My Memories of “9/11” on the 15th Anniversary of September 11, 2001

... und explodiert nach dem Einschlag in das Gebäude. Beide Türme stürzten darauf zusammen. Kurze Zeit später prallte ein Flugzeug auf das US-Verteidigungsministerium in Washington. Die Flugzeuge waren zuvor gekapert worden. Vermutlich hat es hunderte Tote und Verletzte gegeben. (Foto: CNN)

My Memories of “9/11” on the 15th Anniversary of September 11, 2001

Introduction

If you have any memories of 15 years ago you certainly remember where you were, what you did and how you felt when terrorists took over two large airline planes filled with passengers and  crashed them into the World Trade Center in New York leading to the collapse one of towers and the death of thousands of people.

I would like to use this blog to recall my memories and thoughts about where I was, what I did and how I felt. As is often the case in recollecting traumatic events, I may not have every detail correct but this is how I recall things. I should state that I while I was in New York I was not near ground zero at the time and no one close to me was killed or injured.

As a psychiatrist, I previously had some experience in working with people who were traumatized. I was a consultant to a burn and trauma unit of a hospital and had written a book about this subject. A few years previously I was part of a team that studied the psychological effects of a major plane crash in Dallas and I had studied the psychological impact on emergency workers of doing their work, as well as the impact on members of the media who cover such events. I have had occasion to write and speak on related subjects before and after 9/11.

The Event

I was in my office at New York Medical College/Westchester Medical Center, which is a suburb of New York City. My secretary told me that she had heard that a plane had crashed into the World Trade Center. This immediately brought to my mind a childhood memory of when a small plane had crashed into the Empire State Building in New York City. My father was a New York City policeman at the time and called in the event to emergency services. He subsequently brought home, a small piece of twisted metal and wires that I was told were part of the plane. I was soon to learn that 9/11 was a much greater catastrophe than that event.

The nearest television to my office was on a closed psychiatric unit in the hospital not too far from where I was located. I made my way there and in the large day room all the patients and staff were watching a medium sized television. I quickly appreciated the magnitude of this event when shortly after I entered the room and focused on the TV, I saw pictures ofone of the tallest buildings in the world collapse on live TV. As I recall the experience, there was only a quiet murmuring or perhaps some groans coming from myself and the people viewing this together. I should point out that this was a closed psychiatric unit with acute severely mentally ill patients some of who would usually be in an agitated psychotic state, perhaps with hallucinations. I don’t remember any such manifestations being shown. It was almost as if many of the patients were jolted back to reality by this event. I didn’t study this phenomena but it reminds me of an experience that I had in my first year of psychiatric training. I was assigned to an inpatient unit at another psychiatric hospital in New York City when there occurred a highly unusual city wide black out of all power. As I recall, it was in the evening and the hospital basically went dark with no or very little emergency power for lights for several hours . I subsequently wrote one of my first papers examining the reactions of the various patients to this unusual circumstance.

While initially we had no idea of what was the cause of this plane crashing into the World Trade Center Building or that there were other planes involved. It was apparent that many people were killed although there was no indication initially that it would be in the thousands and that people were actually jumping out of windows to their death rather than being burned to death. As the magnitude became apparent, my natural instinct as was that of others, was to be concerned about my loved ones who worked in Manhattan. While I didn’t think that they would be at that location I made phone calls to assure that they all were safe. Many people did not receive good news as they checked with their family and friends. One man who I knew quite well, was director of clergy services at the hospital, lost his son at the World Trade Center. At that time I lived in one of many suburban communities outside of New York City where many people commuted to work by train. That evening there were many cars in the train station parking lot that were not picked up by people who had perished that day. Photographs of those cars that were not claimed by their owners that evening stands out in my memory.

The Aftermath

My wife who worked at a major hospital in Manhattan related how her hospital immediately had gone to it’s emergency plan waiting to receive large numbers of victims with injuries that were expected. Even the suburban hospitals such as mine went on to that mode where surgeons were called in and all personal were on standby expecting to deal with the overflow of casualties from this tragedy. But despite the approximately 3000 fatalities, I understand that there were very few injuries. The ash floating down on the city may have caused some minor medical problems.

Screen Shot 2016-09-05 at 11.01.40 PMIn the days and weeks following screen-shot-2016-09-10-at-12-08-59-amthis horrific event there was this very unusual phenomena of there being many posters on walls, trees, light poles etc not only downtown but in other parts of the city. The theme of these posters was looking for a lost relative. There would be a photograph and a brief description usually stating that the person worked in the World Trade Center and was missing. There would be a phone number to call if anyone knew about this missing person. The reality was that there were no missing people. The very few people who may have visited a medical facility were identified and all of these “ lost “ people had obviously died. However, understandably their loved ones in many cases could not initially accept what had happened and were trying to maintain hope . Over the ensuing days and weeks many of the posters remained in place but their makers had crossed out the word “ Missing” and there were words about how the poster was a memorial to them. Often there were flowers left next to them. I also recall passing a fire station from where many firemen had perished after they had entered the tower to save victims and had been inside when it collapsed. It was shrouded with black draping and an appropriate sign paying tribute to the lost heroes of that fire station.

