P1: KAE 9780521884228c04pre CUUS041/Seeley 978 0 521 88422 8 January 22, 2008 12:24 ii This page intentionally left blank P1: KAE 9780521884228c04pre CUUS041/Seeley 978 0 521 88422 8 January 22, 2008 12:24 Therapy after Terror Therapy after Terror examines the impact of the 2001 World Trade Center attack on mental health professionals in New York City, and on the field of mental health. The events of 9/11 quickly were identified as an unprecedented public mental health crisis, and urgent demands for psychological treatment ensued. Inresponse, thousandsof mentalhealth professionalsvolunteered their services on the scene, while uncounted others provided treatment in their reg- ular clinical settings. Yet few mental health professionals were experienced in assisting survivors of trauma, let alone of a violent catastrophe of this magni- tude. Moreover, like other New Yorkers, many therapists were 9/11 victims themselves, if only indirectly. Based on interviews with New York City mental health professionals, Ther- apy after Terror depicts therapists’ strikingly varied activities after the attack. This detailed study of the post-9/11, mental health crisis recounts the rapid orga- nization and delivery of psychological services in schools and corporations, in restricted locations such as the Lexington Avenue Armory, Family Assistance Center, and Ground Zero Respite Centers, and in therapists’ private offices. It also closely examines the attack’s psychological effects on therapy patients, its unanticipated personal and professional consequences for therapists, and its extraordinary challenges to conventional clinical theories and methods. In addition, Therapy after Terror investigates the social and political dimen- sions of mental health concepts and practices. Critically analyzing shifting notions of trauma, the subjective aspects of psychiatric diagnosis, the increasing medicalization of behavior, and the state’s management of the national mood, this book raises questions concerning the politics of psychotherapy after 9/11. Karen M. Seeley, MSW, PhD, is trained in clinical social work and in cultural psychology. She is a lecturer in the Anthropology Department at Columbia University and teaches in the Psychology Department at Barnard College. Dr. Seeley is also a psychotherapist with a private practice in New York City. She has published numerous articles on culture and mental health and is the author of Cultural Psychotherapy: Working with Culture in the Clinical Encounter. i P1: KAE 9780521884228c04pre CUUS041/Seeley 978 0 521 88422 8 January 22, 2008 12:24 ii P1: KAE 9780521884228c04pre CUUS041/Seeley 978 0 521 88422 8 January 22, 2008 12:24 Therapy after Terror 9/11, Psychotherapists, and Mental Health  Karen M. Seeley Columbia University iii CAMBRIDGE UNIVERSITY PRESS Cambridge, New York, Melbourne, Madrid, Cape Town, Singapore, São Paulo Cambridge University Press The Edinburgh Building, Cambridge CB2 8RU, UK First published in print format ISBN-13 978-0-521-88422-8 ISBN-13 978-0-511-47880-2 © Karen M. Seeley 2008 2008 Information on this title: www.cambrid g e.or g /9780521884228 This publication is in copyright. Subject to statutory exception and to the provision of relevant collective licensing agreements, no reproduction of any part may take place without the written permission of Cambridge University Press. Cambridge University Press has no responsibility for the persistence or accuracy of urls for external or third-party internet websites referred to in this publication, and does not guarantee that any content on such websites is, or will remain, accurate or appropriate. Published in the United States of America by Cambridge University Press, New York www.cambridge.org eBook ( EBL ) hardback P1: KAE 9780521884228c04pre CUUS041/Seeley 978 0 521 88422 8 January 22, 2008 12:24 For Hayley, Brigitte, and Tyler v P1: KAE 9780521884228c04pre CUUS041/Seeley 978 0 521 88422 8 January 22, 2008 12:24 vi P1: KAE 9780521884228c04pre CUUS041/Seeley 978 0 521 88422 8 January 22, 2008 12:24 Contents Acknowledgments page ix Introduction 1 1 Trauma Histories 10 2 Volunteers for America 39 3 “Get Me Counselors!” 61 4 The Psychological Treatment of Trauma 80 5 The Trauma of Psychological Treatment 101 6 Diagnosing Posttraumatic Stress Disorder 125 7 Trauma as Metaphor 147 8 Mental Health in Traumatic Times 168 Notes 197 Works Cited 213 Index 233 vii P1: KAE 9780521884228c04pre CUUS041/Seeley 978 0 521 88422 8 January 22, 2008 12:24 viii [...]