“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.”
And Fieve said it is a particularly bizarre time for some deeply paranoid or phobic patients who have felt exonerated — though not necessarily relieved — by the sudden reality of their delusions. “The people who have paranoid personality traits feel a great sense of vindication. It’s the ultimate I told you so.”
For New Yorkers suffering from varying levels of depression and anxiety, the tragedy has plunged many of them into clinical states. And therapists say there are new challenges for relationships here — couples, families, friendships — that were already strained by percolating anger, distrust and dissatisfaction before the crisis, as preexisting problems have intensified in its aftermath. “This is all felt more profoundly by people who already feel vulnerable. More people are already coming into therapy, and increasing or beginning use of antidepressants. People already seeking help may be looking for more frequent visits. I know I’ve been full up,” said Joyce McFadden, a therapist whose SoHo office is in what was once the shadow of the towers.
And the worst, according to all sources, is certainly yet to come. Even Mayor Giuliani expressed uncharacteristically grave concern recently during an off-camera moment at an Upper West Side temple’s Rosh Hashanah services. He told the congregation he was terrified of the anguish coming when the dust literally clears and New Yorkers realize the true magnitude of the devastation. The words he did not speak, which have been on the lips of therapists and news anchors for weeks, are “post-traumatic stress disorder.”
“We’re gearing up for an onslaught,” said Dr. Fieve’s secretary. “We’re expecting people suffering from PTSD to start calling in droves — it’ll take a couple of weeks.” According to standard psychiatric diagnosis manuals, it takes a month before PTSD sets in. Not coincidentally, a national depression screening day has been set for Oct. 11. Many of the symptoms already have plagued people across the country since catastrophe struck. The symptoms include nightmares, insomnia or prolonged exhaustion and sleep, deep and unshakable sadness, feelings of isolation, heightened sense of fear and paranoia, jumpiness, weakened appetite and a continuous mental replay of the images some people saw firsthand and others saw repeated on television.
“People will keep thinking about the event, keep seeing bodies flying through the air — those images will keep intruding on our consciousness,” said Kiev. “You see it over and over again, imbedded in the memory — a person can be repeatedly traumatized hundreds, thousands of replays of those images.” For the time being, this experience has been classified as a symptom of acute stress disorder. But next week, that diagnosis will slide over to PTSD.
“Our phone lines have already been deluged,” said Elizabeth Vermilyea, who is the training director at the Sidran Traumatic Stress Foundation in Baltimore. For some callers, she said, the symptoms already qualify for PTSD. For example, the Sidran Foundation has been helping hundreds of people phoning in from Oklahoma City, whose symptoms have been reactivated by the recent events. “They’ve had a real resurgence of their fears, their flashbacks, their need for safety and predictability,” said Vermilyea. “But for others, we just can’t call it that yet. And, frankly, it doesn’t sit well with me that Americans can freak out for a month before it’s diagnosable.”
Her concern applies not just to New Yorkers and Oklahomans, but to people all over the country who have been traumatized by what they’ve witnessed through news coverage. “This was a national assault against safety and identity,” said Vermilyea. “People are struggling everywhere, calling here for help. It’s uncanny how universal this is across the country, these same acute traumatic stress responses.”
For an estimated 15,000 children whose parents — one or both — disappeared in the rubble, the trauma has carried with it the devastation of identity and the obliteration of their sense of safety. For the most part, child psychologists say, these children are playing at school, but grieving silently at home. Their anguish and bewilderment are held in check by fear and disbelief; but long-term effects, say therapists, are inevitable.
“These kids know if they bring up stuff about the deceased parent, it upsets the surviving parent,” said Robert Abramovitz, the chief of psychiatry and director of the trauma center at the Jewish Center for Family and Children. “They’re nervous that the surviving parent is so upset it will kill them, so they keep their own grief quiet. Because their biggest fear right now is about the parent who is still living — as in, are you gonna die?”
Abramovitz said that at his center, and in quickly established drop-in centers for kids across the city, “there’s an eerie quiet.” Like PTSD specialists, his therapists are preparing for a belated deluge of stricken, bereaving children. He says that children’s silent grieving and attempts to feign normalcy will not last. They will begin, he says, to digest the unthinkable in gradual doses — and they will need help.
