Responding to Mass Shootings

Responding to Mass Shootings

Curt and Katie talk about how to take care of your clients, your communities, and yourself after a mass shooting. We look at the types of victims, the different stages of response, and treatment considerations.

It’s time to reimagine therapy and what it means to be a therapist. To support you as a whole person and a therapist, your hosts, Curt Widhalm and Katie Vernoy talk about how to approach the role of therapist in the modern age.

Transcript

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In this episode we talk about best practices in responding to mass shootings:

  • Responding to the recent Mass Shootings
  • The different roles that therapists can be expected to play after a Mass Shooting incident
  • The types of victims of these events (from victims radiating out to people who are learning about these events on social media)
  • The different stages of trauma response – and the caution to not assume everyone will end up with PTSD
  • Who is at risk for Post-traumatic Stress Disorder

“So, in your assessments, this is really where you have to look at not just the immediate reactions to the event, but also what other cumulative trauma that people have been through, and really being able to look at what somebody’s coping strategies are not just in the immediate after fact, but also what their coping strategies have been in previous traumatic events.” – Curt Widhalm

  • The different factors that can lead to an emotional response to the shooting, regardless of how close you are to the incident
  • The importance of Psychological First Aid (and how Critical Incident Stress Debriefing can be harmful)
  • Vicarious and Re-traumatization, triggers, no response
  • The impact of previous traumas
  • The importance of community supports and types of community interventions
  • Looking at how to assess boundaries and be part in the community healing
  • Post-Traumatic Growth and finding meaning, purpose
  • How often those with mental illness diagnoses might feel stigmatized when they are scape-goated and should also be supported

“We want to not stigmatize mental illness and say that, that mental illness causes violence…past acts of violence are better predictors of future acts of violence.” – Katie Vernoy

  • How the role that therapists play can impact therapists
  • The careful assessment of how you can help and what you can offer to people impacted by these events
  • Important self-care reminders for therapists

Our Generous Sponsors for this episode of the Modern Therapist’s Survival Guide:

Center For Discovery

Center For Discovery provides evidence-based treatment for eating disorders, binge eating disorders, mental health, substance use, and co-occurring conditions nationwide. Discovery offers gender inclusive and gender-specific treatment with separate programming for adolescent and adults. Programs have a high staff to client ratio because individualized attention is critical when it comes to providing effective and efficient treatment. Learn more about these clinical programs at CenterForDiscovery.com. Discovery offers free resources including weekly support groups, a recovery app, free evaluations, and treatment scholarships. Learn more about Discovery’s Free Weekly Support Groups, for those struggling and loved ones, at SupportInRecovery.com. Center For Discovery is a preferred provider and in-network with all major insurance companies.

My Solution Services

My Solution Services is more than your typical VA. With over 13 years of experience in Mental Health, they specialize in working with professional clinicians all over the US and Canada. My Solutions Services, Inc provides Online Business Management (OBM) and Certified Professional Practice Building Coaching for therapists. They help with the daily tasks of running the business side of private practice – everything on the outside of the therapy room! Working with therapists around the world they provide the assistance you need that is customized to your practice. Visit out their website for resources and information on building your solo or group practice at mysolutionservices.com

AND they have a special gift for you…here is The Ultimate Guide to Outsourcing in your Private/Group practice. With over 200 items here, you don’t have to do the daily tasks of running your business on your own ever again! Get your guide at: https://mysolutionservices.com/free-ultimate-guide-to-outsourcing

Resources for Modern Therapists mentioned in this Podcast Episode:

We’ve pulled together resources mentioned in this episode and put together some handy-dandy links.

Tons of articles:

SAMHSA Bulletin on Mass Violence

America Society of Evidence Based Policing: The Harmful Effects of Critical Incident Stress Debriefing

Disaster Relief.Org Psychological First Aid

National Child Traumatic Stress Network Psychological First Aid

APA “What happens to the survivors”

The Mental Health Consequences of Mass Shootings – Sarah R. Lowe, Sandro Galea

Trauma Resiliency Model and Community Resiliency Model

Heather Littleton response to Virginia Tech shooting

Andrew Smith Virginia Tech

Response at UCSB

APA Statement on Shootings at Dayton and El Paso

NAMI Statement on Mass Shootings in Texas and Ohio

Ben Caldwell Labs Marketing Therapy After Disasters

APA Report on Gun Violence Prevention

Red Cross Trainings

Relevant Episodes of MTSG Podcast:

