UP CLOSE AND PERSONAL: SEPTEMBER 11, THROUGH THE LENS OF A PSYCHOTHERAPIST

The author, a Manhattan-based psychotherapist situated less than 2 miles from the World Trade Center, provides numerous, graphic clinical vignettes of how patients, some of whom actually witnessed the September 11 attack, reacted to the devastation. Two stages are delineated: an initial one in which patients experienced a raising of existential consciousness, a desire to prioritize their lives, an upsurge in the need for meaningful human contact, and a manifest concerted effort to relate in a more compassionate manner, and a second stage, seemingly a backlash to the first, in which patients, now angry, retreated into frank narcissistic preoccupations. Patient dynamics are then placed in a broader context and examined from Christopher Lasch's concept of a culture of narcissism and from Winnicott's formulation of a true and false self. Drawing on his own extensive studies of the self, the author explores the dynamics of what he calls the pervasive inhibition of intimacy, narcissistic giving, and the danger of a mental health profession that yields to pressure to deliver unrealistically rapid symptom relief.