ABSTRACT
The social stigma of having psychological difficulties is a potent barrier to seeking mental health treatment. Diagnoses among these individuals were a confluence of concentric circles, overlapping many spectrums of disorders, and, as is often the case in psychiatry, not easily narrowed down to one DSM-IV diagnostic code. New York City Fire Department (FDNY) Counseling was overwhelmed early on, and many of its longtime employees began logging in hour upon hour to organize treatment and care. Never before had they had so many new clients, and they were also serving higher numbers of family members, FDNY retirees, and support staff. His role developed into offering both psychoeducation about posttraumatic stress disorder to employees and clinical treatment to firefighters. The overdrive of endless working, giving, and volunteering likely served as a way to master the anxiety of helplessness evoked by the uncertainty of the events.
