACCESS, which created the counseling center and offers job training, medical care, adult education and other programs, initially saw very little foot traffic at any of its eight Dearborn facilities after the Sept. 11 tragedy.

What the organization did see is media from around the globe swoop in for stories. A local television station used ACCESS’s main office on Dix Road as a backdrop for a story about the attack two hours after it happened — and “before anyone knew people from the Middle East were involved,” says Ismael Ahmed, ACCESS executive director.

“Since then it has been a constant stream of people from all over the world coming here and asking … questions like ‘do we know the terrorists and when are we going to give them up’” says Ahmed, who had to close one building for three hours because of a bomb threat.

The community group also has been bombarded with e-mails, some of them containing racist comments about Arab-Americans. But the majority have been from supporters of ACCESS and the work it has done in the Arab-American community since it was founded in 1970, he says.

The second week after the attack, folks began using ACCESS’ services again, including the Center for Torture Victims, which was suddenly flooded with clients.

Secondary trauma

In the past month, Abdulkhaleq’s case load has grown. He has 70 patients, compared to about 45 before the terrorist attack, and 15 more are waiting for an appointment to see him. Another full-time staff member has 45 clients and their supervisor, who works with patients part time, has 25 clients; about 30 are on a waiting list to see the other therapists.

Asked how he and his co-workers care for themselves while tending to his their clients, Abdulkhaleq sighs and says, “I don’t know. We are searching. We are searching.”

Abdulkhaleq also is suffering from nightmares and has flashbacks about growing up in a country where he never felt safe.

“It’s called secondary trauma,” explains Abdulkhaleq. Therapists who work with torture victims often develop similar symptoms from listening to their client’s stories.

But there isn’t much they can do to relieve the stress since ACCESS does not have the money to hire more therapists. This is not good news for the father of four, who says that he has little to give to his family after a day’s work at the center.

“I’m there for them physically, but emotionally, I’m gone,” he says.