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By the day after the attack on the World Trade Center, the hospitals were reporting that the injury for which they were treating the greatest number of patients was emotional trauma. Many of these were rescue workers who were witnessing gruesome scenes of death and the relatives of those who are still missing. But as the smoke spreads its way throughout the city, so too does the psychological stress of processing a third-rate disaster movie that has suddenly happened for real.
"Most Americans are probably feeling a great sense of helplessness in the face of the random carnage," said Jeannette Adkins, president of the National Organization for Victim Assistance. Many feel, she said, "as though they are living in a surreal world," and are working through the common pattern of reaction to trauma: first shock, followed by disbelief and denial, then fear and terror, anger and outrage, confusion and frustration, and ending in grief and a form of acceptance. "They may suffer physical symptoms of anxiety, sleeplessness, loss of concentration, and nausea."
After treating more than 2,000 family members of victims and others who needed psychological attention, New York State designated the Armory on 25th Street and Lexington as the site of an official grief-counseling center. The site, opening its doors Thursday morning, will remain open each day from 8:00 a.m. to midnight. Governor George Pataki said that federal grief counselors will be on hand and that the center will provide a place for people to share in the common experience.
Rebecca Thut Witmer, a child victim specialist, said that giving people a chance to share their experiences is the first step in dealing with trauma and grief.
"People experience trauma through sensory parts of their brain," said Witmer. "It does not get stored the way a normal memory gets stored. They process it as a series of sights, smells, and sounds. Debriefing is a process of putting those pieces together in a chronological way so that it makes sense."
"Those who can put it in some order are less likely to have post traumatic symptoms, Witmer added. "And people need to deal with the trauma, before they can deal with grief."
"I think there are going to be psychological scars, but that does not mean we will be a nation of mentally ill people," Dr. Rachel Yehuda, a professor of psychiatry and director of the post-traumatic stress program at Mount Sinai School of Medicine and the Bronx Veterans' Affairs Medical Center, told the New York Times. "This is a big enough event to justify symptoms in anyone who was affected by it...Circle your calendar for October. We're really not post-traumatic yet," she said. "We have not been given the numbers of dead yet. We just don't have the full impact of what we have experienced in front of us."
The city's crisis center at the Armory can be reached at 212-889-6652. St. Vincent's Hospital and Medical Center has set up a mental health crisis service for people experiencing severe emotional distress and trauma from the disaster. In Manhattan, call 212-604-8220. In Westchester, call 914-925-5320. In Staten Island, call 718-354-6300. Or call the National Organization of Victim Advocate's toll-free crisis line at 1-800-TRY-NOVA or 1-800-879-6682.
Emotional Distress Counseling
The City Department of Health, in cooperation with the Mental Health Association, has established 24-hour-per-day/7-day-a-week telephone service to provide counseling, information, and referrals to anyone experiencing emotional distress in the wake of Tuesday's tragedy. There are phone lines in English, Spanish, and Chinese.