What Puppy Husbandry has Taught me about Psychoanalysis and Winnicott

by Sally Rudoy

I guess you can teach an old dog new tricks. In this case, I am the old dog. The new trick is a profounder, deep-rooted understanding of the psychoanalytic concepts I have been immersed in for years. My rediscovery of psychoanalysis’ brilliant take on the workings of the human unconscious has emerged not within the patient/analyst dyad but in my relationship with an animal. Sometimes you have to wander outside the familiar milieus of consulting room and conference hall to gain fresh insights into what you think you already know. For me, I wandered into the world of puppy husbandry.

The kids were launched. The nest was empty. Life was an uncomplicated and spontaneous mix of work and personal pursuits. Yet, as I saw that I had more years behind me than were in front of me, I knew there was at least one thing missing. I wanted to raise a puppy from scratch.

I was set on a rescue dog. As many have pointed out, therapists rescue others to rescue themselves. Years before I had good luck with an older black lab mix shelter dog named Maggie. For my new puppy I was determined to branch out to some other mutt combination. Psychoanalysis teaches us that people are drawn repeatedly to early objects. Thus, after researching many different breeds and visiting various shelters, I impulsively adopted a black lab mix who was a doppelgänger for her predecessor.

I struggled with what to name the new puppy. Ultimately, in a Lacanian sense of inevitability, I shuffled a few letters around and rhymed her , Moxie. "Hmmmm," I hear my former analyst murmuring triumphantly, "Moxie, Maggie, Ma...Ma...Ma...Mama, Mother!!"

From the moment this 3-month bundle of cuteness entered my life my understanding of Winnicott's notion of maternal preoccupation deepened. I monitored, prepared for, and obsessed about Moxie's house training. The rhythm of my days was organized around her toileting, sleeping, and eating behaviors. I suspect this must have happened when my human children were infants. But then I was, well...too preoccupied to notice. With little Moxie, I could stand in the spaces between my obsessive puppy-caring self and my cynical, observing self. The latter liked to remind the former to get a life.

A dog is the ultimate blank screen upon which pet owners can project their inner worlds. They are furry containers of disavowed affects, self and other representations, and unspeakable wishes. In the local dog park I observe my fellow pet owners as keenly as I keep an anxious eye out, plastic bag in hand, for Moxie's productions. I hear all sorts of attributions in the confines of that human-canine space. Standouts are:

· “Binky is uncomfortable around that pit bull"

· “Smudge has finally decided to embrace his life here”

· “Henry is anxious to get home”

· “Contessa is ambivalent about her new food regimen”

· “Do you think Parsnip’s rhinestone collar makes her look like a slut?“

· And, from one under-employed owner of a hyper beag-a-doodle, “Antoine needs a job!” *

For my part, depending on the day, I experience Moxie as having loving, hateful, or indifferent feelings towards me. At times, as she follows my every move, I see rapture, an idealizing transference, if you will, in her intense brown eyes. At others, I "know" she is just playing me with those same brown eyes to get an extra treat. However, now that she has entered puppy adolescence, I am convinced she is determined to show me who’s the boss. And, it ain’t me. In the middle of the night, I fret, “Where oh where did I go wrong?”

Sometimes insights come from unfamiliar and unexpected places. Raising Moxie has taught me plenty about psychoanalysis and the human mind. While animal behaviorists might say that when she looks at me she is calculating, “What’s that nice lady got in her hand and can I eat it?,” I sense so much emotion, so much intention, so much kinship, and attachment. I realize, paraphrasing Winnicott, that for me there is no such thing as a puppy. Only a puppy and her pet owner -- an interlinked couple of mutual and symbiotic connection.

* The names of the dogs have been changed for confidentiality (but believe me, they are not far off)

Are you a perfectionist?

I know a woman who feels she must get everything right. Margaret agonizes over work projects, convinced she will never please her boss. She spends a fortune buying the best of everything, yet still questions her choices. She throws parties and has a miserable time trying to assure that everyone is having fun. No matter what she accomplishes, how much time she spends in the gym, how carefully she prepares a meal, it's never quite enough. Margaret is smart, successful and popular.

She's also unhappy.

She is not alone. We live in a society that teaches us to do more, be more, have more -- now. Perfection is just around the corner, so if your life isn't exactly the way you want, you must be doing something wrong. Just look at the current Republican presidential race, in which candidates are embraced then discarded if they take a single position that doesn't jibe perfectly with right-wing expectations. As the old advertising slogan asks, "Who says you can't have it all?"