I believe it was on Pier 92 in downtown that a massive social service outreach program was set up to assist the family and friends of people believed to be killed in the tragic event. There were places for people to register that they had lost a loved one. In many cases the remains of victims would not be found . There were psychological services offered to the distraught people many of whom were grieving lost loved ones.

I recall it was at this location that on the third or fourth day after 9/11 I was asked because of my previous experience in working with the media around traumatic events, to run a “debriefing group “ for members of the media who had been working day and night on this tragic news story. Many of them had spent hours interviewing grieving friends, relatives and the colleagues of the firemen who had died. They had seen and photographed the gruesome scenes of dead bodies and the partial remains. Some had photographed the falling bodies of the jumpers who chose to die this way rather than by fire. They spent hours talking on and off the air about all the details of news story, edited their material and in many cases went without or with very little sleep since the story broke. In the earlier days of “debriefing” victims of trauma the psychological approach had been to allow each person in the group to recount their experience. We had subsequently learned that such an approach often re-traumatized individuals who heard other people’s stories in the group. The approach now was more geared to explain to people about the symptoms which they might be having or might have in the near future and suggestions about how to deal with them as well as allowing them to ask any questions. We would also try to identify people having significant difficulties and offer them more individual help. In the course of running this group I mentioned how comforting members of the media particularly TV commentators might be to the public as they explain what is happening and try to keep the audience calm. Illustrating this point, I told them about a phone call I had just had with a family member who told me of a dream she had that Peter Jennings ( the ABC anchor) was talking and comforting her about the event. In the group I was speaking with was Peter Jenning’s TV producer who worked very closely with him and said she was sure that he would appreciate that story and she would tell it to him that evening. You can imagine how surprised my relative was when I called her and told her that Peter Jennings would soon know about her dream.

By coincidence I had been scheduled to do a Grand Rounds Presentation at a hospital in Manhattan not too far from ground zero 10 days after 9/11. It was pointed out to me that you could previously see the fallen tower from the room in which I was speaking. I don’t recall what the original topic was but we altered it to focus on that unforgettable event that had occurred in their backyard.

For many years   I have been a very small part of the large number of mental health professionals writing and teaching about how our profession can be helpful in dealing with mass traumatic events. As a therapist I realize that many people have their own individual traumatic experiences that impact them and often alter their lives. These personal traumatic events can be just as meaningful and life changing as a big event that affects large numbers of people .

While I was very fortunate not to have been  seriously traumatized by 9/11, but still the fear and worry that I had living through it along with millions of Americans  is obviously imprinted in my mind. Recounting it now in this blog relieves some of the pain  that is still associated with that memory.

 

Michael Blumenfield, M.D.

Mblumenfieldmd.com

 

Oceans Apart-Book Review

When family members move away from each other for a variety of reasons, there can be a disruption in very meaningful psychological relationships. Author Rochel Berman, a social worker, has put together an excellent book which is reviewed in this blog. It discusses this issue and how family members can address this separation. For example, grandparenting at a distance is examined with many case examples and creative suggestions. There also is a chapter on the use of technology in long distance relationships. At the conclusion of the blog, Ms Berman answers five questions from Dr. Blumenfield

Patients in psychotherapy spend a great deal of time talking about family relationships. We examine the nature of the early childhood memories and interactions with parents, siblings and grandparents as well as other close relatives For most people, these relationships are usually the templates for the development of our personality and the strengths and weaknesses of our character formation. Obviously, sometimes there are problems and conflicts, which make us stronger and teach us how to deal with difficult situations. On the other hand, they may  lead to symptoms and serious difficulties which will benefit from some form of therapy, usually later in life. As we get older we can appreciate how important our presence can be to children to whom we are close. Many of us  also come to value ongoing relationships with our children, parents, siblings, grandparents and other close relatives.

But what happens when life circumstances separate us from important people in our lives? In today’s world most people can’t expect to spend their lives in close proximity to their immediate family. While something may be gained by being more independent, something is also lost by drifting apart from people whom you value, especially when there are children involved.

A New Book for Family  Members When Someone Has Moved Away

This is why I was so interested to see a new book titled Oceans Apart: A Guide to Maintaining Family Ties at a Distance by Rochel U. Berman published this year by Ktav Publishing House of Jersey City. Ms. Berman is a M.S.W. social worker currently living in Florida with her husband. She also is a personal friend of mine. In order to write this book she not only has drawn upon her professional experience which includes conducting an extensive number of interviews with various people from 25 different countries, but has drawn upon her own life experience as her son and his family have lived in Israel for the past 20 years.

In her opening chapter she lists five reasons that people move away.

1- Looking for a better life

2- Forced migration

3- Education and career opportunities

4- Changes in marital status

5- Pursuing an ideology

Even those among us who did not need to pursue a better life or migrate to another country, probably know of how that was a major factor in the lives of a close relative in their family in the last one or two generations. With the ease of traveling and meeting people, it is no longer invariable that people will  find their spouse within walking distance of their own home. Going to college, graduate training, medical residency, job recruitment almost always include “going out of town“ which may lead to a permanent livng arrangement away from family. While not mentioned, it certainly also applies to members of the military who may have to relocate, hopefully with their spouse and children, but when deployed they may be separated for a year or two under the most trying circumstances.

