a young boy and girl hold hands while walking to school

commentary

(RAND.org)

December 20, 2012

In Connecticut, Recovery and Healing Will Take Time

by Lisa H. Jaycox

I've spent much time since Friday imagining the unimaginable—little children murdered in the place that is supposed to be their home-away-from-home, their elementary school. The media fed my curiosity. I could not stay away from checking the news and blogs hourly, despite my family's pleas to stop reading and my own knowledge that it can be too much to read so many details, see so many pictures, grieve from afar.

It's because I want to help. I am a psychologist, and this is why I went into the profession and made trauma my focus. I know from a vast amount of research that many of those touched by Friday's shootings will experience a great deal of distress in the weeks and months ahead. But they will, somehow, miraculously, find a pathway forward to health and productivity. And I am reassured that over the past 15 years or so, we have developed a wide array of practices, procedures, and interventions that are well-tested and helpful for those children that will take longer to recover.

Of course we also know that with an event like this, "recovery" doesn't mean a return to normal, because lives have been permanently altered. Recovery can only mean finding a new normal, a new path forward. And schools, those places of safety and healthy development, can help with that process, by providing a structure and community to support healing.

I've been involved in this type of work for the past decade, and I am reassured that schools play this role in many ways, from the routine delivery of hot breakfasts and lunches to children in need, to sheltering families following disasters, to identification and intervention for mental health problems. Surely they are well positioned to help considerably following a shooting. But what happens when the school building itself was the site of the horror? When the caring teachers and staff are among the victims? When a school entrance, classroom cupboard, or bathroom stall becomes a terrifying reminder? These transformations are part and parcel of traumatic experiences, and cause us all to rethink our concepts of safety and danger, life and death, connection and isolation, healthy and sick.

One thing I've learned over the years is that a strong desire to help does not translate into being allowed to help. Schools and communities that undergo a horrific event like this one need time to settle, reconfigure, and find trusted advisors from both within and outside. Twenty years ago there were few options when a crisis arose—there seldom were local experts. But over time, with sustained efforts and robust federal funding, expertise and capacity to handle trauma and grief, even on a large scale, has grown exponentially. We've come a long, long way since 2001, when there were few resources and little public recognition on how children react to trauma and grieve.

Another thing I've learned: patience. It takes some time for a community to get ready for mental health support. First come the basic needs: funerals, food, shelter, sleep. These take a while to sort out. Structure, routine, and caring adults who can listen are the most important things for a child following trauma. These things can help restore a sense of safety and allow some processing. These have to come first. And many people are able to bounce back—the resilience of kids is incredible. Some will need some support, but we can't know who until later on.

Assistance we provided in New Orleans post-Hurricane Katrina didn't begin until the 2006 school year, a year following the storm. Work we are doing in Chardon, Ohio—where three students were fatally shot at a high school in February—is just getting started. Newtown won't know what type of help it needs, or whether it wants outside help at all, until later. So we wait, with confidence that help is available, and can be successful.

We've learned that specific types of therapies can help those who continue to experience anxiety or depression months after a traumatic event. These therapies contain simple techniques like relaxation, to more complex ones like processing the traumatic event through imagination, stories, or artwork. They have in common a core set of concepts that involve processing the traumatic memory, learning skills to enhance coping, connecting with others, and findings ways to reduce anxiety and improve mood. There has also been much learned over the years about what is not helpful, and can impede recovery.

As I wait to see how the story unfolds for Newtown, I look forward to the stories of heroism, community, and resilience. I look forward to seeing my colleagues help and even learn from their experience so that others can be helped in the future. My hope is that these stories of strength can eventually wash out and replace the ones that are haunting all of us right now.


Lisa Jaycox is a senior behavioral scientist and clinical psychologist at the nonprofit, nonpartisan RAND Corporation.

This commentary appeared on RAND.org on December 20, 2012

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