Wrapping our head around a mass shooting: Post-traumatic Stress Disorder in victims and those that care for them
As a therapist, I am certainly not immune to emotional distress and trauma. The biggest mass shooting ever to occur in the United States just took place in my hometown of Orlando at a nightclub that I have been to before. My friends/colleagues in mental health work at the very hospital where over 53 injured victims were taken and they are frantically trying to comfort distraught shooting victims and the family members who are looking for their loved ones who may be injured or dead. All the first responders who attended the scene may have trouble getting the picture of what they saw in the nightclub out of their heads. My own brain is struggling with the enormity of it all as this huge loss to our community sinks in even though I was safely home in bed when the whole event occurred.
A big part of my practice these days involves using a type of therapy called Eye Movement Desensitization and Reprocessing (EMDR) in my work with clients who have survived a trauma of some kind like rape, plane crashes, car crashes, physical abuse or witnessing a violent death. These clients have developed post-traumatic stress disorder (PTSD) and their symptoms include:
-Experiencing intrusive flashbacks or re-experiencing the traumatic event
-Avoiding the place where the trauma occurred or anything that reminds them of the event
-Feeling hyper-aroused which means they have trouble sleeping and feel jumpy and/or irritable
-Dreaming about the traumatic event
-Having panic attacks
When I think about all the recent victims of this mass shooting, I know that many of the survivors will develop PTSD in the coming weeks and months. Family members and loved ones of those who perished may also develop PTSD as a result of having to identify their bodies of their loved ones and grieving their unexpected and tragic loss. Not everyone develops PTSD as a result of experiencing or witnessing a traumatic event and we don’t really know why that is. But, what I do know is that many people with PTSD suffer in silence for a long time before they go to their physician or a mental health professional for diagnosis and help.
If you or a loved one begins experiencing symptoms of PTSD after a traumatic event or loss, please don’t ignore the symptoms or tell yourself that you just need to “suck it up and be strong.” PTSD is a very treatable condition and the impact that untreated PTSD has on one’s quality of life is profound.
My thoughts and prayers go out to all the victims of this senseless tragedy. I work with a lot of LGBT clients in my practice and I take comfort in knowing that our local LGBT community is very strong and that they will support each other as they heal.
Dana Nolan MS LMHC NCC
Licensed Mental Health Counselor
Altamonte Springs — Orlando
April is Child Abuse Prevention Month. Sadly, child abuse occurs far too often. Some families seem to pass on the legacy of physical, sexual and psychological abuse because many times victims of childhood abuse grow up to abuse their own children. This pattern can be halted if victims of abuse seek and receive professional help to deal with their trauma.
Commonly, a survivor of abuse will “stuff” their emotions and the memories of the traumatic events when they arise. They may turn to drugs or alcohol to numb the pain or to make the memories of their abuse disappear. These strategies work in the moment, but the thoughts, feelings and memories will keep coming up unless they are processed therapeutically. Quite often, my clients have told me that they have tried on their own for many years to get rid of their traumatic memories, anxiety and negative thoughts before they seek counseling.
There are a variety of therapeutic models to deal with the trauma of childhood abuse.
Trauma-Focused Cognitive Behavioral Therapy– helps victims of abuse to reframe the irrational and negative thoughts/beliefs that are often formulated after surviving childhood abuse.
Eye Movement Desensitization and Reprocessing (EMDR)-a very specialized form of trauma treatment developed to address the flashbacks, memories and negative thoughts common in those with post traumatic stress disorder (PTSD).
Dialectical Behavior Therapy-a collection of therapeutic interventions that focus on helping victims of abuse learn to manage their emotions, cope with stress in interpersonal relationships and tolerate emotional distress.
Play Therapy-a therapy for children that helps them express and process their emotions and memories of abuse in a safe environment. Play therapy uses dolls and toys to teach about healthy relationships and boundaries.
Pharmacologic Therapy-many times survivors of childhood abuse develop sleep problems, anxiety disorders (generalized anxiety disorder, post-traumatic stress disorder or phobias) or a mood disorder. Psychiatrists can prescribe medications to help manage symptoms which allow the survivor of abuse to work through trauma in counseling.
In my practice, I work with adult survivors of childhood abuse and utilize trauma-focused cognitive behavioral therapy, EMDR and dialectical behavioral therapy and have found these modalities very successful. It takes a great deal of courage and trust to reach out and seek help. If you are a survivor of childhood abuse and are ready to start feeling better, ask you primary care physician for a referral to a mental health care professional in your area that specializes in post-traumatic stress disorder and interview a few therapists to make sure you feel comfortable talking with them
All too often, there are reports in the news of children being abused or neglected. My heart breaks as I try to fathom what could possess an adult to physically or sexually harm or to fail to provide even most basic care to a child. As a psychotherapist, I am a mandated reporter of abuse or neglect and have made numerous reports to the Department of Children and Families (DCF) over the years. Those calls are never easy to make, but I take comfort in knowing that I may be the only person in a vulnerable person’s life to try to protect them.
