'Everyone understood that it was OK to cry'

Within days of the attacks on the US, Dr Colin Murray Parkes, a psychiatrist and a world authority on bereavement, flew out with other counsellors to help the families of British victims. He tells Julia Stuart what it was like

It is rare for a man to admit to a propensity to tears, rarer still when that man is a scientist brought up in an age when crying was seen very much as a sign of weakness. But for Dr Colin Murray Parkes, the psychiatrist who helped set up counselling for bereaved British families in New York following the 11 September attacks, tears have never been a source of shame.

"I think we all cried at one time or another," says Dr Parkes, 73, a world expert on bereavement who has worked as an adviser in the aftermath of many British disasters. "It was a very moving, sometimes devastating experience for everyone, including the counsellors."

Within days of the attacks, the Foreign Office asked Cruse, the bereavement charity of which Dr Parkes is president, to provide a team of counsellors to fly to New York to support the relatives of British victims arriving in the city. It was the first time that a government had made such a request and backed it up with full financial support. Ten counsellors flew out in the first week; three are still there.

One of the first places Dr Parkes visited on his arrival in New York was Ground Zero itself. "One felt slightly embarrassed to be a sightseer," he says, "though we weren't really sightseeing, of course. We were there because we knew that one of the first things bereaved families would want to do is to see the place where it happened – and we wanted to be sure that if they were taken there, they weren't going to see any remains."

Dr Parkes found understandable variation in the reactions of the families he met. "There were some who were obviously very broken up, and finding it hard to cope," he recalls. "Fortunately, everybody understood that there was no need for them to be embarrassed if they were crying. Then there were others who were coping very well, though you never know quite what is going on under the surface." No one he spoke to sought vengeance. There was, however, anger.

The counsellors' main task was hand-holding and listening. They also offered physical comfort. "You touch the bereaved, put your arm around them. As a psychiatrist, I was always told that you should never touch your patients because it was a kind of sexual seduction, but at times like this you have got to touch people. It's the most natural thing to do. It has an immediate effect."

At all times, however, the counsellors were careful not to give the families false hope. "When we were there, they were still calling it a rescue operation, despite the fact that nobody had been brought out alive for four or five days. Although we knew there was very little chance of anyone being pulled out alive, it was only too easy for families to cling to the hope that their missing person, who was known to have been in New York at that time, was lying unconscious in a hospital.

"We had checked all the New York hospitals, so we knew there weren't any unclaimed, unconscious people at the time. Nevertheless, families were coming out and asking these questions. So part of our role was to help them, little by little, to take in the reality that this person wasn't going to come back."

The biggest single problem for the counsellors was making such an unimaginable horror seem real. "Bereaved people can make it real, but it does take a long time. They have to go over it again and again, and think their way through it," Dr Parkes explains.

Another major trauma facing the families was the fact that, for many, there were no physical remains. "Psychologically speaking, this creates quite a big obstacle. People need to visit a grave to help to make it 'real'. It helps to place a marker and say: 'From this moment in time, I know that that's where he is.' To provide a location for the dead seems to be important to many people."

Dr Parkes believes that it is vital that a memorial is built at Ground Zero, which has already become a "holy ground" for many bereaved families. "What I think memorials do is to say that, even though this person is dead, they are still important. One of the most awful things about bereavement is that the world goes on as if nothing had happened. For bereaved people, the world's never going to be the same again. Memorials help to justify the continuing relationship with the dead person, because although someone may be lost out there, they are never lost in here," he says, pointing to his heart.

A few wanted to talk to the counsellors in detail about how their loved one died. "Part of the problem was, at that stage, we weren't really in a position to tell them. There was enormous variation in how intact the bodies were. It was very difficult to give people accurate information about how their loved one actually died.

"The truth is that most people who die, die very peacefully. They don't actually die screaming in agony. And even in these traumatic deaths, the urgency of the situation seems to drive out pain. So often, when people die, the fantasy for the bereaved person about how they died is much worse than the reality, and as a doctor, I'm often able to correct misapprehensions of that kind."

Dr Parkes, who was a consultant psychiatrist at the Royal London Hospital and the Tavistock Clinic, London, before retiring, has worked as an adviser for numerous disasters, including Aberfan, the Bradford City Football Club fire, the Zeebrugge ferry catastrophe, and Lockerbie. "I know very well how painful they are going to be for me and my family. It doesn't help growing children to have dad disappearing for months at a time. Disasters take over your life," says Dr Parkes, who has three grown-up daughters and lives in Chorleywood, Hertfordshire, with his wife, Patricia, a historian, author and antiques dealer. "In disaster areas, you need an almost military response. You have to get in there quickly, make decisions, tell people what to do and get on with it. You don't have time to consult, and because you're a human being, you make mistakes, and some of them you bitterly regret. Others you don't feel bad about because maybe you've achieved something.

"At the time, it is always extremely frustrating, and sometimes hellish. Anger in particular is always around and goes off in all the wrong directions. Often, the people who are trying hardest to give help are the ones who get battered. In Aberfan [where 116 children died when a coal tip subsided on their school], there were no less than three public meetings that ended in fistfights. It took us a year before we managed to hold a public meeting that was peaceful and constructive."

It was Aberfan in 1966, his first major disaster, that was the most traumatic. The memory still chokes him today. "I hadn't the foggiest idea what to do. I had a few ideas from my experience working with bereaved people, but even when I had a plan I couldn't always put it into effect because it meant I had to convince others, and they weren't necessarily going to be convinced. There is a lot of prejudice against psychiatry and psychiatrists, and a lot of people didn't want to talk to me.

"The first time I drove away from the village, I felt utterly helpless. I had been faced with enormous suffering. Everyone I talked to had been desperate. On my way home – I had to drive about 30 miles to my parents-in-law – I had to stop the car three times because I couldn't carry on driving. I just needed to stop and cry. By the time I arrived back, my wife met me at the door and I remember vividly her asking, 'How was it?' and I couldn't speak. I just stood there tears pouring down my cheek," he says, uttering a brief emotional wail at the memory. "It was very, very hard. Subsequent disasters haven't been quite as bad as that, but you always carry a few scars. But like all things, if you achieve something, then it's worth it. You don't feel diminished by it."

How does he cope?

"Fortunately, I'm a fairly resilient person. I'm well supported by my wife and family. And I know that it's all right for me to grieve, so I don't feel I'm letting the side down if I need a shoulder to cry on. I suppose I have learnt to cry. It wasn't something that came easily to me, because, like most doctors, I had been brainwashed that I had to be in control and have the answers. One of the humbling things about disasters is that you don't always have the answers. You often feel helpless."

Dr Parkes says that it is still too early to say how New York has affected him personally, though when asked recently to write a paper on it, he replied that he wasn't ready. "It is something that has a deep impact, it takes a while before you can step aside from it and see it objectively and write about it. It's still very close to the surface... I needed at least a year before I was ready to start writing about Aberfan, and I guess it will probably be something like that for New York."

The Cruse Bereavement Care helpline: 0870 1671677