While most New Yorkers were understandably anxious in the days after the terrorist attacks, only a minority went on to develop debilitating psychological problems like post-traumatic stress disorder.

“Even among people who were in the towers and who were trying to escape or got injured, the risk of PTSD was still in the minority,” says Galea.

He says it was an “aha” moment for him.

“Human beings are incredibly adaptive and incredibly resilient,” he says. “Even in the face of a dramatic trauma, with horrendous circumstances, most people are still pulling through fine.”

By “pulling through fine,” Galea does not mean that people were not upset. Rather, they were able to function normally even if they had periods of great sadness.

Galea wanted to know: was this resilience unique to New Yorkers, or was it a more general human trait?

So he approached a colleague who had studied the psychological impacts of a devastating flood in Mexico. Torrential rains in 1999 killed more than 400 people and displaced over 200,000.

“Even in the flood sample, where the vast majority of participants are people who had lost homes or lost loved ones, it was still nearly half who qualified as being resilient,” says Galea.

Psychologists are just beginning to understand what makes some people resilient and others vulnerable.

Columbia University psychologist George Bonanno has spent years studying the factors that influence human resilience.

“There are some factors that are inherent in people – their personality and the way they cope – that does tend to make some people more resilient than others,” he says.

Genetics may influence resilience. Also, men tend to be more psychologically resilient than women, although it is not clear why.

Bonanno says external factors also play a role.

“If a person has economic difficulties, or doesn’t have much of a social support network or a network of friends and people to rely on, that person is going to be less likely to be resilient,” he says.

Bonanno hopes that this research will lead to helpful tools for encouraging resilience.

One factor that plays a key role in determining resilience is the presence or absence of chronic stress. In a recent study, Bonanno and his colleagues looked at the mental health of Palestinians living in Gaza and the West Bank.

To Bonanno’s surprise, he found almost no resilient individuals in that population. He says that’s because people there were living under chronically stressful conditions, including “lots of loss, lots of injury and exposure to violence on a regular basis, combined with poverty and all kind of other factors.”

“You combine all these factors together,” he says, “and you get a very, very caustic and chronic situation.”

Bonanno says chronic stress wears us out and prevents us from recovering from trauma.

Fortunately for New Yorkers, the terror of 9/11 has not been repeated in the past decade. That in no way reduces the horror of what they experienced, but it gave most New Yorkers the chance to recover and resume their daily lives.

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This text below is a phonetic transcript of a radio story broadcast by PRI’s THE WORLD. It has been created on deadline by a contractor for PRI. The transcript is included here to facilitate internet searches for audio content. Please report any transcribing errors to theworld@pri.org. This transcript may not be in its final form, and it may be updated. Please be aware that the authoritative record of material distributed by PRI’s THE WORLD is the program audio.

MARCO WERMAN:  We’re joined now by journalist and author Ethan Waters.  His new book is called Crazy Like Us, the Globalization of the American Psyche.  Ethan Waters, you argue that other cultures have their own ways of dealing with mental illness and those can be as good, sometimes better, than western diagnoses and treatment.  So what is your take on the story we just heard?

ETHAN WATERS:  Well it’s difficult to know because without knowing a great deal about those individual cases, it’s hard to say what would have been best for those people.  But if you take a global look at this, take for instance a look at the World Health Organization studies on outcomes of schizophrenia around the world, I do think it challenges a premise that was in that story that suggested that these people would necessarily be better if they were left in the west.  And the results of that World Health Organization study done over decades, multi-cultured studies, suggests that indeed, schizophrenics in the developed world do better than schizophrenics in the developed countries and in the west.  So often times, there is something going on in these cultures that we, I think, under-appreciate that has a remarkable ameliorative effect on even illnesses as severe as schizophrenia.

WERMAN: Now you contend that Americans are forcing their ideas of mental health on the rest of the world.  But isn’t the western understanding of the mind, a scientific objective approach that transcends culture.

WATERS: I don’t think it is.  Every generation of psychiatrists believes they they’ve finally got past cultural influence.  But mental illness and the expression of mental health are always shaped by culture.  You can look across time and you can see every period and every era there is a way to express mental illness.  Scientists refer to this as the symptom pool and each culture has it’s now symptom pool and each period in history has its own symptom pool by which the person learned those symptoms.  In one period it might be symptoms of anorexia, in another period it might be depression, in another period it might be anxiety.  And in this moment in history, the west I believe globalizing ideas about the mind and also beliefs about what are the valid psychiatric symptoms such that we’re homogenizing the way the world goes mad.

WERMAN: Give us an example of that.

WATERS: Well I went to Hong Kong and spent a lot of time with a psychiatrist named Sing Lee there who documented the rise of anorexia in the middle 1990′s of Hong Kong.  This was a very nervous time for Hong Kong.  This was after Tiananmen Square on the mainland.  Families were being broken up.  And there was a great amount of, as Sing Lee says, a general loading of psychopathology in the population.  Into that moment in history, a young woman who was clearly an anorexic died on a downtown Hong Kong street and suddenly the culture was very interested in this disorder.  And flooding into Hong Kong on this very nervous moment in time was the western knowledge about anorexia and western experts saying, dictating basically, what this disease was.  It was only after that moment in time when there was this sudden understanding of anorexia did you see indeed a rise of the disease.

