9/11 One Year Later: A Psychotherapist Reflects on His Experiences at Ground Zero

by Tab Ballis

In This Article…

As we pass the one year anniversary of the terrorist attacks of September 11, 2001, Americans are reflecting on the toll this event has taken on our collective consciousness. Due in large part to the power of the media to magnify this spectacle to epic proportions, it is arguably the most traumatizing event in post-modern times. As mental health professionals, we can witness the reverberations of 9/11 from a unique vantage point. Although clients in my private practice have rarely cited the terrorist attacks as a presenting problem, there was clearly a great deal of thought and energy devoted to reassessing priorities and choices. In the first month following the attacks, it was impossible for me to conduct a psychotherapy session without acknowledging the tragedy. My clients and I had a rare opportunity to share moments of mutual empathy that deviated from the usual limits of the therapeutic relationship.

 

Despite this, my professional activities felt inadequate in addressing my own need to do something more in response to 9/11. When a colleague told me of her positive experience as a Red Cross disaster mental health volunteer, and the need for assistance with the relief effort in New York City, I felt drawn, compelled, to join. After completing the orientation and training classes provided by the Red Cross, I found myself reconnecting with the idealism and passion that first attracted me to human service.

 

Arriving in Manhattan

I arrived in New York on 12/19/01 ready to do my part. I completed the necessary in-processing at headquarters and took a cab to the hotel room provided by the Red Cross in midtown Manhattan. Negotiating subways, cabs, and crosswalks was challenging at first, but I was soon able to pick up a bagel and coffee and make it to the downtown A-train without being late to my destination.

 

Getting to know the city firsthand helped me appreciate the changes that had occurred since 9/11. I was told that in the aftermath of the disaster, New Yorkers became more open than usual, with some people actually talking to strangers on the subway. Those I encountered were genuinely appreciative of the volunteers from out of town, expressing an uncharacteristic sense of their vulnerability, and need for assistance. The 9/11 attacks made us all painfully aware of the limits of our technological infrastructure, and the fragility of our human bonds.

 

I was assigned to a huge tent next to the 16-acre pit at Ground Zero, which served as a respite center for the firefighters, police officers, and other workers. This site was staffed round the clock, and I worked the 4pm to midnight shift in the dining area where the recovery workers took their breaks. Our duties at Ground Zero consisted of circulating around the tent, striking up conversations, and offering support and information. Interactions with the workers ran the gamut, from chitchat about upcoming football games, to personal discussions of the search for missing friends. About half of the contacts were interested in talking about the recovery work, but far fewer were willing and able to express feelings about the disaster.

 

How Ground Zero Stretched the Therapeutic Role

It became clear early on that the workers were making a great effort to suppress their emotions in order to carry out their difficult tasks. Almost all of the workers had lost at least one friend or colleague in the World Trade Center. In this intensely chaotic yet controlled environment, the appropriate role of mental health volunteers was to engage Ground Zero workers in a delicate dance between small talk and existential validation. It felt as if we were there primarily to bear witness to the experiences of the Ground Zero workers, as they endured 12-hour shifts recovering human remains, struggling to keep their exhaustion and grief from interfering with the mission.

 

Balancing this unconventional therapeutic role, alternating between schmoozing and debriefing, proved to be terribly fatiguing at first. It was a stretch from the more evocative style of my mental health practice. At times, I felt as if I was carrying the unexpressed grief of the recovery workers back to my hotel room every night as I searched myself for the empathic response to their ordeal. Processing my experiences on a daily basis with other disaster mental health volunteers rewarded me with the awareness that our mere presence at Ground Zero was our greatest contribution to the workers there. We weren't expected to have any words of wisdom... and nobody did.

 

Some of my disaster mental health colleagues in New York worked with family members of victims who were openly grieving and verbalizing their experiences. My assignment at Ground Zero was quite the opposite; in fact, it may have been the location in Manhattan where one was least likely to witness the venting of feelings.

