9/11 Mobile Trauma Unit Helped Pave The Road to Recovery

On Tuesday morning September 11th, 2001 Paula Madrid was preparing to give a presentation on the treatment of trauma in a New York City hospital but she never made it to that appointment. Glued to the burning towers on her television, the 25 year-old newly qualified doctorate in clinical psychology called the Hospital.

“We need to cancel - the patients aren’t doing well with the whole thing,” the hospital told her.  Minutes later the therapist would begin her own unforeseen journey that would lead her to help thousands heal from the deeply personal mental wounds caused by the events unfolding before her.

On 9/11 Madrid applied the only first aid she knew at St. Lukes Hospital. And in the long days that followed, she helped relatives and evacuees desperately looking for their loved ones.

“I was just listening, helping people connect with their families, friends, and with resources they needed or requested,” she explained. “Psychological first aid had not been coined at the time, but essentially that’s what I was doing.”

“Even the hospital staff weren’t doing very well at all because they weren’t necessarily trained for this type of thing: Post-Traumatic Stress Disorder,” Madrid said.

Weeks later Madrid would get a phone call that would change the course of her life. The Children’s Health Fund called her for an interview in response to her job application. Twenty-four hours later, and still an unlicensed therapist,  Madrid, would become the first person to be hired for what would eventually be known as the 9/11 Resiliency Program.

Parked behind a medical unit designed to monitor and help recovery workers at Ground Zero Madrid worked long days in a similar mobile unit dedicated to people who just needed to talk.

What was the epicenter of so much pain, sorrow, and fear would now begin its transformation into America’s center for recovery, healing, and grief.  While recovery workers began to pick up tons of twisted steel on the outside, New Yorkers began picking up the shattered emotional pieces on the inside.

Widows, first responders, victims family members, recovery workers, and regular New Yorkers would come in and out of the mobile unit’s therapy rooms for months in Battery Park City. Madrid remembers the strong sense of denial people had some even believed their lost loved ones were actually living in another state - a phenomenon called a “fugue state.”

“Denial or the difficulty accepting a loss is a common phenomenon.  Some patients really believed that their loved ones had experienced such severe trauma that they had developed this state of amnesia and were somewhere else not remembering who they were and that they were going to return sooner or later,” Madrid said. “It was very sad.”

Helping first responders and their families proved especially challenging. Madrid would have to help the families “informally” because some just did not want anything to do with the concept of “therapy.”

“It was challenging because at first not many came in,” Madrid said. “We started to offer food and arts and crafts activities for the children and then they started to show up, bringing their families.  They would attend group sessions while their families were enjoying some activities.”

After months at Battery Park City, Madrid and her colleagues received survey data that suggested that those who were most in need of their services weren’t necessarily in the area closest to Ground Zero.  The research showed that there was a real need in poorer neighborhoods like the Bronx, East Harlem, and Washington Heights – and especially with recent immigrants and children.

It was time for the mobile unit to hit the road. For the next six years, Madrid would lead others throughout all the boroughs with the goal of helping anyone who needed it. The Resiliency Program had really now begun offering their free services to those who most needed it –those who could not pay for professional services, those that only spoke Spanish, and those that were already living with traumatic circumstances.

“We started to see widows, women who had lost their husbands, who had not been able to find services at all because there had been no services advertised in Spanish at the time or if they were in Spanish they would have to pay for them or show documentation,” Madrid said. “We wanted to do the work we didn’t expect any of this and we never charged a penny.”

More than 700 students ages 7 through 12 would go through the Resiliency Program through an 18 week span with the hopes of helping them come to grips with a post 9/11 world.

One group of students was especially memorable.

“Some kids we spoke to were literally on the Manhattan bridge and saw the towers fall while on a field trip,” she explained. “Boom – the towers literally collapsed in front of their faces – literally. The teachers were horrified.”

Some teachers didn’t want to talk about the events of that day because some parents told them they didn’t want them bringing 9/11 up with their kids, Madrid remembers.  Other parents told her, “Look I don’t know how to deal with this, help us – it’s your job.”  The children began making drawings, and they were out of control, she says. “No one is talking about 9/11. They are angry, they are crying, and they aren’t learning.”

A multilevel intervention took place at that particular school: Meetings with the principals, training teachers to  not burden their students with their own personal experiences, even a screening process was implemented to help monitor the children.

For months Madrid and her team were charged with helping these kids learn about coping. Simply put, their job was to help students move forward and to understand their emotions.  She would host group “modules,” for weeks at a time while teaching things like communicating feelings and creating space for a grieving process.

“I actually feel very, very fortunate to have been able to put the Resiliency Program together,” she said. “I also know that I learned a great deal by seeing the everyday faces of people who were suffering so much. I learned I was not going to be able to take the pain away from these people even if I wanted too so bad.”

Madrid credits growing up in Medellin, Colombia until the age of 12, one of the most dangerous cities in the world at the time, as to helping her develop a particular sense of compassion and understanding for the events of 9/11.

For six years she lead the 9/11 Resiliency Program that would go on to help and train 10,000 individuals. The program was cut because it was thought that there was less of a need for it in the years following 9/11.

For years Madrid’s job was to listen to everyone else's pain. But, eventually, she found she too would have to deal with her own pain.

“It’s impossible not to be affected by hearing difficult stories. The act of witnessing human suffering can cause trauma,” she said.

“I know that I am still not personally over it. I didn’t start processing my own 9/11 experiences until fiver years later.”

She adds, “No one ever really asked me how I felt.”

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