For New Orleans the arrival of Katrina was The Day the Earth Stood Still. Returning to the city one month after the hurricane, one was confronted with eerie stillness in the mostly unpopulated city—a virtual ghost town. Life as we had known it had stopped.
Though not searching consciously for a metaphor for this vista, my thoughts turned repeatedly to the above-titled 1951 film, a cautionary tale regarding aggression, in which the temporary suspension of all activity had an instructive purpose. Thoughts of the movie, for me a childhood memory of the threat of terrifying power, did seem an apt metaphor as I tried to grasp the scope of interruption of life. It was perhaps unprecedented for an entire American city to simply stand still.
What was unclear, though, was how, or if, life would begin again. How might it be reordered? What might we learn from this about ourselves, about the experience of trauma, and about the process of recovery as we lived within this situation and worked to reconstruct our personal and professional lives? Unlike the film, in which the continuity of life resumes undamaged after an hour's interruption, the effects of the storm and its aftermath are ongoing. The outcome remains uncertain, with what locals refer to as the “new normal” not yet established.
In this context, reporting on the status of the New Orleans-Birmingham Psychoanalytic Center requires discussion of both the psychological situation as well as the practical aspects of our recovery; the two are inseparable. When describing the status of recovery here to those outside the city, New Orleanians are careful to present a balanced and accurate picture that includes both the significant progress that has been made as well as the vast amount of work that remains to be done. It is essential to its eventual restoration that the city remains in the consciousness of the nation, that awareness of it does not fall away due either to unrealistic optimism about the state of its recovery, or because of undue pessimism about the daunting work ahead. Indeed, each of us here works to maintain this balance in our own thoughts and efforts.
Dale Firestone, L.C.S.W., is an advanced candidate in adult analysis at the New Orleans-Birmingham Psychoanalytic Center. He is editor of the center newsletter.
The description of our recovery thus includes the polarities of experience with which each of us struggles daily: hope, planning, enthusiasm, creativity on the one hand, and profound feelings of loss, uncertainty, anxiety, and vulnerability on the other. At the risk of appearing to describe two different environments, I will first report on the forward-looking, restorative work of the center, then comment on some of the continuing difficulties of our situation. Concepts regarding trauma and its resolution are useful in articulating our experience, in identifying what has been helpful, salutary, as well as that which interferes with recovery and reintegration.
Chief among the creative initiatives for recovery is the formation of the joint New Orleans-Birmingham Psychoanalytic Center. Although the post-hurricane diaspora is an impetus for this union, a close relationship already existed between New Orleans and Birmingham. Two of the New Orleans center faculty, Lee Ascherman and Fred Griffin, live in Birmingham and have been active in analytic education in both cities. Both are involved in residency training programs with the University of Alabama, Birmingham, and the establishment of a joint center offers exciting possibilities for analytic education and training there. It is most fitting that Ascherman and Griffin, who were longtime commuters during their respective analytic training, should play such an important role in making training more physically and financially accessible to their community.
The existing relationship between New Orleans and Birmingham deepened in the wake of Katrina as two past New Orleans institute presidents, Sam Rubin and Ted Reveley, relocated permanently to Birmingham. The establishment of a joint center somewhat mitigates their loss for those of us in New Orleans. Additionally, while members of the New Orleans center were mired here in the crisis, Ascherman and Griffin were tireless advocates. It was greatly reassuring to have such colleagues in our corner and on dry land.
The commitment to form the joint center was unanimously made by the center board at a retreat in Birmingham in May. It is expected that the general membership will affirm this decision in its vote for the same compelling reasons that prompted the board's decision: Given the dispersal of so many valued and creative members in New Orleans, the joint New Orleans-Birmingham center will do much to ensure the continuation of psychoanalytic education, training, and community in the region. Classes will be conducted via videoconferencing, allowing candidates and psychotherapy fellows to attend at both sites. Speakers and scientific presentations will similarly be available to attendees in both Birmingham and New Orleans. The February scientific meeting will be held in Birmingham.