 

Herculean Efforts and Unexpressed Sorrow

Being present in this hallowed ground, with the sound of heavy equipment, and the smell of combustion and decomposition ever present, was a trying task for everyone there. The Herculean effort of the recovery workers, to postpone their natural emotional response, was both impressive and poignant. A group of firefighters sat at a table, laughing and joking about some trivial issue, after hours of raking through the piles of debris in search of missing colleagues. One police officer, who led his cadaver dog into the pit to assist in the locating of bodies, told me of the difficulty of suppressing the horrible images he encountered when he returned home to his wife and children. A fire captain solemnly acknowledged to me that, even after three months, the recovery workers were driven by the desperate hope that, somewhere in the six-acre pit, a living soul was waiting to be rescued.

 

Among the recovery workers there was a continuum of emotional expressiveness which appeared inversely proportional to the individual's proximity to the disaster. That is, the closer the worker was to Ground Zero, the less emotional expression was evident. In general, the firefighters were the most guarded and difficult to approach. I am not sure why, but they did suffer the largest overall loss in their ranks (close to 10%). The various police officers were more receptive to interactions with the disaster mental health workers. Perhaps the most approachable and, ironically, underserved group of workers at Ground Zero were the ironworkers, welders, heavy equipment operators, drivers, engineers, and other construction workers who were contracted to clear the site. Unlike the police and firefighters, these workers had no professional preparation for working around human remains. Add to this the reality that many of these men and women had worked nearly every day since 9/11, without break either by their own choice, or by virtue of the critical nature of their skills, and it is becomes clear that they represent a segment of victims of the WTC disaster that warrant closer attention.

 

I had never felt such a heaviness of unexpressed sorrow, though it resonated deeply with my own personal family losses prior to 9/11. My evocative skills were not useful at Ground Zero... I felt burdened, at times, with the violence and trauma that was ever-present yet still mostly unprocessed. Over my two weeks in lower Manhattan, my PTSD response took the form of sleeplessness and fatigue. Yet, too, I was surprised at the absence of nightmares that I had expected would occur. Perhaps the daytime witnessing of horrors made such nightmares superfluous.

 

Leaving Manhattan... Returning Home

The practical function of the disaster mental health professional at Ground Zero was as a vessel, or conduit of pain to facilitate the recovery work; I knew that I would have to carry my share of it home with me.

 

The Red Cross cautioned the volunteers that when we returned home people would ask about our experiences. They suggested that we would find it difficult or impossible to convey our true feelings and experiences to those who had not been there. That was indeed an understatement! Even here, in writing this account, do I find it so hard, so inexplicably difficult to express my experiences fully.

 

As the days and weeks passed, I felt more and more as if I had walked away from a battleground—with all the grief, psychic numbing, and survivor guilt that goes with such trauma. Indeed, I had walked away from a battleground—it was not "just a feeling." I had crossed the line between observer and participant, and no professional objectivity would suffice. My mental health colleagues and anyone else who ventured close to the unprecedented injury and destruction of the 9/11 attacks knows of what I speak. This ineffable experience is captured best, not in any words, no matter how well expressed, but in the silent glances between workers, the hugs of those that care, the hope of those who courageously carry on in spite of loss and despair.

 

Despite the routine debriefings provided by the Red Cross, I left New York with more than a lifetime's worth of intense images and sensations. I intuitively knew that my disaster mental health experience would be life-changing, but I did not know exactly how.

 

At first my clinical practice felt boring in contrast to what I had witnessed in New York.I felt different, as if I had expanded, or gained access to parts of my own life that I had not seen before. At first my clinical practice felt boring in contrast to what I had witnessed in New York. I found myself reaching to find the relevance in the complaints of the worried well, which suddenly felt terribly trivial. My style shifted, temporarily, to a less patient, more emphatic "let's get on with it" tempo. I soon became aware that I was unwittingly projecting my need for catharsis onto my clients. This awareness was the first step in beginning to understand what all this meant to me. I too, needed to know and understand my feelings, to express and share my fears and sorrows, and take the risk at experiencing catharsis in my own life.

 

Opportunities to share my disaster mental health experience, both publicly and privately, have given perspective to my images of Ground Zero, and grounding to my emotions. I feel more vitally connected to my soul and less attached to old assumptions. My work has settled into a serenely energized stance. Now, when I am sitting with my clients, I feel that we are more in touch with each other's humanity than before-or rather, more than I had previously allowed.

 

At Ground Zero, my instincts were all I had to work with; they have since become my most valuable therapeutic resource.