“This is a complicated trauma,” he said. “We know it’s hard enough to get used to never seeing somebody and accept that you’ll only have them in memories, not real life. But the task is to feel safe enough about those memories. Every time kids think about their deceased parents, they’re flooded with images imagining how they died. They see every night on TV how massive that rubble pile is. And it will be hard for kids to imagine beyond that for a while.” It could take between three to six months, he said, for kids to get past these gruesome mental obstacles to deal with their losses.
Given the enormity of the predicted onslaught, some therapists are worried about the ability of the mental health community to cope. “I’m most worried about Social Services,” said McFadden. “They’re underfunded. There will be a real strain, I think. Even long-standing private practices or inpatient psychiatric units that have been up and running will be facing problems in dealing with this different situation. It’s just all so new to all of us.” Kiev is concerned about the level of expertise of the many counselors who will be pitching in to support the afflicted for the first time. “I’m worried that people who aren’t completely or properly trained will be getting in over their heads,” he said.
In anticipation of overwhelming need, out-of-state mental health experts already are streaming into New York, a city that entered the crisis with the greatest number of mental health workers per capita. Trauma experts from the International Society for Traumatic Stress Studies arrived soon after the attacks to help both on the ground and with implementing administrative plans. One member of the group, who was on hand in the Oklahoma City aftermath, immediately prepared a CD-ROM to help mental health workers in New York. The National Mental Health Association has established a crisis response fund to assist in the effort, focusing attention on New York and Washington, D.C., and coordinating local public health response throughout the country.
“It’s a bereavement of the whole city, of the whole country, and it might last for years. This is just the beginning,” said Fieve. “It will be intense, and we can’t predict what’s going to happen, but we’ll be all right because we’re the greatest city with the greatest doctors.”
One can only hope he’s right. As we prepare for this ambiguous and mysterious “war” against terrorism, we enter an even murkier indefinite era: the process of grieving and recovery. Perhaps therapists and mental health workers will form our next battalion of heroes, caring for the rescuers we have honored already, and mending those people who ripple out from the ruins in concentric circles of distress.
Walking down Houston Street in New York this afternoon, in what a few days ago was the shadow of the Twin Towers, a woman lowered the umbrella that had been shielding her daughter and herself from the tapering rain. “Those were God’s tears,” she explained to her little girl.
My mother had a very different explanation for her daughter today. “To me, this rain is proof that there is no God,” she said on the phone from Boston. “People say that God can’t help terrorism, that he gives people freedom to act as they choose. Fine. But a God who would hinder the rescue workers with rain? If God can’t control nature, then what’s the point? How can anyone believe today?”
It’s a bewildering day for us atheists, this state-appointed “Day of Prayer and Remembrance.” Like the faithful, we mourn. We look for guidance. We look for answers. Our commander in chief tells us to find solace in churches and temples. In those churches and temples, people stand at podiums, survey their mass of grief-stricken congregants and intone the unfathomable words “God will protect us.”
Like many New Yorkers, I’ve seen the shattering hell of mass destruction this week. None of this is metaphor: I have touched the ash-covered shoulders of gasping survivors. I have trudged through the debris that thickly coats the ghost town of Tribeca, staring in shock at the five-story pyre that was a tower of human life and achievement. I have watched families crumple into each other in shaking, tear-soaked sorrow outside St. Vincent’s Hospital when they are told, no, there is no information about your sister, your husband, your daughter. And I have done so without experiencing what some people have described to me as a uniting surge of faith in some omniscient, everlasting force that will make us all whole again.
I have long wondered if in the face of tragedy I would suddenly rely on faith. As a member of a generation that came of age in a peacetime society, I have always assumed that this transcendent tragedy would mean losing my mother or father. I’ve seen friends — skeptics like me — pray in the aftermath of such personal suffering. One of the lucky ones this week, I’ve lost nobody close in the rubble downtown. Perhaps if I had, I would seek solace in those exalted institutions that offered comfort to millions today.
Instead, like my mother’s, my atheism has only been strengthened by this week of human catastrophe. At a “Healing Eucharist” service at a church around the corner form St. Vincent’s hospital, I got up to leave when the rector chanted: “Bless the Lord who forgives our sins,” and the congregation responded: “His mercy endures forever.” In a nearby house of alternative healing, I snuck out the side door when I was told, “As spiritual seekers we must understand these things happen for a purpose. If we don’t accept that, all we’ll have is anger and animosity in our hearts.” I believe anger and animosity is an appropriate response to mass murder.