WERMAN: Are you saying that before the nineties there weren’t any presentations of anorexia nervosa in Hong Kong?

WATERS: They were extremely rare.  Sing Lee was studying one in a million anorexics in Hong Kong and he was discovering that they weren’t like American anorexics in a lot of ways.  They didn’t, for instance, have fat phobia.  They didn’t have body dismorphia.  They often came from poor populations on the outskirts of cities and he was trying to find out what this particular rare form of anorexia was at the moment in time when suddenly the earth shifted underneath him.  Suddenly there was an influx of this American form of anorexia.  And I believe that had partly to do with how American experts came in and began to explain to Hong Kong who is at risk, what this disease was, and what it meant.

WERMAN: I guess I’m having a hard time getting my head around the idea that other cultures and nations would essentially adopt American mental illnesses, or diagnoses of mental illness, when, as you argue in your book, they’ve got their own mental illnesses.

WATERS: That’s true, but every culture, including ours, the new mental illness that comes down the line, the new kids are now cutting, or there is a suicide spike.  We are fascinated as a culture by the new mental illness and that’s true of cultures around the world.  And it’s also true that other cultures around the world looked to the west for innovation.  They looked to the west for technology and they looked at the west for modern drug treatments.  They expect innovation from the west.  And so when a newspaper reporter in Hong Kong has to explain what anorexia is, it makes perfect sense for them to look to a western expert.  So it’s not just us forcing these ideas on the rest of the world, it’s the rest of the world literally reaching out and asking for this information from us, because they expect it.

WERMAN: Now even before I let you go, I should tell our listeners that you’ll be taking their questions online.  You’re the guest in our world science forum through next week.  And you listeners can join the online discussion with Ethan Waters.  Go to the world dot org slash science.  Journalist Ethan Waters, author of the book Crazy Like Us, the Globalization of the American psyche.  He joined us from San Francisco, thank you very much Ethan.

WATERS: It’s been a pleasure.

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MARCO WERMAN:  Training is key; not only for the Afghan Army, but for the suicide bombers the Army has to contend with.  Getting people to kill themselves for a cause takes a kind of psychological conditioning.  And researchers have been studying how this works, how it is that suicide bombers are created.  The World’s science correspondent Rhitu Chatterjee is here.

RHITU CHATTERJEE:  Hi Marco.

WERMAN: Hi Rhitu.

CHATTERJEE: Yes, so for my broadcast I interviewed science journalist and author [phonetic] Shankar Vendantam.  He has a new book and it’s called “The Hidden Brain, How Our Unconscious Minds Elect Precedents, Control Markets, Wage Wars and Save Lives”.  One of the chapters in this book is about the psychology of terrorists and suicide bombers.  Vendantam told me that psychologically, suicide bombers aren’t that different from you and me.

SHANKAR VENDANTAM:  There’s been a lot of interesting research conducted among suicide bombers who have failed to complete their missions and are now in prisons of various kinds around the world.  These psychological evaluations show that if anything, suicide bombers tend to have better mental health than the rest of us; they tend to be more idealistic than the rest of us.  They’re often not crazed, religious nuts as we usually think.  They’re also not necessarily people who themselves have suffered great acts of humiliation and are acting out these narratives of revenge.

WERMAN: Suicide bombers are mentally healthier and more idealistic than the rest of us.  So Rhitu, why would they then do something that most of us would deem extreme, irrational or unhealthy?

CHATTERJEE: It all has to do with group psychology Marco.  You have to remember that human beings are hard-wired to be strongly influenced by the people around us.  Whether it’s a group of investment bankers in the game of making money, or missionaries preparing to save the world, Vendantam says small groups of people develop their own norms and aspirations that are different from people outside the group.

WERMAN: Right.  But for suicide bombers the norms and aspirations are killing others and killing themselves.

CHATTERJEE: Right.  And of course the leaders of the terrorist groups are the ones that are creating this norm and imposing it on the young men and women.  Vendantam says that psychologically, the training process is like being in a tunnel.

VENDAMTAM: Within the tunnel that is the suicide bomber’s tunnel, becoming a suicide terrorist is not aberrational; it becomes aspirational.  And when you turn the norm so that suicide terrorism is not aberrational but aspirational, you no longer have to go out to recruit people to come to you.

CHATTERJEE: So you feel privileged to be here.

VENDAMTAM: You feel privileged to be a suicide bomber, so within the world of, for example, Islamic suicide terrorists today, becoming a suicide terrorist is not to be someone who is looked down upon as the dregs of society; it’s to become the rock star.

WERMAN: Wow.  And that sounds like a dangerous status for anyone who is hell-bent on destruction.  Fascinating stuff Rhitu, but we’ll have to leave it there.  Listeners can hear the rest of your interview, though, with Shankar Vendantam on your science pod cast.