Sadly, we tend to hear about reports incidents of abuse where DCF wasn’t able to help a child quickly enough or there wasn’t enough evidence at the time to warrant removing a child to prevent further abuse. However, reports that I have made to DCF have been investigated and acted on properly to further protect the child(ren) I was concerned about.
Governor Scott recently enacted legislation in Florida requiring ANYONE who suspects that a child is being abused or neglected to make a report to DCF. Failure to make a report in those cases is now a felony. I believe that this is a step in the right direction in making everyone accountable to report child abuse.
So what exactly do you do to make a report to DCF? Most people want to do the right thing but don’t know what steps to take. Some people are reluctant to make a report for fear of retaliation from the suspected abuser if they find out who reported the abuse. Others are unsure if they have enough “proof” of abuse and would feel terrible if they falsely accused someone of abuse without being absolutely sure there is abuse going on.
How does DCF define abuse or neglect of a child? According to the Florida Statute 39.01, child abuse means abandonment, abuse, harm, mental injury, neglect, physical injury or sexual abuse of a child. If you are unsure if a particular incident meets the criteria of abuse, review the statute online which provides a very detailed explanation of each term listed above.
Reports to DCF can be made anonymously unless you are a mandated reporter (for example: a physician, nurse, teacher, mental health professional, etc.) However, even if you give your name when you make a report, that information is NOT shared with anyone except the investigator who doesn’t disclose who made the report to the accused or the victim. It is usually helpful to provide your name in case the DCF investigator has further questions about the abuse allegations or has trouble locating the child.
You cannot be held liable if you make a report to DCF in good faith. Let’s say that your child’s friend discloses to you that her uncle molested her last week. It is not necessary to have observed the incident or to investigate if it really happened. All you are required to do is to make the report based on the information you have at that time.
Intentionally and maliciously making a false DCF report is a third degree felony and also carries a fine up to $10,000 per violation.
Making a report to DCF in Florida
There are three ways to make a report to DCF.
Before you make your report, it is helpful to write down as many details as you can about the incident of abuse and risk of further abuse. Here are some things you will be asked to provide to in your report:
Name, age or DOB, race, gender for all adults and children involved
Addresses or other means to locate the adults and children involved
Relationship of alleged perpetrator to the child
What abuse or neglect you observed or were told by the victim (when it happened, where it happened, extent of injuries, etc.)
If you do not have all the details listed above, don’t delay making a report using any information you do have. However, it is very helpful to provide as much detailed information as possible to help the investigator do their job. Personally, I prefer to call the Abuse Hotline (1-800-96-ABUSE) and speak to a person about my concerns rather than make a report online or by fax. When you call, you may have to wait on hold for a while before you speak with a DCF representative. After you provide all the details about the suspected abuse, the DCF representative will inform you during your call if your report was “accepted” and will be investigated. If your report was not accepted, it is because what you are reporting is not considered abuse or neglect according to DCF or there is insufficient information to proceed with an investigation.
There are more than 1 million children each year who are victims of abuse or neglect in Florida according to child protective agencies. Many of these victims don’t ever receive help because their abuse wasn’t reported. When parents don’t, won’t or can’t protect or care for their children, the Department of Children and Families step in to help in many ways. But, DCF can’t help if they don’t know about the abuse. Protecting our children is protecting our future!
From the desk of Dana Nolan, Licensed Mental Health Counselor…
April is Child Abuse Prevention month. In my practice, I have way too many clients who suffered childhood abuse and/or neglect and now have ongoing emotional or psychological issues related to trust, self-esteem, depression, anxiety/PTSD and unhealthy relationships. My job as a therapist is to help survivors of childhood abuse work through the abuse to become happy, well-adjusted adults. Ideally, it is always better to prevent a problem than to try and fix it later on.
Florida Governor Scott recently approved laws aimed at reducing childhood abuse. Today, anyone who fails to report incidents of child abuse, neglect or exploitation can be charged with a felony. Previously, only “mandated” reporters (doctors, nurses, mental health professionals and teachers) were obligated to report known or suspected abuse of a child or vulnerable adult. The purpose of this law was to make EVERYONE responsible for reporting abuse. Historically, child abuse was considered a private, family matter and many adults failed to report abuse they observed or suspected because they believed it was “none of my business.” This new Florida law means that it is EVERYONE’S business to look out for our youth and vulnerable adults.
It is really quite easy to make a report to the Department of Children and Families services here in Florida. You simply call 1-800-96-ABUSE (1-800-962-2873) or log onto https://reportabuse.dcf.state.fl.us. It is important to have specific information ready to provide in making the report: Name, date of birth (or approximate,) race, gender, address or location of child and what exactly you observed that leads you to believe that a child is being abused, neglected or exploited. All reports to DCF are confidential and you cannot be held liable for making a report provided it is made in good faith.
Most of my clients who suffered childhood abuse or neglect have said they always wondered why no one ever stuck up for them or reported the abuse when it was observed. Please know that you CAN make a difference in the life of a abused or neglected child by being that ONE person who does stick up for them and makes that phone call to make a report.