Feature

APA Board of Directors member Laura Barbanel, EdD, lives and works in Brooklyn Heights, just over the bridge from the World Trade Center. Shortly after the planes crashed into the center, her patients called one by one to cancel. "I spoke to each one," she said. "Each one was connected to the tragedy in some way."

Calls to her office increased dramatically after the event. "Every patient who walks into my office has a story related to the tragedy. Each person who was a victim had multiple layers of contact. Everyone you speak with on the streets is affected in one way or another, as a relative of a victim, as a rescuer, as someone who used to work there or was supposed to be there."

One young woman came to Barbanel the Friday after the attack experiencing extreme fear, heart palpitations and neck pain. On the morning of Sept. 11, she had just entered the World Trade Center to start her day, unaware of what had happened. She noticed debris falling past the windows and wanted to leave the building, but the security officers were afraid to let people out, worried that they might be hit by wreckage. The woman slipped past them and ran to Canal Street. Through a series of complicated maneuvers, she got home.

"Despite it all, she got herself home," said Barbanel. "So I told her, she was enormously resourceful. I was emphasizing her resilience. Typically in therapy, we are trying to identify a pathology, but in these cases, we're needing to point out people's strengths." Barbanel believes that many people are feeling like that woman: They don't know that the fear they are experiencing is normal. "Our role right now is to tell them they are not going crazy," she says.

In addition to helping people in her own practice, Barbanel was also among the psychologists who immediately volunteered their services with the Red Cross, working sometimes around the clock at several sites, among them the compassion center in the New York Armory, where families came to look at hospital lists in hopes of finding loved ones. "The Armory walls were covered with pictures of the missing," said Barbanel. "The photos were taken on happy occasions. There's a man wearing a boutonniere at a wedding, a guy smiling on a sailboat."

Barbanel was also struck by the diversity of people at the Armory. "You have families of people all up and down the socio-economic ladder--families of people who worked in kitchens alongside families of millionaires. There is someone from every ethnic and racial group, every nationality--an incredible range of people, all with the same problem, the same tragedy."

Each family has a different way of coping, she said. One Indian woman who had lost her brother wept inconsolably. A white woman stoically walked away; she didn't want to talk, she just wanted to go home. "Some people want to talk, but others don't," said Barbanel. "You have to figure out what's needed. You provide 'mental health presence' for the families and the staff, and are ready for any crisis."

Psychologists will be responding to the tragedies in many ways for many years, she believes. "We will need to flex our capabilities to respond to the grief, the sadness, the fears and the post-traumatic residual," she says.

Meanwhile, she's gratified to see that mental health care emerged as important in the aftermath of this tragedy in ways that it hadn't after other disasters.

"Psychology really came to the fore," said Barbanel. "One morning at 5 a.m., as I sat at the Red Cross waiting for my assignment, I noticed that every second person that walked in was a psychologist that I knew from somewhere. And New York is a big town! I was proud to be a New Yorker, an American and a psychologist."

--S. MARTIN