But while my Day of Prayer has been free of trust in saints, swamis and shamans, it has not been without a resurrection of sorts. Again and again this week, I have found my faith restored by the immeasurably selfless valiance of earthly heroes. Last night I met a holy trinity of ironworkers among the believers who congregated on the western end of Houston Street. There, on the corner of Sixth Avenue, was a mass of citizens waving flags and cheering for each truckload of rescue workers speeding north for a few hours of rest before reentering the inferno.
Mike, Ron and Steve are all local ironworkers who were blowing off steam with a few six-packs of Bud, yelling AC/DC lyrics and flirting with girls before they headed south for another 15-hour shift. (That’s how they were planning to spend their Day of Prayer, fighting smoke and falling debris to cut steel beams away from trapped bodies.) These guys, and thousands like them, marched into ground zero without training or enough fear to hold them back.
“It’s too graphic,” said Steve, as he fidgeted with the gauze that covered a new wound. “Piles of death. I don’t have the words to tell you. But nothing’s gonna keep me away from going back.” Mike wrapped a grime-blackened arm around his buddy Ron, still wearing his hard hat. “Let me tell you, I hung my head low today,” he said. We left a lot of dead people today. But I’ve got faith in my boys here. True faith. Religious faith. We’re ironworkers! And we’ll show them what America can take; I don’t care if we have to die trying.”
Of course many of these rescuers are strong believers, able — some say obligated — to do their brave work because of their faith in God. But listening to the parade of preachers speak in the National Cathedral today, it was these dusty and unshaven faces that I meditated upon like religious icons.
With this astonishing human bravery to bless America, who needs God?
“If you take off your glasses, it looks like a regular book fair,” says a Random House sales manager of the Christian Booksellers Association convention. But with its huge Sunday prayer meeting and daily morning devotion ceremonies, the CBA’s main annual event hardly resembles the liquor-and-lucre-soaked gossipfest that characterizes publishing trade shows. At CBA International, the Jews for Jesus bagel breakfast is as close as you’ll usually come to the New York book game.
But at this year’s convention in Atlanta, which wraps up today, the scent of secularism is in the air. Mainstream publishers like Penguin and HarperCollins traveled to the conference to sniff for the next big thing in the Christian book market. They haven’t just been looking for the follow-up to that odd apocalyptic crossbreed, the Jesus thriller, which found runaway success in the “Left Behind” series. This year, they’ve got their sights on another publisher’s fantasy hybrid: Christian romance novels. Throw away those paper-bag covers, ladies. The fastest growing set of the billion-dollar American romance novel industry is a huge stack of books you can proudly shelve next to your Bible.
Romance novels represent the newest frontier in evangelical Christianity’s adventures in pop culture, following entrepreneurial experiments in spirituality that have tackled TV dramas and the burgeoning Christian pop movement, which Newsweek’s current cover story trumpets. In “family-friendly” fashion, these novels — one hundred-plus of which are published each year — aim to intensify the faith of their born-again readers, or to introduce their less-devout readership to what their authors consider to be the supreme passion. They take the standard romance formula — a happy-ending story about the passion between one man and one woman — and add a third and central character. Yeah, you know His name. “God’s story is a romance,” says Francine Rivers, one of the genre’s most influential writers. “The entire Bible is God wooing man and wanting a relationship with man. That to me is the ultimate romance.”
But it’s not all wine and roses for the hundreds of women churning out inspirational titles. There are the commandments of the Christian Book Association — the foremost being Thou Shall Not Publish Sex Scenes. For writers who wish to branch out into the secular marketplace, writing celibate romances can obviously limit their mainstream success. There are skeptics who suggest that some of these women are trying to find a niche in a downsizing industry. And there’s always the pressure of answering to the highest of critics.
Rivers, like many inspirational authors, started out writing romances for the secular side, selling over 13 million books to become one of the market’s most successful authors. But after a surprising conversion experience (“I was sexually active in the ’60s, I even had an abortion — I wasn’t expecting it in the least”) she found herself contending with three years of writer’s block. “Nothing made sense, my writing didn’t work anymore,” she says. “God shut it off, and said I’m going to use you to speak my truth through dictation.”
“Redeeming Love,” regarded as the “Anna Karenina” of inspirational romance, was the dictation that followed. It’s a retelling of the Old Testament’s Book of Hosea, the story of a prostitute — an unbeliever — who discovers first earthly and then holy love through the care of a man who relies on God’s guidance between the sheets as well as between the pews.
