Over a decade later, we likely are still seeing the psychological reverberations from the September 11th terrorist attacks.
Two similar instances of airline chaos hit the news circuit recently, when a Jet Blue pilot and an American Airlines flight attendant erupted in manic rants on their respective flights. Both personnel made mention of 9/11, expressing an apparent certainty that their planes would become the target of another terrorist attack. With no substantiated evidence to back their claims, it was evident that their bouts of panic were coming from a place of deep-seated fear or psychological distress, if not an unattended medical condition. Now health professionals are struggling to diagnose what seems to be a trend in on-board hysteria.
The popular assumption seems to be that these scenarios were the result of panic attacks, periods of intense fear in which sufferers experience physical distress. It is indicative of a broader panic disorder, which is characterized by the reoccurrence of such attacks.
Clinical Psychologist and crisis intervention specialist Dr. Leslie Seppinni is doubtful that this is the case. In a phone interview, she explains, “During [a panic attack] you feel like you’re having a heart attack, you feel like you’re dying, you can’t breathe, you feel like you need to go to the hospital. In both of those cases, neither one had those symptoms. In both of those cases, they were more delusional, in which they thought things were happening that weren’t.”
Delusion can be indicative of many conditions, and Dr. Seppinni thinks accusations about the involvement of drugs and alcohol may be closing in on the truth. “Substance abuse may have caused some kind of delusional behavior. We recently saw that, unfortunately, in the Whitney [Houston] case, where people saw her having outbursts in public and everyone was questioning why; well, it was substance abuse-induced.”
But this is not the only speculation. Even if these individuals are found to have been under the influence, we must also consider what may have driven them to use. There is an inclination for distressed individuals to use alcohol and drugs as a means to self-medicate and quell a deeper emotional or psychological issue. We’ve all heard the idiom “drown your sorrows,” and these sorrows may have played a key role in the pilot’s meltdown, in particular.
“It’s also possible that it’s post-traumatic stress,” says Dr. Seppinni, “that [the pilot] has continued to fly ever since 9/11 and he has this in the back of his mind and something triggered it, whether it was the day’s news or something someone said or where they were headed.”
The JetBlue pilot, Captain Clayton Obson, had been flying commercially for nearly two decades. As a veteran in the industry, he was undoubtedly personally and professionally affected by the September 11th terrorist attacks; so why is the possibility of PTSD being largely overlooked?
Dr. Seppinni says it’s a matter of misunderstanding. “People don’t give [pilots and journalists] credit for having post-traumatic stress or panic attacks or anxiety attacks because they think they’re just there to serve them; but they’re people too and, yes, they’re going to be affected by what’s going on. And that’s one of the problems with helping people in various fields who are touched by trauma.”
She goes on to explain that many professionals, pilots included, don’t seek help for PTSD because of the societal pressures to remain strong and in control, or because they don’t realize what their symptoms are suggesting. Depression, alcohol and drug use, anger and irritability, difficulty sleeping and nightmares, physical health problems like migraines and stomachaches, and suicidal ideations are all key indicators that the trauma is manifesting into a more serious issue. A good guideline, according to Dr. Seppinni, is that if you are experiencing at least three of these symptoms, then you should talk to someone.
To some extent, it’s a matter of personal responsibility to seek help; but many are now calling for the Federal Aviation Administration (FAA) and the airlines to reassess their medical screening policies. Typically, crew members do undergo some type of personality inventory or psychological evaluation to ensure that they are of sound mind to fly, but are those initial tests sufficient, particularly if a traumatic event occurs post-screening?
According to Dr. Seppinni, the answer is no. “The question really is, how often do pilots go through some type of mental health check-in for the level of stress they have? I think, overall, for people who are in fields that require you to possibly re-experience a trauma, that companies need to start taking more responsibility for those people, and ensuring that they have counselors available specific to that profession.”
While this has sparked the dialogue about PTSD among flight crews, we must consider the same diagnosis among passengers. For anyone who experienced 9/11, whether a survivor, bystander or just a media observer, there is no denying that this was a traumatic event. It made us question our safety, the safety of our borders and, most directly, the safety of air travel.
As it was, there are few scenarios that play on our fears quite like flying. Movies exploit it, the media may intensify it, and 9/11 unquestionably magnified it. The anxiety about being on a plane could be rooted in psychosis (claustrophobia, pteromerhanophobia, acrophobia, agoraphobia), but even those without a preexisting apprehension may have developed new fears as a result of the terrorist attacks.
Psychiatrist Carole Lieberman, author of Coping with Terrorism: Dreams Interrupted, has seen these fears manifest in the subconscious. She tells InsidersHealth, “Airline passengers are continuing to experience anxiety, and sometimes panic attacks, in flight because air travel is the main place where our psychological defense of denial is stretched to the limit.”
Dr. Lieberman calls this diagnosis “Terrorist Stress Syndrome,” a cousin of PTSD specifically attributable to terrorism. She explains that this condition is characterized by a fear of impending doom and helplessness to avoid it, and can also come with physical ailments such as headaches and inexplicable pain.
For many individuals, these indicators may be dormant until a stressor, like air travel, triggers them.
“Americans are mostly in denial about how memories of 9/11 - and the continuing threat of terrorism - impact us,” says Dr. Lieberman. “But, when we are faced with security checks and strange looking or strange acting people on planes, we suddenly remember.”
The result may be anxiety or even a panic attack, which could potentially endanger that individual or other passengers.
To help the individual cope with this condition, Dr. Lieberman developed an audiovisual program called “Shrink on Board: The Art of Relaxation” that uses guided imagery and therapeutic narration to help the passenger manage their anxiety and reach a state of calm.
Meditation and deep breathing exercises have shown to be effective therapies for coping with all levels of anxiety. Dr. Seppinni corroborates these methods, and also suggests writing a narrative to fill in the blanks of one’s traumatic memory, and talking to a colleague who may have gone through a similar situation. These alternative approaches to medication may prove to be just as successful in coping with PTSD, Terrorist Stress Syndrome or broad-spectrum anxiety.
Ultimately, the greatest “lesson” society can take from these headlines is that PTSD exists despite the length of time that has passed and regardless of the profession one holds. Many of us, and particularly those directly affected by 9/11, are still struggling to cope with unaddressed and often suppressed emotions. And while we may be victims of those traumas, there are steps that we can take to avoid feeling victimized. Awareness and education may be our greatest safeguards against these incidents playing out again and perhaps with more devastating consequences.