Many May Have Nightmares,
Flashbacks as 9/11 Nears
Thu Aug 8, 9:58 AM ET
By Gunna Dickson
NEW YORK (Reuters) - Sept. 11, 2001, is a day
many Americans would strike from their collective
memory if they could. But, psychologically
speaking, they may not have that choice.
As the anniversary of the attacks that killed
more than 3,000 people approaches, many Americans
are having nightmares, flashbacks, tearful
outbursts and needless quarrels as their minds
subconsciously dredge up the horror of that day,
The terms "anniversary reaction" and
"grievers' firsts" refer to time cues
that re-trigger feelings surrounding a traumatic
event. The cue can be anything from the season of
the year the trauma occurred, to a specific day,
date or hour.
The anniversary of the terror attacks that
destroyed the World Trade Center's twin towers and
part of the Pentagon presents a danger of throwing
New York, the entire nation and even other parts
of the world into emotional turmoil.
"There could be mass depression,"
said Dr. Michael Nuccitelli, of SLS Health
psychiatric facility in Brewster, New York, whose
patients include families of the World Trade
"We are going to experience grief as a
nation -- parallel to the fact that there was mass
shock. As a nation, we couldn't believe it
happened," he said.
SAW ATTACK TAKE PLACE
On that clear September morning, Dr. Alan
Hilfer was driving on the West Side Highway to
work at Maimonides Hospital in Brooklyn when he
had "the great misfortune," as he put
it, to see the first hijacked jetliner smash into
one of New York's most prominent landmarks at 8:46
"It was a beautiful day and the sun roof
was open," the psychologist said. "I
heard a plane flying very low over my head and
then what I thought was a sonic boom. I looked up
and saw the World Trade Center explode. Other
drivers and I pulled over and just stood and
watched the paper floating down. I can still see
it. It will be burned in my mind forever."
He was already driving away when the second
hijacked airliner struck the other 110-story tower
about 20 minutes later.
DEALING WITH GRIEF
He said the experience changed him.
"I will never, ever, be as complacent or
unaware or take for granted the things I did
before," said Hilfer, who not only had to
help patients, but handle his own grief as well.
"My colleagues and I used to meet
informally and privately for discussions, but
those meetings have tapered off," Hilfer
said. "In general, I've been so amazed by
people's courage, kindness, and resilience that it
has re-energized me."
Many people dread reliving the day and some are
finding they can no longer put off seeking
"A mother who lost her daughter in the
World Trade Center called me in tears. She is
already anticipating the anniversary," said
Anie Kalayjian, visiting professor of psychology
at Fordham University. "Her nightmares are
increasing, she's having flashbacks and her work
is being affected."
Kalayjian has been researching the
psychological effects of the terror attacks on
students, mental health workers and corporate
employees who worked in the area.
She believes the strong emotional response is
involuntary, but may be prevented proactively with
support groups, anniversary gatherings and
memorials to help process feelings.
The Journal of the American Medical
Association, in its Aug. 7 issue, cited a new
Web-based National Study of Americans' Reactions
to Sept. 11, which found that post-traumatic
stress disorder was significantly higher in New
York at 11.2 percent than in Washington, D.C. at
2.7 percent, and major cities including Boston,
Philadelphia, Chicago, Houston, Los Angeles at 3.6
percent. In the rest of the country it was 4.0
percent. The data was collected between Oct. 12
and Nov. 12, 2001, from 2,273 adults recruited
before Sept. 11.
"The tragedy created a developmental
ripple effect," said Nuccitelli. "It has
accelerated people's decision making."
In a relatively short period after the event,
many couples either renewed their commitment or
decided to divorce.
"One couple thinking about having children
made a decision within a month to go ahead.
Another took 11 weeks to agree that they don't
want to bring a child into this horrible
world," he said.
Last Sept. 11, upstate New Yorkers Debra and
Julian Keiser were preparing to celebrate their
daughter Amy's 14th birthday. This year, there
will be no party that day.
"Maybe a week before or after," said
Debra. "It's just too sad."
In the nation's heartland, Kansas antiques
dealer Dagni Anders and her husband, Dale, an
engineering specialist for Cessna Aircraft, are
going ahead with plans to mark their 37th wedding
anniversary, but with a twist.
At their Wichita church with a new pipe organ,
a master organist will present a patriotic
concert. "That should be a fitting way to
recognize both our anniversary and the more recent
events of Sept. 11," she said.
A residual effect for New Yorkers in particular
is a "startle response," meaning they
are more sensitive to loud noises such as thunder
But that should diminish over time,
Kalayjian believes the world community will
experience the anniversary reaction to some
"The feeling of sadness will be
overwhelming," she predicted.
Just after the attacks, she said she got 200
e-mails a day offering condolences.
"I've traveled a lot since it
happened," she said. "People in Germany
-- from 12-year-old kids to 60-year-old women --
were telling me what they were doing or eating at
that exact moment, what they were holding in their
hand. Their memories were very explicit, which is
indicative of a major impact."
To be sure, Kalayjian said the feelings of
sadness will be mixed with some anger and some
"Some people are scared of being sad and
would rather be angry," she said. "But
that is an unhealthy way of coping."
"One of the downsides of grief is that we
can become self-destructive," Nuccitelli
agreed. "People should be careful about doing
too much of anything -- gambling, alcohol or drug
"As we get closer to the day, we'll see
more people reacting. The feelings will build day
by day, and take several weeks to diminish,"
Hilfer suggested people who anticipate being
affected should ignore the media as much as
possible for a week before the anniversary and for
a few days after
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