La autora,Nancy R. Goodman, hace una descripción de diferentes reacciones de psicoanalistas estadounidenses los días que siguen al 11 de septiembre del 2001. Sus reflexiones nos ayudan a pensar en la actual crisis del COVID-19 y su impacto en las consultas.
Prologue Note to “We’re In This Too”
Nancy R. Goodman, Ph.D.
A few days after the terrorist attacks of 9/11, we (Harriet Basseches, Ph.D., Paula Ellman, Ph.D., Susan Elmendorf, M.S.W. and Nancy R. Goodman, Ph.D.) decided to begin a study of our reactions, our patients’ reactions, and the way we worked therapeutically at this time of terror. We were at a meeting together looking out a window over the city of Washington, D.C. remarking at the beauty of the monuments and the horror of knowing about the destruction and deaths at the Pentagon. We spoke about fears of what else could happen. We had personal need to believe there was a place to think and feel and discover and set out to do so. Our own psyches were steadied at knowing we could reflect on our psychoanalytic work at this time and planned to meet regularly. We had previously collaborated in study group explorations of psychoanalytic listening (1993) and female development (1996, 2001). I now see our activity as creation of a witnessing group. We formed a type of ‘Anti-Train’ (chapter 3 ), a place of ‘Anti-Trauma’, from which we could better tolerate the view of terror outside and inside of each of us and our patients. Most of all we knew we could better help our patients when our fears were being held and contained through the group endeavor. This paper illuminates the way the power of witnessing is able to function when external traumatic events set off internal traumatic events.
“WE’RE IN THIS TOO”
PSYCHOANALYSIS IN A TIME OF TERROR: THE EFFECT OF TERROR ON TRANSFERENCE, COUNTERTRANSFERENCE AND TECHNIQUE
Nancy R. Goodman, Ph.D., Harriet I. Basseches, Ph.D., Paula L. Ellman, Ph.D. and
Susan S. Elmendorf, M.S.W.
INTRODUCTION
When the planes struck the Twin Towers, the explosion shattered our view of the world. This paper presents the findings of a New York Freudian Society Washington, D.C. research study group’s work since the 9/11 attacks. Day and night, sirens blared and military jets flew overhead, signals of protection but also reminders of danger. During the weeks and months that followed the attacks, we and our patients were subject to news of the anthrax scares, of suicide bombings, news from New York at Ground Zero, and later, news about sniper attacks fueling speculations about further harm. We noticed our patients were responding to the events, from the first day of shock and many cancellations, to the ensuing responses that ran the gamut from terror to numbness to denial. We oscillated between acknowledging our patients’ terror and making interventions to distance them and us from the horror. We became increasingly aware of the unique impact of these events on our work, in that both we and our patients were experiencing the same traumatic reality situation together.
We offer case vignettes from psychoanalyses and psychoanalytically oriented therapies to illustrate our evolving understanding of the effects of the terrorist attacks on our analytic work. We start with snapshots of what took place in our four analytic offices and in our study group as we and our patients responded to the events of September 11. Then we will describe ways that the traumatic affects opened avenues for exploration and growth and illustrate ways that 9/11 imagery entered the world of metaphor for patient and therapist. Only recently were we able to conceptualize a difficulty that had been plaguing our group — a form of survivor guilt. Though we were at the symbolic hub of the U.S. government, we were not in New York. Since we had not suffered as much harm, were we entitled to claim this trauma as our own and to study and write about it? With some relief, we have worked with this inhibition to our creative process, and share with you the result.
Section 1: A View of 9/11 from Four Analytic Offices
Analyst One
9:30 am Tuesday 9/11. My patient walked in and sat down and said he had heard something unbelievable on the radio on his way to his hour- that two airplanes, one after the other, had just hit into the twin towers in New York, and he does not understand why. I could not understand, thought he had made a mistake, or that it was some accident. We proceeded with the hour as if nothing had happened. That which is outside our usual experience remains unabsorbed, unintegrated, rejected, split off from our present moment’s consciousness. Patient and analyst were in the trauma together: rejecting the foreign, the unexplained, denying what is too horrific even to be able to imagine.
