Presentations
History and Systems (PSA 6601)Dr. AuerbachHistory and Systems of PsychologyFall, 2004
Carl Auerbach, Ph.D. Tel. 718-430-3953 Associate Professor of Psychology Email: carlauer@aol.com Office hours: Tuesday 1 – 2; 4 – 5; Thursday 2 - 3 (by appt)
________________________________________________________________________ Course Description
This course is geared to students in training to be practicing clinical psychologists, who want to know how the history and systems of psychology relates to the clinical issues they will face. In the course of their training, these students will be exposed to the two basic theoretical orientations of CBT and psychodynamic psychology. Most probably they will choose one or another orientation as the basis for their own clinical work, or develop some eclectic synthesis of the two. The course is organized so as to help them understand and evaluate these two orientations. The course explores the classical roots of psychodynamic psychology is platonic philosophy, and the classical roots of CBT in Aristotelian philosophy. It shows how the scientific revolution and the European enlightenment transformed the classical philosophies into clinical theories. Two other secondary themes will be discussed throughout the course. The first is the relationship between reason and passion as it is conceptualized in Western thought. The second is the historical context in which these approaches were developed.
Course Objectives/Goals
The course objectives are to provide students:
An understanding of the fundamental clinical concepts of classical psychodynamic theory.
An understanding of the fundamental clinical concepts of classical CBT.
An understanding of the broader philosophical issues implicit in these theories, as they appear in ancient philosophy.
An acquaintance with the ways in which more recent clinical theory and practice is working with these same issues.
Course Requirements & Evaluation of Competency
Attendance: Attendance at all classes is required.
Grade 75% examination. The examination will be a straightforward essay exam, requiring the student to demonstrate understanding of the material, and integrate it with their own personal and clinical experience. 25% attendance and class participation, and performance on take-home thought projects.
Courses Textbooks and Readings
Mitchell, S. A. (2003). Can love last: The fate of romance over time. New York: Norton.
Seligman, M. (2002). Authentic happiness: Using the new positive psychology to realize your potential for lasting fulfillment. NY: Free Press.
Recommended Readings
Viney, W. & King, D. B. ( 2002). A history of psychology: Ideas and context. NY: Pearson, Allyn & Bacon.
Course Processes
The course objectives will be accomplished using lectures, class discussion, and take-home thought projects.
Course Sequence
INTRODUCTION
Session 1. Why study history and systems?
CLASSICAL ANTIQUITY
Session 2. Plato. The world as illusion and the structure of the soul
Session 3. Plato (continued)
Session 4. Aristotle. People as rational, social animals.
Session 5. Aristotle (continued) Midterm.
MODERNITY: THE MECHANIZATION AND SECULARIZATION OF THE WORLD PICTURE
Session 6. The medieval synthesis and its breakdown. Sir Isaac Newton and the clockwork Universe.
Session 7. Charles Darwin and the theory of evolution. Dispensing with a creator.
Session 8. Classical psychodynamic theory. Freud darwinizes Plato.
Session 9. Classical psychodynamic theory (continued)
Session 10. Classical CBT. Beck operationalizes Aristotle.
Session 11. An illustration of modern psychodynamic theory. Steve Mitchell on love.
Session 12. An illustration of modern CBT theory. Marty Seligman’s positive psychology.
Session 13. Course summary. Loose ends.
Session 14. Final exam.
Session 1. Why study history and systems?A. Preliminary material 1. Introducing myself, my background, my interests, particularly in trauma, particularly post-traumatic growth, and family psychology, particularly the social evolution of fatherhood. 2. Introducing students: what is your name, what is your educational background. If this were a smaller class I would ask you to give me a brief description of your background, and your clinical experience and interests. This probably will not be possible, so please give me this information in your first reaction paper (to be explained). 3. Print your email so that I can contact you if need be. Also type it on your reaction paper. 4. By the next lecture give me a photography so that I can try to learn who you are. Xerox a copy of the photograph on your yeshiva ID. Use letter size paper, and position the ID so that it is face up on the paper when held in the usual position.
B. Course information 1. Readings. Because this course is specifically tailored to YU’s Psy.D. program, there is no textbook. The course is based on lectures, outlines of which will be handed out before each lecture. At the end of the course you will read one of two books by a contemporary psychologist. The lectures will eventually be posted on the yeshiva website. But for now if you aren’t in class be sure to ask a colleague to get a copy for you. 2. Course overview 3. Course objectives 4. Course requirements. Exams as shown on the syllabus. Also reactions papers. These are one page papers to be handed in at the start of the class. On each paper write briefly about any questions you may have about the lecture, any thoughts the lecture stimulated, and, if it called for your answer to a question I pose at the end of class. Include on your paper your name and the date of the lecture to which you are reacting.
Why study history and systems? 1. It is important to honor the past. a. Research student studying the holocaust who is here because her grandmother resolved to survive Dachau. Similarly, we are here because of the early efforts of our predecessors. b. Clinical psychology as we know it wouldn’t exist without Freud. c. Example from trauma. The PTSD diagnosis came into existence after the Vietnam war because of the efforts of psychologists and psychiatrists who worked with Vietnam vets. They were supported by the political efforts of Vets themselves.
2. It is important to understand present concepts in their historical context. a. The concepts are clearer in their original form, and we can often see that they were the result of choices from alternative ways of organizing data. b. Example. When Freud was studying sexual abuse as the cause of hysteria, he had to choose between thinking of hysteria as a result of repression of sexual impulses, or dissociation of traumatic sexual experience. The latter position was advocated by Janet. Freud chose the former, the repression hypothesis, and it was this choice that created the form of early analytic theory. In my view, and much of the field now, Freud’s choice was incomplete or wrong. But in any event, to understand the Freudian concept of repression you have to know the context in which it arose.
3. It is important not to reinvent the wheel. a. Much of positive psychology is a reworking of Aristotle and Aquinas. I think the current researchers would benefit by making explicit use of this. b. There are great affinities between the Freudian concept of fantasy and the Buddhist concept of samsara and maya. These are in fact being explored. Beyond the scope of this course, however.
4. It is important to get a philosophical perspective on clinical theory and clinical practice. a. In the process of doing clinical work issues of ethics and values, issues of human nature, and spiritual issues naturally arise, and cannot be ignored. It is important the have some experience thinking about them, and clarifying your own position. b. Example of spiritual issue. In working with trauma you will have to examine the question of why there is suffering. You have to do think about this because people themselves raise the question, and it is a philosophical question. Some possible answers are: it is part of God’s plan and will make sense in an afterlife, or it is impossible for us to know, or life has not meaning and suffering just happens. c. Example of an issue of human nature. In working with trauma you have to consider the issue of the perpetrators and how they could do what they did. Were they born evil? Were they made evil? Are people basically good, basically evil, or some blend, and if so what are the percentages? d. Example of an ethical issue. Consider a child abuser who was himself abused. Should he be sentenced to jail for his actions, even though they are a result of his own history. Or should he be allowed to escape punishment by seeking treatment, etc.
SESSION 2 & 3. PLATO: THE WORLD OF ILLUSION AND THE STRUCTURE OF THE SOUL
Introductory material. Thinking like a species
My intellectual project is to learn how to think like a species. By this I mean to think of history as a process of the human species self development, particularly cultural development. My general view is that this occurred largely unconsciously up until this point, but now it has to become conscious.
Here are some major landmarks and descriptions associated with them.
We are all African-american. About 200,000 to 175,000ya anatomically modern humans appeared in subsaharan africa.
The cognitive big band and the human diaspora. About 75,000 ya cognitively modern humans appeared, and began to settle the globe, a process completed about 15,000ya with the settlement of the americas.
