9/11/01 Is Not Over Yet Psychologically and Physically, Nor Perhaps Should It Ever Be

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PSYCHIATRIC VIEWS ON THE DAILY NEWS

It is the 22nd anniversary of 9/11/01 today, referring to when the World Trade Center and the Pentagon were attacked by terrorist-hijacked airplanes turned into bombs, killing over 3000.

More died on Flight 93, although it likely would have been even more if a passenger revolt did not bring the plane down in a field in Shanksville, Pennsylvania. There is a memorial there called the Tower of Voices, 40 chimes being rung by the wind, one for each paid flyer and crew member, replacing the most screeching sounds of the crashing of a plane. I wrote a column on March 13, 2023, titled “Let Us Be a Courageous Tower of Voices” about the most moving visit there that my wife and I had earlier this year. Here is my voice of muffled tears once again in writing, to be followed by a video interview by Jon Atack, family & friends out of Great Britain.

However, in terms of the run-up to this anniversary, you would not necessarily have been reminded of it, given the sparse mainstream media attention during the days leading up to it. The exception I saw was a rerun yesterday of the 60 Minutes show about the New York Firefighters, as 343 of them were killed in their rescue mission. They were said to die happy because they were taught that they would not be rich, but always happy due to their work of helping others. As the show concluded, it was said that they climbed physically and metaphorically to rise to a place of selfless devotion. Many of their children have followed their climb into becoming firefighters.

It is common to remember exactly when and where you were and what you were doing that 9/11/01 morning. I finish writing this close to the morning time when the first tower was hit and someone turned on our TV. As Chair of the Board, I was leading a meeting of our local Clubhouse for those with severe mental disorders in Milwaukee. The meeting ended quickly and early, but it was fascinating to see that most of the members coped well for some time as long as they were supported by staff.

For the general public, the closer and more affected by the attacks of 9/11/01, the greater the risk of trauma repercussions.In the immediate times after 9/11/01, there was an increase in clinical depression, posttraumatic stress disorder (PTSD), and substance abuse.

Over time, triggers to the original trauma can complicate the grieving process. Such a trigger may even be seeing Russian rockets hit the buildings in their invasion of Ukraine. The World Trade Center Health Registry has been periodically tracking about 70,000 individuals directly exposed to the attack. As the 20th anniversary report by NPR conveyed 2 years ago on 9/10/21 “For Many Who Were Present, The 9/11 Attacks Have Had a Lasting Mental Health Impact,” with about 10% still having significant symptoms of PTSD.¹

On the rest of the medical side, many more first responders are still getting sick and dying from the ongoing health repercussions from being around the toxic substances at Ground Zero. Common is what is called “9/11 cancer.”²

The anniversary must leave us with this question: How do we adequately mourn the victims of such an attack on our presumed public safety? Analysis of what could have been prevented beforehand is one way. Analysis of the successes and failures of the ensuing 20-year war in Afghanistan is another. Dedicating projects to those who died honors their lives. Never forgetting, the continuing cry after the World War II Holocaust, keeps those lost alive in our minds. It is easy to be reminded by visiting any of the Memorials at other times of the year.

It behooves anyone—citizen, patient, clinician—to reconsider how they have reacted to the trauma of 9/11/01 and whether they are still unduly suffering from the aftermath and perhaps need further processing of that trauma.

A motto? Cry out. Mourn adequately. Remember to prevent. Educate the children. Then make the world a better place.

My gratitude for today is that we have not experienced any similar attacks within the United States since 9/11/01.

Dr Moffic is an award-winning psychiatrist who has specialized in the cultural and ethical aspects of psychiatry. A prolific writer and speaker, he received the one-time designation of Hero of Public Psychiatry from the Assembly of the American Psychiatric Association in 2002. He is an advocate for mental health issues related to climate instability, burnout, Islamophobia, and anti-Semitism for a better world. He serves on the Editorial Board of Psychiatric Times.

References

1. Chatterjee R. For many who were present, the 9/11 attacks have had a lasting mental health impact. NPR. September 10, 2021. Accessed September 11, 2023. https://www.npr.org/sections/health-shots/2021/09/08/1035224815/for-many-there-that-day-the-attacks-on-9-11-have-had-lasting-mental-health-impac

2. Bisram J. 22 years later, the fight continues for those battling 9/11-related illnesses. CBS. Updated September 8, 2023. Accessed September 11, 2023. https://www.cbsnews.com/newyork/news/september-11th-related-illnesses-advocates/#