The next patient, at 10:20, who never misses an hour, entered, lay down, and said he just heard that the Pentagon was hit, and “they think it is terrorism”. He wanted to stay and talk, but also wanted to go home and be close to his family “since we do not know what is happening and we may be under attack”. Unusual for me, I said I understood (eager to get access to my own television)- allowing, even encouraging action, rather than asking him to speak and reflect further about his wish to leave the hour.
This was the start of my noticing how differently I was responding my readiness to act and gratify, rather than preserving my “analyzing function” with my patients. I had been ready to respond in reality, rather than in the “as if” relationship. Was my readiness to appreciate the realities an abandonment of my analytic stance, or was this “analytic” in a time of terror?
I was ready to appreciate the realities -the shared concern with the sounds of fighter jets outside my window overhead, the frequent acknowledgments of the “we” and the “us”, rather than the “you” and the “I”. Even more of a challenge to my analytic position, were questions about my own view of reality which my patient’s associations called into question. My patient described his family’s preparation for an emergency departure from his home; he loaded the trunk of his car with a suitcase of clothes, water, flashlights, extra batteries (the emergency ‘kit’ that the government recommended to have on hand), and kept it there should the necessity for a rapid departure from the Washington area arise. On hearing about his preparations, I began to question my not wanting to prepare my family for an urgent flight. For the moment, I was lost in my own personal questioning. I had then to grapple with my guilt for losing track of my patient’s associations as my thoughts moved between his words and affects and my own. Was I like the many upper middle class European Jews who stood by in disbelief as Nazi Germany conducted the Final Solution, while a few others responded by leaving their comfortable professional lives, and saving themselves from death? This was a trauma for me and my patient and infringed on the usual analytic process.
Analyst II
At 10:30am I drove to my office under the bluest sky I had ever seen. Everything I looked at had a visual clarity at odds with the wordless uncertainty I was feeling since watching the televised images of destruction from the terrorist attacks. My first patient wondered when to pick up her children from school, and then immediately spoke of the Holocaust: “How did people know when to leave?” Her mother was a child survivor who had been sent from country to country which included a voyage on a boat which almost sank. My patient had never imagined being in this situation in the United States. I began wondering if I would ever be telling patients I was leaving Washington, or telling them they should. (Do psychoanalysts say such things?) This was a new terror, and I felt at sea on a boat with an uncertain destination. My patient’s wonderful capacity to take charge when chaos prevailed served both of us as she found a way to recognize the immediacy of our new reality. She looked at me at the end of the session and said in a lilting voice: “I hope we will be meeting at our next session”.
Later in the day, I pointed out to a patient that she was speaking about everything but the terrorist attacks. She told me that she was concerned that I must have been listening to everyone else’s fears and would welcome a rest. She said this in an empathic, caring way which moved me, and I also recognized her statement as an exquisitely beautiful example of the special bond she had formed with her mother in just this way as she subdued her own needs in order to take care of her. I gave her this interpretation of the repetition with me on this day and we were able to think about it. Her actual gift to me that day was not silence on 9/11 but the chance to work in the midst of it. Only seven hours after the collapse of the World Trade Towers, this analytic patient and I were attending to how the present contains aspects of the past especially in the affects, wishes and fears appearing in the transference in the here and now of 9/11.
Mr. W arrived for his first meeting after the attacks on Wednesday, 9/12. Having grown up in a country where threats of revolution and upheaval were constant, he said, “This is nothing unusual, it’s just naive Americans who feel so surprised.” He went on to admit, however, that when he had arrived home the previous night, he had experienced what he called the ridiculous fear of not knowing if he should open the window or keep it closed –how was one to know where the dangers would come from–the ventilation system in the building or something put in the air outside. He said this in an exaggerated way, worthy of Woody Allen, even gesturing with a well-timed shrug of the shoulders and hands put in the air. He laughed slightly, and I laughed slightly with him, commenting on his ability to engage me in this humor as we talked about such awful possibilities. I thought his confusion of whether dangers were outside or inside spoke to the experience of how psychic reality was taking place moment by moment within the shock waves reverberating around us.
Analyst III
My first two patients’ hours preceded my learning of the shocking events of 9/11. Immediately after these sessions, I received a disturbing call from my husband telling me that an airplane had crashed into one of the New York Twin Tower buildings. Only two of my remaining nine patients of the day showed up for their hours. I felt isolated and unable to concentrate on anything. I got out an old rickety radio that had formerly functioned as a white noise barrier. I remained glued to the radio reports much of the day, as I heard about the second tower, then the pentagon, then the horrifying collapse of the towers.