CHATTERJEE: That’s right Marco.  I spoke with Vendantam about how unconscious psychological processes influence our decisions and behaviors in many ways.

WERMAN: To download The World’s science pod cast, go to the world dot org slash science.

CHATTERJEE: Yes.  And listeners can chat directly with Vendantam online.  He’s our guest through next week in The World Science Forum.  You can find that as well at the world dot org slash science.

WERMAN: Great stuff, thank you Rhitu.

CHATTERJEE: My pleasure.

Copyright ©2009 PRI’s THE WORLD. All rights reserved. No quotes from the materials contained herein may be used in any media without attribution to PRI’s THE WORLD. This transcript may not be reproduced, in whole or in part, without prior written permission. For further information, please email The World’s Permissions Coordinator at theworld@pri.org.

100 years ago, Sigmund Freud made his first and only trip to the United States to deliver a series of lectures on psychoanalysis at Clark University in Worcester, Massachusetts. Jeb Sharp talks to Clark University archivst Mott Linn about the historic visit.

“In Europe I felt as though I were despised, but at Clark I found myself received by the foremost of men as an equal.”
—from Freud’s autobiography

Pictured at Clark University in 1909 are, from left (front): Sigmund Freud, G. Stanley Hall, Carl Jung; (back) A.A. Brill, Ernest Jones, and Sandor Ferenczi. (Photo courtesy Clark University)

100 years ago this weekend, Sigmund Freud made his first and only trip to the United States to deliver a series of lectures at Clark University in Worcester, Massachusetts. Anchor Jeb Sharp talks to Clark University archivist Mott Linn about the visit.

Pictured at Clark University in 1909 are, from left (front): Sigmund Freud, G. Stanley Hall, Carl Jung; (back) A.A. Brill, Ernest Jones, and Sandor Ferenczi. (Photo courtesy Clark University)

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JEB SHARP: A hundred years ago a Viennese doctor paid a visit to the city of Worcester in Massachusetts to give a series of lectures. This man had big ideas – about the unconscious, the id, and the ego. Yes we’re talking about Sigmund Freud. But back in 1909 when he made his first and only visit to the US his name hadn’t yet become an adjective. In fact back then Freud was desperate for some recognition. He got it at Clark University in Worcester. At the time the school was renowned for its psychology program. Mott Linn is the chief archivist for Clark University.

MOTT LINN: Today Freud is such a big name but back then he wasn’t. This was sort of his coming-out party. We had some credibility that he was hoping to get. And yet in Europe it may have been because of his new ideas; it may have been in part because he was Jewish but he wasn’t able to get into most areas of academia. And so this was a way to try and …. Okay we’ll go to Clark, get better well known in the US and hopefully that will reverberate into Europe.

SHARP: Let’s go back a little bit. How old would he have been and what stage of his career was he at? And also paint a picture of the journey. This is 1909.

LINN: He was a little over 50 years old. Now he came with a couple of other psychoanalysts – most famously Carl Jung. And Jung was much younger. He was 34. Both of these men ended up getting honorary degrees from Clark University. Freud’s is noteworthy because it’s the only honorary degree he ever received. And so they came over. It took a couple of weeks to sail across the ocean to New York City. Then sail to southeastern Massachusetts, took a train to Boston, took a train to Worcester. And they were there for about a week.

SHARP: So Freud comes to Clark. He gives a series of five lectures on the origin and development of psychoanalysis. Describe the impact both on the people who heard these lectures but also on Freud.

LINN: Well it really kick started his career. Before then not a lot of people knew of him and took his work that seriously. But there was very little of that. His famous book, “The Interpretation of Dreams,” came out in 1909 and even six years later only a few hundred copies had been sold worldwide. So that kind of demonstrates how little cache his ideas had. And this really did kick start his career; was taken more seriously in the US and as he had hoped it translated to being taken more seriously across the Atlantic.

SHARP: I understand Freud and Jung delivered their lectures in German. Was there translation?

LINN: There was not translation there. Back then all your best universities had been in Europe, mostly in Germany. And so if you wanted to be a scholar you had to learn German. And so all these professors of psychology and all the graduate students of psychology would have known German and to a greater or lesser extent would have been able to understand what Freud was saying.

SHARP: Tell me more about his trip. What happened to him? What did he see? What were his impressions?

LINN: Well after Worcester they took some time off. They took a train trip out to see Niagara Falls and then another train trip into the Adirondacks. One of the highlights of the trip, according to Freud, was he seeing a porcupine. And so for whatever reason he thought that this was a wonderful thing.

SHARP: Lovely. Archivist Mott Linn of Clark University. Thanks so much for coming in.

LINN: Thank you very much.

Copyright ©2009 PRI’s THE WORLD. All rights reserved. No quotes from the materials contained herein may be used in any media without attribution to PRI’s THE WORLD. This transcript may not be reproduced, in whole or in part, without prior written permission. For further information, please email The World’s Permissions Coordinator at theworld@pri.org.