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9/11: Emotional Wounds Heal Slowly

Experts look at ways that Americans are coping emotionally five years after the terror attacks.

WebMD Feature
Reviewed by Louise Chang, MD

As we mark the fifth anniversary of the terrorist attacks that occurred on Sept. 11, 2001, leading psychologists tell WebMD the scars are still visible for us as a nation. And for those who were personally affected, the emotional wounds are far from healed.

How we are dealing five years later "depends on how old we were at the time that it happened, how much we were affected by it, and the nature of our experience on that day," explains Donna Gaffney, professor of nursing at Seton Hall University in South Orange, N.J. Gaffney is an advisory board member of the Families of September 11, a nonprofit group that supports families affected by the terrorist attacks and champions domestic and international policies that respond to the threat of terrorism.

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"Certainly family members who lost someone or people who survived the attacks are going to have a very different experience than people who live in other geographic regions of the country," she says. "Family members are still very raw and this is a part of their lives that they haven't moved on from, nor should they ever," she says.

New terror attacks and terror alerts, the release of movies and documentaries on 9/11 -- as well as the trial of Zacharias Moussaoui, the only person in the U.S. charged in connection with the Sept. 11 attacks -- all serve as aftershocks and can reopen old wounds, she explains.

Watershed Moment

"9/11 was such an extenuating circumstance," agrees Carol Goldberg, PhD, a clinical psychologist and TV personality, based in the New York City area. "People are still grieving and the level of their grieving is affected by how close they were geographically to the World Trade Center or the Pentagon, if they lost a relative or friend, or if they had some connection to the buildings themselves," she says. "Even though New Yorkers pride themselves on being hale and hearty, underneath it all, they are feeling very vulnerable and I don't think they have forgotten it by any means," she says.

"Although 9/11 is over, there are continuing issues of terrorists and terrorism throughout the world," she says. Situations such as the recent foiling of a major terror plot to blow up planes in flight from the U.K. to the U.S. can bring it all back in an instant, she points out.

Cycle of Grief

In her book, On Death and Dying, Swiss psychiatrist Elizabeth Kübler-Ross created what is referred to as the grief cycle. This cycle starts with shock and is followed by a denial stage, an anger stage, a bargaining stage, depression, testing, and finally, acceptance.

But this way of looking at grief does not apply to 9/11, says Robert R. Butterworth, PhD, a psychologist at International Trauma Associates in Los Angeles. "Unlike a mourning process where somebody dies and you start getting over it, this is a question of issues continuing to pop up," he says. "Anxiety about terrorism is reoccurring so the national psyche can't use the [grief scale]."

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