The children I’ve treated in my psychiatry practice were my greatest teachers. Especially instructive were those who lost parents on 9/11, and others too young to understand how their loved ones’ emotional scars affected them.
How can children manage recurring memories of planes taking down the skyscrapers that defined their childhood landscape? With help, many did. While we can’t “make sense” of senseless tragedy, children can be stunned by grief yet move toward meaning and purpose following loss. Their growth and emotional work inspired me, helping kids for 25 years.
The attacks showed no two children experience the same event with identical feelings or reactions. Some developed anxiety or deep depression. Some had few concerns; others couldn’t return to school or urban life, anticipating more attacks.
I worked with children who relived panic and flashbacks, and met others who didn’t necessarily make connections between the attacks and the impact on their families. Some needed reliable support; others internalized attention as a loss of privacy while grieving. There were children who no longer wanted to do homework because it reminded them of a lost parent who used to help them, and others who wanted to move on as seamlessly as possible.
9/11’s children also showed me trauma’s impact isn’t confined to one family member.
One family had four children whose reactions to their father’s loss ranged from shock and disbelief to hope for his return. Their mother sought direction as she managed each child’s grief, and her own. She fielded several calls regarding her husband’s remains, then struggled whether to tell her children about each. Her tremendous decision not to share every notification, though unseen by her children, quietly demonstrated her ability to move forward without asking permission from the past.
Trauma like 9/11 can turn a family dynamic upside down when a parent is lost. Some young patients react by stepping into parental roles, like the 18-year-old whose father died when the North Tower collapsed; he’d stayed to help others out of the building. As she coped with those details and the loss, the patient experienced flashbacks. She opted to delay starting college, reasoning she needed to support her family because her mother was too fragile to do so. But as the teen underwent treatment, she became able to make decisions about her future based on her family’s needs, not perceived guilt.
That decision took strength, a quality just beneath the surface of the grief these children and their families carried. I had the privilege of watching them direct that strength toward rebuilding solid emotional ground for their futures. They used it to rebuild shattered safety. Over time, they employed coping skills to keep grief from overpowering them, allowing them to move forward based on what was best for them, not on their worst fears about the worst day of their lives. They learned to seek and create meaning, healing to reach milestones like today.
What my colleagues and I learned from working with the children of 9/11 — from their struggles to their strength — helps today’s kids cope with the aftermath of school shootings, displacement following natural disasters, domestic abuse, bullying, and more. In regaining purpose following tragedy, I’ve learned, the children of 9/11 have generously and unknowingly paid it forward with their own playbook, one of strength, insight, and hope for subsequent generations.
Fornari is vice chair of the division of child & adolescent psychiatry at Northwell Health’s Long Island Jewish Medical Center and professor of psychiatry and pediatrics at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell.