Survivor’s Guilt: Dealing With Being “One of the Lucky Ones”

Survivor’s Guilt: Dealing With Being “One of the Lucky Ones”

Imagine being in a tragic event such as an earthquake that killed dozens, hundreds or even thousands of people, but you survived. Yet you had to bury family members and friends. You were right next to someone who didn’t make it, and you don’t understand why them and not you?

Days, weeks and months go by and you can’t shake that feeling of guilt, loneliness and wondering if you could have done something different to save someone else. When everyone is telling you that you should be happy that you survived, you don’t feel lucky. You may even feel undeserving of having survived.

You may feel like you can’t talk to anyone about what you are going through, after all, what do you have to complain about? You lived! You survived. You were one of the lucky ones! However, for many people who survive such horrific events, being a survivor is just the beginning of what can be a life-long, debilitating relationship with survivor’s guilt.

What Is Survivors Guilt?

Survivor’s guilt is something that may develop in some people who experience and survive a traumatic, life-threatening event. It is something that is common in war veterans, airplane crash survivors, survivors of natural disasters and mass shootings.

In her blog on Psychology Today, the Stoic Warrior, Nancy Sherman, PhD states that survivor’s guilt begins with an endless feedback loop of “counterfactual thoughts that you could have or should have done otherwise, though in fact you did nothing wrong”.

Recently two of the Parkland mass shooting survivors killed themselves a year after the tragedy and one of the father’s of a girl killed in the Sandy Hook school shooting also committed suicide. According to their family and friends, they all had a very difficult time coping after the tragic event and appear to have been suffering from survivor’s guilt.

While not everyone who survives such tragedies will experience survivor’s guilt, some signs and symptoms include:

  • Having flashbacks
  • Feeling irritable
  • Having difficulty sleeping
  • Feeling numb or disconnected
  • Feeling unmotivated
  • Feeling helpless
  • Feeling an intense sense or fear or anxiety
  • Experiencing physical symptoms such as headaches, stomachaches, and heart palpitations
  • Having suicidal thoughts

Survivor’s guilt is a normal response to loss, even if it may appear abnormal to someone from the outside looking in. They may be bewildered to why this seemingly “lucky” person is suddenly withdrawn, depressed or even suicidal.

Some studies suggest that individuals who suffer with depression or have experienced childhood abuse may be more susceptible to survivors remorse since both issues appear to break down a person’s healthy defenses and coping skills making dealing with such tragedies even more difficult.

If you or anyone who know may be suffering from survivor’s guilt, I  have gathered these helpful tips from the Psychology Today website:

  • Give yourself time to grieve.
  • Consider thinking about who was really responsible, if anyone.
  • Remember to take care of yourself physically and psychologically.
  • Think about what those who are close to you are feeling about the situation.
  • Remind yourself that you were given the gift of survival and feel good about it.
  • Try to be of service to someone or something.
  • Remind yourself that you’re not alone.
  • Be patient.
  • Share your feelings with those you trust.
  • Try to stick to a daily routine.
  • Consider journaling your feelings.
  • Get professional help, as needed.

I think it it important that after such tragic events, especially man made, horrible events like mass shootings, that while we are grieving for the ones we loss and reaching out to their families, that we don’t forget those who survived, the “lucky” ones, and reach out to them as well and continue to reach out and support them.

As you can see by the recent suicides, it can be a year or several years after the incident where the survivor reaches his or her breaking point. It also goes to show the bigger pictures of such tragedies and the very far reaching affects they can have on our society.

 

Talking To A School Shooter

Talking To A School Shooter

The other day I had the privilege of talking to a school shooter. When I say privilege, I don’t mean it in a way to glorify what he did, but it’sThe other day I had the privilege of talking to a school shooter. When I say privilege, I don’t mean it in a way to glorify what he did, but it’s not everyday that an opportunity presents itself for me to try to get into the mind of someone who was determined to carry out mass murder. Often these people kill themselves or are killed before anyone has a chance to understand why they did what they did, or like the Parkland shooter, are kept very isolated with only the psychologist and a handful of corrections officers having regular contact with him.

As a psychotherapist, this intrigues me. In undergrad I excitedly took classes such as Profiling Serial Killers, Understanding Mass Murder and The Anatomy of Violent Crimes. Yet, I had never been able to actually study someone in person so that I could better understand how to try to help others before they commit violent crimes as well as identify potential ticking time bombs.

