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April 18, 2018 | Brian Gong, LMHC

The shooting at Marjory Stoneman Douglas High School on Valentine’s Day changed the lives of many forever in profound ways that others who were not there can only imagine.  Those who were in the 1200 building were forced to experience the terror of the incident firsthand and are likely to have experienced the greatest level of traumatization; however, others such as family members, students and staff who were in other parts of the campus, and many more were impacted significantly.  After all, the critical element that makes an event “traumatic” is the subjective assessment of how threatened and helpless one feels during the event (van der Kolk et al., 1996).

Members of the Southeast Florida Trauma Recovery Network (TRN) have had the honor of treating dozens of MSD students, teachers, and family members for post-traumatic stress and have observed a variety of common symptoms and reactions.  Of course, it is important to note that these are all normal reactions to an incredibly abnormal situation, so there is nothing to be ashamed of.  The body has a way of reacting with a mind of its own following an overwhelming, extraordinary event.

Many MSD victims report the presence and interference of memory intrusions related to the shooting in the form of terrifying images, thoughts, feelings, body sensations, sounds and even smells.  When the experience of a trauma is overwhelming beyond the capacity of the brain to process, the traumatic memory becomes dysfunctionally stored in the right limbic system of the brain and not integrated and accepted as part of a person’s past, as a story of an event that occurred and is now over.  Instead, the past is relived as if the traumatic event were happening all over again.  This re-experiencing of the trauma is a hallmark feature of PTSD and often is triggered by some stimuli or reminder of the event. Many students and teachers talk about difficulty getting images out of their heads of the bodies and blood that they saw when being escorted out of the building by police.  One student had a major flashback when he was visiting a college and the fire alarm went off in the building he was in.  Another reported smelling smoke from her family cooking dinner and her mind suddenly went back to the smell of gunpowder that day.  One student described hearing screams of laughter from children playing nearby but had the instinctual feeling of being back at the school that day.  Others have an exaggerated startle response and feel jolted when commonplace things happen such as a door slamming, a book falling to the floor, or the clanking of some ordinary piece of metal.  Nightmares are common, of course.  The unprocessed and unresolved memories of that day continue to haunt them.

Many report a chronic state of hyperarousal, with difficulty sleeping and feeling “jumpy”, “twitchy”, “keyed up” or on edge all the time.  They are finding it impossible to relax and calm their nerves.  Understanding the psychobiology of trauma helps to explain these reactions.  When individuals experience a crisis, they go into fight or flight (or freeze) caused by the sympathetic nervous system increasing the release of adrenaline and other hormones (Solomon & Heide, 2005).  When the traumatic memory is triggered, the body continues to become flooded with these hormones leading to a constant state of physiological arousal.  This chronic stress can cause much distress and the suppression of the immune system.  Several students and teachers have reported taking weeks to get past their colds and other common ailments that normally would have taken only a few days.    These uncomfortable body sensations and feelings often lead to the process of avoidance where individuals try hard not to be reminded or even think of the event so as to prevent themselves from having to experience the pain over and over again.  They will often organize their entire lives around not having to feel these feelings thus leading to the problem getting worse as they’re not processing the event in any way and also start to withdraw from society and healthy social interactions.

Emotional dysregulation and negative cognitions are common.  Many are really struggling with the choice they made in not opening the door for people trapped in the hallway and suffering from tremendous amounts of guilt.  Despite knowing that keeping the door closed and locked is the protocol they were trained in to keep the students in the classrooms safe, the thought of “I should have done something different” continues to cause a lot of disturbance.  Many are analyzing their behavior and wishing they would have taken action to stop the perpetrator from continuing his wrath.  After all, it is way more tolerable for a person to believe they had some control in the situation as opposed to the truth – that they were utterly helpless.  Despite knowing that a person often loses control of their body during a crisis, students and teachers feel embarrassed and ashamed of how they reacted whether it be that they were making nervous jokes after the incident or that they were frozen in fear.  Many have intense levels of depression and anger.

Many report that during the shooting they believed it was all just a drill, that it wasn’t really happening or that they felt like they were in a fog the whole time.  This is likely an example of what is called dissociation which is a very common feature of psychological trauma and is the brain’s subconscious way of coping with the event by disconnecting in some way from the overwhelming reality of the situation.  Many are having trouble feeling grounded and present in the moment and find themselves feeling numb and detached.

I hear many express frustrations that they are having a hard time focusing, keeping up with class conversations and difficulty reading books and organizing their thinking.  Cognitive deficits are a prominent symptom of post-traumatic stress and include impairments in attention, concentration, and memory, planning, and problem-solving due to a hyperactivity in the limbic system, or the emotional center of the brain, and low activity in the prefrontal cortex (Hayes et al., 2012).   This causes clear implications in an institution such as a school where the primary focus is on learning.

These are just some of the common reactions I have noticed in working with numerous Parkland teachers, students, and family members.  And beyond these traumatic stress symptoms are the loss of friends and loved ones and a new harsh reality and reduction of one’s sense of safety in the world.  But there is hope.  With loving support as well as engagement in effective counseling with an experienced trauma therapy professional, the traumatic memory can be cleared away leading to reduction or even an elimination of symptoms described above.  Recovery can indeed happen, one step at a time.

 

Brian Gong is the co-founder and coordinator of the Southeast Florida Trauma Recovery Network which is providing pro bono EMDR therapy to those individuals directly impacted by the Parkland shooting.  For more information or to request no-cost trauma therapy, please visit: www.southeastfloridatrn.org

 

 

Hayes, J. P., VanElzakker, M. B., & Shim, L. M. (2012). Emotional and Cognitive Interactions in PTSD: A Review of Neurocognitive and Neuroimaging Studies.  Frontiers in Integrative Neuroscience, 9(2012).  Retrieved from https://doi.org/10.3389/fnint.2012.00089

Solomon, E. P., & Heide, K. (2005).  The Biology of Trauma: Implications for Treatment.  Journal of Interpersonal Violence, Jan 2005, pp. 51-60. doi: 10.1177/0886260504268119

Van der Kolk, B., McFarlane, A. C., & Weisæth, L. (2007). Traumatic stress: The effects of overwhelming experience on mind, body, and society. New York: Guilford Press.

Common Traumatic Stress Reactions in Parkland Shooting Survivors

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