One of the absent patients who had never “no showed” before in the many years we had worked together, did so on this day. “What is happening?” I worried. That patient, in her next day’s hour explained that, coincident with the terrible news, her phone had been out of order. She had been too frightened to leave her apartment to come to her appointment or even to go out to make a call. In the days that followed, she was agitated in each hour, describing frightening nightmares and feeling terrified. “At any moment we are all going to die!” she repeated in various forms. Retrospectively, I reflected on my reactions and they seemed odd to me. I became very clinical, perhaps denying my own fear that was contagiously building in me. I listened with emotional distance, as if to reassure myself that this was her problem and not mine. I was quick to think in terms of her history, and ironically her pre-history, perhaps in an attempt to move far away from current events of history. She was the child of a European mother, whose father may have been a Nazi, and a South American father, whose forbears were slave holders. She was an only child of privilege, neglect and loss. I listened, explored genetic roots; I listened, while we heard the sirens blaring, and planes constantly flying overhead. Her distress escalated; she became more agitated with each hour and complained of not sleeping. With a sense of helplessness because nothing that usually “worked” in our interaction seemed to be working, I suggested a medication consultation to ease her anxiety during this crisis. In making this recommendation, I thought I might be doing something “destructive” to the analytic process, and yet I could not seem to ride out living with her pain and terror without taking action. She readily agreed to my recommendation and went the following day to the psychiatric consultation. The next day, she was calmer and barely spoke of her meeting with the psychiatrist. Dismissive of him, she said she had not taken the medication and that was the end of that. It was as if what she needed was for me to take her seriously and then she could be calmed enough to settle back into the analytic mode. My thoughts about this one patient epitomized my state of mind. I came to realize that my readiness to suggest outside “help” (i.e., the consultation) reflected how terrified I myself felt, but was not acknowledging.
Analyst IV
I met with two patients early in the morning of September 11 prior to the terrorist attacks. In a break between appointments, I found myself riveted to the TV, while I tried to contact members of my family, none of whom were in DC. Remaining patients scheduled for that day phoned to cancel their appointments; they said that they did not know what was going to happen next. Sharing my patients’ anxiety, I did not question their decisions, or subsequently charge for these initial cancellations. It seemed important to acknowledge the “reality” of what was happening. Yet, I experienced an eerie sense of “unreality” during that day and that week. Time seemed suspended as I struggled to take in the horror of what had just occurred and the prospect of future attacks.
When Mrs. T arrived for her appointment on September 12th, she freely talked about her terror—her sense of helplessness, rage and lack of protection from future attacks. Characteristically, she was conflicted about revealing her upset, for she did not want to appear like a helpless little girl. While her colleagues had gone home immediately after the attacks, Mrs. T said she had been determined to stay at work and stick to her routine. In hindsight, I was surprised not to have questioned this decision. Perhaps, I identified with Mrs. T’s resolve, for I, too, had been determined to continue my regular work routine in a D.C. office. Moreover, in response to Mrs. T’s outbursts of helplessness and rage at the terrorists, I quickly invited genetic associations. And when she remarked I seemed upset, I did not encourage elaboration of this observation. Clearly my responses reflected my own attempts to defend against terror. Only at the end of the hour, did I regain some analytic balance when I addressed the transference ignited by the terrorist attacks. Mrs. T declared: “Zealots have just begun. There may be a lot more people affected. There’s no stopping them!” I replied, “You felt your mother wasn’t able to stop your brother and provide the protection you needed. Now I’m not able to stop what might happen, not able to protect you from future terrorist attacks.” “That’s right!” she exclaimed.
Later that day several other patients tried to distance themselves from the trauma. When I noted that Mrs. C had not mentioned the terrorist attack, she declared that it was just a “riveting story,” which had no personal impact on her. Mr. D mentioned the attacks, but he defended against his vulnerability by being contemptuously scorning of other people’s hysteria. Both of these patients were dismissive of my observations of their wish to shield themselves from the trauma.