With the nature of my job currently revolving a lot around criminal psychology, I end up talking to some of the worse of human kind on a daily basis. On a regular day I talk to murderers, rapists, child molesters and have even on multiple occasions attempted to talk to a hit man for a Mexican drug cartel accused of over a dozen murders. So far he has refused to talk to me or anyone else for that matter.

Without going into too much detail because this case is still pending, I would like to share some of what I have learned from talking to a school shooter.

The first thing I noticed about this particular school shooter was his small, non-threatening stature. He looked like your typical high school student, except there was no light behind his eyes. When he looked and talked to me, there wasn’t any emotion there.

I won’t go into if he has a mental illness or not, but he says he grew up in a family that was full of mental health issues, namely untreated bipolar disorder and schizophrenia. He says he was never physically or sexually abused, but witnessed a lot of family violence. As he says, his earliest memories are those of violence and conflict.

He had isolated himself at a young age. He didn’t feel attached or loved by his family. He had a lot of anger inside of him. He attempted to channel that anger by going into the military, but as a teenager he had gotten involuntarily committed to a mental hospital for a yet unknown reason, something that would later prevent him from joining the military.

Feeling even angrier, depressed and rejected because of that, he turned to Mixed Martial Arts as an outlet for his violent thoughts, but a knee injury caused him to have to stop training for awhile. It was during this time that his anger, depression and feelings of isolation grew and he started planning a mass shooting.

Planning included finding a way to legally buy a gun without a background check through a certain loop hole in the system. Planning included blending in with students of a high school he had dropped out of a couple of years ago, smuggling his weapon in using a musical instrument case and then going into the bathroom and putting on a tactical vest and gloves.

Before and during the incident, he reports he felt no anger or fear, just an adrenaline rush. He denies having any specific targets, any hate or anger towards any individual or group of people.

Although he says he feels remorseful, there are no emotions with his words. Yet he says the incident could have been a lot worse if it wasn’t for a girl’s screams that broke him out of his trance. He says it was her screams that made him feel horrible about what he was doing. Her screaming triggered memories of his childhood and made him and everyone around him, human again.

Some of the signs I’ve learned to look for from talking to him and studying other school shooters include:

  • Leakage- which is when people leave behind often unconscious clues, sometimes as a cry for help such as violent themes in their artwork or writing.
  • Low tolerance for frustration.
  • Poor coping skills.
  • Lack of resiliency.
  • Depression
  • Alienation
  • Dehumanizing others
  • Lack of empathy
  • Family appears to lack intimacy and closeness.
  • No limits or monitoring of TV and internet
  • Turbulent parent-child relationship

While it’s too late to have prevented this incident, I do hope that by continuing to learn from this individual and others, we’ll be able to prevent future tragedies. As long as I have access to him, I will continue to attempt to understand the mind of someone who would shoot up a school in Parkland, Florida, a movie theatre in Aurora, Colorado, a church in Charleston, South Carolina, a restaurant near Nashville, Tennessee, a music festival in Las Vegas or a nightclub in my hometown Orlando, Florida.

Childhood PTSD AND Trauma: Part 1

BW portrait of sad crying little boy covers his face with handsImagine a four-year-old child found covered in blood, lying over her mother’s naked, dead body, whimpering incoherently. She’s witnessed her mother being raped and murdered, and her own throat had been cut, twice in an attempt to leave behind no witnesses. She’s alone with her mother for approximately eleven hours before she is discovered.

After being hospitalized she is released as a ward of the state and put into foster care with no follow up treatment for the trauma she experienced.

How will she go on through life with those images etched in her mind? How will she survive psychologically? How will her mind protect her from such traumatic experiences?

This story is unfortunately a very true story, one of several stories of childhood trauma that can be found in the book, The Boy Who Was Raised As A Dog by Bruce Perry and Maia Szalavaitz.

Tragedies like this occur across our nation and the world everyday, leaving behind sometimes physical, but always emotional and psychological scars.

Post Traumatic Stress Disorder is a condition that 30 or so years ago was reserved only for soldiers who had experienced traumatic events at war. It was later recognized that rape survivors, people who had been through terrible accidents or natural disaster, also exhibited symptoms of PTSD including flashback, hyper-vigilance and avoidance behaviors.

