The Awakening of the Emotional Tragedy of 9/11

Picture is in commemoration of a first responder and dear friend Paul Palmisano.  Paul is a principle that teaches troubled teens and was on the scene of 9/11 to help and provide assistance anyway he could.  9/11 is a very hard day for him to get through.  The memory of 9/11 will be forever with him, and as tragic as it was to be at ground zero that day, Paul has shown resilience through his pain and continues to help those that seem so helpless to help themselves.  I am very honored by his friendship.  This page is also dedicated to those troubled kids that he loves so much.  Please visit the school and see what Paul is doing with his life twelve years later.  www.ourlife.academy.com

Abstract
     Twelve years ago on September 11, 2001 the American people were faced with a national media crisis as the twin towers in lower Manhattan collapsed from terror attacks in full living color from the comfort of their homes.   Never has such an event shook the stability and securities of millions of citizens as each individual can vividly give an account of what transpired that day.  There have been close to 3000 deaths that occurred from the attacks and 2000 more from health conditions afterwards.   There will be an examination of interventions that were used, and the pros and cons of how this one act of aggression on American soil has reshaped a new era of counter terrorism.   There are many questions that are full of gaping debates on how the crisis was handled and what might have been done differently by governing officials. Looking back and into the future America still struggles to find solutions on a grander scale that can bring us to clearer objectives in the wake of 9/11 attacks.  While wars are still being consumed by those past events, there are thousands of military personnel that are still facing the crisis of war, and also suffer from post-traumatic stress disorder along with a country that has grown weary to a battle that is still not clearly defined. There are still many unfulfilled answers that have not been given, which leaves no scab to the current wound of knowing the full truth of what happened on that day, and how it changed our complete perceptions overnight. Until clear answers are given, there is no end to what this aggression has cost so many in their search to find healing.   Americans are looking for closure to what happened on that day. The evidence that will be presented will be based on research of those that seek the truth about 9/11, and more effective ways that we can deal with a crisis that is still plaguing the minds of the American psyche as we continue to deal with terrorist attacks abroad.

The Awakening of the Emotional Tragedy of 9/11

Description of the Crisis

     It was a clear and beautiful skyline across New York City the morning of 9/11.  Four American planes were high jacked after they were boarded.  Two of the planes were purposely driven into the World Trade Center in New York City.  When the first plane hit, most people believed it had been a terrible mistake or accident, and then several minutes later another plane hit the other building.  It became quite obvious to most people that the country had been attacked from within.  The entire country was in a state of shock as millions watched the towers burn and collapse from their television sets in the comfort of their homes.  Another plane destroyed part of the Pentagon building, and the forth one crashed in Pennsylvania.  According to the News broadcast that morning the passengers had tried to prevent the plane from crashing into any more buildings, and a few of the passengers had broken into the cock pit and struggled with the terrorists while crashing into an open field killing all that were on board.

     Who would do such a thing, was the ultimate question of every American that morning.  There were a total of 19 terrorists that were involved in the incident of all four planes.  There were news reports that were calling this group Al Qaeda.  America was told that they opposed western culture, and they practiced an extreme form of Islam that had been orchestrated by Osama Bin Laden. (Natalie Smith, 2013)

     The strike hit at the heart of America, and there was great mourning, anger and confusion that flooded the entire country.  The entire media was flooded with coverage as it played over and over with the scenes of that horrible morning.  Americans were not prepared for any attack of this magnitude.  The United States had been protected from invasions with the vast sizes of the oceans of both coast lands.  At this particular time terrorism was something that most common people in America did not concern themselves with, but the fate of the attack of September the 11^th brought the shock and horror of what can change the feelings of safety to a very insecure feeling of fear, rage and helplessness.

       It was a different crisis; something Americans had never experienced from their very homes.  It was an unthinkable act that our very own planes would become the weapons that destroyed our landmark of national freedom along with thousands of working Americans that set from their desks conducting business from the apple of our land.  Most people can still remember exactly where they were and what they were doing at the time of the attacks.