The author discussed the reason for moving away by giving specific case vignettes, a technique she uses throughout the book which brings it alive as well as making it very practical. She also concludes each chapter with a section called “ Lessons from Life “ applied to the specific chapter where there are usually ten or more specific suggestions or valuable advice. The ideas in the first chapter alone, I thought qualified as valuable pearls of wisdom. For example there was the suggestion to create photo albums of distant grandparents, uncles, aunts and cousins  which should be looked at to reminisce or prior to visits. There also were valuable tried and true techniques for parents to use in dealing with children of divorce.

Living Far Away Doesn’t Mean that You Can’t Be Close

The second chapter was titled  Keeping In Touch: Problems and Opportunities, could best be summarized by the opening quote of that chapter:
There are many families who live next door to each other who don’t have the relationship we do Mom, we will always be close despite the distance

-A son to his mother following her yearly visit

This was followed by the chapter which probably will be the main reason why people will give this book as a gift to loved ones and that is the chapter titled Grandparenting at a Distance. The six very practical areas covered are:

1-    Staying connected between visits

2-    Telephone and other means of communication

3-    Preplanning visits with grandchildren

4-    Grandchildren visiting alone

5-    As grandparents age

6-    The effect of distance on relationships.

Each of these topics are elaborated upon through the use of wonderful vignettes. These are not psychoanalytic case studies although the psychodynamic meaning is usually close to the surface and the practical lesson to be gained is always very clear.

Getting Through The Rough Times

In a subsequent chapter Ms. Berman writes about Getting Through The Rough Times which deals with how to cope with illness and death. This is a subject about which she is quite knowledgable and sensitive. She is the author of an earlier very well received book titled, Dignity Beyond Death . Her advice includes suggestions on establishing your own relationship with doctors and caregivers even when you are far away, planning to have final conversations with your terminally ill loved ones and carving out a role with siblings in the care of loved ones.

Sibling Relationships Can Be The Most Difficult

On the bases of my clinical experience, it is frequently the rupture of relationship with siblings which can be the most painful and difficult to heal. I am speaking of situations where the parties are not even separated by a great distance. Therefore it is interesting to see how the author addressed techniques for maintaining ties with distant sisters and brothers as well as distant nieces, nephews and cousins. I believe that many of the lessons from life in these areas could also well be applied to relationships, which are not oceans apart. She also discusses  the importance of family traditions and rituals, as well as how to share celebrations, even when separated and how to deal with missed celebrations. This includes the issue of the cultural divide and discussion of relating to family members who now have different traditions than the ones with which they grew up. Once again, there is great application for  these ideas even to people who live in close proximity.

Creative Use Of Technology

I loved the last chapter which was written by the author’s husband George Berman  that is titled, Creative Uses of Technology . He clearly is an expert in communication and is comfortable with many modes  which not only include the telephone, but Internet Video, Instant Messaging  and family Websites and blogs. Obviously a chapter such as this one becomes outdated the day that it is written due to constant innovations in social media.

However, the message of this book is definitely current and is becoming more pertinent every year as we become a global society. It should be a great psychological tool for the mental health of those who, in one way or the other, are “oceans apart.”

Take Five With the Author

D. Blumenfield asks Ms. Berman five questions

Why did you decide to write the book?

For the past 20 years I have struggled to maintain family ties with my son, daughter-in-law and four grandchildren who live in Israel.  This led me to research the network of distant family relationships with 70 people from 25 different countries.  Oceans Apart tells their stories and describes the courageous and creative responses to the challenges they face.

Are you concerned that the application of some of the suggestions made in the book might be considered as being too intrusive to the distant family?

It’s true that some people move far away because they want to get away from family so that they can develop their own lives.  This, however, wears thin after a while, and most of them wish, at some point, to reconnect with their roots.  I believe that in order to develop meaningful and lasting relationships at a distance, one must be proactive, plan ahead and be specific in terms of goals and objectives.

Do you feel that anything has been lost since people rarely sit down to write long letters anymore and instead rely on more instant communication?

Email and text messages tend to convey only information.  What’s missing from them, that is embedded in a long letter, is the contemplative and reflective aspects of what’s going on in one’s life.  While this can be done via email,  unfortunately, we rarely take the time to do it.

If it is only practical to make one visit to a bereaved far away family member, would a more leisurely visit several weeks after the death be better than a short condolence visit immediately after the death or attending the funeral?

There are several issues that need to be considered, namely the needs and expectations of the bereaved, your needs as well as family and/or religious customs.  This is something that should be discussed with the bereaved family at the time of death or in advance if it appears that death is near.

You have written very effectively about death and separation.  What is going to be your next project?

I am coordinating a half-day seminar on “Families at a Distance” that my synagogue is sponsoring for the entire community including people of all denominations and faiths.  The centerpiece of the seminar will be five concurrent workshops led by mental health professionals.  The purpose of this innovative endeavor is three-fold: To ensure participants that they are not alone in their struggles; to share information; and to seek solutions that they will implement going forward.