9-11 15th Anniversary

Fifteen years after.  That means there are sentient, living teenagers who are (I hope) somewhere in school learning about this devastating event in some kind of secondary school curriculum, or perhaps witnessing public patriotic events. — But they don’t remember it, because they weren’t born yet.

It has moved into our “collective consciousness,” our collective soul as a nation. We can share the experience as we once did the death of President Kennedy by assassination, by asking each other, “where were you when you first heard about it?” For Sept. 11 2001, my husband and I were listening to the radio while he was taking me into a day of practicing psychiatry at the beautiful downtown Las Vegas Veterans Affairs Medical Center.

Here is a pretty high quality explanation of what happened for anybody who wasn’t born yet. And now, back to my profession. Lots of people were shocked off their gourds by this unprecedented American Event.  Flocks of therapists (including some friends and colleagues) scrambled to the site.  I would and did not, but took care of plenty of military veterans who had their old (generally military) Post traumatic stress disorder exacerbated by events. I saw the effects on some general public, and now I have seen how it has become part of our culture and soul.

I was also in Oklahoma City during the bombing of the federal building in 1995, working at the VA hospital when the explosion rocked the city and the nation.  I knew that the veterans would need special care, but little did I know that this was only a warm-up for 9-11, 2001. There is long enough to look back, and to assess how mental health care dealt with these tragedies — especially 9/11 — and how things have progressed in the 15 years since. I wish I could give my “peeps” in mental health care better grades. Instead of a tedious catalogue, here are some of the basics.

Those people who flew to New York to “debrief,” which basically means sit with people and have them tell you what they have seen and done, may not be helpful or even necessary.  It makes the mental health professionals feel better — something I understand, as there is a strong “I’ve got to do something; this is terrible” feeling, which I felt, too. I also think that those in authority feel like they need to show the public they are doing something — even if it is after the fact. But I think people themselves are often stronger and more caring for each other than we give them credit for. Of course people are anxious and can’t sleep and need a little extra time to get a feeling for what happened. But there seem to be more than anyone could have realized who actually have a pretty benign reaction, like what we shrinks call an “adjustment disorder,” and seem to do just fine. That means they develop new “coping mechanisms,” new ways to deal with the circumstances around them, and “keep on trucking.” On the other hand, I don’t think we had a good handle on who would suffer the most.

Aside from first responders — firefighters, police and emergency workers who had an especially tough time — a lot of folks did heal quite a bit over time. Some people seem to have become quite ill just from the television coverage.  We have known for a long time that PTSD is one of those things that if you had it before, you got it again. I remember an especially dear veteran patient I saw cowering in a corner, crying to me,”It was right there on my TV, hollowed out buildings from blasts, just like downtown Saigon, but now it’s in New York. This has got to be how the world ends.” But more than we would have believed, people do “keep on trucking,” rearranging what they must and living the lives they were born to live. In literature, they call this “The Flitcraft phenomenon.”

I’ve written about this before. Terrorists work by making people live in fear. We project that fear excessively into distant and sometimes not very responsive institutions like government, we can only know that this is to be expected. Solace is found in patriotism.  Hopefully personal strength and sense of patriotism are enough to say,  “I will not let their induced fear let me stop or in any way control my life.” The best positive outcome is a strengthening of our shared identity, like the tradtional, “let’s put all the wagons in a circle,” and take care of each other.”