The trauma to come

A city reels -- and braces for the psychic fallout of its monstrous ordeal.

By Lauren Sandler

Oct. 4, 2001 | NEW YORK -- "I never thought I'd be saying this, but I'm gonna get therapy. After the shit I've seen? Lots and lots of therapy." So said an ash-covered rescue worker in a hard hat the other day, sipping from a can of Bud on his break from picking through the rubble of what was the World Trade Center.

His buddies -- standard-issue tough guys, ironworkers all -- nodded their heads in agreement. "Straight to the headshrinker's," said one of them, staring south down Sixth Avenue. "I'm gonna be there a long time. No kidding." He shook his head and popped open a new can. "And I know I won't be the only one. You can't believe the things we've seen, we keep seeing. We're gonna be needing all the help we can get."

The subdued mood that cloaked New York in uncharacteristic serenity for the first few weeks after the attacks is gradually cracking apart. These trembling psychic aftershocks continue to resonate as time plods on. And while New York's reputation is hardly one of civility, bursts of rage have begun to pierce the quiet public mourning. The incidents feel extreme, even for this robust population: Two women incited a pushing fight on the F train from Brooklyn last Friday. A passenger on a different train that day began screaming in rage, and the rest of the car joined in. Nerves ran so high at a usually collegial workplace that a fistfight broke out between co-workers.

New York, has, of course, long been a world capital of psychotherapy, famous for its neurotic, analysis-seeking denizens. Vienna may have Sigmund, but we have Woody. "It's the temperament of this city," said Ronald Fieve, a professor of psychiatry at Columbia University with his own practice. "New Yorkers are stimulus-addicted, high-energy. That gets into mild manic or manic-depressive disorders, bipolar types. We've always been that way, far more than other places."

But in the aftermath of the terrorist attacks, the field is no longer reserved for Upper West Side yentas and self-absorbed downtown hipsters who feel more comfortable on their analyst's couches than on their own. Since the first hours after literal fire and brimstone struck, teams of triage psychiatrists set up shop at ground zero to deal with psychic fallout. More arrived in the days that followed, counseling at the family center, the armory, wherever the grieving gathered.

Since the second week, crisis counselors have flooded workplaces all over the city, some visiting daily to offer individual grief counseling in cubicles, and to lead group sessions in glass-walled conference rooms. This week, psychologists and psychiatrists, already feeling the strain of high demand before the terrorist attacks, are braced for thousands of new clients, many of whom will be seeking counseling for the first time.

Meanwhile, drugstores all over the city say they've had a surge in demand for antidepressants since Sept. 11. Prescription requests for Ambien (a sleeping aid) and Klonopin (for panic attacks) are flooding pharmacists' phone lines. "I don't think there's a pharmacy out there that hasn't seen it go up," said Dino Papoutsis, at Bigelow Pharmacy in the West Village. "Anxiety level is high right now. Who's sleeping? A lot of people need all the help they can get."

And for perhaps the first time in this headshrinking city, therapists are sharing in the trauma of their patients, unable to function at a remove from the crisis under discussion. "I had a psychotherapist in my office this morning telling me he had been in tears a number of times this week, and I mean during sessions," says Ari Kiev, director of New York's Social Psychiatry Research Institute. "People are coming in with tremendous, horrific stories about things that have affected us all." One therapy patient reported how a recent session opened with the tables turned: Her therapist told her she had lost a patient of 10 years in the attacks. "My first question was, do you have someone to talk to?" she said.

Immediately after the attacks, people who had been in precarious mental states were in many cases forced beyond their already shaky limits into mental turmoil. "We had many patients go right into the hospital," said Fieve. "Borderline manic-depressive or schizophrenic patients, anyone with a psychotic disorder, they've all been hospitalized. Just think of the paranoia, the fear, the pictures of gas masks. It's enough to put anyone over the edge."

Next page: This is all felt more profoundly by people who already feel vulnerable