“Redeeming Love” is as steamy as Christian fiction gets. For that reason, Rivers had great trouble selling the book. “It was far too racy for the Christian market,” she says. Most of these books are so tight-bun-and-sweater-set prudish it’s remarkable they’re called “romances” at all. “Inspirational” foreplay usually involves a church and a white dress, and almost always serves as the book’s regulation happy ending. You want steam heat? You’ll find far more of it in Gideon’s book than in one of these.
But there’s a double bind for Christian romance writers. Secular publishers want a little romance in their romance — “flesh of my flesh” isn’t the kind that’s marketable to their greater readership. For most secular presses, the Christian content of Rivers’ book made it a tougher sell, despite her previous mainstream success. The author thought she had a deal with Berkeley Press, but her editor rejected it as soon as the strains of violins in the first draft gave way to the thump of Bibles. She eventually sold it to Bantam, but had to eliminate the whoring heroine’s pivotal (and remarkably erotic) conversion scene. It was only after the book’s success that Multnomah, an evangelical house, bought it and reinstated that scene.
It’s hardly shocking that Christian romance hasn’t gained instant acceptance among members of the church, or within the CBA. It’s only relatively recently that fiction, romance or no romance, has been deemed appropriate for Christian readers. The CBA has only published novels for a decade now, when the powers that be finally realized that non-scriptural books didn’t necessarily lead to fire and brimstone. This new era of enlightenment has turned out to be highly profitable: The most notable success was the “Left Behind” series, which gave Christian readers all the suspense and drama of secular fiction with an overtly evangelical bent. Romance fans have long demanded the same mix from their preferred form of fiction: faith-based fantasy. They’ve craved the titillation offered by these novels, but have complained of having to skip what most of us would consider the good parts in order to remain within the parameters of wholesome Christianity, missing plot twists and character turns along the way.
Christian authors have been as frustrated as their readers when it comes to providing sizzle and scandal for a yearning secular market. Robin Lee Hatcher, another secular author who became a Christian after hearing the “call God placed on my heart,” says the greater her success, the higher a price she paid in her religious comfort. “That’s something I’ll always regret, that I gave in on things as I built my career,” she says. “But as my own spiritual walk deepened, I recognized that I was not writing the kind of stuff that would be pleasing for me to read.”
While sales in Christian bookstores have soared, secular publishers like Random House and HarperCollins have dispatched their acquisitions staffs to nail down distribution deals with Christian companies they previously ignored. Harlequin started up its own line, Love Inspired, that now churns out three titles a month to stack alongside increasingly hotter titles. And so inspirational romance has bridged the religious divide, selling at almost any secular establishment that sells romantic fiction, from Borders to Kmart.
This boom has rejuvenated careers for Christian women, like Francine Rivers, who had seen great success in the secular marketplace. Several years back, top-selling author contracts were being slashed and romance publishers were cutting midlist writers. This shift came just as the Christian romance genre began to gain momentum. Carol Stacy, who publishes Romantic Times magazine, sees the choice to go evangelical as primarily a sound business move. “For authors who have left the mainstream for Christian writing, it was simply a choice for them because there was more opportunity,” she says. “Why stay in this really rocky market that’s just creating anxiety for them when they can go into a new market that’s opening up and embracing them?” she says. “Think about it: Why would I deal with this market when I could become a star in this other arena?”
For those writers who have now made careers in the Christian marketplace, success in the mainstream arena can be alluring, and access can seem as protected as the gates of heaven. Take Dee Henderson, who recently won the Romance Writers of America’s highest honor, the RITA award, for her Multnomah romantic thriller “Danger in the Shadows.” Henderson is certainly a Christian — her minister father proofreads every page. Christian fiction was the best place for her to get started. “Frankly, it was the easiest place to sell,” she says. And Christian publishing’s rise has introduced her to success in the secular world. “Doors swung open at Barnes & Noble and Borders.” But to write material appropriate for her publisher, she has to curb the sort of writing that would make her attractive to a secular publisher. “It’s too tame,” she sighs.