These people were hunter-gatherers, and hunter-gather societies are probably what we are biologically evolved for. Important to correct misconceptions about these societies, as they are relevant to understanding human nature, particularly with respect to the issue of whether we are naturally violent. They are egalitarian, both in terms of gender and social hierarchy They are peaceful, conflicts resolved without killing They are migratory, and of low population density They are informed by a shamanistic consciousness, the interpenetration of the spirit world and the mundane world They have a highly detailed knowledge of the natural environment All these arise from the fact that they are without property, and are dependent upon each other and nature for their survival. Mutuality.
The first human revolution, by which I mean change in the deep structure of society. We are all middle eastern. About 10,000 ya agriculture was invented in response to climactic instability at the end of the ice age. The possibility of food shortage created the necessity for food storage. This occurred first in the middle east and soon spread possibly by diffiusion of the idea, although there may have been as well independent invention.
The invention of agriculture led to the domestication of plants and animals, by about 5,000 BCE. By about 3100 BCE people had created preindustrial civilizations. Important for the study of western civilization are Mesopotamia, Egypt, The hittite civilizations around Turkey, Minoan Civilization on Crete, and the Mycenean civilization of Greece. These ranged from the unified kingdom of egypt to the city states of mesopotamia and greece, to the Palatial kingdoms of Crete. These formed a network of trade in the Eastern mediterranean, and this network is the birthplace of Western Civilization.
The characteristics of preinsustrial agricultural civilizations are quite different than those of hunter-gatherer societies. They require a large scale coordination of labor. They have an elaborate social hierarchy, kings & priests, warriors, and workers. They are based on manual labor and so slavery and subordination is always a possibility. They are of necessity violent warrior societies They have a gendered division of labor. They are motivated to trade They create the city as a form of life They tend to invent writing, with a corresponding shift of cognition. They tend to have a religion that justifies the social organization.
We begin our story in 5th century greece, a society consisting of small independent city states. Some of them are ruled by kings, and some, like Athens are democracies. We will focus on athens.
Conceptions and misconceptions about Athens. Greece was not a nation in the modern sense, it was a group of constantly feuding city states. Athenians had a participatory democracy in which every citizen voted in a large scale public meeting. Every citizen could in principle occupy every political position. Their economy was based on slavery. Women didn’t vote, nor did slaves. They were not homosexual in our sense. Rather the male life cycle involved an adolescent boy being courted by an older man who would serve as his mentor. When the boy aged out of this position and had his own family, he would in turn court younger boys. If anything they were bisexual, but our categories don’t really apply. They believed in a pantheon of gods who were like people but more powerful. In that sense they were religious, but they didn’t have a sacred text. By the 5th century the belief in the gods was probably fading.
By the early 5th century the Greek mainland had defeated the persian empire in a large scale war, the Persian war. It lasted from 490 to 480, and was spearheaded by Athens and Sparta. Following the war the greeks formed the athenian led delian league to defend against further invasions. Athens began to exploit the other members leading to the Peloponnesian wars between athens and Sparta (431 – 404) which resulted in the defeat of Athens.
Soon after this, all of Greece was conquered by Alexander the great, and Greek culture was disseminated throughout the world, although Greece itself was never again a major power.
This was a time of turmoil and insecurity, of rapid social change with no predictable outcome. A time much like ours. It may be no accident that our culture originated in this way.
Three philosophers will be crucial for our discussion, listed below.
Socrates (469 – 399, Athens). Introduced. the Socratic method of philosophizing through relentless questioning dialogue, without a definite answer.
Plato (428 – 348, Athens). Pupil of Socrates. Explores the inner life and the soul.
Aristotle (384-322, Macedonia). Pupil of Plato, tutor to Alexander the great. Explores the outer life and society.
In my view, these philosophers were thinking about the problem of how to control the impulses which had gotten out of hand in their era, the impulse to dominate and aggress and conquer, even though it is ultimately against one’s own interest.
Plato: The world as illusion and the structure of the soul
0. We are going to be examing two basic platonic ideas. First, the idea that our ordinary world of the senses is an illusion, and second, the idea that the soul isn’t unitary, but is, instead, divided into three parts whose interelationship must be set in order.
1. The problem in studying Plato arise because he advocates ideas very foreign to the modern sensibility. This challenges us to examine our modern sensibility. I also discuss Plato because of the almost uncanny parallel between Platonic doctrine and dialogue and psychoanalytic theory and technique. This shows the persistence of the past and how theorists rework the ideas given to them to make sense of contemporary facts.
a. Most modern people are moral relativists, but Plato believed in an absolute, objective morality, that is part of the structure of reality. b. Most modern people think of reason as something like mathematical or scientific inference, but Plato thinks of reason as a faculty of mind that can see into the structure of reality, including moral reality. c. We are going to see that Plato thought of the ordinary sensory world as an illusion, that the soul must learn to see through in order to be happy. This later became a part of Christian thought.
2. Beginning the study of Plato with an ethical issue in therapy a. My Tony Soprano problem. I describe a Mafioso client I had, who came to see me for a problem unrelated to his criminal activity. I didn’t challenge his life style, having been trained not to impose my values on his, unless the issue came up. The therapy wasn’t a success and I have come to wonder whether I should have been less value free. I know the arguments against this, but I am raising the question anyhow.
b. The ring of Gyges Plato, in the Republic, tells of Gyges, a shepherd, who discovers a powerful ring that makes him invisible, and thus free to act on his every impulse without fear of consequence. How could we convince him otherwise (assume he has no guilt, or gets over it.). The general problem is to find a reason to behave morally without fear of an internal or external punishment.
c. Breakout group class discussion about this.
3. Plato’s answer begins with the tripartite structure of the soul analogous to the tripartite structure of a well governed city. a. These ideas will later become the id, ego, and superego. They also seem remarkably like Paul MacLean’s theory of the triune brain, for which see a description below. b. The well governed city, well functioning city as a hierarchy of human types: philosopher kings, guardians, workers c. The well governed soul as an equivalent of the well governed city, where reason = philosopher king, spirit (pride, self worth) = guardians, and passions = workers. Just as philosopher kings rule city and regulate the other two, so reason should rule the soul and regulate the other two. d. The plausibility of the answer. Being in St. Petersburg where my angry emotional reaction to being shoved is overridden by reasoned judgment that this is cultural and not personal.
4. More generally, why should reason rule? We are going to examine a rather implausible argument from the modern point of view. a. This will later become the Freudian idea of primary and secondary process. b. Plato drew an important distinction between appearance and reality, as evidenced, for example in sensory illusions. c. Appearance is revealed by the senses, and reality by the intellect. Example, in a perfect mathematical circle the diameter is twice the radius, but in a circle drawn on the board this isn’t true exactly. d. Plato makes the astonishing claim that the perfect mathematical circle is more real than the circle that we draw. He then generalizes to say that reason can reveal to us an unchanging world of which our transient world is an imperfect copy. This is called the world of forms, and mathematical truth is true of the world of forms. The circle is an imperfect copy of the CIRCLE. You are just going to have to accept this provisionally, to go further. e. Plato went even further and said that there were also ethical truths that are equally absolute, and equally permanent as mathematical truths. These were also discoverable by reason. Here we challenge both relativism, and also the modern sense of reason. f. It is thus clear why reason should rule the soul and its conduct. Only reason gives us this access to the world of ethical form and ethical truth. Normally we are blinded by the lower faculty of pride or passion, which blind us to reality. Whether or not you believe the whole platonic apparatus, this seems true. g. What about an example. Socrates and Plato never gave them, but drawing on the assumption that there is an Indian influence I’ll give one. In ordinary reality, the world of appearance, good goes unrewarded and evil unpunished. In a more extended reality, karma operates, and people’s next lives take into account their actions in this one.
