Friday March 29, 2019

The Long Shadow of Trauma

The news has been filled with grief and confusion emanating from the recent suicides of a father of a child who was killed in the Sandy Hook shootings and two Parkland students. These individuals were survivors of the school massacres that occurred on 14 December 2012 and 18 February 2018, respectively. Until now.

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These most recent deaths link collective traumatic events with individual suicides. Tragedy x 2. About a year ago, I wrote a  Five on Friday blog on suicide following the deaths of Kate Spade and Anthony Bourdain. The most recent suicides bring home the most unfortunate sequelae that can follow in the shadow of collective trauma.

 

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1.The effects of trauma can linger, fluctuate and return. Typically, the immediate aftermath of a traumatic event is the window of time when we are most emotionally and psychologically impacted. As days turn to weeks turn to months, we gradually move to a place where the trauma is less raw and its apparent impact on our daily lives recedes. This is true for most of us, most of the time. However, even the most resilient of us can be assailed by a traumatic experience such that the impact endures in ways that can be impairing and even debilitating. In the case of a mass-casualty, about 1 out of 10 people experience continued symptoms long after the event and develop what is known as complicated grief.

 

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2. What increases risk? Some evidence suggests that violent deaths are more likely to cause complicated grief disorder among family members and friends, but complicated grief can follow many different losses. Reminders such as anniversaries can prolong complicated grief or even reactivate grief and trauma. On the anniversary of the Parkland school shooting, dozens of media outlets re-posted information about the original shooting in combination with memorials. Columbia epidemiologist Dr. Madelyn Gould researches suicide contagion, and the impact of reporting on suicide on others. After the recent Parkland and Sandy Hook suicides, she warns that these first suicides, coupled with the anniversary of the Parkland shooting, and the reporting, could be associated with increased risk for other suicides.

 

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3. The idea that we can “take care of trauma once and for all” is naive; and the rush to “move on” is problematic. Of course, we want to provide resources and support to help survivors cope with traumatic events. But “grief isn’t something to get over” and the risk of trying to move on too quickly is not only unhelpful, but potentially, a high risk strategy. Each of us needs time and space to fully feel what is unique to our evolving emotional and psychological journeys, and trying to rush to some imagined “finish line” will be more elusive than recovering the holy grail.

 

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4. Collective trauma. After a mass shooting, trauma manifests not only individually, but also collectively, as the community grieves together. In the case of  collective trauma, not only are we united in our exposure to the traumatic event, but we share a common psychological experience in the aftermath. Such is the case for veterans who battled together and survivors of the holocaust, for example. Collective trauma is evident among survivors of the terrorist attacks of 9/11. More than five years later, 4 of 10 people described full-scale complicated grief, and 3 of 10 reported suicidal ideation. In the case of mass shootings, survivors are at great risk for mental health difficulties, with those most directly exposed to the shooting most likely to develop depression, anxiety and post-traumatic stress disorder.

 

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5.How to help. Recognizing that trauma has a long shadow is the first step. The tragic suicides one year and six years following the traumatic school shootings of Parkland and Sandy Hook are clear evidence of this. Perhaps in our “hurry-up” world, these most recent deaths remind us that community supports matter not only in the immediate aftermath of traumatic events but also for individuals who continue to suffer over time. Knowing the signs of risk of suicide and intent to harm oneself, can help prevent additional tragic deaths. This week, Dr. Kelly Posner Gerstenhaber, Director of the Columbia Lighthouse Project, spoke with PBS News about how community members in Parkland can use of the Columbia Protocol to identify who is at imminent risk for suicide, what are the important suicidal thoughts and actions to be addressed, and how individuals can best assist someone with suicidality in that moment.

 

Just two weeks ago, 50 people died in the Christchurch mosque shooting in New Zealand. May their communities rally to provide supports needed now – and in the long shadow of trauma – to all in need.