The impact of sudden, overwhelming, experiences, which render us helpless and shred the fabric of our lives, have a traumatizing effect that may last a lifetime. All we need to do is to turn our attention to the daily news on television or read the daily newspaper. As we are so aware, trauma comes in many forms: plane crashes, earthquakes, flood, fire, war, terrorist activities, mass murder civil unrest, nuclear accidents and chemical spills. People are victimized daily by rape, robbery, drive-by shootings, bus crashes and economic hardship. It seems the list of potentially traumatizing events is endless. If we live long enough, we in all probability, might eventually experience many of these things. Yet, in spite of all these contingencies of the human condition, we try to live in a manner which gives us a sense of meaning, purpose and significance. We act as if we are immune, immortal, and entitled to our lives of comfort and safety. This allows us to live even though to live is to experience pain loss and suffering. We act as if it will never happen to us. And then something happens which penetrates the safety cocoon.
I was sitting on my couch watching the news when pictures began being fed from a breaking story in Colorado, a high school. Up until that moment Columbine high school was a school that few of us had ever heard about, the events that ensued changed all of that. Shock, horror, chaos, terror, confusion, appalling images, frantic parents, frightened students running from a school with their hands in the air. News reporters trying to piece together a story from too many fragmented sources. On the whole it was a montage of a community coming apart, the fabric of suburbia torn asunder by a rage filled rampage by two of its own children. And typically, the network stars raced frantically to set up their locations and do their “prime time broadcasts on site, live and in living color.” Shattered lives, victims telling their stories while still in shock and unable to process what was in actuality happening to them: all trying to make sense of the senseless. Searching prematurely for the answers to why and why me.
That day in April has become a marker, a point in time much like the Kennedy assassination where everyone remembers where they were and what they were doing. This year has brought to light the fragility and vulnerability of life as we conventionally live it It has highlighted violence and in particular brought into focus the heretofore unknown phenomenon of children marching into their schools with guns and randomly killing their peers. These extreme events shock and traumatize those who are immediately victimized by the events but they also effect us all. The concentric circles of victimization radiate out from the epi-center much like the shock waves of an earthquake. They cause us to question our most cherished beliefs and values. These extreme events as horrifying as they are can teach us a great deal about ourselves and our culture: about our common human needs, capacities, illusions, fears, prejudices, ignorance, and heroics. By understanding trauma we learn about ourselves, victims and nonvictims alike. It is in the extremity of these events that we see the dynamics of wounding and healing and sobering glimpses into the dark side of human nature. Much like the weather reconnaissance planes flying into the eye of hurricanes, Columbine and other incidents have much to teach us about trauma and recovery.
The first lesson to be learned, if we have learned anything from them it is that they are far more deeply traumatizing and long lasting than most people would suspect, and that in fact many individuals do not come to terms with the event and do not go on with their lives. In a recent article in the Los Angeles Times, April 27, 1999 the lead article covered the Oklahoma City bombing. The article title: Oklahoma Bombing Toll Keeps Climbing. “Four years later, at least six people have become explosion-related suicide victims and at least twice as many have attempted it. And many more survivors racked by emotional pain are leading troubled lives....Many survivors--building workers, paramedics, police officers--were haunted by the guilt that they had lived while others died--people they were unable to save. The resulting psychological wreckage is everywhere: spousal abuse, failed marriages ruined careers, school problems, nightmares; drug and alcohol dependence....Professionals trained and experienced in the horrible business of mass killings know to expect such plagues. Within days of the bombing, trauma experts began warning that the suffering would likely reach its peak in three to five years--long after the national outpouring of sympathy had stopped and residents were left alone in their anguish. These years have now arrived.” I can only add my personal emphasis to this point, the same conclusions apply to Columbine and every other mass traumatic event. What determines the severity and scope of the degree of trauma is a function of the nature of the traumatizing events, their context and the number of people involved.
The second lesson to be learned from these very public events is that they are actually infrequent and isolated and that the real problem is much more widespread. Because of the magnitude and scope of the event they affect a great many individuals, but they are relatively small in scale compared to the actual number and frequency of traumatizing events which occur every year in this country. Case in point, there are approximately 2 million deaths per year in which 8 to 10 people are affected. This means that there are as many as 16-20 million newly bereaved every year. It is estimated that as many as 1/3 of these bereavements will result in serious, complicated reactions. As a consequence of this Complicated Grief Reaction is becoming recognized as a disorder that has serious psychological, behavioral, social, physical, emotional and economic consequences. Individuals who experience difficulties in recovering from a traumatic loss may require extensive, intense, and knowledgeable interventions. At the present time there is a serious lack of accurate information available on this disorder as well as availability of sources of competent care.