Outreach efforts, an impetus for the transition to a center model for New Orleans a year ago, continue to be a priority. There are five scientific meetings scheduled for the coming academic year, with each speaker presenting at an additional community event. Partnerships with community organizations, and the arts community in particular, are being developed. Other outreach activities, which had been in process, will resume, including a film series, honorary fellowship program, teaching in the residency training programs at Louisiana State University and Tulane, and our Psychoanalytic Evaluation and Referral Service. Regarding classes, our two fifth-year candidates resume class in the fall, and potential candidates are being interviewed in hope of beginning a new class in January 2007. Classes for the psychotherapy program will not be held currently, due to the dispersal and relocation of fellows, but will be continued as new fellows enroll.
Yet this favorable news of restitution and recovery occurs within a general surround of profound loss, anxiety, and uncertainty. One encounters such juxtapositions everywhere. New Orleans, a year after the flood, is still a place in which one can be driving within the narrow margins of what appears to be normal life, and turn off the peninsula of high ground (“the sliver on the river”) that had been the unflooded footprint of the city 130 years ago, and within a few blocks encounter miles upon miles of ruined, empty neighborhoods. To some degree, we wonder if something similar may be said about the status of our practices: While many analysts may now have practices approaching their pre-Katrina caseloads, it is difficult to know whether this too is an uncertain security within narrow margins, another peninsula, and whether the eventual population and economy of the city will sustain such activity.
It would be remiss not to convey something more of the dynamics of the psychological crisis that persists here. In so doing, I would like to refer to a few concepts regarding trauma which we understand to either facilitate or impede its working through. While these concepts and dynamics are no doubt familiar to all analysts, they are perhaps understood anew,
and in a unique way, when one is personally experiencing the trauma, concurrently treating others for its effects, and when the effects are felt—without exception—by everyone in one's environment. A few of such issues will be discussed in a mostly anecdotal and impressionistic way to communicate more of the affective climate here.
Reviewing the 1986 APsaA monograph, “The Reconstruction of Trauma,” I found a statement by Harold Blum that was particularly resonant with something I felt and many I spoke with had confirmed: “Trauma may encompass radical change in the self and object world, leading to a ‘great divide’ in the patient's life…which anniversary reactions attempt to bridge and reintegrate.” Many of us appear to experience such a “great divide” in our before and after lives along with a curious effect: a kind of temporal confusion and dislocation. Within the relatively uninterrupted continuity of our lives before Katrina one could easily locate events and their landmarks within time; on this side of the “great divide,” time is experienced in a somewhat vague or unreal way. It is as if the part of us that measures time, and knows our location in it in an automatic and preconscious way even when our attention is not focused upon it, remains in the pre-Katrina time line and we are not yet fully oriented in the nascent post-Katrina continuity.
My initial experience and recognition of this occurred on my first day back in the office, excited to see my first patient since the storm, hopeful my practice would survive. At the end of the session, the patient and I discussed the next appointment. I reached for an appointment card and, without hesitation or thought, wrote: August. It was in fact October 6—six weeks after I had last been in my office. I looked at the card, quite taken aback, and became aware of a gaping emotional and temporal divide; in a very meaningful way, I was not quite sure when it was.
The disruption of continuity has had implications for analytic practice. Many analytic cases have been lost due to relocation of analysts or patients, or to altered financial and employment circumstances. Beyond this, doing work that requires a reasonable presumption of stability, consistency, and availability has been something that both analysts and analysands may have had difficulty committing to in this environment. My impression, also, is that it may have been difficult for both parties in the analytic dyad to sustain listening in an attentive or attuned way with so many noisy survival demands clamoring for attention, particularly in the first six months after the storm.
Somewhat in retrospect, I realize that I was able to begin two new analytic cases eight months after the storm because it was only then that I began to have faith that an analytic process could be sustained in this environment.