       There was horror and destruction at ground zero as many first responders, policemen and fireman sacrificed their lives to save any remaining survivors.  In the American spirit this attack entered the hearts and minds of all that witnessed the tragedy, and many are still unable to grasp such a horrible incident.  The faces covered in white ash running away from the building.  The jumpers that fell to their death rather than being burned alive was not a motion picture coming from the screens, but real life people just like the rest of us.  These scenes are buried into the memories of all that witnessed these events on that memorable day that will never be forgotten.

Historical Context of September the 11^th after the First Five Years

     In October following the attacks, the US and its allies invaded Afghanistan where the terrorist cell was based.  The Taliban government was protecting Osama Bin Laden and there were training camps that were being ran from the country itself.  US forces destroyed the Taliban.  Since 2001 there were many Al Qaeda members that were captured or killed.  The US then invaded Iraq in 2003 because of intelligence that Sad am Hussein was hiding weapons of mass destruction.  This war was one that was well supported by most of the American people because of the fear that was inflicted from the attack on 9/11.  It was later determined that no chemical weapons had been found.  Hussein was later captured and executed by an Iraqi court.  The US government took steps to ensure tighter security and safety for the American people during this time.  Airports were more secured and people welcomed the changes hoping it would make lives more secure from the events of 9/11.  Public buildings were more secure, and a new government position was taken to secure Americans against terrorism known as Home Land Security.

     According to Christopher Reed (2004), in global statistics of war world wide 9/11 was relatively minor, but due to the fact that Americans have lived for centuries protected by bodies of ocean water, the US was over confident that no foreigners or invaders could bomb the area. Reed stated, “September 11^th carnage was psychologically catastrophic.  Americans said it changed the world, but in fact Americans, or the US government, are making the most changes” (p 1).   Americans have taken losses in the casualties of war, but the war against terror cannot be so formalized, but that is really not the point of the statement.  Americans need to be advised that the world is a very shocking and violent place and 9/11 is a constant reminder of the day that a country awoke from their sleep (Reed, 2004).

     During this time period President Bush made claims that war in Afghanistan and Iraq had made not just the US safer, but the entire world.  This statement is simply not true.  The death toll from terrorism in the year 2002 was approximately 750.  In 2003 it was around 650.  In 2004 it exceeded 1000 deaths, and this did not include the 191 deaths in Madrid, and the 271 deaths in the Shiite festival in Iraq the same month (Reed, 2004).  The most hoped for incident had not occurred, the capture of Bin Laden as he presumed to move about from cave to cave in neighboring countries.  The frustrations and effect of war was taking a toll on the American people will very little closure of the atrocities of 9/11.  America was suffering causalities of war, and the structure of a safe place has been changed by the new policies of Home land Securities.

                              Historical Context 10 years after the Tragedy of 9/11

     According to the Lancet journal (2011), the attacks of 9/11 were the deadliest seen on American Soil since World War 2.   The events from that day changed the Historical Trajectory of the United States of America, and it continues today to have profound effects and consequences in health.  It was further stated that “One inadvertent consequence was that, on a population level, anxiety, fear, and sometimes xenophobia were fostered at home and overseas”. (p 1).   Many American Muslims felt stigmatized and intimidated, while the government continued to shift its spending priorities into home land security and emergency preparedness, and because of these things, health as a whole suffered greatly. (Lancet Journal, 2011).

     Ten years after the 9/11 attacks New York City is still greatly affected.  During this time more focus was being placed on the surveillance of the World Trade Center survivors and there long term mental and physical health concerns.  In 2010 Health and Compensation Act was established providing 2.8 billion dollars with those that had been affected by illnesses caused by the attack of the World Trade Center.  There were 3000 victims as well as first responders that endured ongoing health problems that needed a continuation of treatment.  The health of troops returning from Iraq and Afghanistan is an ongoing concern.  There were an estimated 46,000 troops that were currently serving in Iraq with 98,000 deployed to Afghanistan.  There was a growing number of military personnel that were returning with brain injuries as well as Post Traumatic Disorder, depression, suicide, alcohol misuse, and sometimes aggressive behavior towards others.  As many as 10 to 20 percent of soldiers that have been exposed to combat were suffering from mental illness that resulted from the 9/11 attacks as they were called to defend the country against terrorism (Lancet Journal, 2011).

                                    What has the country learned from the attacks of 9/11?

