The 10th anniversary of 9/11 has set in motion a week of non-stop media coverage that will culminate today with commemorations at Ground Zero, at the National Cathedral in Washington, DC, and in Shankesville, Pa.—the three locations where the planes seized by the 19 Al-Qeada terrorists crashed, leaving three mass graves. Much of the public discussion has focused on the “meaning” of that catastrophic day in light of the decade that followed. Two endless wars and the loss of immense blood and treasure; atrocities like secret renditions and torture; absurdities like the color-coded terror alert that were, like more and more government policies generally, cynically manipulated for partisan political ends; a financial meltdown and economic recession of a severity not seen since the Great Depression.
It almost comes as an afterthought that Osama bin Laden, the nearly forgotten mastermind behind the attacks, was finally assassinated, in a quick and slick operation by a small team of Navy SEALs, counterterrorism at its most effective.
Ten years later, only the silly color-coded threats have been corrected. Other moral, economic and political lessons have gone stubbornly unlearned, even unrecognized. A darkening 10 years, many Americans agree, with recent polls finding that three out of four say they and the country itself are “worse off” or “going in the wrong direction” since that fateful day. In this light, recalling September 11, 2001 as a “national tragedy,” “a hinge of history,” and a “collective trauma”—all frequently heard terms this week—takes on an added grievous dimension.
But for some Americans—above all, those survivors who were directly exposed to the catastrophic collapse of the Twin Towers and the aftermath’s long rescue-and-recovery labors at Ground Zero—9/11 was a tragedy and a trauma of a more personal, daily and lasting order. These are people who experienced terror, captivity, powerlessness; who came face to face with mortal danger and what psychologist Robert Jay Lifton, the pioneering theorist of Post-Traumatic Stress Syndrome (PTSD), called “the death imprint,” the overwhelming, unassimilable presence of bloody and burnt bodies and body parts in the hellish landscape of ash and smoke.
PTSD was one serious psychological risk faced by the thousands of survivors and many more participants in the prolonged rescue and recovery operation. Another equally serious, and directly related, risk was substance use, abuse and addiction. Both legacies of 9/11 have gone almost entirely unmentioned in the media’s backward glances at the event, though both have irrevocably changed the lives of large numbers of people over the past decade.
“I couldn’t see my hand in front of my face. The world went silent,” Marcy Borders said. A photographer took a picture of her so haunted and haunting that it ran worldwide and immediately became one of the most iconic shots of 9/11.
Consider some of the statistics:
Thirteen percent of the population of Manhattan showed signs of PTSD or depression in the wake of 9/11.
On 9/11 and its immediate aftermath, the relapse rate of the city’s heroin addicts soared, with one half of the recovering addicts in local outpatient clinics and 37 percent in methadone programs taking up the needle again.
Proximity to the World Trade Center on 9/11 was found to be significantly associated with increased alcohol consumption in the first four months following the attacks.
By December 2001, Columbia University’s National Center on Addiction and Substance Abuse (CASA) was reporting that cities and states all up and down the East Coast were already registering an increased demand for alcohol and drug treatment; by April 2002, 23 states were logging an increased demand, according to CASA.
In the year after 9/11, a survey of some 265,000 people who had been in the city on that day found that 226,000 consumed more alchohol than they had in the year before the attack, 89,000 smoked more cigarettes, and 9,000 used more marijuana.
In the wake of the disaster, New York City’s Fire Department was left coping with an ever-worsening drugs and alcohol problem; in the spring of 2004, the number of FDNY firefighters and EMS workers being treated for substance abuse was 50 percent higher than in 2003.
While many survivors and first responders proved resilient and emerged relatively unscathed, others have found recovery far more elusive. And as is inevitable in the wake of every deeply traumatic event, the use and abuse of alcohol and drugs to self-medicate has only raised the bar and the stakes of recovery.
Few survivors hit a deeper and longer bottom than Marcy Borders. Borders, now 38, had been at work in the Bank of America office high in the North Tower when the first plane struck. Ordered by her boss to stay at her desk, she soon panicked and, bolting, began the long, slow descent down the emergency stairs, with thousands of other trapped souls, to the street. She will never forget what she found there. “There were wounded and the injured everywhere,” Borders told the New York Post in June.
Stunned, she barely escaped the North Tower’s collapse a few minutes later. “I couldn’t see my hand in front of my face. The world went silent,” she said. A stranger led her to safety in a building lobby, where a photographer took a picture of her so haunted and haunting that it ran worldwide and immediately became one of the most iconic shots of that day. It came to be called “The Dust Lady.” It shows a thin African-American woman coated head to toe in yellowish-white ash and dust, with only the gold of her tastefully “professional” necklace showing through. Her face, thick with the sickening powder, expresses a shock and horror beyond words; her hands grope blindly in a featureless scene of ash and dust.
Immediately after 9/11, Borders started drinking heavily. “It was like my soul was knocked down with those towers,” she said. “I was convinced Osama bin Laden was planning more attacks. Every time I saw an aircraft, I panicked.” Falling prey to crack cocaine addiction, she watched helplessly as her partner left her and her two children were taken away from her. “My life spiraled out of control. I didn’t do a day’s work in nearly 10 years, and by 2011, I was a complete mess.”