Many of these writers, like top-selling author Liz Curtis Higgs, are former “bad girls” with whose stories less-than-saintly readers can relate. Higgs’ writing grew out of a career speaking about her own salvation, offering up titillating and vastly entertaining tales of a bad girl gone good. “Before I walked with the Lord, one of my finest hours was when I put a cigarette out on a woman’s hand in a bar in Detroit. I worked in rock radio there, with Howard Stern, actually, at a station called WWWW, if you can believe it, which was perfect because even when I was stoned out of my head I could remember where I worked.” Higgs has made this bad-girl persona a one-woman enterprise; her “Bad Girls of the Bible” titles, fictional narratives of biblical vamps from Jezebel to Delilah, have outsold even her most popular romance titles.
You’d think this former bad girl would be the first to unbelt the chastity laws that govern Christian publishing. Yet Higgs’ books make “Mansfield Park” read like “The Story of O.” And even her chaste narratives have drawn criticism. “Just to show you what a Christian writer has to deal with, I took heat for the kisses!” she says. Robin Lee Hatcher, who ripped her fair share of bodices for a secular publisher, now keeps the door open, the lights on, and one foot firmly on the floor. “I regret that I ever gave in to the market demand in my love scenes,” she says. “I don’t think it’s necessary. And it’s not because I’m a prude, because I’m not. Ask my husband.”
That these godly writers are so clearly of the flesh has made their personal histories as important as their books to faithful readers. By the thousands, women living in prisons as well as wealthy suburban developments have connected to these personalities with, well, religious fervor, often because these writers find their material in their personal pain. “I always start from a place of pain or question and use writing as a tool to go before Lord and find out what to learn — like the atonement I had to do with my abortion,” says Rivers of writing her phenomenally successful book “Atonement Child.” Abortion, prostitution, drug abuse, adultery, you name it — there’s a Christian romance to help you through what ails your soul.
Consequently, and perhaps surprisingly, the trend is that inspirational romance has opened a whole new realm of possible topics for romance writers, who within other romance genres are limited to less issue-oriented story lines. “One of the things we found quickly was that we could handle much grittier situations than you can in traditional romance,” says Tracy Farrell, who edits the Love Inspired line. “Readers who are more religiously centered tend to look at life as more of a commitment to certain things; they like to see characters who have real experiences and real purposes.”
The emphasis on grit, pain and personal experience unites this literary ministry and its sisterhood of ministers. Hatcher, for example, based her first foray into the inspirational market, “The Forgiving Hour,” on her experiences in coping with infidelity. “When God called me to forgive my husband’s former mistress — this is my first husband, and his first mistress; after the third we divorced — I knew I had to write this book so I wouldn’t hold onto any bitterness. Now I get letters all the time from women whose husbands are unfaithful,” says Hatcher. “Because of the way my writing speaks to people, I get incredible stories of peoples’ lives — but they are really seeking answers from God.”
The evangelical aspect of Christian romance novels doesn’t sit well with some critics — or readers. “I think there’s a shameless appropriation that goes on among evangelicals trying to almost commandeer various cultural forms so they can use them for their own ends and advantages,” says Randall Balmer, author of “Mine Eyes Have Seen the Glory: A Journey Into the Evangelical Subculture in America.” The authors don’t deny the charge: while they claim broader intentions in their work, “it can be seen as an evangelical tool,” admits Hatcher. And quite a successful one, according to Rivers. “I received letters from quite a few who have had their own born-again experience through reading my books. But,” she insists, “it’s not the book that saved them; the only one who can save is Christ.” Higgs sees her trademark brand of self-deprecating humor as the ideal path out of pagan darkness. “A lot of people use my books to reach out to friends who aren’t really involved in God or church because of the humor,” she says. “Sneaky deep, is what my friends call me — it’s not in your face but it’s there.”
Not so sneaky, say Romantic Times magazine readers who have written to voice their discontent at being targeted for conversion, according to publisher Carol Stacy. “They perceive the books as some holy rollers cramming Christianity down their throats.” But letters to the editor are hardly slowing down this train to glory. The industry word is that those major publishing houses that don’t yet distribute inspirational fiction have their corporate eyes trained on the Christian bandwagon.
To even the most devout writers, like Robin Lee Hatcher, this is just God’s way. “Am I surprised that the secular market wants to jump in for the cash cow? No,” she says. “This way people are picking up books that make them look at issues of faith.” And in this peculiar genre of thumping hearts and Bibles, who need fear market competition — or even writer’s block — when you’ve got divine power on your side? “I have one thing to be faithful to in my work,” says Hatcher, “and that’s every day when I sit at the computer: I pray and ask God what he would have me say today.”