Trauma may encompass radical change in the self and object world, leading to a ‘great divide’ in the patient's life…which anniversary reactions attempt to bridge and reintegrate.
One knows it when one sees it. Defined as a continued environmental effect, one feels it constantly. Virtually everyone describes a degree of fatigue that is unrelenting and not easily attributed to any specific momentary factor. At the first social function at the center following the storm, at the Christmas holiday, it was somewhat surprising to find that a staple of conversation was about nap taking. The tension is palpable at almost all times. Many report feeling worse now than in the months immediately following the shock of the hurricane's devastation due to the cumulative effect of strain.
Active social support is essential to mastering the affective reliving and reintegration of trauma. The well-chronicled failings of FEMA and the federal government to respond in a prompt or protective manner has not only interfered with the processing of traumatic experience but is likely to have engendered tremendous rage. Added to this are the many instances in which contractual relationships have not been honored (e.g., insurance policies), further eroding the social fabric and confidence in reciprocal relationships. The resulting helplessness, rage, and nihilism no doubt contribute to the rise in aggressive behavior, both outwardly and inwardly directed. Surveys conducted by the local Office of Mental Health indicate endemic depression, and estimate that rates of suicide may have increased by as much as 300 percent, with these estimates likely representing only the obvious intentional acts.
Much in contrast to this, the support of the Association, and the concern and kind offers from institutes and centers throughout the country should be acknowledged as one of the salutary effects for analysts here.
Anxiety and hypervigilence naturally accompany increased vulnerability. One notable result of the storm is that with our heightened sensitivity there is a certain difficulty in evaluating the power and reach of the traumatic agent even a year past its initial impact. Even now there is a tendency to wonder whether every reported misfortune, crime, or death may be an effect of the hurricane. Locals read the obituaries and question whether the death of each young person lacking mention of a specific cause of death is a suicide and whether the deaths of the elderly or infirm were hastened by some aspect of the storm, perhaps just the despair of their situation. The same is true when crimes are reported. In all these cases one often wonders: Would this have happened without the storm?
Indeed, the effects of the hurricane are vast and continuous, and some of these events are in fact distal effects of the storm. However, there is a component of this feeling that each insult might be a continuing cascade of damage from the storm that seems due to continued
vulnerability, and reminds me of the attribution of near omnipotence I have seen some abused children assign to a parent who has been a longtime agent of abuse—regression, helplessness, with omnipotence assigned to an agent one is powerless to escape. Some children I have seen have been delusional or nearly so in this regard; we, here, are perhaps anxiously “confusional” in our regression. Such is the looming largeness of Katrina.
At the risk of having written too dark a description of experience in New Orleans, I should also note that the members of the New Orleans-Birmingham center appear to remain both committed and determined. But, some of the normal and necessary denial with which one lives, which keeps stark, unmitigated vulnerability out of conscious awareness, has been breached along with the levees—at least for the moment.
Those who do not live in hurricane-threatened areas may not be familiar with the weather forecasting term for the projected path of hurricanes which has become fashionable in the last several years: the cone of uncertainty. It is a visual model of the possible courses a hurricane might take, the probabilities broadening in range and less certain the farther one is from the center of the storm.
Although this term was no doubt coined by a cabal of weathermen somewhere, and assuredly not by existentialists, it does much to describe our existential situation. We live much more in the cone of uncertainty than do others, and now have a forced consciousness that we remain within it. And, it seems that the farther we move from the point of impact of the hurricane the less certain we are of the probable courses and trajectories of our lives. To illustrate, I had a phone supervision soon after Katrina with a supervisor who had evacuated to Birmingham. At that time it was unclear to me whether his relocation was temporary or permanent.
I asked which it was, to which he replied: “Permanent? That's not in my vocabulary anymore.” Such is the damage of the storm, as we thus search for a new vocabulary for our experience.