5. Plato’s allegory of this cave as giving us a picture of this. See accompanying text. a. We are going to see how much this parallels the psychoanalytic process.
6. How do we leave the cave? How does reason come to rule? a. Before birth the soul occupies the world of forms. (See dialogue, Meno). At birth the soul enters the body and forgets the world of forms. To get in touch with reality the soul must remember. This parallels the Freudian view as uncovering/remembering repressed memories. b. Remembering occurs in the process of dialogue in which Socratic questioning reveals contradictions in ordinary belief. Thus parallels the “talking cure” in psychoanalysis. Incidentally, this may be why Plato and Socrates give no examples, they wants us to discover the truth for ourselves. d. Plato believed that the motive for remembering was Eros. The journey begins with the experience of a sensual attraction to the appearance of beautiful people. With proper philosophical education the person sees beyond transient physical beauty to BEAUTY itself, the form of beauty, and from BEAUTY to the GOOD, the highest truth. (See dialogue Phaedrus.) This parallels eliciting and then analyzing transference love.
7. The major difference between Plato and Freud is that Plato saw this process as an ascent of the soul to the higher world of forms, whereas Freud saw the process as a descent to the lower world of instincts.
8. Plato’s answer to the four questions of clinical theory
The Allegory of the Cave And now, I said, let me show in a figure how far our nature is enlightened or unenlightened: -- Behold! human beings living in a underground den, which has a mouth open towards the light and reaching all along the den; here they have been from their childhood, and have their legs and necks chained so that they cannot move, and can only see before them, being prevented by the chains from turning round their heads. Above and behind them a fire is blazing at a distance, and between the fire and the prisoners there is a raised way; and you will see, if you look, a low wall built along the way, like the screen which marionette players have in front of them, over which they show the puppets. I see. And do you see, I said, men passing along the wall carrying all sorts of vessels, and statues and figures of animals made of wood and stone and various materials, which appear over the wall? Some of them are talking, others silent. You have shown me a strange image, and they are strange prisoners. Like ourselves, I replied; and they see only their own shadows, or the shadows of one another, which the fire throws on the opposite wall of the cave? True, he said; how could they see anything but the shadows if they were never allowed to move their heads? And of the objects which are being carried in like manner they would only see the shadows? Yes, he said. And if they were able to converse with one another, would they not suppose that they were naming what was actually before them? Very true. And suppose further that the prison had an echo which came from the other side, would they not be sure to fancy when one of the passers-by spoke that the voice which they heard came from the passing shadow? No question, he replied.
That is certain. And now look again, and see what will naturally follow if the prisoners are released and disabused of their error. At first, when any of them is liberated and compelled suddenly to stand up and turn his neck round and walk and look towards the light, he will suffer sharp pains; the glare will distress him, and he will be unable to see the realities of which in his former state he had seen the shadows; and then conceive some one saying to him, that what he saw before was an illusion, but that now, when he is approaching nearer to being and his eye is turned towards more real existence, he has a clearer vision, -- what will be his reply? And you may further imagine that his instructor is pointing to the objects as they pass and requiring him to name them, -- will he not be perplexed? Will he not fancy that the shadows which he formerly saw are truer than the objects which are now shown to him? Far truer. And if he is compelled to look straight at the light, will he not have a pain in his eyes which will make him turn away to take and take in the objects of vision which he can see, and which he will conceive to be in reality clearer than the things which are now being shown to him? True, he said. And suppose once more, that he is reluctantly dragged up a steep and rugged ascent, and held fast until he's forced into the presence of the sun himself, is he not likely to be pained and irritated? When he approaches the light his eyes will be dazzled, and he will not be able to see anything at all of what are now called realities. Not all in a moment, he said. He will require to grow accustomed to the sight of the upper world. And first he will see the shadows best, next the reflections of men and other objects in the water, and then the objects themselves; then he will gaze upon the light of the moon and the stars and the spangled heaven; and he will see the sky and the stars by night better than the sun or the light of the sun by day? Certainly. Last of he will be able to see the sun, and not mere reflections of him in the water, but he will see him in his own proper place, and not in another; and he will contemplate him as he is. Certainly. He will then proceed to argue that this is he who gives the season and the years, and is the guardian of all that is in the visible world, and in a certain way the cause of all things which he and his fellows have been accustomed to behold? Clearly, he said, he would first see the sun and then reason about him. And when he remembered his old habitation, and the wisdom of the den and his fellow-prisoners, do you not suppose that he would felicitate himself on the change, and pity them? Certainly, he would. And if they were in the habit of conferring honors among themselves on those who were quickest to observe the passing shadows and to remark which of them went before, and which followed after, and which were together; and who were therefore best able to draw conclusions as to the future, do you think that he would care for such honors and glories, or envy the possessors of them? Would he not say with Homer, "Better to be the poor servant of a poor master," and to endure anything, rather than think as they do and live after their manner? Yes, he said, I think that he would rather suffer anything than entertain these false notions and live in this miserable manner. Imagine once more, I said, such an one coming suddenly out of the sun to be replaced in his old situation; would he not be certain to have his eyes full of darkness? To be sure, he said. And if there were a contest, and he had to compete in measuring the shadows with the prisoners who had never moved out of the den, while his sight was still weak, and before his eyes had become steady (and the time which would be needed to acquire this new habit of sight might be very considerable) would he not be ridiculous? Men would say of him that up he went and down he came without his eyes; and that it was better not even to think of ascending; and if any one tried to loose another and lead him up to the light, let them only catch the offender, and they would put him to death. No question, he said.