Well, anyone with a modicum of common sense. And yet, sometimes without even realizing it, people labor under the false belief that if they just try hard enough, they can always get things precisely right. What a burden! Perfectionists tend to be insecure and overly critical -- certainly of themselves, but also of others. (Some perfectionists, however, are not equal-opportunity critics -- they hold themselves up to impossible standards, while giving everyone else a free pass.)

In truth, perfectionism exists on a spectrum. To one degree or another, we all sometimes demand just a little too much of ourselves, at least in certain areas. Up to a point, this can be healthy. A little perfectionism sets high standards that force us to grow. The problem is when taken to an extreme -- when it becomes the person's predominant way of functioning.

Except for fleeting moments, perfection is impossible to achieve. No one (and no thing) can be absolutely perfect. We all have flaws and anything we do could probably always be improved upon. An accurate self-assessment allows us to accept our imperfections and to decide what might be worth striving for.

True perfectionists have a hard time doing this. Deep down, they are convinced there is something fundamentally wrong with them, and so all the praise and success in the world isn't enough. Since they drive themselves, they may, like Margaret, accomplish a great deal, but they take little pleasure in their accomplishments, much less in the process of getting there. Sometimes, they can be self-destructive; since they are always ready to fail based on excessive internal demands, they may procrastinate or miss deadlines obsessing over details. Ironically, they then prove their fear -- that they are somehow fundamentally flawed.

Perfectionists can come across as controlling -- of themselves, of situations, and of others -- since they fear being out of control. They torment themselves into knots of second- guessing, often suffering from anxiety, depression and difficulty sleeping. They have a hard time seeing beyond the black-and-white extremes of absolute success or abysmal failure.

It can be challenging to work with a perfectionist in psychotherapy. They want lots of tasks, guidelines, answers and homework. Even when they do gain an important new insight, they may quickly ask, "Okay, so now how do I fix that?", without taking a moment to even consider the complexity of what they have just learned.

Since they can be impatient about the time the process takes, and the fact there are no easy answers, psychoanalysis initially can be challenging. Starting sessions can sometimes feel torturous, since they believe they must come up with the one most important thing to say in order for the session to have value.

Yet the same analytic process of taking pleasure in finding unknown aspects of oneself in spontaneous interaction with the therapist can be precisely what the doctor ordered. In demanding perfection from themselves and/or the therapist, they unwittingly sweep the analyst into their world. Without realizing it, the therapist may feel the need to be brilliant, despairing that they are failing the patient when really they are feeling precisely what it is like to be that individual. If the analyst can take a step back and realize this, she can find some way to interest the patient in just why things must be done perfectly, what the costs are, and the possible alternatives.

These alternatives include accepting oneself as we are, even as we continuously push for further growth, to test the limits of our potentials. Perfection is a necessary -- even healthy -- illusion. It is the demand that everything be perfect that truly makes a person miserable.

-- Eric Sherman, LCSW

Sexual Abuse -- New Statistics, New Hope

The numbers are staggering.

According to a just-released government survey, nearly one-third of women report they had been victims of sexual violence — rape, beating or stalking — at some point in their lives. Additionally, one in seven men had experienced severe violence at the hands of an intimate partner and 1-to-2% had been raped.

The high numbers surprised even some experts. They point to a problem in our society that is poorly addressed and that has profound implications for its victims.

Not surprisingly, the report showed that people who survive sexual violence suffer from physical and psychological problems, including diabetes, chronic pain, difficulty sleeping, increased risk of smoking, depression and Post-Traumatic Stress Disorder.

Part of the toll comes from the fact that rape is not only an act of sexual violation, but of power and control exercised over a helpless victim. The survivor must contend not just with being brutalized physically (often by someone he or she trusted), but also with the violation to her or his sense of self integrity and safety. The experience can be overwhelming, particularly when it stirs up memories of earlier examples of vulnerability, betrayal and shame going back to childhood.

In my practice, I have worked with many such individuals. Some report anxieties and inhibitions around sex, as well as guilt, anxiety, anger and mood swings. It can take a toll on their sense of confidence and trust, and on their ability to grow close in intimate relationships. Because of shame ("What will people think of me?"; "Maybe it was my fault") many do not talk about what happened to them. Some are afraid that to speak about it — even in therapy — would leave them once again feeling trapped with the very overwhelming feelings and memories they are trying to avoid.