When it came to children however, the mental health and medical fields were slow to realize the impact of trauma on their lives.

Children were thought to be naturally resilient and would “bounce back” without the aid of any type of support or treatment. Those same children who had experienced trauma would often later develop psychiatric problems, depression and attention issues that would sometimes led to medication.

We know  now that children who have live through tragedies, are just as affected as adults, perhaps even more so. This is evident in the great way the mental health community around the nation responded to the Sandy Hook Elementary School tragedy.

What Causes PTSD?

PTSD can occur in anyone who has lived through an event in which they could have been killed or severely hurt or where they witnessed someone else getting killed or severely hurt. These can include violent crimes, physical or sexual abuse, someone close to them committing suicide, car crashes, shootings, war and natural disasters just to name a few.

Approximately 40% of children by the age of 18 will experience a traumatic event, which includes the loss of a parent or sibling and domestic violence. In the United States, child protective services receives an estimated 3 million reports of abuse and neglect yearly, involving approximately 5.5 million kids. About 30% of all those cases show proof of abuse:

  • 65% neglect
  • 18% physical abuse
  • 10% sexual abuse
  • 7% psychological (mental) abuse

This of course doesn’t include the estimate 66% of child abuse cases that are never reported.

The Likely Hood Of PTSD Developing

Girls are more likely than boys to develop PTSD symptoms. Approximately 3-15% of girls and 1-6% of boys who experience a trauma will develop PTSD. The chances of developing PTSD are higher depending on the type of trauma experienced. Some of the risk factors for PTSD include:

  • How severe the trauma was
  • How the parents react to the trauma
  • How close or far away that child is from the trauma

Of course children who go through the most severe traumas have the highest level and severity of PTSD symptoms. Incidents where people are hurting other people such as assault and rape, tend to result in PTSD more frequently. Children who have healthy support systems tend to have less severe symptoms.

The age of the child during the traumatic experience doesn’t seem to effect rather PTSD symptoms will develop, however PTSD looks different in children of different ages.

What Does PTSD Look Like In Children Ages 5-12?

  • children may not have flashbacks or problems remembering parts of the trauma like adults with PTSD often do.
  • Children might, however put the events of the trauma in the wrong order.
  • They might also think there were signs that the trauma was going to happen and thus they think that they will see these signs again before another trauma happens.
  • They think that if they pay attention, they can avoid future traumas which can lead to hyper-vigilance.

Children around this age may also show signs of PTSD during their play. They may keep reenacting part of the trauma. For instance, a child who has seen a shooting may want to play video games involving shootings or carry a gun to school.

Teens (ages 12-18)

In teens, some of the PTSD symptoms may be similar to those of adults including flashbacks, reoccurring nightmares about the event, hyper-vigilance and exaggerated startle responses. Teens are more likely than children or adults to show aggressive and impulsive behavior.

What are the other effects of trauma on children?

Other effects of trauma on children from PTSD comes from research done with children who have been through sexual abuse. They include:

  • fear
  • worry
  • sadness
  • anger
  • feeling alone and apart from others
  • feeling as if people are looking down on them
  • low self-worth
  • not being able to trust others
  • undesired behaviors such as aggression, out-of-place sexual behavior, self-harm, and abuse of drugs or alcohol

For many children, PTSD symptoms go away on their own after a few months. Yet some children show symptoms for years and possibly a lifetime  if they do not get treatment.

How Is PTSD Treated In Children?

For some children, the symptoms of PTSD will go away on their own with healthy supports and when they aren’t being re-traumatized by anxious parents or the media. For others, they may need professional help including:

  • Cognitive-Behavioral Therapy such as Trauma-Focused Cognitive Behavioral Therapy
  • Psychological first aid/crisis management
  • Eye movement desensitization and reprocessing (EMDR)
  • Play therapy
  • Special treatments may be necessary for children who show out-of-place sexual behaviors, extreme behavior problems, or problems with drugs or alcohol.

What Can You Do To Help?

Educated yourself on PTSD and pay attention to your child for signs such as anger, avoidance of certain places and people, problems with friends, academic changes and sleep problems. If you need professional help, find a therapist in your area that treats PTSD and that your child feels comfortable with.  Where to Get Help .