Managing Vicarious Trauma

Compassion Fatigue

Who we are:

Picture of Curt Widhalm, LMFT, co-host of the Modern Therapist's Survival Guide podcast; a nice young man with a glorious beard.Curt Widhalm, LMFT

Curt Widhalm is in private practice in the Los Angeles area. He is the cofounder of the Therapy Reimagined conference, an Adjunct Professor at Pepperdine University and CSUN, a former Subject Matter Expert for the California Board of Behavioral Sciences, former CFO of the California Association of Marriage and Family Therapists, and a loving husband and father. He is 1/2 great person, 1/2 provocateur, and 1/2 geek, in that order. He dabbles in the dark art of making “dad jokes” and usually has a half-empty cup of coffee somewhere nearby. Learn more at: http://www.curtwidhalm.com

Picture of Katie Vernoy, LMFT, co-host of the Modern Therapist's Survival Guide podcastKatie Vernoy, LMFT

Katie Vernoy is a Licensed Marriage and Family Therapist, coach, and consultant supporting leaders, visionaries, executives, and helping professionals to create sustainable careers. Katie, with Curt, has developed workshops and a conference, Therapy Reimagined, to support therapists navigating through the modern challenges of this profession. Katie is also a former President of the California Association of Marriage and Family Therapists. In her spare time, Katie is secretly siphoning off Curt’s youthful energy, so that she can take over the world. Learn more at: http://www.katievernoy.com

A Quick Note:

Our opinions are our own. We are only speaking for ourselves – except when we speak for each other, or over each other. We’re working on it.

Our guests are also only speaking for themselves and have their own opinions. We aren’t trying to take their voice, and no one speaks for us either. Mostly because they don’t want to, but hey.

Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:

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Consultation services with Curt Widhalm or Katie Vernoy:

The Fifty-Minute Hour

Connect with the Modern Therapist Community:

Our Facebook Group – The Modern Therapists Group

Modern Therapist’s Survival Guide Creative Credits:

Voice Over by DW McCann https://www.facebook.com/McCannDW/

Music by Crystal Grooms Mangano https://groomsymusic.com/

Transcript for this episode of the Modern Therapist’s Survival Guide podcast (Autogenerated):

Curt Widhalm 0:00
This episode of The Modern Therapist’s Survival Guide is sponsored by Center for Discovery.

Katie Vernoy 0:04
Center for Discovery provides evidence based treatment for eating disorders, binge eating disorders, mental health, substance use, and co-occurring conditions nationwide.

Curt Widhalm 0:14
Discovery offers free weekly support groups for those struggling and loved ones. Learn more at supportinrecovery.com.

Katie Vernoy 0:21
Listen at the end of the episode for more information.

Curt Widhalm 0:23
This episode is also brought to you by My Solution Services.

Katie Vernoy 0:26
My SolutionServices provides online business management and certified professional practice building coaching for therapists.They help with the daily tasks of running the business side of private practice everything on the outside of the therapy room.

Curt Widhalm 0:39
Visit their website mysolutionservices.com for resources and information on building your solo or group practice and listen at the end of the episode for a special offer.

Announcer 0:49
You’re listening to The Modern Therapist’s Survival Guide where therapists live, breathe and practice as human beings. To support you as a whole person and a therapist, here are your hosts, Curt Widhalm and Katie Vernoy.

Curt Widhalm 1:04
Welcome back modern therapists, this is The Modern Therapist’s Survival Guide. I’m Curt Widhalm with Katie Vernoy. And I’m frustrated that we are creating a evergreen episode in response to mass shootings. And this is very much on the heels of whatever ones are in the national news at this particular moment. We’re not going to get into the specifics about this one, because it’s going to happen again. And we really sat down and we wanted to create a resource for our listeners as far as how we as therapists are looked to in the response to these sorts of events, and what kinds of things happen to our clients, what kinds of things happen as a profession, and especially when questions about mental illness come up in response to this. So this is very frustrating episode that I’m very disappointed that it’s going to be relevant again. And again.

Katie Vernoy 2:09
Yeah, it’s been a hard few days and thinking about creating an episode like this has been weighing on me because I don’t feel hopeful that it won’t be relevant again, and probably soon. And so we will work to make something that’s very, very practical. But we are also wanting to do another episode that’s going to speak more into the issues of why all of this is happening. But this episode is really going to focus on how do we as therapists take care of ourselves, take care of our clients and take care of our communities.

