Psychiatric Quarterly

, Volume 80, Issue 3, pp 173–189 | Cite as

Stories Behind the Symptoms: A Qualitative Analysis of the Narratives of 9/11 Rescue and Recovery Workers

  • Corey B. Bills
  • Nancy Dodson
  • Jeanne M. Stellman
  • Steven Southwick
  • Vansh Sharma
  • Robin Herbert
  • Jacqueline M. Moline
  • Craig L. Katz
Original Paper


A qualitative study of the experiences of rescue and recovery workers/volunteers at Ground Zero following the terrorist attacks of 9/11/01 is reported. Information was extracted from a semi-structured clinical evaluation of 416 responders who were the initial participants in a large scale medical and mental health screening and treatment program for 9/11 responders. Qualitative analysis revealed themes that spanned four categories— occupational roles, exposures, attitudes/experiences, and outcomes related to the experience of Ground Zero. Themes included details regarding Ground Zero roles, grotesque experiences such as smells, the sense of the surreal nature of responding, and a turning to rituals to cope after leaving Ground Zero. These findings personalize the symptom reports and diagnoses that have resulted from the 9/11 responders’ exposure to Ground Zero, yielding richer information than would otherwise be available for addressing the psychological dimensions of disasters. This work shows that large scale qualitative surveillance of trauma-exposed populations is both relevant and feasible.


Mental health Trauma 9/11 Responders Disaster World Trade Center Qualitative analysis 



The Department of Psychiatry, Mount Sinai School of Medicine and Disaster Psychiatry Outreach assisted in development and administration of the mental health aspects of the World Trade Center Worker and Volunteer Medical Screening Program. We are indebted to the many organizations and staff members who worked to inform WTC responders of the program and facilitate their participation. Special thanks to the Robin Hood Foundation Relief Fund, the American Red Cross Liberty Fund, The September 11th Recovery Program, The Bear Stearns Charitable Foundation, The September 11th Fund, and many others. This work was supported by the Centers for Disease Control and NIOSH, contract 200-2002-00384 and grants U1O 0H008232, U10 OH008225, U10 UOH008239, U10 OH008275, U10 OH008216 and U10 OH008223. The views expressed in this article are those of the authors and do not represent the views or policies of the Department of Health and Human Services or the National Institutes of Health.


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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Corey B. Bills
    • 1
  • Nancy Dodson
    • 2
  • Jeanne M. Stellman
    • 3
  • Steven Southwick
    • 4
  • Vansh Sharma
    • 5
  • Robin Herbert
    • 6
  • Jacqueline M. Moline
    • 6
  • Craig L. Katz
    • 5
  1. 1.Pritzker School of MedicineUniversity of ChicagoChicagoUSA
  2. 2.Department of PediatricsYale University School of MedicineNew HavenUSA
  3. 3.Department of Environmental and Occupational Health SciencesSUNY Downstate Medical CenterBrooklynUSA
  4. 4.Department of PsychiatryYale University School of MedicineNew HavenUSA
  5. 5.Department of PsychiatryThe Mount Sinai School of MedicineNew YorkUSA
  6. 6.Department of Community & Preventive MedicineMount Sinai School of MedicineNew YorkUSA

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