For months after the ghastly terror attacks in Mumbai, one of the police constables on the Chhatrapati Shivaji Terminus beat could not go back to the station area, recalls Parul Tank, consultant psychiatrist, Wockhardt Hospital, Mumbai, who counselled policemen after 26/11. For many employees of the Taj Mahal Palace and Tower, and the Oberoi and Trident hotels, every day at work would be a gruesome reminder and they had to undergo counselling sessions and Art of Living workshops to cope. “An incident like this can have long-term repercussions," says psychotherapist Ashit Sheth, consultant psychiatrist at Bombay Hospital and Lilavati Hospital, Mumbai.

Burning concern: Experts suggest seven strategies for coping with the memories of 26/11. Arko Datta / Reuters

Traumatized anew

With the first anniversary of the attacks just two days away, and the gruesome scenes and images being replayed on television and reprinted in newspapers, recurrence of trauma is inevitable. “This could trigger some flashbacks," says Amit Desai, consulting psychiatrist, Jaslok Hospital, Mumbai, who fears that his 26/11 patients, now thankfully reduced to a trickle, will start coming back. “It is going to happen. Children often relive trauma on the anniversary of (an) incident," agrees Mumbai-based Pervin Dadachanji, a child psychiatrist associated with Child Development Centre, Ummeed, who counselled children after the attacks.

According to mental health experts, those who lost close friends and family in the attacks, and even those who just watched the scenes on television, could face acute nervous anxiety. Harish Shetty, consultant psychiatrist, LH Hiranandani Hospital, Mumbai, sees four sets of vulnerable people: those at the scene who were witness to the horror, train travellers, the spouses of those working in hotels (many of whom have begun making frequent calls every day to check on their loved ones, he says), and those who lost a loved one. He also says, however, that “given the chronic disaster syndrome plaguing Mumbai (which regularly suffers torrential rains, flooding and recently, high tides), some amount of stress acclimatization could be setting in for its residents."

But the reminders of 26/11 are everywhere just now, so how do people cope? Experts suggest seven strategies:

• Don’t go into denial: Dr Sheth says many people think they are coping pretty well and don’t require support. “But there are bodily changes associated with this (kind of trauma). Studies of American soldiers returning from Afghanistan and Iran have shown that exposure to violence and terror can alter brain structure," he says. If you have been having vivid dreams, are easily startled or become prone to anxiety, seek help rather than believe you must be brave, he advises.

• Air your feelings: Use all available resources for catharsis. Talk to family members, friends, write blogs, keep a diary, advises Dr Tank. Don’t keep your emotions and thoughts bottled up.

• Grieve in a group: Memorial services are a good way to heal, believes Dr Tank. Dr Dadachanji agrees: “Ceremonies give a sense of closure, especially to children."

• Limit TV time: Since you know it is inevitable that the media will revisit those horrifying scenes, it’s best to limit TV watching for children, says Dr Dadachanji. Choose other forms of entertainment—music, reading instead. If a child picks up a paper or magazine with 26/11 news or sees images of it on TV, a parent needs to be around to answer questions or talk it over.

• Do not avoid: Adults need to be engaged actively. “Don’t avoid watching war movies or terror scenes," says Dr Desai. Some of his patients invited to the memorial service have declined to go, and while he respects their feelings, he says it is better to confront fears. Dr Sheth, however, feels that if certain situations induce great anxiety, it is best to avoid them.

• Exercise to relax: Join exercise sessions or yoga classes to relax and calm the mind. Almost all mental health experts advise this as complementary therapy. Mumbai-based yoga expert Shameem Akthar notes a resistance towards exercise, apathy towards food or out-of-hand cravings often affect those in the grip of depression, so there’s all the more reason to motivate them for exercise.

• Say no to alcohol: Dr Sheth says that drowning depression and grief in drink can lead to alcoholism. “People drink alcohol thinking it will subdue memory, but it further aggravates trauma and is extremely damaging," he says.

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