Taking America's pulse: Resilient spirit takes front stage
By Marilyn Elias, USA TODAY
Nearly one year after Sept. 11, a vast majority of Americans have recovered from the most severe and widespread emotional trauma inflicted on them in modern history, evidence suggest.
Metropolitan New York is the only region that continues to suffer significantly higher rates of anxiety and depression than before Sept. 11, says Harvard Medical School health policy expert Ronald Kessler, whose surveys track mental health trends for the National Institute of Mental Health.
But that doesn't mean terrorism didn't leave its mark on people. Although there's no evidence of lasting effects on Americans' mental health, some experts contend that Sept. 11 sparked the start of changes in values and behavior, with potential for even more shifts ahead. These changes and what they portend for the future will be reported at the American Psychological Association (APA) meeting starting Thursday in Chicago.
About 100,000 Americans either saw one of the attacks or knew someone involved, says psychologist Susan Solomon, trauma expert at the National Institutes of Health. "They saw it in person, had to run for their lives or had somebody close to them killed, injured or at the scene."
Most everyone else watched on TV, repeatedly. Mental health experts weren't surprised that 90% of Americans had at least one stress symptom — from flashbacks to insomnia — in the week after.
Although the anxiety has eased, many Americans don't feel safe anymore. In a recent national survey, nearly half of women and one out of four men said the attacks had shaken their sense of safety and security. About nine out of 10 felt at least as threatened as they did last fall, says Michael Traugott of University of Michigan's Institute for Social Research in Ann Arbor. Some 84% thought future attacks were likely.
Recovery is most elusive for those reminded of loss every day. Mary Ellen Salamone, 40, is a leader in Families of Sept. 11, a support and information group for survivors. "A huge majority of the families are nowhere near out of the woods yet," she says. "We have OK days and awful days, but nobody says, 'I'm all better and moving on.' "
Others who are "moving on" may land in new territory because of Sept. 11. Harvard political scientist Robert Putnam, a speaker at APA, lamented the exodus from community pursuits in favor of solitary activities in his instant classic of 2000, Bowling Alone: The Collapse and Revival of American Community (Simon & Schuster).
Now Putnam thinks lessons from Sept. 11 could spur positive change, especially for youth. "We have an opportunity to create a new 'Greatest Generation,' " he says. Putnam's surveys after Sept. 11 found surges in mutual trust, national unity and interest in politics. Although these effects had decreased by spring, he thinks it's vitally important that adults younger than 35 are significantly more "we-oriented" than their elders.
"For the first time in their lives, terrorism reminded them what Americans share and our responsibility to one another," Putnam says. As ongoing threats of terror mark their coming of age, today's youth may be responding as their World War II grandparents did: by pulling together and prizing the common good above all.
That will only happen, Putnam predicts, if adults channel young people's service impulses into positive paths. A recent doubling in the size of AmeriCorps (a domestic Peace Corps) is one positive step. Major reform of public school civics education to emphasize concrete ways that kids can get involved in their communities, a plan reportedly being weighed at the federal level, could help too.
Some researchers point to signs that the terrorist attacks may be altering character traits of even older Americans. Responses to an online survey on how people view their own traits post-Sept. 11 found increases in traits such as love, kindness and spirituality. The increases had slipped by summer, but they're still higher than before Sept. 11, says University of Michigan psychologist Christopher Peterson, co-director of the survey. "We may be seeing a sustained change in American character."
But others argue that such changes are wishful thinking. Charity and church attendance rose briefly after the attacks, then sank to normal. Peterson has no proof that people are kinder and gentler. Putnam concedes that the heightened interest in community hasn't translated to joining more groups — yet.
Some question the mental health impact. "It's been way overblown," says psychiatrist Sally Satel of the American Enterprise Institute, a Washington, D.C., think tank.
Although counselors in other parts of the nation see no significant increase in clients, therapists around Washington, D.C., and New York say there's a continuing need for added help.
"We have never been involved so long," says psychologist June Feder, who oversees volunteer therapists for the New York State Psychological Association. "It's almost a year later, and we're still doing a lot of therapy work on this."