Curt Widhalm 2:44
So this being kind of sparked by some of the conversations that have come up in our practices, our personal lives, whether it’s family members, whether it’s friends, whether it’s online discussions, but people do turn to us as therapists as far as what, what the answer is to this, what from afar, we have opinions on as far as what the answers to mass shootings is whether this is caused by mental illness. And this is one of those areas where it’s really, as us as professionals, our voices do really hold a lot of gravity to people who aren’t in our fields who don’t necessarily have the deafness of understanding these conversations, as lay people come to us and really are looking for some sort of professional direction on where this goes. We’re gonna get a little bit into that towards the end of the episode. But that’s kind of sparking this because I know for me, this comes up after every single event. I remember one of my hardest days in the office was the day of the Sandy Hook shooting, which was nowhere close to my office. And this being several years past that event. It doesn’t change doesn’t matter where in the country that these kind of events come up. It’s in the news, it’s pushed to us. And there’s different levels of people who are affected by these events. I think at breaking this down, there’s really three or four identifiable sorts of victims and different types of responses that come up when these kinds of events happen. And I think the most obvious one is the people who are at the events, the ones who are most affected are really the ones who are at the scene or in the very immediate vicinity. If it’s a school shooting, it’s the people who are on campus. If it’s out in public at someplace else, it’s the people who are in in the store, in the mall in in that very immediate sort of reactionary space.

Katie Vernoy 4:53
And also then the first responders as well the people that are for lack of a better phrase in the carnage of it.

Curt Widhalm 5:00
The next group that we’re identifying is the family and friends of the people who are on site that those might be people within the community. They might be people who are across the country. They might be people in other parts of a large city, but they are people who are going to have responsive, where is my son? Where’s my daughter? They if their children are survivors, then there are people who are going to be how do I react to what my son or daughter or husband or wife went through?

Katie Vernoy 5:29
Yeah.

Curt Widhalm 5:30
The next group is the community at large, the immediate surrounding community, or town, that is not necessarily people who are at the site, but the ones who are going to drive by on their way to work the next day. And the last group is the people who are going to be watching the news from afar and maybe not necessarily involved directly in the community, but might have an interest in it, might be something that’s just unavoidable and watching on the news. And these are people who are going to have a response. And it might be very emotional. And it might bring up a lot of their personal anxieties, their fears, their…

Katie Vernoy 6:10
Their own experiences.

Curt Widhalm 6:11
Exactly. And each of those kinds of people are going to have a different presentation that is potentially coming to you in your services. And they’re going to need potentially different responses.

Katie Vernoy 6:26
And I think it’s important to also note that each person in each of those groups is also going to have a very variable response. I think when we look at some of these incidents, if it’s someone who is in the religious community that has been targeted, or someone who’s in the demographics that have been targeted, it can it can be something where there are folks who however close they are, I mean, we kind of talked about these as kind of radiating out people there, people who are related to the people there, people who are in the community nearby, and then people in the kind of the the world at large. I think, regardless of kind of where someone is, I think it’s also important to recognize the diversity within each of those groups, and how that might impact how they respond.

Curt Widhalm 7:10
And especially when we look at the differences between victims at a scene versus the first responders that Katie brought up. That this is something I’ll credit to a conversation that we’ve had with one of our listeners, Yael Shuman she, she works with first responders. And she’s talked about that it’s it’s a different mindset of people who are going in potentially SWAT members who are looking at my job and going into this as potentially to shoot a kid. And they’re going to have a very different response than somebody who is out in, in the community going about their day to day lives and reacting to something that’s completely unpredictable, which is a big part of what makes all of this so scary, is the unpredictability of having our day to day lives.

Katie Vernoy 8:00
And I think the the unpredictability of it the the way that people are being targeted. I think that’s why it feels and is now being called domestic terror. I think that there are a lot of times that we have to really understand how much this is impacting the people who are directly involved. But all of us, I mean, I think that there’s, you know, the the we’ll get into the the kind of the expanded influence and expanded impact. But I think the the difficulty of this is that it feels less and less like these public spaces are safe. And each time that a public space is attacked, I think members of society at large are feeling this. And so I think it’s just, it’s just hard to kind of put any of this in a neat box is I guess what I’m saying.

Curt Widhalm 8:45
And we’ll get into a little bit more broader role towards the end of the episode here. But I’m looking at a 2017 bulletin by SAMSA. And this is talking about the different stages of reactions that people are going to have to the aftermath of a mass shooting.

Katie Vernoy 9:03
And we’re going to put all of the resources that we mentioned, and any that we find into our show notes at mtsgpodcast.com. Please check those out, we’re going to have so much there because I think this is such a critical thing for us to understand.

Curt Widhalm 9:15
So SAMSA defines that there is three different stages that people are going to have as responses to mass shootings. And the first is the acute stage, which is immediately after the event. And this is often characterized by denial, shock and disbelief. And this really is a lot of fear, a lot of anxiety, a lot of helplessness that people are going through because as Katie mentioned, when terror happens, it’s when a completely unpredictable event happens in an otherwise predictable world. And there’s really not a lot that people are trained to understand this. And it’s really having a lot of normalization to that just shock and disbelief of what’s going on that helps to normalize the stage for clients.

Katie Vernoy 10:12
I think that oftentimes, and this is something where Curt and I were trained long ago, and at the time critical incident stress debriefing was one of the things that was used in this stage. And subsequently, it’s been found to be actually ineffective, at best and actually harmful at worst. I’m gonna put in the show notes, an article from the American Society of evidence based policing. And it talks about the research on how critical incident stress debriefing is actually ineffective and potentially harmful. The recommendations are actually to do psychological first aid. And, and one of the reasons that that is, is because when we’re trying to immediately go into debriefing someone and talking with him about the incident, and I think this is something that, you know, kind of a whole other group of people are trying to do this, you know, the news media, and reporters are trying to get first hand accounts. And I think, especially if you have people you know, who are there, those kinds of things, letting them know, within the first several days, weeks, months, you know, until they actually are feeling safe and able to talk about the incident, it can actually be very harmful to start talking about what happened and the details of that before it happens. The what I was reading, if I’m understanding correctly, is basically when you go into the details of these incidents before you’re truly ready, it actually creates more PTSD symptoms. And so the idea behind psychological first aid is that you actually do kind of the things that belong on the first couple tiers of Maslow’s hierarchy of needs, you provide practical care and support, make sure people are getting medical care, making sure that you’re assessing what their needs and concerns are. Helping with food, water, information, protecting people from further harm, connecting them with the information and the services that are available, listening to them, but not pressuring them to talk and just helping them feel comfortable and safe. I think getting someone back to kind of a more, and I and I’m thinking more resourced place, because I know you’ve talked about resourcing and EMDR. I think even I think we should note that even folks that are trained in trauma therapy, do not do intense trauma work until someone’s fully resourced. And so being able to get into that space, where someone feels like things are not normal, but a little bit more normal, a little bit more, you know, out of the crisis, out of the immediate adrenaline rush of I am going to be killed, I think it’s really important to to recognize that until someone is feeling safer, we do not want to start talking with them about what happened. We can allow them to speak but I don’t think we we really, we really need to make sure especially the those of us trained long ago that we are not immediately trying to do some sort of incident debrief.

Curt Widhalm 12:53
And for a good resource on the psychological first aid core actions I have found the National Child Traumatic Stress Network is having a really good resource that I really want to highlight the connecting victims, connecting community members to just the idea that services are offered. And I’m seeing a quote from Dan Mosley, an American Red Cross disaster mental health services volunteer, that he gave to the APA. And he said simply ensuring victims are aware that support is available and accessible to them, even if they never take advantage of it can help immensely. This is very likely due to the empirically supported benefits of connection over isolation, noting that knowledge of the resources is one way of feeling connected, and that people are less anxious and worried if they know that help is available if they need or want it.

Katie Vernoy 13:45
So I think I think the takeaway for folks, right initially afterwards, especially those who are right in the incident is that we need to make sure that we’re providing space for them. To come back to baseline, we need to make sure they have they understand what happened that they have the information they need, the resources available, they’re aware of the resources available to them, and that they are getting basic human needs met.

Curt Widhalm 14:11
Moving into intermediate stage this is a few days to several weeks after an incident. If you’re going in diagnostic terms, this might be that acute stress phase. And back to the SAMSA article, this is characterized by fear, anger, anxiety, difficulty paying attention, depression, disturbed sleep. And this is really where therapists can play a really huge role in getting communities activated to set up and provide more long term support to survivors. I know that places like Red Cross often send out mental health professionals to big events like this, and these might be volunteers from all over the country who are only available for a few days or weeks. That when you’re a therapist in one of these more local communities, it is really again, being able to connect to broader services, if it’s not just your individual practices, but taking kind of this community network of mental health services approach of being able to, again, speak to that level of connectivity over isolation. And this is also when in your treatment, that you’re really going to be able to start implementing some of the evidence based treatments for reacting to traumatic situations.

Katie Vernoy 15:32
And I think it’s important to note that we have as as human beings, a natural resilience, the potential to naturally heal ourselves after a traumatic event. And so sometimes with intervention, we can actually get in the way of that. And so I think really pushing any particular treatments at this stage, assuming that they’re going to have PTSD, I think those things are something that you really want to stay away from. And I think it’s really about assessing and observing and providing support in a way that’s going to be helpful to the individual in front of you, versus assuming I now have to act like they have PTSD.

Curt Widhalm 16:11
And then there’s the people who are continuing to respond several months after the events. And this is what Samsung calls the long term affected group.

Katie Vernoy 16:17
And that’s PTSD, like that’s where we’re going.

Curt Widhalm 16:18
Right, and this is, you know, characterized by adjustment relapse, it’s people who might see other community members moving on and isolating themselves because they’re continuing to suffer images or reliving the event, and potentially at further risk of isolating themselves even more, just because they’re not responding in the same way that other people who have more resilient factors are able to really implement. This can leave them feeling lost and disconnected. And this is really where you can kind of start to identify who’s at risk, even even in that acute phase. And this is coming again, from connectivity and looking at what somebody’s strengths are, their resources, whether it’s social, whether it’s interpersonal, but you can kind of conceptualize that the ones who are going to be most affected are the ones who are closest to the event. That as we go back to those groups of victims, the people who are at the incident are obviously going to have a much more visceral response than the people who are watching on the news from across the country. That doesn’t mean to say that anybody in either of those groups has to respond in one of those ways, but that the people who are on site are the ones who are more at risk.

Katie Vernoy 17:53
I agree, I think that it’s something where we also have to recognize that we may have clients who are sitting across the country from an incident and are highly identifying with the targets, the victims of the shooting. And I think it’s important for us to continue to assess our clients, especially if they have past traumas, I think, you know, I think locally, for you know, for some of us in Southern California and people on kind of the the western side of the United States, you know, I’m certain that there are folks who are reliving the route 91 shooting, you know, there’s there’s people that potentially are going to be being re-traumatized or having some of their own triggers come up. And I think it’s just really important to assess each person. I do believe that the people on site are probably more likely at risk for getting PTSD. But I do believe that we also have probably a whole community of trauma survivors, of people who are in some of these communities that have been targeted, that are being vicariously traumatized. And so I just as therapist, I think we just really need to kind of come from a place of observation to really assess how this is impacting folks. And there’s going to be people who walk into your sessions, right after a mass shooting and say nothing about it. I I don’t know if I’ve said this on the podcast before but I became a therapist like, like my practicum started right before 911. And I was terrified that I was going to have to all of a sudden deal with this, these heavy trauma responses, even though as all the way across the country, I felt very impacted. I had family nearby. Fortunately, the impacts on them were fairly reversible. But I had only a couple of clients out of like five or 10 clients who said anything about it most were just kind of still caught in their everyday life. And I think it’s being able to accept people wherever they are when they walk into your office.

Curt Widhalm 19:48
Katie’s speaking to the prior trauma exposure, and this is from a journal article in Trauma, Violence, & Abuse in 2017, Sarah Lowe is lead author on this, but this article talks to that previous mental health symptoms, pre existing anxiety disorders, depression, you’re gonna be more vulnerable to the adversity after exposure to mass shootings. And previous trauma might also be a reason why women are more likely to develop PTSD after mass shootings, since it’s more likely that they’ve probably had multiple forms of traumatic exposure before and this is cumulative.

Katie Vernoy 20:29
Just pisses me off to hear that stat. I it’s absolutely true. But it’s it’s so sad, and so frustrating.

Curt Widhalm 20:36
And so, in your assessments, this is really where you have to look at not just the immediate reactions to the event, but also what other cumulative trauma that people have been through, and really being able to look at what somebody’s coping strategies are not just in the immediate after fact, but also what their coping strategies have been in previous traumatic events. And this is big T little t conversation of how people respond to these kinds of things. Because as habitual creatures, we’re going to go back to the things that we know. And if we have responded poorly to trauma and stress in the past, that’s a pretty big predictor that we’re going to respond poorly now and might increase somebody’s need for psychological responsiveness in the immediate aftermath of an event.

Katie Vernoy 21:27
I think the other thing, that there’s two, two things that actually came up for me when we were talking, when you were talking about those things, I think the first thing is with people who have been previously traumatized, people in targeted communities, I think that there is a real need to understand their experience, to validate their experience and to not say, Oh, you’re safe. Because I don’t I think we can now see that, in truth, there is a level of awareness that many of us need to have, and and be able to and even with that, there are spaces that are just not safe. You know, and we don’t know we’re not we don’t know. And so that’s the unpredictability of that. I think it’s it’s important to talk about the likelihood of something occurring to each individual is low. But the fact of the matter is, we can’t say unarguably that we’re all safe, because we’re not. And so I don’t know how to make that sound like I’m not freaking out. But I think it’s this piece of like, we can’t just pretend like Oh, everything’s gonna be okay. I think there’s, there’s a part of this responsiveness, which is, how do you keep yourself safe? How do you identify what situations you want to put yourself in? How do you understand if what you’re experiencing in this moment, is a trauma response and a hyper alertness or actually a cue: I gotta get the, you know, what out of here, you know, so I think it’s that piece of being able to honor that, because I think oftentimes, when I’ve heard folks who’ve had a lot of complex, ongoing trauma, and people are saying, Oh, well, you’re safe, stop worrying about it. It’s like, no, sometimes these folks are the ones that are most adept. And it you know, even though their, their trauma signals might be higher and more finely tuned, or might be a little bit off, saying, don’t trust your instincts, you’re always safe, is harmful.

Curt Widhalm 23:24
And in my trauma work, I don’t use the word safe, ever. That really, if I’m trying to help somebody build skills, I move it into something along the lines of peaceful or grounded. And…

Katie Vernoy 23:40
Ah, I like that.

Curt Widhalm 23:41
…really, really being deliberate with our language. Because there have been people who’ve reported to me that past therapists have used the word safe. And the clients immediate response is what the F do you know about safe?

Katie Vernoy 23:55
Yeah, yeah.

Curt Widhalm 23:56
So really being cued in and deliberate with what you’re talking about can help in these discussions. And kind of making it okay to talk about these kinds of events in a number of different settings, that this doesn’t have to be just something that people seek out as far as individual sort of flawed I need to go and hide away in in a single therapist office someplace, because a lot of the resiliency factors we’ve talked about come from that community aspect.

Katie Vernoy 24:34
And there’s actually some training and I’ll link to it, I’ve only been to a short training, so I can’t speak to it. Maybe we’ll have to have the woman who created that on, but there’s the trauma resiliency model and the community resiliency models that really speak to healing communities and healing and develop individuals through you know, kind of increasing resilience and I think the community aspect can be extremely important especially in these very publicized out in the open kind of events. So just to quickly note, the second thing that came up when you’re talking is that I think that there’s also a dampening of experience or a numbing that’s happening as a society. And I think when we’re looking at building community resilience, people can be acting, okay, they can be ignoring what’s happened. And I think for, for those folks, there could be stuff that’s underlying, or it could be that they just have, you know, they’ve lost the sensitivity to these types of events, because they happen so frequently. But it can also impact I think the folks who are deeply feeling the experience, because they, they’re, they’re feeling like their feelings are being invalidated. You know, I’m fine. It’s over there. It’s not that big of a deal, like people who are truly, you know, kind of numb to it, or even like, Oh, what happened? like people that are not paying attention, because it’s really hard to continue to pay attention right now, I think can be devaluing. And making these folks who are feeling these things intensely, whether they were in the event or across the country, for example, and feeling the effects of the event, may think it can really create the separation, that can be very harmful to folks where they feel very isolated in their responses.