The following is an excerpt from a sub-page of www.kheper.auz.com but any query at an internet search engine with the buzzword "Paul McLean" and "triune brain" will report numerous links. The Triune Brain
The neurologist Paul MacLean has proposed that our skull holds not one brain, but three, each representing a distinct evolutionary stratum that has formed upon the older layer before it, like an archaeological site :He calls it the "triune brain." MacLean, now the director of the Laboratory of Brain Evolution and Behavior in Poolesville, Maryland, says that three brains operate like "three interconnected biological computers, [each] with its own special intelligence, its own subjectivity, its own sense of time and space and its own memory". He refers to these three brains as the neocortex or neo-mammalian brain, the limbic or paleo-mammalian system, and the reptilian brain, the brainstem and cerebellum (see above diagram). Each of the three brains is connected by nerves to the other two, but each seems to operate as its own brain system with distinct capacities. This hypothesis has become a very influential paradigm, which has forced a rethink of how the brain functions. It had previously been assumed that the highest level of the brain, the neocortex, dominates the other, lower levels. MacLean has shown that this is not the case, and that the physically lower limbic system, which rules emotions, can hijack the higher mental functions when it needs to. It is interesting that many esoteric spiritual traditions taught the same idea of three planes of consciousness and even three different brains. Gurdjieff for example referred to Man as a "three-brained being". There was one brain for the spirit, one for the soul, and one for the body. Similar ideas can be found in Kabbalah, in Platonism, and elsewhere, with the association spirit - head (the actual brain), soul - heart, and body in the belly. Here we enter also upon the chakra paradigm - the idea that points along the body or the spine correspond to nodes of consciousness, related in an ascending manner, from gross to subtle. The Reptilian Brain. The archipallium or primitive (reptilian) brain, or "Basal Brian", called by MacLean the "R-complex", includes the brain stem and the cerebellum, is the oldest brain. It consists of the structures of the brain stem - medulla, pons, cerebellum, mesencephalon, the oldest basal nuclei - the globus pallidus and the olfactory bulbs. In animals such as reptiles, the brain stem and cerebellum dominate. For this reason it is commonly referred to as the "reptilian brain". It has the same type of archaic behavioral programs as snakes and lizards. It is rigid, obsessive, compulsive, ritualistic and paranoid, it is "filled with ancestral memories". It keeps repeating the same behaviors over and over again, never learning from past mistakes (corresponding to what Sri Eurobond calls the mechanical Mind). This brain controls muscles, balance and autonomic functions, such as breathing and heartbeat. This part of the brain is active, even in deep sleep. The Limbic System (Pale mammalian brain). In 1952 MacLean first coined the name "limbic system" for the middle part of the brain. It can also be termed the paleopallium or intermediate (old mammalian) brain. It corresponds to the brain of the most mammals, and especially the earlier ones. The old mammalian brain residing in the limbic system is concerned with emotions and instincts, feeding, fighting, fleeing, and sexual behavior. As MacLean observes, everything in this emotional system is either "agreeable or disagreeable". Survival depends on avoidance of pain and repetition of pleasure. When this part of the brain is stimulated with a mild electrical current various emotions (fear, joy, rage, pleasure and pain etc) are produced. No emotion has been found to reside in one place for very long. But the Limbic system as a whole appears to be the primary seat of emotion, attention, and affective (emotion-charged) memories. Physiologically, it includes the hypothalamus, hippocampus, and amygdala. It helps determine valence (e.g., whether you feel positive or negative toward something, in Buddhism referred to as vedena - "feeling") and salience (e.g., what gets your attention); unpredictability, and creative behavior. It has vast interconnections with the neocortex, so that brain functions are not either purely limbic or purely cortical but a mixture of both. MacLean claims to have found in the Limbic system a physical basis for the dogmatic and paranoid tendency, the biological basis for the tendency of thinking to be subordinate feeling, to rationalize desires. He sees a great danger in all this limbic system power. As he understands it, this lowly mammalian brain of the limbic system tends to be the seat of our value judgments, instead of the more advanced neocortex. It decides whether our higher brain has a "good" idea or not, whether it feels true and right. The Neocortex, cerebrum, the cortex , or an alternative term, neopallium, also known as the superior or rational (neomammalian) brain, comprises almost the whole of the hemispheres (made up of a more recent type of cortex, called neocortex) and some subcortical neuronal groups. It corresponds to the brain of the primate mammals and, consequently, the human species. The higher cognitive functions which distinguish Man from the animals are in the cortex. MacLean refers to the cortex as "the mother of invention and father of abstract thought". In Man the neocortex takes up two thirds of the total brain mass. Although all animals also have a neocortex, it is relatively small, with few or no folds (indicating surface area and complexity and development). A mouse without a cortex can act in fairly normal way (at least to superficial appearance), whereas a human without a cortex is a vegetable. The cortex is divided into left and right hemispheres, the famous left and right brain. The left half of the cortex controls the right side of the body and the right side of the brain the left side of the body. Also, the right brain is more spatial, abstract, musical and artistic, while the left brain more linear, rational, and verbal.
Psychology of TraumaFall, 2004, Carl Auerbach, Ph.D. Tel. 718-430-3953 Associate Professor of Psychology Email: carlauer@aol.com Office hours: Tuesday 1 – 2; 4 – 5; Thursday 2 - 3 (by appt) ________________________________________________________________________ Course DescriptionEver since the tragic events of 9/11, American psychology has taken a renewed interest in trauma. The recent war in Iraq has made this subject even more salient. Indeed, trauma has become part of our everyday vocabulary, a theme running through our daily experience. As a result of these developments, it is important for all clinicians and clinical students to have a working knowledge of the processes of trauma and recovery. Providing this knowledge is the aim of the course. The course addresses three basic questions concerning trauma: (1) What is trauma – the question of recognition and diagnosis, (2) What causes trauma – the question of theoretical explanation of trauma, and (3) What can be done to alleviate trauma – the question of treatment. Upon completion of the course the student will be in a position to take further more advanced courses in trauma theory and trauma therapy. Also, the student who so desires will be able to conduct research in trauma.
Course Objectives/GoalsThe course objectives are to provide students: Understanding of the basic approaches to the study of trauma. Understanding of how to diagnose trauma, including both the basic diagnosis of PTSD, and also more complex traumatic disorders. Understanding of the social constructivist, cognitive behavioral, physiological, and dissociative process models of trauma. Familiarity with the basic approaches to the treatment of trauma.
Course Processes
The course objectives will be accomplished using didactic instruction, analysis of interviews with traumatized persons, class discussion, and examinations. Course Requirements and Evaluation of Competency. Attendance. Attendance in all classes is required. Grade50% examination. The exam will be a straightforward set of essay questions, covering the course material. The student will be expected to demonstrate his or her understanding of the course material, as well as integration of the material with their own personal and/or clinical experience. 50% class attendance and class participation.
Course Textbooks and ReadingsAuerbach, C. F. & Shiro-Gelrud, E. (in preparation). The psychological structure of trauma and recovery: An integrative model Horowitz, M. J. 9 (1999). Essential papers on posttraumatic stress disorder. New York and London: NYU Press. Stout, M. (2001 ) The myth of sanity: Divided consciousness and the promise of awareness. New York: Penguin. Siegel, D. J. & Hartzell, M. (2003). Parenting from the inside out: How a deeper self understanding can help you raise children who thrive. New York: Jeremy P. Tarcher.
Recommended ReadingsHerman, J. L. (1992). Trauma and Recovery. New York: Basic Books. Siegel, D. J. (2001). The developing mind: How relationships and the brain interact to shape who we are. New York: Guilford.
Course SequenceSession 1. Introduction. Structure of the course. What is trauma? Approaches to trauma? Auerbach and Shiro-Gelrud, The psychological structure of trauma and recovery: An integrative model
Session 2. Defining trauma I. Simple trauma and PTSD Horowitz, Wilner, Kaltreider, & Alvarez, Signs and symptoms of posttraumatic stress disorder. Reading 1 in Horowitz
Session 3. Defining trauma II. Complex trauma Terr, Childhood traumas: An outline and overview. Reading 3 in Horowitz Herman, Complex PTSD: A syndrome in survivors of prolonged and repeated trauma
Session 4. Explaining trauma I. Cognitive Social constructivist approaches Auerbach and Shapiro, The psychological structure of trauma and recovery: An integrative model 9/11 interview to be analyzed
Session 5. Explaining trauma I Cognitive Social constructivist approaches Auerbach and Shapiro, The psychological structure of trauma and recovery: An integrative model 9/11 interview to be analyzed
Session 6. Explaining trauma I. Cognitive social constructivist approaches Auerbach and Shapiro, The psychological structure of trauma and recovery: An integrative model 9/11 interview to be analyzed
Session 7. Explaining trauma I. Cognitive and social constructivist approaches Auerbach and Shapiro, The psychological structure of trauma and recovery: An integrative model 9/11 interview to be analyzed
Session 8. Explaining trauma II. Trauma and the self. Dissociation.
Putnam, Pierre Janet and modern views of dissociation. Stout, The myth of sanity
Session 9. Explaining trauma III. Trauma and the self. Dissociation. Putnam, Pierre Janet and modern views of dissociation. Stout, The myth of sanity
Session 10. Explaining trauma III. Trauma and the brain. Siegel, The developing mind or Siegel and Hartzell , Parenting from the inside out
Session 11. Treating trauma I. CBT approaches. Lang, Imagery in therapy: An information processing analysis of fear. Reading 21 in Horowitz
Session 12. Treating trauma II. Psychodynamic approaches. Wilson and Lindy, Empathic strain and counter transference. Reading 28 in Horowitz Session 13. Treating trauma III. Body based approaches. Van der Kolk, The body keeps the score: Memory and the evolving psychobiology of posttraumatic stress Session 14. Wrap up
Session 1. Introduction. Structure of the course. What is trauma? Approaches to trauma?
