Treating Anxiety
Which therapy technique works best?
By Sarah Glazer

The terrorist attack on the World Trade Center sent thousands of terrified people running for their lives. Many of those survivors — and perhaps tens of thousands of other New Yorkers — are now showing classic symptoms of the anxiety disorders that typically develop after a horrifying event. America's largest mental health emergency has turned the spotlight on the debate over which treatments. . . .

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Is PTSD an “invented” disease?

Derek Summerfield Honorary Senior Lecturer, Department of Psychiatry, St. George's Hospital Medical School, London. From British Medical Journal, Jan. 13, 2001	Arieh Y. Shalev Professor of Psychiatry, Hadassah University Hospital, Jerusalem. From British Medical Journal, Jan. 13, 2001

The Day the Sky Fell — A Mother's Story

On Sept. 11, Rachel Leventhal had planned to shop for clothes for her 3-year-old daughter at the World Trade Center's underground mall, a mere six blocks from her home.

Her daughter Zoe was still in her pajamas when they both heard a plane fly directly overhead, so low that they could see a bizarre shadow cross the front window. Three seconds later, Leventhal and her daughter were startled by an unusually loud sound. Unbeknown to them, it was the first plane crashing into the famous skyscraper.

The scene from their window looking onto Broadway resembled a Superman movie. Hundreds of people were streaming down the street gasping and pointing downtown in horror. Downstairs on the street to investigate, Leventhal felt an earthquake-like boom.

“Time started to move really slowly. We looked and there was a gigantic hole in the Trade Center,” Leventhal recalls. Neighbors on the street were saying it must have been a drunken pilot, but Leventhal had a terrible feeling it wasn't over yet.

She took her daughter upstairs and tried to keep her busy making crafts. Then she turned on the TV news. As the second plane was striking the second tower on live TV, she heard and felt the explosion. Her floor shook. There was another huge rumble.

“I screamed to Zoe to get away from the windows and threw her down on the floor,” she remembers shielding her daughter with her body. “I thought we were being bombed and the house was about to come down on top of us. You couldn't see outside; it was blackened with smoke and debris.”

Her husband called from his office and told her to get out of their Tribeca neighborhood right away. Grabbing a toothbrush and thrusting Zoe in her stroller, Leventhal fled the building. Just as they reached the street the second tower came down. “I was worried it was a nuclear bomb. Debris was snowing all over us,” Leventhal recalled. “Smoke and clouds of debris enveloped us.”

At first, Zoe looked up at her mother and smiled, saying, “A bad Pokemon hit the building.” Her mother answered, “No, this is a real thing.”

They began a long, terrible run uptown, away from the trade center, weaving their way through thousands of New Yorkers who were looking back at the towers gasping and crying. Zoe became hysterical, crying, “Don't stop here!” each time her mother stopped.

Finally, Leventhal reached a church where parishioners were standing outside offering help. “I'm Jewish, but I thought, 'This is what churches are for.'” A group of African-American women standing on the church steps, greeted her with: “Praise the Lord, you're OK.” Leventhal stayed with them until her husband, whom she reached by cell phone, arrived.

Leventhal and her family spent the next two weeks in her mother's apartment uptown. That's when she and her daughter started to experience classic signs of traumatic stress.

“I couldn't eat. I lost 15 pounds,” she recalls. “If my mom was 10 minutes late getting back from her health club, I was scared. I couldn't sleep at all.” The fear had gripped her so deeply, she says, that her sleep felt more like restless hallucinations than dreams. Her daughter obsessively replayed the Twin Towers' collapse in the form of Pokemon figures knocking down towers of blocks. Such repetitive re-enactments are a classic sign of trauma in children.

Gradually, Leventhal started taking her daughter to nursery school in their Lower Manhattan neighborhood even though their apartment was still off-limits. For the first three weeks, Leventhal stayed at the school for six hours a day, afraid of another terrorist or anthrax attack. “I didn't know if I would have to save Zoe,” she explains.

Eventually the teachers started sending Leventhal to the local coffee shop at lunch time, pleading with her to eat something. She started volunteering, making food for Ground Zero workers at a local restaurant.

The family has finally moved back to their Tribeca apartment. “I'm doing really well now,” she says. But her plans to go back to work as a children's book writer are on hold. She says she cleans house and exercises “obsessively.”

And some days, if she hears a tale like the one about the Catholic priest who administered last rites to firemen entering the towers on Sept. 11, it sets her back a few days. “I feel very sad, depressed. I have vivid imagery of the firemen. I can imagine the scene as they went to their deaths. I think maybe I'll leave the city. It's hard.”