PTSD: National Center for PTSD
What to Expect in the Wake of Mass Violence
What to Expect in the Wake of Mass Violence
Mass violence events happen with alarming frequency. Large scale shootings in public places - malls, workplaces, entertainment venues, and schools - receive the most attention in the media, but incidents in which two or more people are the victims of serious violence happen regularly. These deadly crimes may be committed using guns, knives, fire, bombs, or even cars and trucks.
Mass violence events may cause a range of responses in people who were directly exposed to them and in those who are more remotely affected. We know from the research on mass shootings that the people who were directly involved are likely to have more severe traumatic stress reactions, and that these reactions will last longer.
In the midst of mass violence, there is often also bravery, service, and compassion. Emergency responders rush to the scene. Strangers come together to apply first aid and transport victims to hospitals. Doctors and nurses work long hours to save lives and give comfort. After the immediate crisis has passed, communities may hold vigils or events to remember their neighbors and friends.
Almost everyone who was at the scene of an act of mass violence will have symptoms in the immediate aftermath. The initial relief to be alive may be followed by distress, fear, and anger. Survivors of mass violence may find it hard to stop thinking about what happened, have trouble sleeping, or feel keyed up or on edge. For most people, reactions will lessen over the first few weeks after the event. For those who lost a loved one or were injured, reactions may be more intense and longer-lasting.
What Is Affected after Mass Violence?
Sense of Safety. Mass violence harms our sense of security and safety. This is true for individuals, communities, and society as a whole. The unpredictability and life threat of mass violence can make people feel at risk for similar events - even if they were not directly affected.
Ability to Remain Calm Emotionally. People who were directly exposed to mass violence may feel a range of reactions that occur on and off, even years later. Anger, frustration, helplessness, grief, sadness, fear, and a desire for revenge are frequent reactions to crimes like these. Physical symptoms and sleep problems also occur. These reactions are normal - and common - but they can cause a lot of distress. Getting community support, practicing good self-care, and taking advantage of mental health counseling can help.
Coping after Mass Violence: Immediate Needs
After mass violence, people’s reactions, needs, and priorities will vary depending on many factors. In the immediate aftermath of mass violence and disasters, most people have a core set of priorities that are related to five key needs:
- Reestablishing a sense of safety
- Regaining control and calm
- Connecting with loved ones and others
- Getting through the crisis
- Feeling hope, optimism, faith, or the belief that things will work out
Feelings of distress following mass violence or disaster cannot be resolved by a simple fix. But there are some important principles to remember:
- There’s no “right way” to deal with these things. We each need to find the way that works for us, and be patient in applying simple, ongoing strategies.
- Talk when you need to; listen when you can. It sometimes helps to hear the perspectives of other people who share your values and experiences. Take what helps and leave the rest.
- You don’t have to talk when you don’t feel like it. Survivors sometimes do better when they are given space. If you are the loved one of a survivor, respect the survivor’s desire not to talk if that is what they want. Give them space, and check back later.
- Resilience often means rolling with the punches. Disasters highlight the forces in life that are much bigger than we are, and remind us that there’s only so much we can do.
- Social support is key. Positive social support plays a crucial role in helping people recover from threat, trauma, and adversity. Reconnect with those you feel closest to, or reach out to others who have had similar experiences.
- Give it time. Resilience means that you bounce back in the end; it doesn’t mean that you never feel the impact of traumatic events. Learning to accommodate the things you experience is a continual process.
Coping after Mass Violence: Long-Term Needs
Most people who experience mass violence will recover. Having symptoms in the immediate aftermath does not mean that you will have symptoms forever. People who lost a loved one or were injured are more likely to have long-term reactions. Recovering may take time, and it may require you to learn how to adapt in new ways. What you need in the long term may be different from what helped you immediately after the event. Here are some strategies to help you continue to recover over time.
Strategies for Managing Ongoing Distress
As time moves on, if you still feel distressed or have trouble functioning, it is important to continue with general self-care activities. But you may also want include some of the following strategies:
- Safety. To lessen worries, it can help to stay focused on specific routines of day-to-day living.
- Media Viewing. Turn off the television if watching coverage of the event is increasing your distress.
- Problem-Solving. Take an active, problem-solving approach to ongoing challenges by breaking problems into smaller chunks, brainstorming solutions, and planning for simple, achievable steps towards solutions.
- Positive Activities Scheduling. Try and engage in positive, healthy, or meaningful activities. Doing things that are enjoyable, even if you don’t feel like it, can make you feel better.
- Volunteering. Volunteer work may also be a way to find meaning in helping others and building relationships with people who share your interests and values.
- Managing Emotions. Look for positive coping strategies that help you manage your emotions. Listening to music, exercising, practicing breathing routines, talking with others, spending time in nature or with animals, journaling, or reading inspirational text are some simple ways to help manage overwhelming or distressing emotions.
- Social Support. Spend time with people who give you a sense of security, calm, or happiness, or those who you feel you can support.
- Helpful Thinking. Reframe or divert your attention by practicing acceptance, prayer, or mindfulness. You can also use humor, or try to think through the costs and benefits of holding onto negative thoughts or behaviors and then practice more helpful ways of thinking or acting.
- Meaning Making. Reflect positively on people or aspects of life that you may have lost. Try to find meaningful ways to honor that loss, either on your own or through contact with others. You can also shift your expectations about what is considered a “good day,” and reconfirm the people, values, and goals in your life that you realize are most important to you.
There is no standard timeline for recovering from an event as intense and potentially traumatic as a mass shooting. Depending on how close you were to the event, it may take a long time to feel better. If you develop your own ways of adapting to ongoing events and situations, you may gain a stronger sense of being able to deal with challenges, a greater sense of meaning or purpose, and an ability mentor and support others in similar situations.
When to Consider Professional Help
Those who are most at risk for developing mental health problems following mass violence are the people who were closest to the event. If you or a loved one had direct exposure to a mass shooting (such as injury, threat to life, and loss), you may be at higher risk for more serious or longer lasting distress or trouble functioning. If you are distressed, or unable to function well, consider seeking help.
There are competent and caring professionals available who can effectively treat the most common responses to a mass shooting, like depression, anxiety, PTSD, and complicated grief. The most effective treatments give you tools to problem-solve, mourn and make sense of what happened, deal with numbness or intense emotions, and foster resilience. It is a good idea to try meeting with a mental health professional at least once. The sooner you get help, the sooner you will feel better.
For those in need of more intensive services, research supports trauma-focused psychotherapy for PTSD as an effective treatment following disaster. Trauma-focused psychotherapy is a broad term that refers to several specific psychotherapies for PTSD. “Trauma-focused” means that the treatment focuses on the memory of the traumatic event and its meaning.
Trauma-focused psychotherapies use different techniques to help you process your traumatic experience. For example, some involve visualizing, talking, or thinking about the traumatic memory. Others focus on changing unhelpful beliefs about the trauma. They usually last about 8-16 sessions.
Tools and Resources
- PTSD Coach Mobile App
This mobile app has tools that can help you deal with common reactions after mass violence, like, stress, sadness, and anxiety. You can also track your symptoms over time.
- Resources for Survivors and the Public Following Disaster and Mass Violence
Disasters and mass violence may lead to injury, death, and psychological distress. This page links to information to help affected individuals and loved ones deal with distress that may result from these events.