Last April, realizing that she had to choose between living and dying, Borders entered a New Jersey rehab hospital. On May 1, in a case of remarkable serendipity, she learned with the rest of America that bin Laden was dead. She felt liberated, and the event served to catalyze her rehabilitation. “The death of bin Laden helped focus my recovery,” she said. “God got rid of my biggest fear.”
Recovering addicts know that geopolitics don’t cure the disease; only the support of Borders’s rehab program and her own steadfast will helped her get clean and sober, regain custody of her son, age 3, and daughter, 18, and even welcome her former partner back home. When her story appeared in the Post, its symbolic weight struck a chord with many readers, who likely projected the darkness of that terrible day onto her own terrible decade. It was easy to take comfort in the intensely personal closure the murder of bin Laden afforded her, and her story became immediately popular, making it as far as Calcutta, and precipitating a barrage of internet traffic around her name. On September 6, she even appeared on The View, looking aglow with health and smiles and reporting that she had been sober for 145 days.
The use of alcohol and drugs has long been a common response to PTSD, with abuse and addiction a result. Although The Fix was not able to confirm that Mary Borders has a PTSD diagnosis, many of her symptoms fit the profile of a trauma victim. Researchers have repeatedly drawn a strong statistical link between PTSD and drug and alcohol abuse; as many as 75% of combat veterans with PTSD are also alcoholics or addicts. Other studies show that the more severe the trauma, the more extreme the addiction is likely to be. In this context, one only has to glance at that ghastly, ghostly image of “The Dust Lady” to see into the depths of what Mary Borders’ rock-bottom days must have been like.
“Alcohol would make me numb,” Borders said, “and it helped me forget being trapped in the Tower—and looking at that photograph.” The reasons for the co-occurrence of addiction and PTSD are complex, and the research supports a range of theories. In one popular view, the syndrome caused by trauma is marked by a self-reinforcing pattern of intrusive feelings—an intense reliving of the traumatic event—followed by psychological constriction or numbness. Victims use drugs and alcohol in an attempt to regulate these extremes and to recover a lost sense of well-being; with development of tolerance, substance use increases and can spiral into abuse and finally addiction. Paranoia, like Borders’ obsessive fear of bin Laden, is also associated with PTSD, and can equally drive a victim to substance abuse.
A strong statistical link exists between PTSD and drug and alcohol abuse; as many as 75% of combat veterans with PTSD are also alcoholics or addicts. And the more severe the trauma, the more extreme the addiction is likely to be.
Symptoms of PTSD were widespread among people who were in New York City on 9/11; at least 10,000 survivors and first responders were diagnosed with the syndrome. But the actual number of victims is likely much higher, since the numbers don’t include those who consulted private doctors or who got no treatment at all—a category likely to include many who self-medicated with drugs or alcohol. And yet the funds set aside to compensate and treat 9/11 survivors are unavailable to people with “only mental and emotional injuries.”
Because it was a major, public trauma, “9/11 changed the picture of PTSD, and transformed it from being simply a mental disorder that psychiatrists deal with to a public health issue,” Dr. Charles Figley, a professor of disaster mental health at Tulane University, told the Los Angeles Times. He added that researchers now believe that how well communities recover from mass violence is a barometer of their overall mental health. Sadly, people who are low income, who are vulnerable because of their immigration status, or who are members of a marginalized demographic are more prone to PTSD, perhaps because the stress of the trauma is added to the routine stress of daily life.
PTSD can create an echo chamber in the victim’s mind, where any reminder can force a replay of the trauma. Simply living in the same city can be a trigger. Dr. Figley noted an important difference between wartime trauma and the trauma that many suffered on 9/11: “You go into a combat zone and then you leave. You don’t leave home. You return all the time.”
And so it’s no surprise that PTSD symptoms—and relapses from recovery—tend to reemerge around important anniversaries of the traumatic event, causing paranoia, anxiety and depression. As we go into this weekend, with the dedication of the 9/11 memorial and the revelation of new artifacts, such as the Times’ release of new audio from that day, many 9/11 survivors and addicts will face both heightened stress and increased risk of relapse.
There is no drug to treat trauma, no quick fix (although certain medications help control the symptoms). However, new research shows that people who suffer from PTSD benefit from the support of family and friends. This weekend, if we do more than pay lip service to coming together around this anniversary, and reach out to anyone who was damaged by the event, we can help restore, even in a small way, the trust in the universe that is shattered by trauama, “One of the healing factors was the community,” says Dr. David Spiegel, director of Stanford University’s Center on Stress and Health, who was in New York City on 9/11. This kind of support is also what many recovering addicts and alcoholics rely on to prevent a relapse.
So, this weekend, Marcy Borders may be the lucky one—lucky to have won through to sobriety, and to the return of her family, and to the sympathy and support of the entire city, who now know the “The Dust Lady,” a decade later.
Jed Bickman is a frequent contributor to The Fix. He also writes for The Nation, CounterPunch and other websites and magazines.
