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David Flomenhaft, LCSW, PhD

“The Forgotten Ones”: Adult Brothers and Sisters of 9-11 Victims

In the days and weeks following 9/11, many mental health professionals in the New York City area staffed crisis centers that provided counseling for first responders, as well as for spouses, children, or parents of those who had fallen. As the enormity of the tragedy became apparent, David Flomenhaft, LCSW, PhD, part of a Nassau County mental health team, saw that although resources were available to support surviving children and spouses, “I realized there was another group that hadn’t been served – sibling survivors.” Over time, the sibling counseling group his team established grew from five people to eighty. “They named themselves ‘the forgotten ones,’” said Flomenhaft, because in the months after 9/11 the public (and media) tended to rally around children and wives of the lost, while siblings’ grief seemed overlooked.

Speaking at a Ph.D. Colloquium at the school, Flomenhaft told attendees that the siblings often found themselves in emotionally difficult straits when, in addition to coping with the sudden loss of a brother or sister, they had to take over family and legal issues while spouses and/or parents of siblings were too grief-stricken to act on their own behalf.

Flomenhaft, who was a doctoral student in the years following 9/11, came to find that there was very little literature on the socio-emotional impacts of terrorism, and decided to look at those impacts as they affected adult sibling loss. Given his experience counseling sibling survivors, his dissertation research examined this group and focused on the role of grief counseling in such situations, including how those individuals viewed and interpreted their circumstances. All the siblings he studied had lost brothers, ranging in age from 27 to 65 years, at the World Trade Center. The siblings, all from the NY metro area, included three males and three females (median age was 40). He gathered 20 hours of recorded interviews, resulting in 550 pages of transcripts, in the course of his qualitative research investigation.

Among Flomenhaft’s findings: loss due to an act of terrorist violence is sudden and unexplainable, causing grief to be exacerbated; the circumstances of 9/11 contributed to a lack of “finality” because of delays in receiving remains, receiving them incrementally or not at all; and that in instances where the siblings’ grief was recognized, many felt they were caught up in “the bizarre celebrity of public loss,” he said. He also found that siblings of emergency responders and of civilian victims had very different grief experiences and that, surprisingly, religion did not play a role in coping among the group he studied. He added that, in some ways, the grieving process adhered to traditional modes: female siblings sought the solace of community and forums allowing the expression of grief, while male siblings tended to isolate themselves.

While his findings indicated that, overall, sibling support groups were helpful in dealing with grief, Flomenhaft also saw that some turned their grief into activism – organizing memorials, becoming public speakers, even getting into political advocacy.

The implications, he said, point to the need for counselors to better understand “the significant gender differences in mourning and coping,” noting that when dealing with men, the avenue for treatment may begin by reaching them through their spouses. He added that it was important to let adult siblings and their families know that there is “an evolution to their grief,” and that hope and healing are possible. In the wake of 9/11, he saw value in family-centered, community-based trauma support groups, which he felt reduced the perceived sigma associated with seeking mental health treatment.