Six million individuals suffering the consequences of complicated, uncompleted mourning indicates that in many cases there are individuals living with psychological wounds which have not healed. Additionally, this number does not include all of the individuals, who in previous years, have had traumatic losses and are still struggling to regain normalcy. The actual number of individuals suffering from unhealed psychological wounds due to traumatic losses is probably badly underestimated. Individuals who have had their lives changed forever by sudden and overwhelming events: that is to say, a loss which is complicated by violence, accident, suddenness, murder, suicide, or unexpected medical problems are at great risk for eventual Complicated Grief Reactions. These life changing experiences are characterized by trauma and victimization which leave individuals not knowing how to cope, appropriately grieve, and return their lives to normalcy. In essence they are living lives distorted and compromised by tragedy.
What makes events like Columbine and Oklahoma City so difficult to comprehend is the combination of two factors. Violence at the hand of another. When someone we know intentionally sets out to harm us it is far more traumatizing than, say, losing one’s child to a tornado or car accident And secondly, these events violate the community by transgressing against our values and covenants which hold our worlds together.
A third lesson from Columbine, et al. is that recovery is very difficult and the resulting sequelae of unresolved grief tends to be a tenacious, persistent, and disabling problem unless the mourner is able to successfully pass through the necessary stages of mourning. Complicated mourning is defined as, given the amount of time since the death there is some compromise, distortion of failure of the mourning process. Usually after one year has passed. (Therese Rando) The work of mourning is the gradual restoration of harmony to both the external and internal world. What is their about Traumatizing Events which leads to the problem of Complicated Grief? The more personal an event is, i.e., when trauma becomes personal, and we become a victim, it takes on a much different character; we experience the world from a perspective altered by our suffering. The world, once you have been victimized, no longer feels safe. Our relationships with others take on another character altogether. And when we have been traumatized intentionally by another, or in a seemingly random “Act of God,” the world is never the same again. The operative word here is victimization. The American Psychological Association defines Trauma as being subjected “to a sudden and overwhelming event outside the usual range of normal of human experience that would be markedly distressing to almost anyone, which exposes the individual, or loved ones to threat, death, horror, sudden destruction of one’s home, or seeing another person killed as the result of an accident or violence. Psychological trauma, in brief refers to the wounding of a person’s emotions, spirit, will to live, beliefs, self-esteem, relationships and security. Traumatic loss is an all encompassing event which leaves people deeply affected in several areas. 1) Their basic assumptions about the meaningfulness, order, justice and controlability of their worlds may be shattered. 2) Their sense of significance and worth may be deeply affected or compromised, leaving them with an enhanced sense of shame and guilt. 3) Because of the sudden and often shocking nature of the event, the overloading of the psyche can also impact the body and produce psychosomatic effects that are difficult to treat. 4) Trauma also disrupts relationships and family networks in ways that may cause concentric circles of victimization. And 5) attempts to normalize life after trauma may lead to secondary problems. Substance abuse and other addictive behaviors are very common as attempts to avoid psychological pain and acute grief become deeply ingrained habits. In short, trauma creates an intensely emotional experience which entails many psychological risk factors. There are many issues in traumatic loss which may complicate grieving. Most of these risk factors are largely unknown by the public at large.