0. Introduction & administration a. Who students are, why you are taking the course, what experience you have had with trauma, same questions for instructor. b. Course orientation & syllabus c. Course objectives. d. Course requirements e. emails for distribution of readings and syllabi. Be sure to print legibly.
1. Two perspectives on trauma: the medical-biological perspectives and the cognitive-social-constructivist perspective.
2. The medical-biological DSM IV perspective a. It is based on linear cause and effect thinking. b. These translate into an analysis in terms of precipitants and circumstances cause symptoms, or make them more probably to occur. c. This is a discourse of diagnosis and cure, in which treatment consists of interventions that reduce symptoms and restore the person’s normal functioning. They return to the way they were before. d. The virtue of this perspective is that it normalized the symptoms. e. The problem with it is that things can’t be restored to the way they were before; it ignores meaning, context, history.
3. The cognitive-social-constructivist perspective a. Trauma described as a disruption of the person’s ability to construct a meaningful experience of self and world. b. These disruptions also occur in normal development, but they are dealt with by normal reparative social interaction. In trauma the day to day processes of healing don’t work, and special assistance if required. c. We will see how trauma disrupts people’s core assumptions, so that they cannot hold onto their pre-traumatic assumptive world, and must construct a new one. Depending on what they do or fail to do the outcomes can be decline, precarious stability, or growth. My research is concerned with facilitating growth. d. The virtue of this perspective is that it takes into account people’s own experience, in particular that things are not the same after the trauma, and they can’t go back. It also raises the question of post-traumatic growth. e. The problem with this perspective is that it doesn’t take into account the physiology of trauma, as well as the real damages of trauma to the person.
4. Need for a both/and perspective, although this course will focus on the cognitive-social-constructivist model.
5. Illustration of the two perspectives with case of a Bosnian refugee traumatized in an automobile accident.
Session 2. Defining trauma I. Simple trauma and PTSD
Diagnostic Criteria for 309.81 Posttraumatic Stress Disorder
A. The person has been exposed to a traumatic event in which both of the following were present: (1) the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or physical injury, or a threat to the physical integrity of others. (2) the person’s response involved intense fear, helplessness, or horror. Note: in children this may be expressed instead by disorganized or agitated behavior.
B. The traumatic event is persistently reexperienced in one (or more) of the following ways: (1) recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. Note: In young children, repetitive play may occur in which themes or aspects of the trauma are expressed. (2) recurrent distressing dreams of the event. Note: in children there may be frightening dreams without recognizable content (3) acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur on awakening or when intoxicated.) Note: in young children, trauma-specific reenactment may occur. (4) intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event (5) Physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event
C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma) as indicated by three or more of the following: (1) efforts to avoid thoughts, feelings, or conversations associated with the trauma (2) efforts to avoid activities, places, or people that arouse recollections of the trauma (3) inability to recall important aspects of the trauma (4) markedly diminished interest or participation in significant activities (5) feeling of detachment or estrangement from others (6) restricted range of affect (e.g. Unable to have loving feelings) (7) sense of a foreshortened future (e.g., does not expect to have a career, marriage, children, or normal life span)
D. Persistent symptoms of increased arousal (not present before the trauma) as indicated by two (or more) or the following: (1) difficulty falling or staying asleep (2) irritability of outbursts of anger (3) difficulty concentrating (4) hypervigilance (5) exaggerated startle response
E. Duration of the disturbance (symptoms in Criteria B, C, and D) is more than 1 month.
F. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Specify if:
Acute: if duration of symptoms is less than 3 months Chronic: if duration of symptoms is 3 months or more
Specify if: With Delayed Onset: if onset of symptoms is at least 6 months after the stressor
Diagnostic criteria for 308.3 Acute Stress Disorder
A. The person has been exposed to a traumatic event in which both of the following were present
(1) the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury or threat to the physical integrity of self or others. (2) the person’s response involved intense fear, helplessness, or horror
B. Either while experiencing or after experiencing the distressing event, the individual has three (or more) of the following dissociative symptoms
(1) a subjective sense of numbing, detachment, or absence of emotional responsiveness (2) a reduction in awareness of his or her surroundings (e.g. “Being in a daze”) (3) derealization (4) depersonalization (5) dissociative amnesia (I.e. Inability to recall an important aspect of the trauma)
C. The traumatic event is persistently reexperienced in at least one of the following ways: recurrent images, thoughts, dreams, illusions, flashback episodes, or a sense of reliving the experience, or distress on exposure to reminders of the traumatic event
D. Marked avoidance of stimuli that arouse recollections of the trauma (e.g. Thoughts, feelings, conversations, activities, places, people.)
E. Marked symptoms of anxiety or increased arousal (e.g. Difficulty sleeping, irritability, poor concentration, hypervigilance, exaggerated startle response, motor restlessness)
F. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning or impairs the individual’s ability to pursue some necessary task, such as obtaining necessary assistance or mobilizing personal resources by telling family members about the traumatic experience.
G. The disturbance lasts for a minimum of 2 days and a maximum of 4 weeks and occurs within 4 weeks of the traumatic event.
H. The disturbance is not due to the direct physiological effects of a substance (e.g. A drug of abuse, a medication) or a general medial condition, is not better accounted for by Brief Psychotic Disorder, and is not merely an exacerbation of a preexisting Axis I or Axis II disorder.
Session 4. Explaining trauma I. Cognitive Social constructivist approachesAuerbach and Shapiro, The psychological structure of trauma and recovery: An integrative model 9/11 interview to be analyzed
Trauma Interview
1) Describe to me an event in your life which you experienced as traumatic.
I worked in the World Trade Center, so I was obviously a victim to the September 11th attacks- the high jacking attacks. I worked on the 60th floor of the South Tower and I was there, obviously, I was in my building when the 1st plane hit (the north tower) and I was on the 44th floor when the (2nd plane) hit my building (the south tower). Yeah, so…. We were not officially evacuated. It was kind of, obviously, no one had ever experienced anything like this before so the first plane hits and it was on the far, north side of the building and I work on a trading floor so it’s all open and all the windows just looked like a ticker tape parade was outside. I just kind of, my reaction was... everybody was flying to the other end of the windows to look out and see what this huge thing was. We couldn’t hear it because the buildings were soundproof. It was weird, I was sitting at my desk and I felt a … wait, how did it go? Was it a rumble? You heard a noise then a couple seconds later you felt a rumble because it went through one building, under the ground and back up ours, so, you know what I mean? They’re soundproof so it was a delayed reaction. The first plane hit and then you saw the lights flicker when it hit, then almost five seconds later you felt the shaking of it. It was the weirdest thing, like a delayed reaction almost- the shaking of it, nothing really clicked in my mind; it was like- that didn’t make sense, why did the lights flicker? Something was off; I thought maybe it was a power thing had blown.
So everyone ran to the windows and I just remember standing there in my shoes being like, I can’t move my feet were like glued to the floor. Slater, who at the time, we were just dating, he was at the desk like right next to me and he was like let’s leave. By the time we decided to leave it felt like it was fifteen minutes, but it was really more like a few minutes. I remember looking around at the older traders and the management, just seeing what they’re reaction was because most of these guys had been there during the bombing six yrs. ago, so I was like, do we stay here? It’s not our building. You could just tell some people, were like, oh it was nothing, let’s just, whatever, go back to work. But we didn’t, we obviously left.
2) Did you go to the window?
I couldn’t bring myself to walk to the windows. It was that frightening to me... someone screamed that a plane had hit. I thought it was like a helicopter maybe that swiped the side. I knew that if I looked there was the possibility that I might see like a body, seeing one person hurt or blood, you know, the minuscule little details I remember like that.