     The greatest significance to 9/11 is that the entire country woke up to something it had little knowledge of because of our vulnerabilities of our constructed safe haven.  Our minds turned away from the simple things, and made us examine other parts of the global world, and the ugly faces of terrorism, no matter who was responsible there have been huge debates on what actually happened on the date of 9/11.  In the wake of the incident the country rose above it differences and united for a time period with people that simply dropped everything they were doing at the time to reach out to a disaster they felt so helpless to.  It was a clear example of the human spirit and empathy towards each other in the period of shock and despair.  Many people had a growing concern for their families at home, and viewed what happened to those that passed on could have been their own family members.  It was a call of the American people to act quickly, and there was a huge response during a time that the complete Nation mourned over the aggression on civilian suffering and loss.

     In the response of war I think there has been discovery that has been seen that terrorism brought a new type of crisis in which we were not fully prepared, even those that had been trained for such events ever expected something so tragic.  Terrorist knew that playing upon the fears of the American people would create an unbearable wound.  In the progress to move forward we have ventured out to learn more about global cultures in trying to grasp an understanding of how something like this could have occurred.  Looking back to what happened from the beginning until now, we definitely need to be more psychologically prepared for terrorist attacks and there will be years of studying new crisis interventions to meet that calling in the future. 

     What we failed to understand was the impact of who was affected by these senseless attacks.  According to Roxane Irvine (2011), she stated that “most of the research has considered the burden of posttraumatic stress disorder on individuals who were proximal to the attacks, lost a loved one, or engaged in cleanup or recovery, but the psychological impact spilled over beyond those directly exposed, affecting those who merely witnessed the attacks indirectly.  Indeed, this spillover went far beyond posttraumatic stress responses” (p 427).  Although many questions have remained unanswered, psychological research is making impressive contributions towards bringing these topics that are of great consequence to our survival past an attack such as 9/11.

     The aftermath of 9/11 also opened up new doors that included faith based groups that have proven to have valid consideration to helping those with these types of disorders.  Before 9/11 there were no answers in a way to intervene outside of secular means, but many felt the need of spiritual interventions as well as other resources to help them cope.  There has been a huge increase of lay counselors that have increased since the incident of 9/11.  There has never been a greater need of spiritual strength in the face of complete darkness and despair.  Many of the survivors and first responders felt a strong desire to help, and most drew incredible strength from God to help them digest what they were up against.

       I hope in the field of crisis interventions there will be more spiritual counseling on a wider scale so that we can prepare Americans on an individual basis of the realities of what can happen in the wake of such a man-made disaster.  Not only as a crisis counselor intervening, but also educating people to be aware of the dangers and stay diligent in the days ahead.  Many believe that 9/11 was a huge call for Americans to get there houses in order, and to also prepare themselves for the evil that dwells among us.  9/11 was a clear call to awake from every individual perspective.

            Taking a look closer at the Interventions that were used after the 9/11 attacks.

     There are several aspects of crisis intervention that should be clarified through the attacks of 9/11.  According to Irwin Mansdorf (2008), first there needs to be an understanding that terror attacks are far different from other disasters.  There is no warning or familiar scope of nature.  Second, the stress was not only associated to those that were victims, but were felt across the country, showing 44 % of adults and 35% of children showing what is called as substantial symptoms that related to upsetting reminders, disturbing memories, unable to concentrate, sleep deprivation and irritabilities.  This crisis is one that is known as crisis by observation.  The third and most important of all is how terror can create an ongoing personal threat in different societies.  This creates an ongoing need for vigilance that is not at all common in other types of crisis or natural disasters (Mansdorf, 2008).  He further suggests that this type of exposure to terrorism increases the vulnerability on a wider scale, and there have been suggestions made that pre attack intervention or preparation would be helpful in dealing with these sorts of symptoms.