The first major factor which may complicate bereavement is the specific circumstances of the death, if the death is 1) sudden, 2) violent, mutilating, destructive or suicide, 3) random, and or preventable, 4) multiple, 5) the mourner is exposed to horror or death, and 6) the death is at the hands of another, then one or more of these factors may contribute to the death being traumatic. And, of course this will increase the probability that the individual or individuals will be highly at risk for a Complicated Grief Reaction. In Columbine, of course, all of the above risk factors were involved. This means that in all likelihood the students, families, teachers, friends, and emergency responders will suffer from at least some of the following symptoms: The shock and stressors will overwhelm their ability to cope. Their basic life assumptions about safety, order justice, meaning and control may be severely compromised. They will have difficulty making sense of, understanding or absorbing what happened. Their will be lack of closure and unfinished issues because they did not get to say goodbye. Psychological and physiological symptoms of trauma will persist and interfere with ongoing daily life. Many of the bereaved will fixate on the event and obsessively seek solutions. This may take the form of going on a mission, or a crusade. Others may get caught in a trap of avoidance which often leads to other forms of obsessions or addictions. The danger is that the victim may latch onto some form of escape which makes him or her feel momentarily better and then continue to utilize this behavior because it works for the time being. Gambling, substance abuse, spending, compulsive sexual relationships, working, thrill seeking, all have been known to be the result of unresolved trauma. For many of the bereaved they will begin to experience feelings of panic, anxiety, vulnerability and helplessness as the shock wears off in the months to come. We are already seeing that in the high degree of students who had a hard time returning to school. Secondary losses and trauma may arise as mourners perceive a lack of social support and understanding from well-meaning people. It is very common for victims to feel particularly estranged and alienated when they see others returning to “normal.”
Post traumatic stress symptoms may persist: sleeplessness, hyper-sensitivity, hyper-vigilance, flashbacks, intrusive memories, depression, somatic distress and illnesses, lack of energy, and an inability to feel any loving feelings. Many will experience issues related to the stigma of being a victim, shame, guilt, self-reproach and feelings of inexpressible anger may interfere with recovery. And finally, the many unrealistic ideas, myths, expectations and ignorance about grief may interfere with the healing process. In fact, it is very common for these inaccurate ideas about bereavement to actually create secondary injury. I have had many reports of well meaning spouses and family members chide the victim for “not getting on with life.” Probably the most typical is “Are you still crying about that, you’ve got to forget about it, get busy and get on with your life.” These statements are often made because the individual is frustrated, doesn’t know how to help, and also is very uncomfortable with the feelings being expressed. What are the implications of Columbine for the Recovery or Healing Process? I was watching a program the other night on the Discovery Channel on the topic of earthquakes. The commentator made the remark about Greenland, “It is very hard to live in a laboratory.” For the citizens of Colorado, as well as any other victim of a traumatic event, it is indeed very hard to live in a laboratory. Life goes on amidst all the trauma and the astonishingly complex after effects. We will not know the final toll for years to come. What we do know is that the effects are hard to measure. That when a whole community is impacted, life will never be the same. And that the recovery process will be very much by trial and error. It too is a laboratory. Several years ago, I had a unique opportunity to help a community go through a similar event. This was the Chino Hills Massacre. An inmate walked away from the Chino Men's Correctional Facility and hid in a house in Chino Hills. He killed in a very bloody and horrific way an entire family, the Ryan family and one neighbor boy were murdered. I was called in by one of the families to see if I could help them recover. I spent 6 weeks with them. Here is what I learned about recovery on an individual and community wide scale. I met with 10 to 15 families on a weekly basis for 6 weeks. We met as a group in one of the homes. It was a tightly knit neighborhood. The first session I asked them to describe what they had seen, heard, and participated in and how it affected them. This procedure is now known as Critical Incident Debriefing. This was done very soon after the murders. The literature now suggests that these debriefings are crucial to prevention of long term effects of trauma. The debriefings should be done as soon as possible. Debriefings provide an opportunity for catharsis, education, support, validation, and making the event real. Whether we are dealing with trauma, or recovery from addiction, I think the principle holds the same. In the early stages of recovery maximum support is needed because this is when maximum effects are being experienced and individuals are least prepared to cope. Their resources are low, stress is high, and they are overwhelmed by the problem. Early intervention actually sets the stage for the beginning of recovery. This illustrates the second principle: It is the quality of the recovery environment that is critical for maximum healing benefit. In order for individuals to survive trauma or any other psychologically debilitating event there needs to be a “context of hope, meaning and caring.” In order for an entire community to heal there needs to be a lot of work done to create, discover, or reestablish a sense of community.
In my work in Chino Hills, it immediately became apparent that their greatest asset was their community spirit; i.e., their strong bonds with each other. This led to their providing social, physical, and other forms of support. Some stood guard, others went shopping, others looked out for the children. They cared for each other. In our discussions, they all were sensitive to the needs of the others and were quick to step in and volunteer assistance when requested. This was very healing.
Stage 1 The task of bereavement in this stage is Recognition, which is to say, being able to realistically face the problem and break through the natural defenses of denial. This may take several weeks or months. The work of individual recovery is harder to measure and effect. Essentially, each person must go through several stages of Bereavement. The first stage is the impact phase which is typified by shock and numbing.
