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From street shrines to light shows, from museum walls to classroom halls, New Yorkers after 9/11 created artworks honoring the victims, rescuers and other survivors of the World Trade Center (WTC) catastrophe. Artists came to the rescue like EMTs equipped with paintbrushes and dance steps. Popular art became a form of therapy for the walking wounded of the city.

But what about those trauma victims for whom the mental anguish was incapacitating? Many turned to long-term care by more specialized artists, creative arts therapists, who knew from working in hospitals and clinics how to help people heal from trauma when medication and talk therapy were not enough.

Dan Summer is an art therapist at Woodhull Hospital in Brooklyn, where he helps clients struggling with both mental illness and substance abuse. After aiding workers displaced from the WTC, he volunteered at September Space, a wellness center created in response to 9/11.

One of his clients told him that she emerged from the subway as the second plane hit the WTC. Frozen in her tracks for what seemed like hours, she later felt depressed, anxious, and restless at home. Nightmares plagued her; work eluded her. Being an artist, she requested art therapy. Said Summer, "I let her dictate the course of her therapy. She used crayons and colored pencils to free associate and talk about the trauma. In six months, she made lots of progress and terminated therapy. Shortly thereafter she mounted her own art show—partly about 9/11."

Creative arts therapists are artists trained in psychology (or psychologists trained in art). They use art, music, dance, drama, and poetry to help people deal with mental anguish originating in neural synapses, body musculature, or the unconscious, depending on their point of view.

Both artists/educators and arts therapists tap pre-verbal feelings and change perceptions through sensor-motor activity, but the former focus on technique and appreciation whereas the latter concentrate on what the artwork evokes in the individual psyche.

Although Post Traumatic Stress Disorder (PTSD) was first defined in Vietnam vets, it took 9/11 for the public to recognize its gravity. Ani Buk is an art therapist who teaches at NYU and trains volunteers for Doctors of the World, a haven for victims of torture and other abuse. She has written about the three main categories of symptoms: Re-experiencing the traumatic event through nightmares or flashbacks; avoidance and numbing, such as forgetting aspects of the event and feeling estranged from others; and increased arousal, as with sleep disturbance, irritability, and lack of concentration.

Surprisingly, avoidance and numbing, rather than the other, more familiar signs, interfere most with establishing a therapeutic relationship. Creative arts therapists are especially successful with trauma victims because the victim's horror is literally and figuratively unspeakable.

Barbara Bormann is a drama therapist and coordinator of the child/adolescent psych unit at Elmhurst Hospital in Queens. She discovered recently that her adolescent patients, hospitalized for violent behavior, disagreed about the effects of 9/11. Some were still moved, others expressed indifference. Nevertheless, the event triggered risky behaviors in all of them, from stealing and robbery to unsafe sex and drug use.

Said Bormann, "The group agreed to take two peers from either extreme and improvise a drama. The play explored the friendship of a drug addict and drug dealer. Learning that the drug addict lost a family member in 9/11, the dealer reacts to the addict's helplessness by giving him drugs. A counselor challenges their actions. Unable to persuade them to come clean, the counselor helps a cop arrest them." By reversing the roles of "dirty" vs. "clean" characters, the young people embraced their opposites. Added Bormann, "They connected with their emotions, spoke their minds, appreciated the views of others, and realized the consequences of their actions."

When the American Music Therapy Association and the Society of Recording Artists asked for volunteers after 9/11, music therapist Peter Jampel answered the call. Director of the Resource and Treatment Center at the Baltic Street Mental Health Clinic of South Beach Psychiatric Center in Brooklyn, Jampel had many clients who experienced childhood trauma. At Hoboken High School, he helped adults who worked at the WTC or knew people who worked there. All who participated in the counseling group were drawn to music and the arts, whether or not they had training.

Together they improvised with voices and instruments, composed songs, and reflected on their experiences. Through music, one woman found a new dimension in words to her grief and sadness. A graphic artist, she later helped design the Hoboken memorial to the dead. Another, who barely escaped on the ferry, returned to work in a relocated office. Others grew to accept their situations and moved on with their lives.

Joan Wittig is the coordinator of Pratt Institute's dance therapy program and co-producer of Brooklyn Cable Access TV's Frontiers in Psychology. She noted the advances made before 9/11 by a group of high-powered women who were compulsive eaters. After the collapse of the WTC, they did not leave their houses; their weight soared. The blackout of last August added to their burdens. Wittig used "authentic movement," giving each woman a turn to follow her impulses around the dance floor as the others witnessed and supported her movements. One woman readopted a childhood behavior of hiding under her desk. Wittig explained, "Movement holds [contains and liberates] a lot of body memory. Hiding was symbolic of her desire to return to safety. By moving in and out from under the desk, she worked through [her fears]. You can talk until you're blue in the face. But it doesn't reach the heart. [Dance] brings the body and mind together."

Art therapist Buk described a young boy who grew silent and sleepless after losing a close relative in 9/11. Buk tells her patients that they are artists in charge of what they do. The boy spent many weeks using a ruler and pencil to create graph paper. He colored each square differently. Feeling more in control and safer in Buk's presence, he relaxed his visual language.

Next, he filled sheet after sheet with swirls of color depicting raging infernos. By expressing his rage on paper, he began to unlock the feelings bottled up inside. The boy started to talk of the things he missed most about his lost relative. According to Buk, this was the beginning of mourning.

Then, he drew an old man's dream—a cityscape of an imaginary foreign country attacked by crashing planes. He identified with the children who lost their relatives there yet he thought himself a terrorist. Once he told Buk his worries, she helped him understand that they were just fantasies. That was a turning point in his treatment. Eventually he resumed sleeping and his normal activities.

The New York City Board of Education reported after 9/11 that school children experienced a rate of PTSD five times higher than normal. Yet Craig Haen, a drama and play therapist who worked with groups of kids in New York City and Westchester County, found, "Often, working with traumatized children is an act of witnessing the powerful juxtaposition of incredible strength in the face of overwhelming catastrophe." Jan Orzeck, a relief agency social worker who has supervised assistance to 600 individuals and families since 9/11, was "blown away by how well many survivors are doing, although some are still grieving."

During 9/11, Bronwyn Rucker worked as a drama and art therapist at John Heuss House, a drop-in center for people who were homeless and mentally ill. She helped her clients write a play with poetry and songs called "Survival NYC." One of the actors, Raymond B., wrote, "No matter how much money you make or have, when Wall Street was covered by debris as well as madness, many Wall Street employees came to John Heuss drop-in center to avoid the destruction of WTC unaware JHH has always been a safe place...we hope that Wall Street does not forget the little red door at 42 Beaver Street. May we all find a safe haven. God Bless America." Long after the city cleaned up Ground Zero and made new plans for the site, creative arts therapists were still pumping up the hearts and minds of many New Yorkers. For the sake of those still seeking their way from danger to safety, we need to remember how to find "the little red door" inside us.