This past Sunday, a new 9/11 memorial was dedicated in central Pennsylvania as a reminder of the heroism of the 40 passengers and crew of United Flight 93, who died in the crash when they fought back against the airline terrorist hijackers. It seems full of symbolism. It holds 40 wind chimes, representing those victims of the attack. It is 93 feet high, representing the flight number. Each of the chimes are constructed to sound different, reflecting each individual, but be musically compatible with the others, just as individuals can merge into an heroic and therapeutic community.
Such symbolism seems psychologically astute. Confronting psychological trauma head on generally doesn’t work well. The brain tends to try to protect itself by dissociating devastating trauma from memory until – if and when – it can be slowly and carefully exposed. examined and processed. The same principle seems to hold true for collective trauma, which is why none of our monuments to Sept. 11 just play video or audio tapes of the events over and over.
But isn’t it a bit late for a Sept. 11 monument? Not at all, especially if you consider the psychological sequelae of trauma. The aftereffects never seem to go away completely, and for some individuals, the emergence of consequent post-traumatic stress disorder can take years. Moreover, having such a striking new monument helps to prevent taking 9/11 for granted after so many years and the continuation of the “war on terrorism.”
We in mental healthcare can also make a contribution to the memory and heroism of 9/11. Best may be the indirect and symbolic approach reflective of the new monument.
For patients: Stay on the alert for clues, obvious or subtle, of patients for which the anniversary of 9/11 will be a trigger to personal trauma psychologically associated to that day.
For staff: Use the anniversary as a reason for an annual inservice about cutting edge treatments for PTSD in general, perhaps creatively incorporating the sounds of chimes and bells or the like.
For the system: Reassess whether your system is doing its best to reflect trauma-informed care, including the use of adverse childhood experiences (ACE) questionnaires for new patient evaluations.
For the community: With many communities now realizing that unresolved childhood trauma contributes to ongoing later life social and health problems, advocate for related agencies to embark on community prevention programs, like the new SWIM (Scaling Wellness In Milwaukee) endeavor in my hometown of Milwaukee.
For the nation: Although 9/11 each year is a reminder of a single day of national trauma, those in the military continue to develop PTSD and be at higher risk for suicide, needing appropriate and adequate treatment resources.
Perhaps in the spirit of synchronicity, that concept developed by the psychiatrist Carl Jung, there are other events this week that seem to connect in meaning to this anniversary. It is National Suicide Prevention Week, and suicide is a significant risk for anyone subject to untreated severe trauma. It is also the beginning of the Jewish New Year, Rosh Hashanah, for which we begin a personal analysis of how we’ve done this past year, try to improve on our shortcomings, and look forward to being put in the “Book of Life”. All together, these events suggest that communal responses, whether in psychiatry, society, or religion, have the potential to produce a more mentally healthy year for all.