Alan Lipman, a Washington, D.C., psychologist, says some victims of the Pentagon attack only recently have sought counseling. "These are happy, glib, well-organized people with no previous emotional problems. They tried to manage it on their own."
As the first anniversary of the attacks approaches, many dread the retriggering of pain. "Stress inoculation" groups to help survivors deal with the anniversary are underway at a Long Island family center directed by psychologist Thomas Demaria of South Nassau Communities Hospital. Survivors of loss heal best when they gain support from their religious and community moorings, Demaria says. He thinks the Catholic Church's sex abuse scandal has delayed the healing of some Catholic survivors "because it's another great shock from a place they thought they could trust," and terrorism in Israel is having a similarly corrosive effect on Jewish survivors.
The center's support groups provide a chance to share with and comfort others feeling similar emotions. Rosaleen Shea, 39, attends a weekly group for adults who lost siblings. "You look each other in the eye, and there's a comfort there. It's almost as if you've been through a war together," says Shea, whose sister, Mary Yolanda Dowling, died at the World Trade Center. The group has helped a lot, but she still feels grief.
Although victims' surviving loved ones tended to suffer the worst emotional blows, last fall's terrorism also battered certain kinds of people who weren't directly involved. Others recovered quicker, showing ways to cope with future terrorism. Among key findings, many to be reported at the APA meeting:
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"Worriers" and those who habitually take responsibility for others had the worst stress symptoms. People prone to "survivor guilt" holed up the most, couldn't allow themselves to have fun and may be at risk for depression, says psychologist Lynn O'Connor of the Wright Institute in Berkeley, Calif.
| Adults found to bounce back quickly from setbacks, in studies before Sept. 11, didn't bury their bad feelings after the attacks. They were only slightly less angry and sad than adults who aren't as resilient, says University of Michigan psychologist Barbara Fredrickson. But they felt many more positive emotions, such as gratitude and love, than the less resilient did. These positive feelings accounted for their ability to weather tough times last fall, Fredrickson says.
| Spirituality helped and hurt. The more adults felt that terrorists had violated something sacred or linked to God, the worse their stress symptoms and physical ailments two months after the attacks. But they also reported growing the most: They revised priorities, took stock of their lives and worked on relationships, says Bowling Green State University psychologist Annette Mahoney.
| The more TV people watched, the worse their stress a week after the attacks, a large national survey shows. That's worth remembering after future incidents, says University of Texas psychologist Etzel Cardena, who did the study.
| Teens and young adults took the attacks hard but report greater respect for authorities than before and a hunger to serve others.
| The elderly were toughest. In New York, visually impaired old people recovered normal levels of mental health by November, say psychologists at the Lighthouse International agency. In a Muncie, Ind., nursing home, "the lady in a wheelchair hooked up to an oxygen tank was saying, 'Don't worry, dear, we've gone through so many wars and tough times, we know we're going to be OK,' " says Ball State University psychologist Michiko Iwasaki. |
Solomon, the NIH trauma expert, doesn't doubt that many families continue to feel the scorching aftereffects of Sept. 11. Americans didn't cave in, though. "To me, the amazing part of the story is the resilience, the courage we've seen," she says.
Even in the face of horrific bereavement, life does go on. A baby helps to remind you of that, says Terry Strada, 39, of Chatham, N.J. She lost her husband, Tom, a bond trader at Cantor Fitzgerald. Strada suddenly became a widow with a 7-year-old, a 4-year-old and a 4-day-old son.
Now baby Justin is starting to stand. "He's been something for us to love and focus on. ... A lot of women were pregnant or had babies and say the same thing. These gifts from God help us because we don't have time to wallow."
She still indulges in "a good cry" from time to time and is grateful for a weekly support group.
Despite her grief, Strada feels she must be a rock of stability for the kids to lean on. As childhood milestones pass, she's trying to keep alive the spirit and memory of their father. Kaitlyn, now 5, learned to dive off the high board this summer. "She said, 'Daddy would be so proud. Do you think Daddy's watching me?' I said, 'I'm sure he is.' "