Unfortunately, denial rarely works. In order to shut down anything associated with the experience, the person numbs her or himself (sometimes with alcohol, food or cigarettes), reliving what happened in flashbacks or through persistent fears and hypervigilance. They are always mobilized and on the lookout for danger. Some isolate from friends and loved ones. Without being able to deal with what happened, the trauma lives on within them, and gets created with others around them.

Since my practice includes men who have been physically and sexually abused — many, but not all of them gay — I wanted to address the special challenges they face. Both male and female survivors have to battle stigma and shame, but a man who is overpowered is often deemed weak and unable to fight back. There is a great hesitation to report crimes for fear of how the police and others will react, whether they are gay or straight. Much of the abuse takes place in romantic or sexual relationships, which can lead to guilt, stigma and self blame. Women who know their attackers often struggle with this as well, although in somewhat different ways.

Regardless of the circumstances, a goal of therapy is to create a sense of safety that allows the patient to feel she or he can talk about what had happened without being judged or overwhelmed by their feelings and memories. The therapist is careful to move at a pace that feels comfortable to the patient, in a way that is respectful of her or his need to feel in control.

The ability to speak the unspeakable before a carrying, nonjudgmental other can help relieve shame and give the person a sense of control and understanding. To the degree that the experience stirs up pain from the past, the ability to shed new light on earlier experiences — and to see how they connect to the person's current reactions and coping skills — can be profoundly healing and self-esteem enhancing. Ultimately, the person can move from feeling like a victim to a survivor who might actually grow stronger from the experience.

-- Eric Sherman, LCSW

Learning for Penn State: the Legacy of Childhood Sexual Abuse

Much has been written about the recent news out of Penn State. Throughout the country, people were disturbed by the magnitude of the sexual abuse allegations, and the negligent way that coach Joe Paterno and the administration swept aside this serious matter.

The news brought home a dynamic of childhood sexual trauma with which many survivors and fellow professionals are familiar. In fact, a number of former abuse victims in my practice again felt violated by the news that unfolded throughout the week, including the way the beloved father-figure Paterno had further betrayed the children involved by not acting on the charges more seriously. (The insensitivity of Penn State students who violently rallied on behalf of Paterno as if he, and not the boys involved, was the victim also upset some.)

It is sadly ironic that the name Paterno sounds so much like paternal. When a young person is abused, frequently a parent (or both) who should have known instead adds to the victim's trauma. Whether consciously or not, they ignore signs (including of the child's distress) that something is amiss. Worse, they may disbelieve or even blame the child, perhaps re-creating a dynamic from their own childhood. (Victims of child abuse frequently marry abusive partners to whom they cling.)

The results can be devastating. Sexual trauma -- including various forms of seduction and boundary violation -- can overwhelm the child's ability to make sense out of what has happened, leaving him or her feeling frightened, overwhelmed, and guilt-ridden. Without the support of protective parents, the child feels doubly isolated and betrayed. He or she may blame themselves for whatever small degree they enjoyed the attention. Incest and other forms of child abuse generally take place in dysfunctional and chaotic households where children feel unseen and unprotected. The attention of a seductive father can be the only form of love the child knows, leaving her to blame herself for what had happened. ("I must have wanted it.") When one or both parents reinforce this message, the child is left burdened by a sense of guilt and shame too massive to process.

And so the victim frequently employs something called dissociation to try to maintain some form of self integrity. Dissociation is a coping mechanism designed to help an overwhelmed individual cope with trauma -- although at great cost. Threatening experiences and feelings are split off from the person's conscious awareness and are experienced as if not part of the self. The unconscious is acting like a surgeon, sacrificing a cancerous limb to protect the rest of the body -- except the person is not aware of what they are missing. In severe cases, called Dissociative Identity Disorder (formerly Multiple Personality Disorder), the parts of the self associated with the trauma become autonomous personalities that take over the person's consciousness.

However, dissociation need not be so pervasive. An adult can function quite competently in the world, yet be afraid of sex, for instance, since sexual feelings cannot be tolerated due to their link to the original trauma. Or he or she may be unaware of their own anger, dating back to the original betrayal. These people present as compliant adults terrified of aggression or confrontation. Without being able to get in touch with their own healthy assertion, they attract demanding others who use them and leave them confused -- precisely the original trauma from childhood the person was trying to avoid.

