WHILE PSYCHOLOGISTS of various stripes have long offered counseling to help people cope with losses of loved ones, the sickening acts of terrorism that struck the U.S. on Sept. 11 seem different and worse. Tragic events often happen without warning in our lives, but the sheer scope of the death and destruction in New York, the fact that the jetliners' passengers were aware of their fate and that some struggled valiantly to overcome the hijackers, the symbols of America being attacked, and the number of people--survivors, relatives, and friends--suffering and struggling to regain their psychological balance put this tragedy in a category of its own.
It is different, too, in how Americans perceive it. The terror created by the image of jetliners smashing into the World Trade Center and the Pentagon, as well as the crashing of a hijacked plane near Pittsburgh, did not end with these events. In fact, there was and is deep fear that the "other shoe may drop." Anxiety concerning future terrorism as well as the ongoing dramatic economic ramifications of these attacks cannot easily be put to rest. Does anyone, therefore, really know what advice and/or counsel should be given to all those Americans upset by these horrible events (which would seem to include virtually everyone) and to those who are directly connected by blood or friendship to the victims?
Helping people cope with loss, brought about by terrorism or other causes, generally falls to professionals in the fields of psychology and psychiatry. In the wake of the tragedy of Sept. 11, there was--and continues to be--a spate of articles in the popular press on the psychological dimensions of the events of that day, especially the effects on those close to the victims as well as those who were actual observers.
Singled out for much analysis are the cell phone calls made by passengers who knew or sensed that they were going to die. These passengers wished to call loved ones as a last goodbye. Several articles addressed whether it was better for survivors to have "closure" by receiving a call from a loved one to say a final goodbye from a doomed airplane. E. Fuller Torrey, among the U.S.'s most high-profile psychiatrists and brain researchers, concluded, "I'm not sure that the shrinks have any more insight to answer this question than the average folks on the street. I'm not sure that I have any more wisdom or knowledge than anyone else because nobody has done any studies on this." He added that it was his "gut reaction" that it is better to make the call if you can because it "would presumably provide some closure." Similarly unsure of the answer as to whether it is better or worse to receive such a call was Linda Kovalesky-McLaine, a clinical social worker, who said simply, "I can't answer that question. I think it would be a different answer for every person."
Mental health writer Sandra Boodman wrote in The Washington Post (Sept. 18, 2001) that the witnessing of the horrific events on television will lead to some people's not regaining their "psychological equanimity." In fact, she maintains that mental health professionals believe such witnessing can exacerbate or even "cause a diagnosable mental disorder." Psychologists and psychiatrists around the country seem to be divided on the issue of whether such severe psychological consequences are likely.
While most of them support making counseling readily available to survivors and observers at large, there are some psychiatrists who believe that there is too much of a rush to provide psychological "aid" to those who may not need it. In an interview with us, Sally Satel, a psychiatrist in Washington, D.C., and a fellow at the American Enterprise Institute, pointed out that, although those who feel the need to get "professional help" should seek it, there may be a self-fulfilling prophesy at work. When people are convinced that they surely are under unmanageable psychological stress, they tend to believe it and feel just that sort of stress. …