So then the whole mayhem of getting everyone off the trading floor. We went out into one little hallway to go down this one particular stairwell. The whole thing was that our security guard got us down the stairwell. He got everyone out and he was the only one who didn’t make it out. He was waiting around. He had been in the Vietnam War and he was not going to leave his post until he was done with his assignment and he was just really great. He took us to this one stairwell, where the office space below us was empty. So as we were coming down the stairs nobody was filing into us, backing it up, hours and hours as we had heard it had been when the bombs went off (6 yrs. Ago). It took people two hours to get down the stairs, hordes and hordes of people.
I know it was like that for the people on the floors above me. As I learned later, that’s where the plane had hit, people had to go up stairwells, across the 80th floor, and then come down mine- people that were actually below me, floors below me (they had to walk up and around).
We get down to the 44th floor- this happens to be where our lobby is. Our elevator lobby, instead of continuing on down the stairwells… umm…some guy on a megaphone was telling us to come out to the main floor. At this time... I got cut-off on my cell phone. I had my cell phone with me and I already called my mom and she was already hysterically crying. She made me so nervous. I told her I was just going to go outside and it was going to be fine, it’s going to be like a fire drill. In my mind, I thought it was so nothing. My mom was home watching TV. She knew something had hit the first tower, knew it wasn’t mine. She was crying and said, “Please call me when you get outside.” And I said, yes, I would call her as soon as I got outside. I told her we got stuck on the 44th floor and they were making us stop, and she was trying to tell me not to stop, but as soon as I walked through the door out of the stairwell (of the 44th floor), my phone got cut-off so that was the last call I made on my phone.
I remember we were just all standing in the lobby and I was … so it was set-up so that windows were on the south side and everything else is inside, and you can’t see out to any other side of the building or uptown and the south side, where the windows were was where the 2nd plane came around. So it came through kind of like where we were standing. At the time we didn’t know what we were doing we were just standing there and the guy on the megaphone says this building is secure it wasn’t our building, everyone, you can go back to your desks there is no evacuation or whatever... But everyone’s looking at each other- they’re like “no way”. I, in my head, probably would have listened to this guy if everyone else had followed his instructions. I was ready to follow the hordes.
I don’t remember what my thought process was… this is at the point in which I’m not sure if my sequence of events is right or not because it took me forever to put this couple of minutes, this period of time in my life back. For almost a year, I had blocked it out, I couldn’t remember. It’s just a weird feeling. You think you’re totally fine, you’re like yeah I remember walking down the stairs- but no you forget a period of the day which was when the guy gets on the megaphone and from what I remember Slater telling me was that within seconds, I do remember this, within seconds, behind him, he’s talking, there were two TVs, the Morgan Stanley screens. I saw the two towers; I saw the other one that was... tons of smoke was coming out. Oh god, that must be a power generator, or I know, I uh, I remember looking at that and him saying it’s safe go back to your desks and within seconds the bang. The plane hit the building.
They’re designed to sway, but it torqued, it turns like this- we fell forward then back again and that’s the last thing I remember, but I remember thinking it was a power... but the weirdest thing is that we were probably all watching it on the screens … watching the second plane come around, but as soon as it hit, your eyes, you know, you instantaneously you don’t look at the screen anymore, it’s weird, like we probably all watched it happen but don’t… for whatever reason your defense mechanisms just shut it down, so I totally didn’t remember that. We all got thrown like two feet or whatever. People were trampling each other. People were screaming… and this and that and the other thing and we were still pretty close to the stairwell and the elevators.
So we continue down the stairs again and I could see some of the people from my department on the stairs below me I could see and hear the people above me. Guys from my floor calling down to some girls below me. They were all a mess but luckily there was … everyone was kind of hysterical, even some of the guys were worse than I would have expected. I remember being dead silent and just walking. I had, like these heels on. I kept seeing tons of shoes on the stairs, just walking by and I thought about stopping and switching them to flats because my feet were starting to hurt and I was still moving pretty fast. At every floor we would go down, Slater would pull the door open and nobody would be there, it would be dark. And I was like, “Why are you opening the door?” And he’s like, just in case when we get downstairs, if there’s a lot of smoke… And he was very well calculated, he was thinking ahead. So he’s checking every door and there are these women who are just like really overweight, having asthma attacks and freaking out and saying prayers, and we’re all praying together, and there’s two young girls behind me hysterically crying and one guy with them, like one of the girl’s brothers was in the other building and I remember thinking about him the whole way down. I mean, because this is a good amount of time you’re walking now, but you know…
3) At this point you know you’ve been hit?
Yes, but no clue it’s a plane. I don’t even know what I was thinking at this point. It took me a while to figure this all out. I could have sworn…I mean, it must have been such a frightening blow, to the building, that I really must have shut down. All I was thinking was getting down to the floor, floor one. It was like 23, 22, 21... You’d run down and count down another number and pray there was no one coming in on the floors below you. It was the only stairwell where people weren’t filing in. It was kind of the same group of people the whole time. People would stop and sit down…If we had stayed up there 15 min. longer our stairwells could have been destroyed. The plane hit something like the 68-78th floors. We were on the 60th. We were lucky timing was pretty good.
We finally get down onto the concourse and you could usually just go out the door to where the middle was- where the big globe was… you looked out and it was like pitch black. It looked like night out there, and it was a gorgeous day out and I remember looking at it and thinking oh my god, what has gone on here? There were already people lined up. There were fires out there, pieces of chair, pieces of airplane, like, things that I know that I definitely saw …and I’ve talked to everyone I work with and piece little things all together again and we all walked out the same way and looked at the same things, but some people remember them better than others, I guess.
Then we weren’t allowed out there because that’s where all the debris was still falling and people got killed just from pieces of debris falling. So we had to go down the escalators and through the mall and come out on Church Street. Because, when you came out on Church St. there was kind of like an overhang... it was pretty well executed by the time I got downstairs. It took about 20 minutes. It was unbelievable. People were like running, but at every post in the hallways there was someone- the port authority and they were just like screaming at us and telling us to turn our cell phones off, to keep walking, and head-out this way. That was a huge thing. I remember being so scared, thinking, what if something happens to us now when we were so close to getting out? I remember being so scared at that. Never in a million years, at any point, did I ever think the building was going to come down. So I get outside and none of us had a clue.
The last picture, in my mind, of being inside the Trade Center, was having to go down the escalator to the mall and back up again near Borders. And just seeing the faces of all the firefighters as they first started to come in. I guess they had already been in the first building but the first one was the one all the guys were going into, running up the stairs. By the time I got there, they were probably random guys who were off duty or something, and I remember their faces; I remember how good-looking just young, healthy guys just going in to go do their jobs. And that was something weird- that I could remember that, their faces but I couldn’t remember the faces of the people I was standing with when the plane hit our building. That period of time on the 44th floor that I couldn’t remember.
Then we got outside and they were like don’t turn around, keep walking, don’t look back, but obviously, we had to look back, to see what happened. I need to look at the building. You had to really look up to see. It had to be the bluest clearest sky ever and looking up to see the giant orange flames- the whole building and thinking it must have been another plane cause it was a clean break. The first building didn’t fall into the second building, which is something I thought. I mean, no one had a clue. We got outside and it was like a war zone. It was crazy to see…There was no barricade or cops, random people of authority, but there was no order. And it was the scariest feeling to see something like that in New York, so freshly made, just happened- it was the weirdest thing.