This is one explanation why trauma survivors often unwittingly reenact painful situations in the present. What cannot be integrated and understood can only be lived out over and over again, seeming to reconfirm for the adult that life is in fact terribly dangerous, that they are bad and worthless and sure to be betrayed.

For such adults, psychotherapy -- particularly a psychodynamic approach -- can be a vital part of the healing process. Therapy helps the individual understand and incorporate parts of themselves that have been left behind. The analyst -- another parent-like authority figure -- creates a safe environment to inevitably reawaken the patient's hope and dread of being both recognized and helped, but also once again seduced and betrayed. It involves more than simply recovering memories, but rebuilding trust. This involves the adult being able to experience and integrate what had previously been dissociated. Rather than simply reenacting the trauma in adulthood, the person finally begins to see themselves in a new light and moves on in their lives in ways they never would have imagined.

If some good comes from the Penn State tragedy, perhaps the discussion about sexual abuse and adult responsibility may increase awareness and make it that much easier for others to come forward and get the help they need.

-- Eric Sherman, LCSW

Contentment: What you can find in a pill

According to a new survey, the use of antidepressants rose 400% in the United States in little more than a decade. (If only I could say the same for my stock portfolio.) The National Center for Health Statistics reports that antidepressants are now the most commonly-prescribed medications among 18-to-44 year olds. Nearly a quarter of women age 40 to 59 take them.

Sadly, less than a third of people taking antidepressants, and less than half of those taking two or more, had seen a mental health professional in the previous year.

It gets more depressing -- every pun intended. According to the study, most people on antidepressants suffer from relatively minor depression (sometimes called dysthymia), and some may not be clinically depressed. And yet as many as two thirds of Americans with severe depression receive no treatment at all.

A number of experts believe that we have reduced depression, anxiety and other states of the mind into simple neurochemical disorders, failing to address the broader psychological aspects.

Psychotropic (psychiatric) medications have helped many people; I have strongly recommended them for some of my patients over the years. I do not wish to minimize their importance in any way. But their overuse, particularly without accompanying psychotherapy, is part of a larger problem. As a society, we are mired in a get-well-quick mentality that treats complex emotions like a Betty Crocker cake mix -- a right-out-of-the-box approach that's quick and easy, but minimizes the pleasure and importance of finding out what's really cooking, so to speak, to cause a person's suffering.

Something is wrong when we have gone from self-examination to Prozac Nation -- a situation which has only worsened since the famous book of that title was published in 1994.

When people pop pills without also engaging in psychotherapy, they are not addressing the deep-seated problems that are caused their depression, anxiety, self-doubt and compulsions. The act of avoiding what makes them anxious about themselves likely is at the heart of their problem to begin with. Without making the effort to address how they got stuck, they are likely to only perpetuate their shame and feelings of inadequacy regardless of the effectiveness of the medication. "I am not strong enough to tackle my problems," is the message they give themselves. "I have to find an easy way out."

The benefits of psychotherapy are numerous, particularly a psychodynamic approach which looks to understand the underlying causes of maladaptive patterns and find ways to permanently alter them. The person's sense of self and ability to navigate their lives improve immeasurably. There is great joy in being able to understand and master issues which have kept us stuck. As change unfolds in the psychotherapy sessions and in the person's every day life, most people find their relationships -- with themselves and others -- and their sense of accomplishment and confidence improve in dramatic ways.

The process involves work -- more than just popping a pill. But if you really want to get to the crux of your problems, looking inside to find a sense of purpose may be more profound than anything you keep in your medicine cabinet.

-- Eric Sherman, LCSW

Understanding self sabotage

Still repeating the same self-defeating patterns?

Dating the same kind of controlling jerk you vowed to avoid three controlling jerks ago?

Putting off assignments until the last minute, then making sloppy mistakes in a rush to meet deadline?

Sleeping late, not going to the gym, overeating... and then hating yourself for it?

On the surface, it makes no sense. Why would anyone keep shooting themselves in the foot when clearly they can see their toes smoking?

But when you consider the unconscious -- the thoughts, feelings and motivations that "secretly" guide your actions -- even the most irrational behaviors come in to focus. Consciously, you want to complete the assignment, find a healthy romance, and stop angering friends by running late. But deep inside, conflicting desires are at odds with your conscious intentions.

Sure you want to prove yourself, but what if you unambivalently attack an assignment and then fail? What if you pursue a romantic partner who can truly nurture you -- and he walks away? It feels worse to be rejected by Prince Charming than to stick with the jerk you know isn't right for you.