Commentary: These snapshots are as varied and diverse as we and our patients. In an effort to grasp and cope with the trauma and its immediate aftermath, affects and defenses appeared, ranging from shock, disbelief, fear, terror, anger, denial, humor and intellectualization. Some patients readily spilled out their reactions, flooding the hour with anger and helplessness. Other patients held the trauma at a distance. At times, we found ourselves joining with our patients’ emotions, as well as with their defenses, especially intellectualization and humor. We felt a pressure to communicate that we were in this together, and acted, often without reflection, to alter our customary frame by not charging for canceled hours, offering telephone sessions, or making medication referrals. We were confronting a new reality—that in a climate of terror, analysis could not provide the illusion of safety, or the promise of a hopeful future. Yet, at the same time, we and our patients experienced the routine of appointments, and the analytic space as a refuge from the noise and chaos filling the air and airwaves outside our offices and in our minds.
In spite of the many pressures to merge in sharing our patients’ experiences, we were surprised to discover that even in the early days following the 9/11 attacks, there were moments we set ourselves apart through our capacity to analyze. We questioned what was occurring between us and our patients. We intervened to contain patients’ flooded affects or to point out their defenses against terror. Analyzing, being curious, reflective, and creating interpretations also seemed to serve as a personal defense, for, at these times, we often experienced a sense of relief.
Section II: The Study Group
Shaken by the attacks and ongoing threats, we launched our study group 3 weeks after 9/11 to provide a structure, a safe place, to view the traumatic sequelae taking place in our lives and in our work with patients. From the first meetings, we spoke of concern for our patients and concern for ourselves and our families. We asked each other, were we focusing too much on patients’ affects, encouraging flooding? Were we too quickly diverting patients from their terror and our own? Was our thinking too paranoid, too extreme, too filled with denial? We asked ourselves: “What is analytic in a time of terror?” We experienced an ongoing tension between feeling relieved that our own experiences of terror were so similar, “We’re in this together,” and wanting to assert differences, “Well, I’m not like you.” We were witnessing horror, fear, death and experiencing retraumatization after meetings, including nightmares and difficulty sleeping. Humor helped ease the tension.
Some months after the attacks, we began to find it difficult to schedule group meetings. September 11th was floating out of sight, like a storm that had blown over.
As we continued to discuss clinical material, we realized that many of our patients seemed to share this avoidance. Rarely were our patients referring to the recent trauma, nor were we interpreting or linking their emotions to it. We questioned whether our own avoidance sprang from a fear of retraumatizing our patients or ourselves?
We turned to history. What did analysts do in Vienna and Berlin under the threat of Hitler and the SS? What did analysts do in London when the bombs were falling and in Buenos Aires, Santiago, Bogotá, and Lima in times of terror? We turned to Freud. Under the press of colleagues leaving for the US, Israel, and England and anticipating catastrophe, Freud kept working on Moses and Monotheism ( ) even though this work could place him in further danger. While our group meetings continued to heighten our anxiety, they also helped us to reestablish our footing, to engage our observing egos. We had a compelling view of the unique ways each patient was transforming a “real trauma” into psychic reality. Like the blue lights marking the empty New York skyline, the mind was finding ways to represent and rework what was traumatic–through dreams, fantasies, and the creation of metaphor.
Section III: Further Reverberations
We will now present vignettes illustrating some of the ways representations of the September 11th trauma and subsequent terrorist threats entered the psychic reality of our patients and ourselves and affected our analytic dialogue.
Case I
In a session ten months after the September 11th attacks, and shortly after I had informed Mrs. Q about an unexpected absence, she displayed a greater freedom to express her anger towards me, including a wish to attack me. Then Mrs. Q went on to describe having raw feelings; “I feel like those people who were caught on the floor just above where the planes hit the tower—the whole building is going to collapse in just another minute.” I said, “What a horrible idea. I’m wondering whether you are recalling this image right now might have to do with the anxiety you feel when you get in touch with your anger, your wish to lash out at me, wish to attack me?” Mrs. Q replied, “Well, I’m angry about your absence. This is a terrible time for you to be away!”