Stage 2 is a difficult task because it requires Recollection. In this stage the task is to begin connecting the memories and the feelings. The very nature of shock and coping to survive have frequently been dissociated. The psyche can only integrate or experience so much pain. This is the work of mourning, on the one hand trying to feel the feelings, and on the other fighting to not feel them. I call it “playing hide and seek with ourselves.” It is also the task of relinquishing the deceased and all psychological attachments. This stage may also last several months, depending on the complexity and nature of the relationship with the deceased. More complex and problematic attachments often signify greater difficulty in letting go.
Stage 3 is built on the work of the two preceding stages. This stage, Reconciliation involves the work of trying to make sense of the senseless and working through the conflicts in feelings, thoughts, and relationships brought about by the event. There may also be many internal areas which need healing and reconciliation, including with oneself. This is also the stage where any shattered beliefs or assumptions about life must be reconciled. In my own grief work discovered an analogy for this process. After my daughter died (SIDS) I described my life and belief systems as, “I am standing amidst the remains of a bombed out cathedral. All of my cherished icons and sacred images are destroyed. My task now is to reconstruct a new cathedral with new sacred images and icons which reflect the reality of my current predicament.” That is the task of this stage, to regain faith, if it was lost, and to be able to find new meanings and images worthy of caring.
Stage 4 is one of Rebuilding. Traumatic Bereavement involves the shattering of beliefs, feelings, self, and entire life. It is not easy task to overcome the very real disorganization and dislocations caused by trauma. This is the task; form new attachments, replace what was lost, and develop a new relationship with the deceased. This stage may require new beliefs, new attachments, new reasons to live, and a new identity. You will be a different person because of this life changing event.
Large scale catastrophes leave an imprint on not only the individual lives which are touched so urgently, but the entire community is also impacted. Healing the wounds of a community go hand in hand with the healing of individual lives. The healing of all our communities touched by violence and tragedy will require intelligent, committed leadership, knowledge, and faith. This kind of faith is based on what Erikson calls a “convincing ideology.” This is a shared core of values and covenants which bind the institutions and social structures together into a cohesive sense of identity. As James Fowler puts it in his book on Stages of Faith, “Religious faith must link us to communities of shared memory and shared hope with which we join in symbolizing our human condition and in enacting the visions that can animate and give new Life.” Our lives, our roles, our meanings, our identities are sustained by these covenants. It is these beliefs, and covenants which are threatened and often shattered by trauma. And it is these very core values, beliefs, and covenants which must be restored if there is to be healing within the community and if it is to be a healing community.
There are many lessons to be learned from Columbine and other disasters. Crises expose and
illuminate our inherent weaknesses and default institutions. They expose us to violence, chaos,
and madness. They remind us of our fragility, vulnerability, and mortality. They shatter our
comfortable lives and illusions which sustain our daily activities. They throw us out of the
conventional pathways of existence into the wilderness of new and horrifying experiences for
which we have no framework of understanding, experience or skills. This is the inherent nature of
trauma. Traumatic events leave us with many problems, and the work of mourning and
bereavement is the gradual restoration of harmony to both the external and internal world. We
begin the healing journey in chaos, with lives turned upside down: in total disorganization and
disarray. The task is to restore order, integrate the post event world into what is left of our worlds
after the disaster. The process of transformation must go through the gateway of suffering.
This kind of a journey is not accomplished in a day. What is most important for survivors to hear
and believe is: 1. You are not alone; 2. It will not always feel this bad; 3. There is hope; 4. There are things which can be done to heal.
As one of my survivors said to me one day, “I now realize that I belong to a very select club, it’s just
that the price of membership is so high.” This sort of wisdom is everywhere, I have discovered it
every time I hear someone tell me his/her story. People do survive, communities do survive, and in
the surviving their lives are transformed. In the work of bereavement people often discover
strengths and skills they didn’t know they had, friendships blossom, they gain wisdom and an
appreciation for the significance of their lives, they cherish their moments together and come to
value the very experience of being alive. They often report a re prioritization of values and a
keener sense of the importance of time and their mortality. As St. Thomas Aquinas once said,
and I paraphrase, “It is only in our encounter with death that the self is born.” Trauma often
becomes the vehicle for thrusting us into unimagined new realms of experience. None of us goes
willingly.