I crossed the street and there was a guy that was having a seizure and I remember that so clearly, do I stop and help this guy? Do I turn around and find everyone I work with? It was just mayhem. There was this one guy I work with who was holding the door and I was like, “what are you doing?” He said that the head of our department told him to just stand there and tell everyone to go to Varick Street, our emergency location to continue business- you know… No one was thinking straight. We told him, you can’t stay here, you need to leave. So he was coming with us. So, we crossed Church Street, right in front of Century Twenty-One, right by the Millennium Hotel, where that guy was having the seizure and people were helping him. Then we crossed the other corner and there were people in streets with cameras, everywhere. I was in total shock at this point, shaking random people asking them what happened. There was a giant puddle of blood in the street with random newspapers in it. I remember being so freaked out by sight of it, aside from some other things I saw that have started to come back to me. I remember seeing that and being freaked out by that and Slater being like don’t worry that’s someone’s slurpee or smoothie or something and I totally believed it. It’s unbelievable what you... I mean, I’m not a very fragile person or damsel in distress but I could not believe… I just shut down functioning. I just kept following…I obviously, I mean, Slater was taking care of me. It was like five blocks and the building fell behind us.
We walked down John Street towards South Street Seaport. We wanted to get toward the FDR/Brooklyn Bridge area, walking east. It was smart because we wound up getting to the water quicker- we weren’t stuck in the cloud of smoke and debris falling after that.
But, we were close enough to it, that, cause I had remembered turning around because I was waiting for Slater who was going to get us bottles of water at this bodega, and I turned around when he was coming out of the door and I looked up behind and I saw the twin towers; meanwhile, clear as day you could see people jumping out, this whole time. I was transfixed on that. That was the most awful thing for me to see, when I came out. What is so bad up there? It made it such a reality. What is so bad up there that you would choose jumping out of that building instead of waiting for someone to come help you? That was such an awful thing. It wasn’t just one person doing it either, that’s why it was like mass hysteria to me. What’s going on that is so awful? Then, uh, it was weird; it just dropped right below the skyline. When you’re downtown it’s tough to see Trade Center if you’re anywhere near Wall Street, cause the buildings are all tall. But we just happened to be in a clearing and it just fell, like a movie scene, right out of the sky and that was it, in an instant, not even an instant, the second it moved, not even a millisecond, I was like- that’s it, my life just changed.
I knew there were still thousands of people behind me that still had to take the 20 minute walk it took me to get out, that I just left the building ten minutes ago. Forget it, then, I was hysterical because my mom thinks I’m dead because I hadn’t called her The last time I talked to her I had been on the 44th floor and had got cut-off and it was the last phone call I made and she knew…and I felt it was it was hours ago, but it was really only half an hour or so, but, there’s no way in her mind when she’s looking at the building where it hit, it looks like exactly where I worked, which is a very scary thing to go back again and watch on TV. I mean, I can’t, you know…She, literally, I mean, my family definitely thought I was gone because it took me 2 hours to get through on the phone. Pay phones weren’t working.
The whole way up, the walk from downtown to here (14th Street and Avenue A) Slater was hitting redial, redial, redial on my phone and it went through, randomly, somewhere down here, near the power plant, after the second building had fallen. I mean, obviously, you can imagine what kind of phone call that was. He had to speak because I couldn’t. He said I have your daughter here, she’s alive. You can imagine having to tell your mom that you’re alive? I couldn’t even absorb what was going on around me. I knew what it was like for them at home- they’re sitting in front of the TV, and I know I’m alive, and Slater’s telling me, you’re alive, just keep moving, you’ve got to keep moving. So I keep moving, but I really just wanted to get to a phone. People are saying the Pentagon is hit, the White House it hit, I’m thinking it’s WWIII, but really the focus of my attention was just the fact that I needed to call my mom to let her know I wasn’t dead, because I knew what she was going through. That was the hardest time for me.
Then after we talked, it was like your adrenalin wears off and you can feel it, it was like pins and needles and I was sitting in here (living room) and it was right outside this window, you used to be able to see it perfectly, just the Trade Center, perfectly. So, I was watching it on TV- they were there (the towers), then they weren’t there. And I’d watch it again; they’d show it again, the news was replaying it over and over again. I was seeing an empty thing in the sky that was just bugging me out, and so then we left. We walked up to the ferry, we took the last ferry. It was on 36th Street (east side of Manhattan).We walked to that ferry, the last one out of the city. I didn’t care where it was going to take us. It could have been Queens, I didn’t care, we just wanted to get out of the city. It went around the southern tip of Manhattan. You could see the huge dark clouds. There were people at the Seaport with masks on their faces waiting for a way to get out and we sat on the ferry with people covered in dust, telling their stories of how their friends were decapitated. I was just sitting there numb.
We get down to Atlantic Highlands (NJ) and there was already this giant triage that had been set up. We had to take buses from where the boat was. I told my dad I would be at Atlantic Highlands. I didn’t know where Atlantic Highlands was, I just knew that’s where the ferry was taking us. We got there after an hour and it was like mass amounts of buses, you couldn’t get anywhere near the place, so you had to get on this bus and I was like, oh great, I have to get on this bus and he’s never going to find me.
They bused us to this other place, this compound that was set-up; it was maybe a public school or something. The bus pulls into the area, you can see ahead, there’s like a line, there’s this giant carwash people have to go through, if you come from Manhattan. The Red Cross had set-up tons of food and water.
Then when the whole… the bus pulls into the thing and then I look down the side of the bus and walking into the whole place, on the sidewalk, is my dad, just walking, right next to the bus. It was the weirdest thing. There were thousands of people there waiting to pick up their family members and he was running alongside the bus jumping and down banging on the window. The window was tinted. I couldn’t believe that he looked in and saw me first. I was going to stop the bus driver and be like wait, you don’t understand what just happened to me, there’s my dad, but meanwhile, everyone on the bus had just gone through it. He followed us up to where the bus stopped; I think it actually let us out. At that point I would have said anything to anyone and not even have known what I was doing. You’d never stand-up in a public bus and asked to be let out, but at this point, it was normal.
My dad had touched us so we had to walk through this thin, walk through the car wash and get hosed down. Anyone coming from Manhattan had to get washed off. They thought there were chemicals, they thought we had taken back chemicals- they were being cautious. I was amazed how it was set-up. There were priests and nuns and we had to sign our names everywhere we went and write down the names of people we knew were alive.
4) What was it like seeing your dad for the first time?
It was weird because I knew my mom couldn’t come. I knew she was home. It wasn’t like she could greet me there; it was like she had to be home. It was really emotional. We were all crying. A woman, who had been waiting for someone she knew, had been standing with him too and she was crying for him and for us because she knew he was waiting to find me. She said thank god you’re alive, I mean I didn’t even know this woman, you know. We got in the car and drove home and listened to the news for like an hour on the way home and I was like a zombie and soaking wet and miserable.
We pulled into the driveway of my house and my sisters came out and my mom was so traumatized, probably more than I was. She couldn’t even walk outside the door. I had to walk in. She was holding herself up in the doorway. It was so bad. She told me she thought she lost her first child. It’s funny, she said when she saw the tower fall, she fell to the floor, and when I saw it, I fell to the ground. My muscles…..it wasn’t like I fainted, I mean it was, but I was still awake. Slater had picked me up, right as I fell onto the pavement, in the middle of the street. It was so weird… the physiological effects. Right away, how that happens. So, it was a really emotional homecoming. I didn’t leave home for a while but we did go back to work pretty soon, two or three days later, to this emergency sight in Jersey City, where we’ve been ever since.
5) How did you feel after the event?
It’s funny I guess obviously sadness. Just, I was angry and very overwhelmed. Everyone in our country, especially where we live have never experienced. I thought of everyone else. There were so many people in our town (Short Hills, NJ) that had lost fathers. My sister’s friend’s father’s funeral and my mom was spending time with them, going over to their house. I remember thinking…. I was never that freaked out about how I almost died. I remember just being so sad for those other people.
