The Toll On Our Psyche

It was surely no accident that the terrorists struck at the symbols of America's military might and economic strength. Where the Pentagon stood intact and seemingly impregnable just seconds before, where the Twin Towers of the World Trade Center once appeared to scrape the very sky as soaring emblems of American power, there lay rubble and ruin--images forever frozen in time as the moment when America finally, and perhaps forever, recognized that it was not invulnerable to horrific attack by those who hate her. With the most devastating blow ever landed on U.S. soil, the terrorists did more than rack up a staggering death toll: they struck at the country's very psyche. As Los Angeles psychiatrist Calvin Frederick put it, "It's psychological warfare."

The terrorists were clearly intent on more than a shocking body count. "The target of terrorism is not the terrible number of deaths and injuries," says Dr. Robert Ursano, chair of the Department of Psychiatry at the Uniform Services University School of Medicine. "It is to disrupt the rest of the nation" by shredding our collective sense of security. Judging by the attacks' immediate aftermath, the terrorists were wildly successful. The White House, Capitol and Pentagon were evacuated, as were federal office buildings in Washington and New York, the United Nations, the Sears Tower in Chicago, the L&C Tower in Nashville, the glass-clad John Hancock Tower in Boston and Disney parks in Florida and California. Major-league baseball games were canceled until further notice--for the first time since D-Day. All airline flights were grounded for at least 24 hours. The Hoover Dam, Seattle's Space Needle, Minnesota's Mall of America, dozens of state-capitol buildings, the Kennedy Space Center, bridges and tunnels into Manhattan, every airport, every museum and monument in Washington, the stock markets--all closed. So, too, was Mount Rushmore in South Dakota, as well as Independence Hall and the Liberty Bell in Philadelphia. Literally and symbolically, the terrorists had struck at the soul, and indeed the meaning, of America. "Freedom and democracy are under attack," declared President Bush on the day after.

The president himself played out a microcosm of the country's initial panic. Chased from Florida, where he was to deliver a speech on education, he flew first to an Air Force base in Louisiana and then to the Strategic Command Center's underground bunker in Omaha, Neb. Air Force One was finally wheels up and back to Washington by mid-afternoon: but the spectacle of presidential zigzagging must have delighted those behind the attacks. "Terrorism's goal is to disrupt the feeling of safety," says Ursano. "Leadership in times of disasters is critical: they're the ones who re-establish the sense of safety."

That's going to take a while. In the hours after the atrocity, dazed business people wandered the canyons of lower Manhattan, briefcases in hand, as if lobotomized. Hundreds of people sat on curbs near Times Square, staring at the Jumbotron images, or gathered in silence around any car or hot-dog stand with a radio. People wanted to be with others. In Chicago, a lone bell chimed from Holy Name Cathedral as, inside, Father Bob McLaughlin solemnly declared that "our illusion of invincibility, security, power, self-sufficiency, was shattered. This series of events reminded us of our own fragility--our inability to control events. We became aware of our need to pray." And so we did.

At an individual level, "there will be a massive wave of post-traumatic-stress disorder among survivors, and among the families of survivors and victims," says neuropsychiatrist Jeffrey Schwartz of UCLA. Terrorism triggers more psychiatric problems than natural disasters like earthquakes--perhaps because of "the willful human element," says Dr. Carol North, professor of psychiatry at Washington University in St. Louis. Lives will change in ways great and small. "This tragedy is going to affect how we relate to our children and prepare them for the world," says Dr. Carolyn Newberger, assistant professor of psychology at Harvard Medical School. "The sense that we can keep from them the horrors of the world is gone." Fewer parents will try to shelter their children from the knowledge of evil in the world, she suspects. "Instead, we will be honest with them that there are dangers and that bad things can happen," says Newberger. "We will recognize that the best way to protect children may be to teach them these realities."

The change in the nation's collective psyche will be even more profound. The attacks have broken the illusion, deeply embedded in the American mind, "that we are more protected, and safer, than other countries," says trauma specialist Terrence Real of Massachusetts' Family Institute of Cambridge. Buried under the ash and wreckage in lower Manhattan is our long-held sense of ourselves as safe in an otherwise dangerous world. "This is a loss of innocence for Americans," says Newberger. "We as a country have been living as though the catastrophes in the rest of the world don't apply to us, disaster doesn't happen on our soil. But from now on, we can no longer deny that we are vulnerable." So much of the national character--from entrepreneurial risk-taking to technological innovation to an abiding optimism that has existed since Tocqueville was taking notes--reflects the sense of security provided by two vast oceans. The terrorist attacks show those seas to be no greater barriers than puddles. "It's difficult to predict how the national character will change in response," says Dr. Paul Appelbaum, president-elect of the American Psychiatric Association. "But we're not going to be the same country after this." Some changes were immediately obvious. Aircraft carriers and guided-missile-carrying destroyers were stationed off New York and Washington. Said one Manhattan tour guide, "This is the day New York died."

