2001 : WHAT NOW?

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M.D. is Associate Professor of Neurology and Psychiatry at Albert Einstein College of Medicine and Chief of the Yarmon Neurobehavior and Alzheimer's Disease Center, Beth Israel Medical Center in New York City
Associate Professor of Neurology

Complacency or Denial? According to reports, after the first plane hit Tower One of the World Trade Center, and the evacuation of the second tower was in progress, there was an announcement that the second tower was secure and everyone should go back to their offices. Upon hearing this, some workers unfortunately returned to their desks and some of these persons perished when that building later collapsed.

As a neuropsychiatrist who has studied psychological defense in patients who have neurological disease, I found the account of these events quite extraordinary. How could anyone who was responsible for the safety of that building declare that the building was "secure" when the tower next door was in fact in flames and the cause of that unfolding disaster was still unknown? How could someone believe that the building was safe when they knew the first tower was still ablaze? I further wondered how safe these people felt in the Twin Towers in the first place, given that there had been an attack on one of the Towers in 1993 and organizations associated with that attack were still in operation. Nonetheless, rational and good people went to work at the Twin Towers every day without undue anxiety, and while a catastrophe was in progress, they felt safe enough to return to their desks.

An even greater mystery is how the widespread terrorist activity that was required by these attacks unfolded right in front of our nation's collective noses. One wonders how many people working in banks and other financial institutions noticed "odd" transfers and disbursements of funds yet explained them away as somehow acceptable. How many flight instructors quietly wondered why so many of these future terrorists needed flight training, yet said nothing?

Were the people that worked in the World Trade Center, their loved ones, indeed America, in denial of the now obvious fact that there were more attacks in the offing? After the dust settles and all the facts are known, I suspect it will be shown that America has not been merely complacent, but that we have indeed been collectively as a nation in denial.We have been in denial because the possibility of a catastrophe on the scale of the recent airplane attacks on The World Trade Center was simply unthinkable.

In the medical and psychiatric patient, when psychological denial lifts, common reactions include anxiety and depression. In the poorly adjusted individual, there may be serious disruption and even breakdown of the personality.On the other hand, in the well adjusted individual, the lifting of denial enables the person to adjust and adapt in a constructive fashion.America will now come out of its denial and face these new challenges with a transformed sense of who we are as a nation.