I have worked with numerous people who, on the verge of important accomplishments -- or perhaps right after something good has happened -- become anxious and yank the rug out from under themselves. It may seem counterintuitive, but it sure beats getting your hopes up and having somebody else dash them -- especially if that's been a frequent experience in life. By extinguishing your own hopes, your unconscious is trying to protect you from the rejection that has already happened in the past, and that it is sure will happen again if it lets its guard down. The pain you know is familiar, and by causing it yourself, you at least feel in control. You know how things will turn out since, without realizing it, you have engineered them that way.

People often say they procrastinate because there are lazy. I like to reframe it so that they can see what they really are is frightened. They put off a daunting task because they are afraid they will not be good enough to accomplish it. Or what if they do, and still feel empty inside? Not trying is a way to keep alive the hope that things will still work out in the future.

Also, by unconsciously repeating the past -- by dating an aloof, rejecting man like father -- you hope to master the pain and come up with a new ending. If you can win over Mr. Wrong, you can finally please daddy (in abstentia) and feel worthy, powerful and recognized.

The problem is that it rarely works. Instead of mastering and changing the past, we repeat it almost verbatim. What may be required is a working through facilitated by psychodynamic psychotherapy. In treatment, you confront your unconscious belief systems and finds new ways to address them. This happens in vivo with the psychoanalyst, another parent figure likely to stir up familiar rejection anxieties, but who is also able to find new ways to respond to them. Rather than reject, he affirms. Rather than become angry, he remains curious.

So stop procrastinating and start looking inside. You may be surprised by what you find.

-- Eric Sherman, LCSW

REMEMBERING 9/11: Four Stories

On the 10th anniversary of the unimaginable, four members of the CPPNJ community -- Sally Rudoy, Martin A. Silverman, Lillian Shaw and Eric Sherman -- share their memories of the day that changed us all, personally and professionally. We welcome your comments, including your own 9/11 reflections.

A Day, At First, So Ordinary
by Eric Sherman

The thing I remember most -- besides the images of people jumping to their deaths -- is the smell.

A stench that hung over lower Manhattan, reaching the Greenwich Village neighborhood of my New York office. It smelled like burning rubber. Everyone knew what it was, even if we didn't want to acknowledge it. The odor carried the charred remains of the World Trade Center and -- most horrifying -- the people who had perished inside.

I had loved my office because of its giant windows and sweeping view of lower Manhattan. The regal Woolworth Building and the Twin Towers in the distance. On bright days, like the morning of September 11, 2001, I kept the blinds closed. The sun would have been too distracting.

At 8:48 am, as the unthinkable happened beyond my giant windows, I was in session with the same patient I saw every Tuesday morning. What stands out for me is this -- we heard nothing, we saw nothing, we knew nothing. The session went on like any other. How could I ever trust the ordinary again?

When the session was over, I bumped into my suitemate in the men's room. "Did you hear?" he asked excitedly. "A plane just flew into the World Trade Center."

I rushed back to my office and peaked through the blinds. I saw clouds of smoke billowing from what I assumed was one of the towers. I had no way of knowing that both buildings had been hit. I assumed a Cessna or other small plane had gone off course and accidentally struck the tower. I wanted to keep looking at the scene, but I had no time. I was off to teach my first post-graduate class ever, and I was nervous as hell. So I closed the blinds to the last view I would ever have of the World Trade Center and rushed to the subway. The towers crumbled while I was underground.

My first inkling that something frightening had happened was when the train I was in, trapped in a tunnel for 20 minutes, finally pulled into the Columbus Circle station and Transit Authority personnel ran on with bullhorns shouting that the station was being evacuated. A New Yorker from birth, I was concerned, but not terribly phased. Perhaps I would have an interesting story to tell the candidates when I began class moments later.

There would be no class that day, and no return to normalcy for some time. As I walked the 2-1/2 miles back to my office wondering how I would get home (the subway and New Jersey Transit were no longer running and Manhattan had been sealed off), my mind raced. Didn't one of my patients work in the Towers? The thought that he might be dead chilled me. (He had in fact been at his desk when the second building lurched forward upon the plane's impact. When I spoke with him that evening, he was fine, though quite shaken. So was I.)

The weeks after 9/11 were surreal. At first, I needed to show a photo ID to get past the police barriers on the corner of my office building. I kept the blinds closed tight, occasionally peeking out at the sight of the giant gray cloud engulfing what used to be the World Trade Center. I could only look for a few seconds at a time. The scene disturbed me too much.

