Incidents like the movie theatre shooting in Colorado demonstrate how sudden, unexpected acts of violence can not only end lives, but change lives.
“The immediate impact is a sense of shock, disbelief, and confusion which is almost universal even for trained first responders,” says Julian Ford, professor of psychiatry at the UConn School of Medicine. “This is followed by heightened emotions such as fear, guilt, anger, or grief—or a ‘shut-down’ response of feeling nothing or numb, both of which are normal reactions in the first few hours and days, sometimes occurring gradually and other times happening suddenly when a ‘wave’ of emotion or troubling memories takes the person by surprise.”
Ford, who is an expert on post-traumatic stress disorder, says for those who were involved in such an incident or who witnessed it on-site, the impact can linger far beyond when physical wounds heal. This is especially true if they felt as though they were trapped or believe they were specifically targeted.
“They also are more likely to be intensely affected if they felt that they didn’t do enough to prevent it from happening or protect themselves or others, that they can’t get certain parts of the experience out of their mind, that they can’t face any reminders without feeling overwhelmed or breaking down, or if they sustain physical injuries that cause persistent pain or disability,” Ford says.
Family and friends may notice survivors to be angrier, more withdrawn, more tense, less communicative, or less able to be intimate than they were before the trauma. These changes can be attributed to persistent PTSD.
When the scene of the incident is a workplace, it comes with additional dynamics.
“It is reasonable for employees to expect to be safe at their place of work—especially one would think at a movie theater,” says Elizabeth Robinson, who manages the UConn Health Center’s Employee Assistance Program. “An incident like this shatters our sense of security in our ‘immediate worlds.’”
Robinson, a licensed marriage and family therapist and certified employee assistance professional, says there are steps employers can take, starting with providing an organized response of support.
“Establish times and places for employees to meet, and provide refreshments at these times,” Robinson says. “Be sensitive to the fact that everyone reacts differently and thus, do not be judgmental. Allow employees to participate as appropriate in any of the ritual activities following the trauma and perhaps most of all, know that the trauma response is a process over time and does not necessary proceed in a linear fashion. There is no clearly defined end point.”
Robinson recommends employers make EAP available to employees and their family members.
“There is no getting back to normal, or how things were before the event,” Robinson says. “Those affected are forever changed and their journey includes getting to know themselves and their world in a new way.”
Crucial to emotional recovery is information, Ford says, to enable people to anticipate their normal reactions and recognize signs that they may need to talk to someone qualified to help them. His office, for example, offers a brochure on PTSD and stress management.
“Counselors and therapists should provide this information as well—repetition often is necessary when people are recovering from emotional shock—and they should know how to help victims or family members to first regain their emotional balance and then, usually not for several days or weeks, deal with troubling memories that persist,” Ford says.
Many factors go into how people react to tragic situations, Robinson says, including personal history regarding trauma, support network, family situation, other major life events or co-occurring situations. “Some individuals may be in a state of shock longer than someone else, some may cry, or not cry at all. Some may want to talk, others not. Some may want to crack a joke to relieve the tension and stay away from the intense emotional feelings of being reminded about the fragility of live and how one’s reality can change in a heartbeat.”
Another thing to remember, Ford says, is that media accounts can deliver an event’s impact to those who weren’t there.
“Besides feeling a sense of sympathy for those affected, it can reach others mainly by reminding anyone who has experienced violence in the past in their own life of those past events. This could lead to a worsening in past PTSD, by opening up old emotional wounds, or symptoms such as anxiety or depression,” Ford says. “But it won’t cause anyone to develop PTSD out of the blue.”
This article first appeared on UConn Today.