In this vignette, Mrs. Q appeared to use a terrifying image of being caught in one of the Twin Towers just before the building’s collapse to represent a masochistic retreat from her rageful wishes towards me. Typically this patient retreated from her aggression by recalling a salient childhood humiliation. Here she substituted 9/11 imagery to depict this core trauma. Because this imagery was affect laden for both of us, it served as a particularly vivid communication of her narcissistic vulnerability.
Case II
During a session the week after the September 11th attacks, Mrs. G began with a long silence. She quickly dismissed several of my attempts to understand what was going on. I observed that Mrs. G looked sad and upset, and commented that I seemed unable to provide any relief. In the following extended silence, I became aware of images of the planes tearing into the twin towers and the huge, fiery explosion that followed. I realized that I was experiencing the patient as a terrorist who, through her silence, appeared to be spoiling, damaging the analytic process. I thought that Mrs. G must be taking satisfaction in shooting me down again and again. Only later did I consider that Mrs. G might have perceived me as a terrorist who was attempting to break through her protective, silent cocoon. Near the end of this mostly silent hour, Mrs. G finally remarked, “I don’t feel sad and upset—just diluted anger.” Connecting the fiery explosions and the patient’s rage, I said, “You say ‘diluted’ anger. Perhaps you wish to dilute your anger because you fear its full force.” Mrs. G tensely replied, “I’m not afraid of my anger.” In this hour, the vividness of my associations to 9/11 imagery gave me access to the rage of this patient who rarely acknowledged any emotional response toward me.
Case III
On Thursday September 13th, Ms. S came to her session having canceled the meeting on September 11th. She wept the entire session and spoke of frightening possibilities of what could happen to her children and her husband who worked in downtown D.C. She was afraid to sleep and kept imagining herself falling through the World Trade Towers. Like painters mastering a vision of horror, we used words to depict the events of two days before. I was aware of feeling pain in my back and shoulders and wondered if I would scream at her to stop because I had a daughter in New York City and a husband who would soon be traveling to Latin America. I was so close to her fears–these were our fears–and yet I was the therapist.
Three weeks post 9/11 this patient stated, “I need you to help me, I cannot stand feeling this way anymore”. I too felt the need for a ‘break’ from the continuous, vivid images of destruction. I told her of something I had learned about trauma from a study of the film Schindler’s List–the necessity of allowing the mind to shift focus from that which is overwhelming to other events. I had found a way to tell her to stop. I was also reinstating my position as an active therapist who could help my patient. In the next session Ms. S sobbed and told me her terrible dream of the night before in which she could not find her children after an atomic bomb warning. Working with these internal images of trauma, put me on more familiar ground. As we worked with the dream, I asked if she had ever felt similarly at other times. She went on to tell me of a tragic event of her adolescence when a favorite aunt died and she felt she could not speak about the depth of her grief because it hurt her parents and grandparents so much. She now told me how she had felt then. Analysis of the shattering impact of 9/11–as symbolized in the dream–led to the recovery and working through of the deeply buried remains of her psychic pain. Sharing the trauma of 9/11 together greatly facilitated this process and brought to the transference her deep doubt that anyone, and now her therapist, would want to know her pain and could tolerate her pain.
Case IV
With Mr. W an intense transference/countertransference configuration appeared around the anthrax scares. Mr. W tracks potential bioterrorist attacks for his agency. He started or ended sessions with comments such as “don’t sniff your letters” or no one with Ebola virus has shown up on airplanes, or have you gotten your antibiotics? I was already finding myself terribly troubled about potential bio-terrorism and reading information, that was far too scary, on the Johns Hopkins bio-terrorism site. This patient’s demeanor was unusually calm, seeing himself as someone who could organize and disseminate information. He was placing all of the panic in me and I was receiving it. We began to understand that he was attempting to frighten me and treat me as he felt he had been treated as a child when he was alone and quite helpless. This was a profound insight for him.
During the height of the scare, he missed many appointments, and left me messages like: “two new cases today, unlikely to be positive”; “nose swabs taking place, nothing much to report today”; or, “a bunch of false alarms today”. I found myself waiting intently for every bit of information. I was developing a “savior” fantasy about this patient whom I imagined had access to medical interventions such as small pox inoculations. When I wondered with him about what effects his reports could have on me, we began to uncover core fantasies of destruction and salvation. There was a heightened here and now significance to quick moving wishes and fears about who would save and who would be abandoned and destroyed because we were living together in a time of terror.
