Introduction

The terrorist attacks of September 11, 2001, made mental health professionals keenly aware of the need for relationally and developmentally focused interventions for traumatized young children and their families with greater urgency than ever before. Healthcare providers, educators, the media, and politicians were barraged by questions about parents who were concerned about the effects of this very public political violence on their young children,whether or not they were directly affected by the attacks.

Those young children who were directly affected by the attacks in New York or who witnessed the crashing of the two passenger planes into the World Trade Center (WTC) and the toppling of the Twin Towers were many in number: over 3000 children lost a parent, thousands of children attending schools and day-care centers near Ground Zero directly witnessed the attacks. Additionally, untold millions of children around the world watched the attacks repeatedly on TV. Children worldwide were reported to suffer from nightmares following the events of 9/11, and for weeks had difficulty concentrating in school (Hoven et al., 2003).

Historical overview of understanding trauma in a relational context

One of the most important observations which has informed our current relational view of child traumatic stress came from the study by Anna Freud and Dorothy Burlingham (1943). They noted the following during the London Blitz of World War II: “The war acquires comparatively little significance for children so long as it only threatens their lives, disturbs their material comfort, or cuts their food rations.