It took me a really long time until it started becoming a personal thing for me. That sounds weird. But when the publicity of the pain and tragedy started dying down a little bit is when I started feeling it. I started to re-examine what happened, but I always had Slater to talk about it with. It was so good. The good thing was that I didn’t have to talk about. People always want to know where you on Sept. 11th. At work I didn’t have to talk about it because we all experienced the same thing so I didn’t have to tell the story everyday. It was really… I can’t explain it…I just sat there everyday in disbelief – I couldn’t believe how close I was… how did I walk out of there without a scratch on me? There were people who didn’t even work there who got killed because a piece of something hit them, you know? The odds were freaking me out really. What if? What if? What if? You have to stop doing that to yourself because it did happen. I remember driving, not me driving, if I was in a car, that whole period, I was an absolute nervous wreck- thinking that every car was going to hit us. That we were over the line on every lane. It was so weird. It took a while. The first few nights I didn’t sleep and I did have to start taking something. I had major anxiety.
6) How long did you stay in NJ?
A pretty long time. For almost three months. I went back to the city after three weeks to get my stuff. It was a long time. I was commuting to Jersey City (from Short Hills) and I didn’t have to go through a tunnel or bridge which I was scared of doing.
7) How did you feel some time after that? Did you need to talk or remain silent?
I really liked being home because I didn’t have to talk about it that much and Slater lived with us for a while. Being back home, around family, was the most comforting thing. I knew I could shut the world out if I wanted. I wasn’t ready to deal with real life again on my own, to come back here (apt. in NYC). It was weird coming back here, sleeping in my bed again and looking at the skyline. When I first came back here was when I first decided to talk to someone. It was a month after… just once. A psychiatrist. He sat me down, I told him my story. It was weird; because it was clear he had never handled a tragedy like that before. He could have dealt with the biggest psychos in the world… but yet he couldn’t…He said he didn’t know what he could do for me, that I was pretty well aware and had a grasp on what I’d gone through. He said he’d never helped anyone who had been through something like this. I walked out of there and was like… that wasn’t very helpful. He gave me someone’s name who specialized in trauma, but I wound up never making the call because I felt I was doing fine.
I was feeling like I was getting back to normal and then my aunt got sick. She was sick before Sept. 11th; she is my god mother, one of my best friend’s. She has no kids, she’s divorced- she was always fun to visit on vacations. She lived in Florida. She went into the hospital on Sept. 11th with some random lung disorder that she had been battling with for about a year but it was never bad. She would take and antihistamine and be fine. I spoke with her that night (9/11) and told her I was okay; I had gotten out and told her, “I love you”. The next day she went into a coma and then she needed a lung transplant. By the time you find out you need a lung transplant; you’re so far down the road…she just passed away- on 9/28. That was when I had first gone back to the city. I got my stuff and went back home. It was a really fragile time, especially for my mom. We had services for my aunt and the next week I started going back to work, regularly. There was a new kind of pain, although, I was almost fine with it. I knew she was okay then, and I had seen so many deaths. All those people died that one way and her death was in some hospital in Florida. A very weird feeling.
Then two weeks later my grandmother passed away. So, it was obviously… I mean I guess that’s as bad as a year gets. It was really hard for my mom. Her sister, then her mom… My grandmother lived in Short Hills. Her heart just stopped, it was like a sign to us that she couldn’t deal with everything. So we had another funeral. It was the worst on my mom. She said then worst day for her had been Sept. 11th because she thought she had lost her child for a 2 hour period. I was trying to be sympathetic to her and I was just depressed, you know. I wasn’t motivated to do anything. I just sat on the couch all the time.
8) How and when did you start to feel better?
I remember things started to get better around Thanksgiving because I remember that being the first holiday and I remember sitting around the table and everyone was kind of like being thankful for a lot of things and I just remember feeling better because everyone was just being so amazing, like everywhere you went, New Yorkers, neighbors, people were, there was a tremendous outpouring. People were cleaning up Ground Zero and volunteering and that was a really good feeling. It was like that one time in the world you knew wasn’t going to be like that ever again. I just remember feeling better, I guess, then. But then Christmas got hard again. You know I just never really got to, it was just like within one day, I got…. Aside from all the tragedy, all the sadness and the deaths, I still left New York City one day and was never able to go back to work there. I’ve been in Jersey City everyday since. It’s like a closure thing. I had never gone back down there until the anniversary.
9) What was that like?
It was weird because it was really touristy and it was really bothering me that there were people making money out of it. There was tourist stuff everywhere and it was dirtier and just giant fences up so you couldn’t get really close, and you know the blocks were lined off because the President was coming down, and because of the ceremonies it was a lot harder to get to than it is now. I remember being really really angry that I could never walk back into the buildings again. I just missed… it was the greatest… I loved working down there. I loved those buildings; I thought it was the greatest place to work.
10) Did you feel better having gone down there on the anniversary?
I did, because the week previously, the actual anniversary and the week after, was probably, I felt, worse than I had remembered feeling since the day it happened. It was a raw. It was almost a sadness that had been so long had passed and had been forgotten, so many months had gone by- then it comes back and you knew the day was coming and the hour was coming and there was nothing you could do to stop it from happening again. You knew that you couldn’t erase it in history. It was the date and it was a year ago. And I was remembering what I was doing that morning, I remember everything, I remember the security guard, and I was rushing in the door to get to my meeting and it was all coming back, it was so sad to me. I had to go back. I wanted to do something. I had never done anything; I wanted to in a weird way, it was like paying respect to all the lives that had been lost around me. I wanted to do the same walk back that we had originally done, that was the plan. I wanted to re-trace our walk back, but, it was so crowded and I was just burnt out and tired. I had been at work and we, everyone just kind of went in to kind of be around each other in a weird way. The market didn’t open until 11 and everyone was kind of zombie-like. We had moments of silence and I just, it was… to step away from the shock of it… because there was no shock. The shock had worn off. And then it was just reality. The anniversary was just the pain of it again and reading the names and seeing the faces and hearing the stories and that stuff. I mean, whether you worked in the building or not or you were a survivor, I mean everyone in New York, everyone close to here was affected by it in some way or another. Just knowing people down there… It was hard for everyone. I just felt like another face in the crowd, that way.
11) Did anyone or anything help to get the process started? Slater (fiancée) or anyone else?
We got engaged in June. And that was a whole uplifting time. It was a really happy time. It was a good thing because it was a happy thing to happen to our family too and that was good because I knew… It was the beginning of the summer. It made it a lot easier because I knew… When summer came around I was remembering what we were doing at the end of last summer and it was getting to be that point. I don’t know, I had him and I was really glad that we had gone through it together and we were ready to, not put it behind us, but we knew it was something that would never be forgotten because it would be between the two of us forever and it … you know… I knew before we got engaged that we were probably going to spend the rest of our lives together but, he definitely, if I didn’t have him, I don’t know what I would have been like. I would have felt very alone. I probably would have felt like… I could talk to some of my friends about it. I could talk to Dana because she worked across the street; she saw these things first-hand. She saw some of the things I saw that you can’t get out of your head no matter how hard you try. But other friends, I mean, how many times can you tell the story? You just don’t want to anymore. It’s not like they don’t want to hear it, but you don’t want to tell it because yo |
Dr. Carl Auerbach, Associate Professor of Psychology, received his Ph.D. in Psychology from the University of Pennsylvania in 1968. He is the co-director, with Dr. Louise Silverstein, of the Fatherhood Project. His research interests are the evolution of family structures, and the psychology of trauma.