Section IV: The First Anniversary
The anniversary of September 11 brought a return of some of the emotional intensity of the early weeks following the attacks. Yet, even though the press, TV, and a series of sniper attacks in the Washington area also heightened our fears, we felt less emotionally labile, and less defensive than we had one year ago. Our observing egos seemed more resilient. We had a keen curiosity about how this anniversary would affect our listening and interventions with our patients. And, of course, this study kept us focused.
Case V
A couple, married for many years, called for a consultation on 9/11. The husband had discovered his wife had been having an affair with a colleague. She insisted that she was not involved sexually with this man. Even after the husband threatened to leave her, the wife continued her extra marital involvement. In order to begin to heal and to regain his trust, the husband said that he needed to hear what was on his wife’s mind. The wife expressed her grave reluctance to having her private thoughts intruded on, stating she never took the involvement seriously nor questioned her love and commitment to her husband. She wondered why he needed to hear from her in this way since, in all their years of marriage, he had never done so before. The husband expressed that their world had changed, that the landscape was completely different and the old rules no longer applied.
I could not help but think that the husband’s descriptions of his new surroundings were spoken in terms of a 9/11 metaphor: the terrorist attacks had eliminated the trust and security previously built into our country’s foundation, as the wife’s betrayal seemed to have destroyed the foundation of their marriage. Old rules no longer applied, since our landscape, our world, was forever changed. Here, the use of metaphor enhanced my empathic position with the husband. Perhaps I, in the countertransferece, identified too easily with the husband’s difficulties grappling with the aftermath of the shock of his wife’s attack on what had seemed a secure and trusting foundation, further setting me apart from an empathic position with the wife.
Case VI
The following case illustrates an uncanny psychoanalytic moment where, on the anniversary of 9/11, analyst and patient were joined together, experiencing life’s fragility. I began my morning hours preoccupied. My 10 year old daughter had gone to feed her beloved pet rabbit (her baby) before school, and was distressed that the rabbit was lying down, with a peculiar odor, not eating nor startling. Both she, and secretly I, believed the rabbit was dying. Concerned about my daughter’s possible loss, I urgently arranged a veterinary appointment during my morning break.
Ms. R began her hour, “I was scared last night, didn’t think I would be alive today. It was so silent. The past few nights, there have been a lot of military planes but not last night. I listened to the list of names of the dead. I was certain I must know someone. I read about a man who worked at the Pentagon and didn’t want to go back to the building last year. I felt ashamed for what I had thought. ‘You’re one of our Marines, and you can’t go back to the building.” I commented, “If he didn’t go back, you would not be protected.” Ms. R went on, “I had some anxiety about sending my child to school.. I am so angry that they haven’t caught Bin Laden nor solved the anthrax problem. The leaders are not taking care of me. There’s an orange alert, we are definitely a target. I didn’t clean my child’s rabbit’s cage yesterday. When my daughter takes it out to play, it’s jumpy and startles easily. Today, something was wrong; the rabbit was too still. It was not eating much, not active as usual. I think it’s dying.”
Having no memory of hearing before about Ms. R’s daughter’s pet rabbit, I felt this uncanny sense of too close a coincidence. On this anniversary day, “we were both in this too”, feeling overwhelmed with worries about life and death. Ms. R spoke of feeling victim to the night noises, to waiting for the protection of the “leaders” and marines, and to waiting for her daughter’s rabbit to die. My patient’s feelings of helplessness and yearning for protection mirrored the way I had felt on this day and one year earlier. Now I, in a more activated state, wanted to do anything I could possibly do to protect life.
Case VII
A couple who lost their only daughter in the 9/11 tragedy–a daughter who began working at the Pentagon just two weeks before the attacks — entered therapy because they could not seem to get past this traumatic loss. Obsessed with thoughts of “if only” and “what if” they were wracked with guilt and self-torturing aggression. They reported that, on the anniversary, they had gone out to the country to avoid radio, TV, newspapers, public places, and other people. “Going off by themselves achieved what purpose?”, I wondered aloud “Because” they said, “We can’t stand it–the constant public outpourings, ceremonies, headlines, radio encomiums. They won’t let us forget!” Rather than feeling recognized and supported in their grief, they felt that the publicness was an unrelenting intrusion on their ability to metabolize the trauma and to mourn their daughter in peace. It was as if the repeated emphases, by many voices, on many losses minimized their own personal loss. Moreover, they seemed to need to find some wrong to rail against as a road back from their grief and rage. Their idea of mourning required space to forget, as well as to remember.
