Post 9/11 Reflections*
Priscilla Kauff, PhD, CGP, DFAGPA

It is now nearly four months since the attack on the World Trade Center. My involvement began within the first week after 9/11 when I was asked to lead a crisis team to help the survivors of a major corporation that had offices on the corner of the World Trade Center site. As an individual and group analyst, I should point out that I have never had counseling training, trauma or bereavement or stress reduction training, or specific crisis intervention experience. Nor am I an expert on PTSD. I was asked, and I said yes. 

My lack of such specialized training not withstanding, I found that combination of psychoanalysis as a way of thinking and the skill I had in the use of the group modality proved ideal for this situation. 

I started with a small introduction in which I attempted to touch on virtually any response that anyone present might have had or might develop over time. The purpose was to establish that any response would be expectable and acceptable. To further emphasize this point, I described my own experience of the attack and focused deliberately on my feelings, hoping to model sharing and to encourage participation. I also asked the highest-ranking members of the group to join in if they felt they could, because I felt that would go a long way in encouraging the other members of the group to speak.

Each time I began with a new group or in a new place, I followed this format, with some revision of the introductory remarks to accommodate the time lapse and the likelihood that unanticipated reactions or more serious symptoms might have developed. Following the introduction and comments by the rest of my team, members of the group did indeed begin to speak, usually starting with the more senior people. After this, we broke up into smaller groups and also offered, when desired, individual consultations. Interestingly, the latter were not as well attended as the group meetings, which were clearly the most relevant and desirable. Individual sessions tended to be utilized by the most senior people who had special needs and by the most seriously affected individuals who needed extra help, but these were few in number.

I had to forge a relationship where none existed and where the expectation was that I would enter and leave as fast as possible because although the company knew it needed me, it did not necessarily want me there.

The good and interesting news is that my training and experience as a psychoanalyst and group therapist came through for me. The last four months have resulted in my rethinking my conceptual “bible” as I have been trying to work backwards to understand what in my knowledge and training was so relevant that it rescued me in this rather precarious but always exciting and rewarding endeavor. Here’s what I found:

• The need for a working alliance and the necessity of dealing with resistance was critical in getting rapidly through the initial stages of introducing a service that was received ambivalently at best.
• External events are meaningful beyond the facts that describe them. The unconscious meaning of events will play a large part in their ultimate impact, even in situations which are fairly described as massively traumatic. 
• Understanding that transference is a ubiquitous phenomenon even if it could not be dealt with directly was, I believe, critical to the success of this endeavor. 

These are just some of the issues that I have found engaging and compelling and continue to think about. At the present time, I am still actively engaged in doing this work and I feel so grateful to have had the opportunity. Nothing is a better antidote to helplessness than the opportunity I have been afforded during this time. 

* This article originally appeared in Psychodynamic Update, a publication of the Center for Psychoanalytic Studies at Massachusetts General Hospital, Winter, 2002. It was published with permission in the April/May 2002 issue of The Group Circle.