... practices, and to reassess their social roles and political responsibilities This book presents mental health professionals’ urgent personal and institutional efforts to prepare themselves and their field for a world in which acts of mass violence that engender severe and extensive psychological damage are no longer unimaginable In critically analyzing the mental health response to 9/11, Therapy after Terror. .. and external worlds, and by identifying various parties with evident interests in naming and assuaging suffering, Therapy after Terror illustrates that the mind, emotional states, and psychiatric disorders are inextricably entangled in politics and society Of particular interest in the 9/11 context is the rapid emergence of mental health discourses as a preferred and legitimate mode of explaining and. .. increased after the attack (Vlahov et al 2002) and that prescriptions for sleeping pills and antidepressants had risen by 17% and 28%, respectively (Harvard College 2002), they added to growing fears of an impending mental health emergency.7 Even before public health officials had predicted widespread psychological disorder, and before studies documenting it had been published, thousands and thousands of... assaulted by 9/11 and in transition after it Further, by exploring the social and cultural dimensions of mental health discourses, it seeks to identify the links between individual and collective suffering, the means by which this society makes and feels its ills, and the various parties involved in shaping the emotional life of the nation About the Research The research for Therapy after Terror took place... professional and political entailments of PTSD diagnoses after 9/11 Chapter 6 concludes by examining the medicalization of 9/11, and the transformation of collective reactions to an act of terrorism into individual mental disorders Because mental disturbances are political and historical as well as psychological and biomedical phenomena, Chapter 7 examines connections among psychotherapy, politics, and history... decades, and to the multiple factors fueling diagnoses of PTSD after the attack Moreover, Therapy after Terror analyzes the mental health response to 9/11 through social and political frames Challenging accepted conceptions of psychological disorders as internally generated phenomena, it describes the numerous and dynamic intersections of the intrapsychic, the collective, and the political after the... Wounded City: The Social Impact of 9/11 (Seeley 2005b), and as “Trauma as a Metaphor: The Politics of Psychotherapy After September 11” in Psychotherapy and Politics International (Seeley 2005c) I am especially grateful to my family – to my children, Hayley, Brigitte, and Tyler, and to my husband, Brinkley Messick – for lovingly standing by me and giving me the space to complete this project 12:24 P1:... individuals, and its professional and personal impacts on therapists, Therapy after Terror uses the specific case of 9/11 to critically investigate prevailing mental health theories and practices It explores fundamental contradictions between conventional theories of psychopathology, which underplay the extent to which social and political events inflict psychological damage, and notions of psychic trauma,... assistance to the bereaved, the displaced, the unemployed, escapees, and rescue and recovery workers convey the workings, tone, and feel inside these highly restricted spaces In addition to examining their professional activities following the attack, Therapy after Terror takes a look at the therapists themselves Prior to 9/11, very few mental health professionals were prepared to respond to a tragedy on... diagnosis of PTSD after 9/11 as a metaphor for the victimization of the nation Chapter 8 charts the uncertain, and still untallied, effects of 9/11 on the field of mental health, its theoreticians, and its practitioners It examines shifts in the mental health landscape as the result of the attack, describing the ways therapists have reevaluated clinical practices, models, concepts, and training programs, . 12:24 Therapy after Terror Therapy after Terror examines the impact of the 2001 World Trade Center attack on mental health professionals in New York City, and. diagnosed with PTSD and other mental disorders. Finally, Therapy after Terror documents the overall and ensuing impacts of the attack on the field of mental health.