My office -- the world -- no longer seemed safe. My patients and I -- the city, the country, the world -- were in a state of trauma, and there was no escaping it. The ever-present stench. The bomb-sniffing German Shepherds and National Guard officers with giant rifles at every train station. The terror that it could happen again at any moment.

Seeing patients in the days after 9/11 was both life-affirming and traumatizing. As much as I wished to work through what had happened and be present for my shell-shocked clients, at times I had the desire to shut down and forget. I kept the blinds closed tight in my office partly so that I could pretend that when I opened them again, there would be the World Trade Center, gleaming in the sun.

But there was little opportunity for denial. Session after session my patients relayed the horrors of that day and the anguish they were going through. I tried to help them sort out their feelings even when, occasionally, I wanted to scream: "Stop, please! I can't hear anymore." Instead I listened, shared my own experience when helpful, and cried with each one. Together we healed.

I have since moved my office to another part of the Village. It's on the ground floor overlooking a courtyard. There are no tall windows with views of the downtown skyline, no need to shut the blinds. Each morning that I commute to my New York office, I walk by the now-closed St. Vincent's Hospital, where many of the victims of 9/11 were rushed. The emergency room that served as a chaotic triage center is bordered up and ghost-like. Perhaps it is fitting. It is also terribly sad.

At some point this September 11, I will watch as much TV coverage as I can stomach. I will pause to think about trauma and bravery, finding meaning in what seems too much to bear. It is what I do every day as a psychotherapist. It is what gives life purpose.



First Responders
by Sally Rudoy

One memory I have of 9/11 and the few days in the aftermath was a feeling of wanting to be useful – to do something to help others. Somehow providing succor to others’ fear and shock would mitigate my own. I wanted to run toward Ground Zero, not away.

I heard from a colleague of mine that the next day there would be a coordinating meeting in the High School library. The board of education had put out a call for therapists in the community who would be willing to volunteer time to counsel traumatized students. When I arrived at the meeting in the library, it was standing room only. Around every table, packed against the book carrels, and perched along the length of the check out desk were psychotherapists of every discipline. Clearly, I was not alone in my need to do something: to make order out of chaos, return the world, now forever changed, back to its pre-9/11 predictability.

Somehow I thought this impulse to run toward disaster might be unique to those in the “helping” and first responder professions. However, as I counseled students and patients throughout the weeks following, I heard echoes of the same impulses. Teenagers wanted to go to lower Manhattan and help dig in the rubble, make casseroles for the families who lost parents, or sign-up for military service and go get the guys who “did this to us.” Younger children wanted to raise money or hold a bake sale for…for…for somebody, for something.

Early psychoanalysts discovered the phenomenon of the mind’s use of defense mechanisms to protect the self from disturbing thoughts, feelings and behavior. In those early days after 9/11, enveloped as I was in the same trauma as the ones I sought to help, I began to recognize a universal defense of keeping helplessness at bay by helping others. On the face of it, this seemed adaptive and a testament to the resiliency of the human spirit. Now, from the perspective of the tenth anniversary of 9/11, I also see my response as more nuanced. The person most helped by my actions in those dark days was myself.


PTSD Hits Too Close to Home
by Martin A. Silverman

Our daughter, 2000 miles way, called us that morning to tell us that an airplane had crashed into the WTC. We turned on the TV and watched the second plane hit the other tower and the two towers collapse to the ground. A few hours later, a woman called me and asked me to see her son, who was very upset about the incident, which he too had watched on TV. I helped her son deal with his agitation and distress -- and I helped HER to deal with it as she was even more upset than he was. I saw them a few more times, but my main preoccupation, as president of the Association for Child Psychoanalysis at the time, was that of working together with heads of many other mental health organizations to help children and families across the country to deal with the emotional impact of that terrible occurence.
Exactly six months after the 9/11 terrorist attack on the WTC, on 3/11/2002, I had left my home office and was in my kitchen getting an apple, when I heard a roar that sounded like it was coming from the engine of something gigantic racing up my driveway. Then I heard an explosion and saw debris flying up into the air. I realized suddenly that what I saw were pieces of my house. A woman, in a huge SUV, with her children in the back seats, had started to use my driveway to make a k-turn. Then she lost control of her vehicle, raced up my driveway, plowed into my station wagon, crumpling it like an accordion, and pushed it into the back porch of my house, demolishing the steps outside the kitchen, sending the pillars holding the roof up over those steps flying into the air, and knocking a hole in the side of my house!
When I stepped outside, I found that it was that same woman who had come to me with her son after the World Trade Center attack half a year earlier. "I'm so sorry," she exclaimed; "I don't know what happened!" But I knew what had happened. She had returned to me, and to my dismay, had re-enacted, at my expense, what had upset her and her son so much on 9/11! I am glad to help children and their parents who are emotionally distressed, but this clearly was over and beyond the call of duty, don't you agree?