Case VIII
Mr. B, a patient who suffers from strong feelings of vulnerability, described his activity on the night of the 9/11 anniversary. He and a girl were walking near Dupont Circle, when they came upon a street band. They saw that a crowd had gathered to hear the band, so they sat down on the curb to watch and listen. More people began to congregate. People began to dance on the broad sidewalk and even in the street. They danced in couples, and in three’s and four’s. Others began to sing. This, he thought, had not happened at other times when he had heard the band playing. It felt to my patient as if these strangers had joined together to remember those lost on 9/11. But more, he felt that the group was saying: “We can dance, sing, play music; we can remember, but we also can go forward.”
Listening to him, I felt both uplifted and almost moved to tears, so touched by a feeling of hopefulness and, maybe resiliency, not only for this patient, who often feels so damaged, but for us all. I was surprised by the intensity of my emotional response, as if my own anniversary reaction was evoked, complete with my own longings to mitigate the feelings of loss with thoughts of hope.
Commentary: Throughout the past year, we watched the symbolic use of the 9/11 attacks take on evocative significance in the psychic realities of our patients. Patients’ overwhelming affects once split off from traumatic events and fantasies were reconnected as 9/11 responses led the way back. Core fantasies such as fantasies of destruction and salvation were played out on the 9/11 stage. Patients depicted old compromise formations with the vivid imagery of the terrorist attacks, thereby facilitating further work on these conflicts. Analysts’ experiences of their own terror, just following 9/11 and at the one year anniversary, brought an emotional immediacy to the work as “we were in it too”. At moments, this shared trauma offered analysts access to the patient’s emotional state, and often led to powerful identifications with the patient.
Discussion
This paper has explored the effects of the 9/11 attacks and their aftermath on the work of four psychoanalysts. The question “what is psychoanalytic in a time of terror?” continually surfaced as we processed our collected snapshots of responses to trauma in our patients and in ourselves. What is analytic is the capacity to witness and acknowledge the shared trauma, “We’re in this too”, as well as to explore its unique impact on the psychic reality of each patient in order to help develop more adaptive, creative responses. Immediately following 9/11, we experienced a greater tendency to merge with our patients’ fright and terror as well as to share similar defenses. At times, in our own states of shock, there was a struggle to maintain free floating capacity to oscillate between empathic identifications and analyzing. Yet even during the first days and weeks, the ability to acknowledge the images and affects of sessions and to reflect on their multiple meanings was available as we used our observing egos. We were surprised and comforted by the resilience of the analytic work in the midst of these days of terror.
Over time we watched with excitement how our patients made symbolic use of the trauma to express and rework previous traumatic events and core conflicts. The way trauma appeared gathered intense affect and fantasy around it and was felt deeply. We could observe first hand, with immediacy, what was taking place for our patients, ourselves, and between us in our offices. Retraumatization for patients and ourselves was a recurring aspect of the work particularly with the occurrence of the new threats of anthrax and sniper attacks in the Washington D.C. area. Retraumatization was also an unexpected and constant presence in our group meetings as we examined our analytic hours and discussed their content and our own affective responses.
Countertransference reactions ran the gamut from joining patients in fear to distancing ourselves. We recognized that when we focused only on analyzing patients’ responses and failed to acknowledge the actual horror, we were defending against the intensity of our own fear with intellectualization and compartmentalization. Both with patients and in the group discussion, there was continual tension between when “we were in this together” and when we individuated from patients and each other, “my response is different from yours”. Working analytically in a time of terror heightened the emotional intensity of our work and presented us with a unique view of the way the psyche, our patients and our own, responded to traumatic events. Ultimately, the answer to the question “what is analytic in a time of terror?” was found to be the ways we assisted our patients on the journey of creating meaning after 9/11. We are grateful to psychoanalysis for giving us the tools to think about these complex issues, for providing us the framework for work with patients, and for offering us a forum to discuss our ideas with each other when facing terror.
References
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