Once before, of course, a sneak attack shook the nation. But there was a difference 60 years ago. In December 1941 America knew who the enemy was and knew how to respond. "There's a war on, boy--get a uniform!" friends told friends the moment they learned of the attack on Pearl Harbor, which killed 2,400. The attack pushed America into immediate action, starting at the top. President Roosevelt planned troop deployments, dispatched guards to defense plants and wrote his "date which will live in infamy" speech. He approved the Doolittle raid over Tokyo: of questionable value militarily, but an enormous boost psychologically.

"We need to feel empowered," says Dr. Art Rousseau, who was president of the Oklahoma Psychiatric Association when the Murrah building was blown up. Retribution offers the hope of at least mitigating the sense of victimhood. "I think it's important psychologically to feel like something is being done," says Dr. Dan Creson of the University of Texas Medical School. "Otherwise it adds to the feeling of helplessness." But until we know whom to strike back at, the frustration will leave us feeling even more vulnerable, even more impotent--a helpless victim. "Helpless" is not a word Americans like to apply to themselves. "America's sense of who we are has been challenged in a very serious way," says University of Chicago psychiatrist Bennett Leventhal. After the Pentagon attack, employees literally ran screaming from the White House.

Many survivors were ready to give in. Felipe Oyola worked in the World Trade Center; he survived the 1993 bombing and returned to his office with few qualms. Hours after the towers collapsed, he said he would never again work in a famous building. But Greg Ciaverelli, who was evacuated from his office at the investment bank Goldman Sachs just blocks from the World Trade Center, said, "I'm not going to give them the satisfaction. I'm going to be at work tomorrow."

That isn't just whistling past the graveyard. "FDR's declaration that 'the only thing we have to fear is fear itself' is very relevant right now," says UCLA's Schwartz. "People need to understand why not capitulating to fear is so important: you lose much of what makes us human." What FDR refused to do sent a powerful message: he rejected the Secret Service's plan to ring the White House with soldiers, camouflage it and position tanks at the entrances.

There are other ways to show the terrorists that America remains unbowed. "What the country needs to do is get that sense of control back," says Dr. Daniel Yohanna, medical director of the Stone Institute of Psychiatry at Chicago's Northwestern Memorial Hospital. "We can't let a terrorist act stop our country or our government." President George W. Bush emphasized that federal offices had reopened by the day after the attacks. Tales of heroism abounded. New York's Bravest and New York's Finest--its firefighters and police--risked their lives, and in hundreds of cases lost them. One man carried a hobbled woman down 54 flights of the World Trade Center.

In little ways and heroic ones, ordinary citizens wrested control from the chaos. Former president Bill Clinton called on the country to "be strong, calm and good Americans"--and to a remarkable degree, they did. Owners of grocery stores near New York hospitals carried provisions to medical workers treating casualties. The driver of a bread delivery truck offered rides out of the Manhattan war zone. Pleas for food and water for emergency personnel were met with a cornucopia of donations. By 3 p.m. hundreds of people were waiting on line in midtown Manhattan to donate blood. There were mothers pushing strollers, 60-year-old men in suits, college kids and a laborer in dirty jeans and hard hat. Hundreds more thronged centers where the Red Cross organized volunteers. "It's the smallest thing I can do," said Amy Wells, 39, who signed up her husband too. In Santa Fe, an elderly man in a wheelchair rolled himself into a blood center. Teens with green hair and Goth clothes joined him. "Disasters can pull people together," says Carol North. "A community outpouring of support can make an enormous difference."

The terrorists struck closer to the country's heart than any foreign forces since the British torched the White House and the Capitol in the War of 1812. In the wake of the tragedy, America needs to be able to say that terrorists hit us with the most horrific peacetime assault in the country's history, but that--after the shock, after the mourning--we squared our shoulders, screwed up our courage and vowed that the United States will neither be bowed or swayed from our principles. As Bush said, "We will show the world that we will pass this test." However we respond, America was not the same country on Sept. 12 that it was on Sept. 10. Exactly how we change will be shaped by the actions of our leaders, by the retaliation we launch and, more than anything, by our character and our spirit as a people.

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