September 11, 2001, Ten Years Later
by Lillian Shaw

The morning of September 11, 2001 dawned easily with the bright sun in place, a warm and welcome visitor, cool breezes, and billowy clouds dotting the sky-scape. As I walked into the day room of the hospital where I worked, to gather together ten patients for their ongoing twice-a-week therapeutic group, the television was on and the New York panorama looked crisp and bright.

“We will have our group now” I told the patients. It was 9:15 AM. The patients were accustomed to joining together and talking about their illness, themselves, their struggles and even current events. Especially loved was the topic of the baseball playoffs, and the World Series, set to begin in September, 2001. Groups, I had told them, allow you to change. You sit together and come to understand your thoughts and behaviors, responses and reactions to others, and theirs to you. You learn about yourself, in a group. Nothing could be truer for the close-knit September 11 terrorists, who planned their activities well, and were self-supporting, and increased their functioning and resolve, through their network.

One patient moved quickly into my personal space, and said “Did you see? Look at the TV”. I looked and saw the instant-replay of a plane smashing into the World Trade Center tower. The announcer was saying something about a plane off course. It was quiet in the room. I stood there and saw the replay three times in quick succession. Inside I felt as if raw nerves were being hacked, producing feelings of numb, and helpless abandon. Vulnerable and overwhelmed America, I thought, already had experienced atrocities resulting from the Achille Lauro, the Gulf War, the Unabomber, Oklahoma City, Atlanta Summer Olympics, the USS COLE, and others, and I felt the pull. The Twin Towers were icons, and all the people who would die that day had left home in the morning never to return. I had never been in either Tower, or navigated to the top.

After the group, I went back to the day room and watched the replay of the second plane hitting Tower two. America’s blood, tears and tissues were being poured onto New York’s pavement, I thought. And then came the horrible, terrible stories of untimely death, unasked-for and unsought bravery, and running to escape, running to save self and to save others, running for your life. The Tunnel-Run race honors Stephen Stiller’s brave run through the Battery Tunnel with 75 pounds of fire gear on his back, to help. And we watched heroes live, and we heard of heroes dying.

A socials worker on the next unit left the building in tears. Her father worked in the World Trade Center and she could not get him on his cell phone. My son Tom was out of work and had several interviews the previous week in the WTC section of the city. Does he have any meetings scheduled today, I thought? The cell phone was dead as I tried to call. No cell tower transmission, I was told. I later found out that Tom had no interviews that day and that he and my nephew Ted, each living in Hoboken, had met at the fence surrounding a waterfront park, after the first impact. They saw the second plane hit, and heard the whoosh of the fire as it enraged into a red and orange ball, and witnessed the changing of the New York harbor line, and our secure feelings, our concept of freedom, and many lives, forever, in a quick few seconds.

Then the towers came down, and New York looked like a ghost town in black and white, as the world was riveted to the television. The firemen, police, ambulance workers, hospital workers and nearby workers, all pitched in and ran and helped, and we saw an unfolding of life in goodness. It was butted against evil. Mayor Giuliani was there and it felt terrifying

We heard about the crash of a plane into a field in Pennsylvania. More heroics and bravery from people who stood up, never thought of themselves, and wanted to save others and stop the terrorists’ attack. Todd Beamer’s “Let’s roll” has become a mantra for action-oriented goodness and Mark Bingham and Tom Burnett’s bravery, and that of others on flight 93, an inspiration. Then more desperate death. And you began to worry if we will ever understand the trauma of that day, the inconceivable and despicable acts of a few, and then war. The Lord’s Prayer and Psalm 23 were prayed on board, in those last minutes, and over the phone.

The rebuilding continues. Much the same as individuals rebuild lives after emotional illness, mental illness and physical illness, trauma and abuse, and it takes time. Our nation continues to build and grieve, and to know that life matters, our lives matter, and our freedom is worth fighting for.