     Although there is some evidence of research that indicates that immediate calls for psychological first aid rather than those of clinical interventions, there are questions that have been raised about conducting any intervention at all, because research has also shown that some people may if fact do better the less emotion they express at the particular time of the trauma.  CISM has a lengthy history and there have been questions that have been raised about the efficacy.  The most controversial aspect of CISM is the debriefing phase where it takes place within 24 hours of the crisis.  It is where emotional expression is encouraged, and a review of the experience in group settings to cognitively process the experience.  At Oxford University there was a study that was conducted known as the Cochrane group study.  The conclusion regarding the one session was viewed as direct and blunt.  Psychological debriefing can contribute to making the severity of post-traumatic stress disorder worse.  It is also not recommended for depression, anxiety or psychological morbidity.  The study indicated that it may further the risk of PTSD as well as depression (Mansdorf, 2008).  After reviewing the evidence of the use of CISM with the first responders of 9/11 there is also research that would strongly disagree, and the arguments were defended by an accurate debriefing rather than one with lack of proper training.  A high base line of hyper arousal has a tendency to show worse results than other types of de briefing.   After the attacks of 9/11 the APA published fact sheets that encouraged the usage of resilience in dealing with psychological symptoms.  The fact sheet identified with the belief that most individuals were able to deal with high levels of stress and challenges.  Resilience is defined as the process of adapting well in the face of adversity, trauma and tragedies.  Consistent with the ability of resilience, there were a large number of people that suffered from PTSD, it was apparent that the largest majority of those that were exposed to terrorism showed a positive display of resilience.  On a reasonable basis it should be stressed on the importance of realistically providing an assessment of the damage from any attack, and the focus would be well on resilience, and using several specific interventions such as cognitive behavior therapy, medications as needed for high risk individuals that suffer a serious stress reaction (Mansdorf, 2008).

     Terror victims are unique and should not be treated the same as those from other disasters or trauma.  Regarding the events of 9/11 there would be a great deal of relevance and meaning to this particular group in the act of supported adjustment and reducing fears of a further attack or future terrorism.  The main objective is not whether psychological help should be given, but rather to know the limits, or if intervention should be needed at all.  Providing intrusive intervention could intensify the trauma by not allowing natural coping skills to be engaged would not be productive in the events of terror attacks.  There should never be an intention to expose individuals to emotional levels that are not productive.  There was a review of crisis intervention that included several approaches including CISM and debriefing and the reports came back effective, and it was focused on guidance on handling emotional and behavioral symptoms.  There is no definite treatment for terror related attacks.  This is the reason it is vitally important to take a conservative outlook while being extremely careful to not worsen the crisis or cause harm by intrusively conducting interventions.  It is critical that one does not attempt to overtreatment.  There are disasters with crisis intervention workers and their thoughts are well and meaningful, but sometimes poorly prepared volunteers that are seeking to help providing psychological assistance can be over intrusive which could possibly cause the crisis to worsen for the individual if they are suffering from PTSD.   There will be a continuation of broad scientific based interventions that will continue to be developed as past events continues to occur.  In the mind of a crisis intervention team, the main focus should be to do no harm intrusively, and to be empathetic to those that suffer from such incidences (Mansdorf, 2008).

                                                            Conclusion

     There are still many unanswered questions that surround the attack of 9/11, and with truthful answers there is a closure that can take place in the minds of those that witnessed these things personally, as well as indirectly.  There are wide spread debates that have surfaced about whether we were told the truth of what occurred on the day of the attacks.  It is in the spirit of men and women to search out the truth, and then the bondage of freedom can be released.  There are many families that are still wondering about what happened to their loved ones, and question why the investigations of 9/11 are still incomplete.  Many of these problems have caused divisions even among our very government and where there is truth, there is closure.  Many people wonder if the wars have helped the situation of safety for those of our country.  Many people still live in a dark place concerning 9/11.  It was a dreaded scar that struck deep in the heart of every American that morning.  While sometimes it is not apparent for us to be able to understand something as horrible as 9/11, it is encouraging to think we can go back to that day where the country met in a united spiritual place that impacted our nation.  Learning to overcome and perhaps less of knowing why is what we long to seek in the days ahead as God guides us to move forward as a divine people who will lean on one another through our attempts to rise through the ashes.  Resilience is what has made this country the greatest of all nations.  May we live by that, and learn tolerance towards one another as we move forward in a dangerous world.  Perhaps in spite of the tragedies surrounding what happened on 9/11, it was a time like no other that we needed to awaken from the sleeping giant known as evil.