Emotional recovery after 9/11 marks resilient nature

On the morning of Sept. 11, 2001, America woke up, got some coffee, and started its day as if nothing was wrong, as if the world was basically safe and predictable. The big story on NBC’s “Today” show was Michael Jordan’s upcoming return to the NBA. It was the very definition of a slow news day — until that first jet plane hit the north tower of the World Trade Center.

Ten years later, we live in a different reality. The country is fighting two wars, the Middle East is in upheaval, Osama bin Laden and Saddam Hussein are dead and MJ is in upper management. But we still get up every day and do what we need to do.

The world has changed — except in the countless ways in which it hasn’t changed at all.

We all honor the memory of the nearly 3,000 victims who lost their lives in New York City, the Pentagon and that field in Pennsylvania. And we’re all just a YouTube clip away from reliving the horror. But on a personal level, most of us have moved on.

Psychologists have found that the emotions that surrounded New York City and the rest of the nation 10 years ago — the fear, the anger — have largely faded into the background, often with remarkable speed. “A lot of people were surprised at how quickly the trauma disappeared,” says George Bonanno, professor of clinical psychology at Columbia University in New York City.

With some exceptions, even people who lost the most on Sept. 11 have found solace over the years. Beatrice Beebe, a clinical professor of medical psychology at Columbia, says she has seen “remarkable resilience and growth” in widows who were pregnant at the time of the attacks.

The attacks underscored the enduring strength of both the national psyche and the human mind. We’re a resilient country, the experts say, but we’re also stubborn. No matter the scale of tragedy or good fortune, we tend to bounce back (or sink down) to our usual state of mind.

We have many of the same strengths, anxieties, hopes and bad habits that we had before the attacks — we just happen to have them in a post-Sept. 11 world. And even as we mark this grim anniversary, we should embrace our return to normality. “The fact that we’re so resilient is absolutely a positive thing,” Bonanno says.

The entire country recoiled at the events of that day. People living in New York City faced an especially potent mix of danger and uncertainty — a perfect recipe for fear. Many New Yorkers managed to focus that anxiety in a positive direction. “There was a lot of civility,” Bonanno says. “There was a shared sense of cooperation. And there was a great affection for the policemen and firemen.”

Pulling together is a classic coping mechanism; we saw the same response in tornado-ravaged Joplin, Mo., and we’re seeing it again in areas flooded by Hurricane Irene. But Bonanno believes his city turned rallying into an art form. “People think of New Yorkers as rude, but this is a real problem-solving city,” he says.

Of course, the civility and goodwill that swept through New York and the rest of the country was mixed with considerable distress. A telephone survey of more than 1,000 New Yorkers conducted within a month of the attacks found that about 8% had developed the telltale signs of post-traumatic stress disorder, a condition marked by flashbacks, intrusive thoughts and hyper-anxiety. Six months later, the same researchers found signs of Sept. 11-related PTSD in less than 1% of respondents.

Though PTSD is a difficult condition to diagnose over the phone, the trend was clear. After the dust settled, many people felt better — fast. “A few people are going to have lingering pain for a long time,” Bonanno says, “but the majority were fine right away.”

It’s important to note, though, that some who seemingly recovered quickly may still be carrying hidden baggage, says Barbara Ganzel, director of the Lifespan Affective Neuroscience Lab at Cornell University in Ithaca, N.Y. Ganzel and colleagues looked at the brains of 17 mentally healthy people who lived near the World Trade Center at the time of the attack and compared them with 19 other adults who moved to New York after Sept. 11.

Though the subjects who had lived through the attack didn’t suffer from obvious depression or PTSD, the scans suggested that they had lost gray matter in many parts of the brain, including the amygdala, a region that detects threats and generates fear. Importantly, MRI studies showed that these shrunken amygdalae tended to overreact when the survivors looked at pictures of fearful faces. The study was published in a 2008 issue of the journal Neuroimage.

The survivors seemed fine on the outside, but their brains were still on edge, an imprint of the attack that, according to Ganzel, could linger for decades.

But even as tragedy fundamentally changes our circuitry, we still have a strong drive to feel normal again, says Michael Poulin, an assistant professor of psychology at the University at Buffalo who has studied the emotional aftermath of Sept. 11. Poulin says he can cite many studies to back up his position but that an article published in the satirical paper the Onion on Oct. 3, 2001, nicely sums up his point. The headline: “A shattered nation longs to care about stupid [stuff] again.” The accompanying graphic showed Britney Spears dancing with a large snake.

And, Poulin says, that’s exactly what happened. As a nation, we endeavored to put our fear and grief in the back of our minds so we could return to our usual, sometimes trivial, business. These days, it’s more about Lady Gaga than Britney, but the point stands. “It’s generally a good feature of the human mind,” he says. “Whatever happens, you adjust to it.”

That longing for normality has a downside. As Poulin explains, the positive things that came out of Sept. 11 — the sense of national unity, the civility, the newfound desire to help neighbors or donate blood or volunteer for the Red Cross — faded just as quickly as the pain. “Resilience is a double-edged sword,” he says.

In a 2009 study published in the Journal of Traumatic Stress, Poulin and colleagues found that people who valued the positive changes in society shortly after Sept. 11 felt slightly worse in later years than people who didn’t see any upside to the tragedy. The message: Put a lot of stock in people’s ability to suddenly become more altruistic, compassionate and cooperative, and you’ll likely end up feeling let down and disappointed.

In retrospect, Poulin isn’t surprised that the positive changes didn’t last. “As the pain subsided, the motivation to do things out of the ordinary subsided as well,” he says. He points out that the desire to return to the norm is so powerful that even good news tends to only have minimal, fleeting effect on a person’s state of mind. Lottery winners are the classic example. Studies have found that the lucky few who hit the right numbers aren’t any happier in the long run, partly because their normal lives will always feel relatively boring compared with the moment when they won the prize.

Normality is easier in some cases than in others. The sixth anniversary of Hurricane Katrina has just passed, and the wounds in hard-hit Louisiana neighborhoods are still remarkably raw, says Katie Cherry, a professor of psychology at Louisiana State University in Baton Rouge. As part of a research project, Cherry recently interviewed nearly 150 people who felt the brunt of the storm. They’re still mad at the government response, they’re still grieving and they’re still trying to rebuild their social networks along with their neighborhoods. “It’s like it just happened yesterday,” she says. “The pain of such a disaster won’t go away soon.”

But even in that wreckage, Cherry sees pockets of emotional strength and recovery. People who were optimistic by nature before the storm are faring better than their neighbors. And older people who have lived through other storms have brought some much-needed calm and wisdom to the situation.

Few in New York City on that awful morning had ever seen anything that could prepare them for the tragedy. The magnitude of the attack was unprecedented, it was terrifying and it put the entire nation in a state of shock. But shocks don’t last.

Bonanno has a message for people who today manage to go days or weeks without thinking about that tragedy, for people who, as former Vice President Dick Cheney might say, are still stuck in a “pre-9/11 mind-set”: You’re not callous or insensitive. You’re human.

health@latimes.com