 

Sources: The National Center for PTSD

Before Adam Lanza, Seng-Hui Choi, Eric Harris And Dyland Klebold, There Was Charles Whitman

whitman000As the nation and the world continues to mourn for the victims of the Sandy Hook shootings and for Newtown, Connecticut altogether,

we are finally having some extensive and serious dialogue about gun control and mental illness.

It usually takes something like this to happen before people talk about these issues, but something I was thinking about was the continued argument I have been hearing about banning assault rifles as if that alone will stop mass murders from happening.

I don’t necessarily want to get into that argument, but it made me think about people like Timothy McVeigh who used racing fuel, fertilizer and a rental truck to blow up a building and kill 168 people including children attending daycare.

It also made me think about one of the earlier, popular mass murders on a school or college campus done by Charles Whitman at the University of Texas in Austin on August 1, 1966.

Leading up to the shooting, Charles Whitman had been suffering from tremendous headaches, health problems and abusing amphetamines.

The day before his rampage he begin writing his suicide letter which included:

I do not quite understand what it is that compels me to type this letter. Perhaps it is to leave some vague reason for the actions I have recently performed. I do not really understand myself these days. I am supposed to be an average reasonable and intelligent young man. However, lately (I cannot recall when it started) I have been a victim of many unusual and irrational thoughts.

Around midnight the next day he drove to his mother’s house and killed her, stabbing her in the heart and leaving a letter saying that he loved her. Apparently he wanted to rid his mother of the troubles of the world.

He then drove home and stabbed his wife three times in the heart while she slept and finished writing his suicide note including saying:

“I imagine it appears that I brutally killed both of my loved ones. I was only trying to do a quick thorough job […] If my life insurance policy is valid please pay off my debts […] donate the rest anonymously to a mental health foundation. Maybe research can prevent further tragedies of this type.”

He requested an autopsy be done to see if there was an organic reason for his terrible headaches and increased irrational and disturbing thoughts. Thoughts he said he couldn’t take any more.

He then prepared for his rampage and went to the University of Texas at Austin with weapons that included two rifles, a shot gun, a hand gun, a machete and some knifes. He shot several people before reaching his destination, which was the observation deck on a tower on campus.

From there he would shoot and kill 14 people while injuring 32. An autopsy would reveal a highly aggressive and fatal brain tumor that would have likely killed him within the year.

This tumor no doubt was responsible for his irrational thoughts and violent impulses.

Before the murders, Whitman did seek help for his headaches and violent thoughts and impulses from no less than five doctors, including a psychiatrist he visited once and said of the psychiatrist:

“I talked with a Doctor once for about two hours and tried to convey to him my fears that I felt come (sic) overwhelming violent impulses. After one visit, I never saw the Doctor again, and since then have been fighting my mental turmoil alone, and seemingly to no avail.

Medical records released from Dr. Heatly, the psychiatrist he saw only once say:

“This massive, muscular youth seemed to be oozing with hostility […] that something seemed to be happening to him and that he didn’t seem to be himself.”

And:

“He readily admits having overwhelming periods of hostility with a very minimum of provocation. Repeated inquiries attempting to analyze his exact experiences were not too successful with the exception of his vivid reference to ‘thinking about going up on the tower with a deer rifle and start shooting people’.”

The above statement is chilling because that’s exactly what he ended up doing. If he would have been involuntarily hospitalized then for homicidal thoughts, maybe all of those people would have been alive to see another day.

Sometimes trying to find the origin of mental issues is difficult, but it seems like Whitman at least tried and was failed by his doctors (or maybe just the victim of the period of time he was living in).

If his brain tumor could have been found earlier, or if he could have been hospitalized in a psychiatric institution, maybe the murders could have been prevented.

There are no doubt evil people in the world who commit mass murder like the one at Sandy Hook, but I think for the most part, people who decide to commit mass murder, have underlying emotional/psychiatric problems, that if caught and treated early enough, could prevent such senseless tragedies.

The tragedy at Sandy Hook and the many more before it have no doubt brought us to a place where we will change the way we do everything from protecting our schools, to protecting our communities from guns and those with mental issues that need to be kept safe from others and themselves.

I just hope that as we grief and eventually heal as a nation, that the talks about reform don’t die down until the next tragedy rips us out of our false sense of security and throws us back into outrage and panic.