Curt Widhalm 26:16
We’re going to come back to this point at the end of the episode when we’re talking about things that you need to do for yourself. But I will come back to this point, then. I want to hit a couple more of just the importance of the community support and a little bit of the research behind that while we’re kind of talking in this space, Heather Littleton a psychologist who, after the Virginia Tech shooting, did a survey of 300 female students there. And she found that students who identified that they had good support in their families were better off in their terms of adjustments after the event. And that’s in an article in Psychological Trauma: Theory, Research, Practice, and Policy. And also from Virginia Tech, Andrew Smith, found that when mass violence occurs on college campuses, that collective identity often forms that can help boost a sense of social support in the aftermath. And we also saw this with the vigil that happened at UC Santa Barbara with the surfers who went out into the water and did the vigil. So this is really again, where you as the therapist, you don’t have to be the savior. And in a lot of this, that this is really being a part of the community, I know that we have a lot of boundaries around being with our clients out in the community. But sometimes the most healthy thing that we can do with them is actually be out at these events too. That, you know, this is handling some of those potential boundary issues in a way that is healing and showing that this affects all of us.

Katie Vernoy 27:59
I really like that because I think there is a normalization and a support that can happen when therapists show up in these spaces. And I think as far as the boundary issues, you just show up as your therapist self. And I think that’s the way you would in a day treatment or milieu setting or a residential setting, you just show up as yourself. And I think, you know, as the professional sel. And I think that there’s there’s another aspect to this is that there is part of the healing process or the post post traumatic growth can be in finding meaning and helping others. And I think, you know, in the fight for our lives movement, and some of these other movements that have come out of some of these shootings, these communities are finding healing and strength in coming together and trying to make some change. And so I think being able to support our clients in those things, I think can be very helpful in whatever way it looks like. I don’t know that you join these movements or those kinds of things. I think those are individual decisions for each therapist, but I think supporting these communities in finding their way back with these positive identities, hopefully to create some change or to support each other.

Curt Widhalm 29:07
And as we look at what our roles are, this is also where we can look to our professional organizations and looking for the guidance that they lay out for us. And because I know for me in the aftermath of a lot of these kinds of events, the questions that I get is Why is this happening? What can be done about this? Is this actually caused by mental illness? And so some of the statements that professional organizations that have been released that are available to us at the time of this recording, one is from the American Psychological Association. These are very brief overviews of what these statements are. I will include the full statements in our show notes. American Psychological Association, blaming mental illness for the gun violence in our country is simplistic and inaccurate and goes against the scientific evidence currently available. I think that that’s a pretty strong statement.

Katie Vernoy 30:07
It’s pretty clear. And I think it reminds me that the other folks who may be impacted during this time are people with mental illness diagnosis, people who are feeling categorized as mentally ill. I think that if they are looked at as being violent, and they’re facing some of the prejudice and the scapegoating, I think that’s also something that may be something you want to assess with some of your clients.

Curt Widhalm 30:33
And this is from NAMI, the National Alliance on Mental Illness again, paraphrasing a lot here. Every time we experience tragedy like this, people with mental illness are drawn into the conversation. The truth is, the vast majority of violence is not perpetrated by people with mental illness, statements to the contrary, only serve to perpetuate stigma and distract from the real issues.

Katie Vernoy 30:56
And I think the thing that’s really important as mental health providers, whether we’re being asked to respond to those types of questions, is that NAMI does go on to say that they really would, you know, in some of the different things and I’ll see, I’ll kind of I went down a kind of a rabbit hole when I was reading about this yesterday, increasing access to mental health services will help.

Curt Widhalm 31:16
Definitely.

Katie Vernoy 31:16
And so so we want to not stigmatize mental illness and say that, that mental illness causes violence. But we also want to increase the ability for people with these concerns to access mental health services, so that they can improve the chances that they’re not going to be violent. I think that the thing that in everything that I was reading is that past acts of violence are better predictors of future acts of violence. And so I think, summarizing it with mental illness is what we need to address I think, is really hurting our communities, it’s hurting the efforts. And this is a whole other episode. So I’ll kind of leave it here. But I think that when we are working with our clients, who a lot of them will have some sort of mental health diagnosis, I think that we also want to make sure that we’re, you know, if it seems appropriate with the client, exploring their responses to basically being scapegoated by everyone with a microphone.

Curt Widhalm 31:17
Moving this onto you, and if this is an area that’s going to come into your office, and through all of my experience, it it will come to office. So much of this is if you’re in the immediate vicinity of the community, know your bandwidth, know what you can offer, you might be very tempted to offer free services, we’re going to include a link from our friends over at Ben Caldwell Labs around some of the ethics of doing that, and doing it in the right way. But also understanding your capacity and what your reaction to the situation is going to be in those in those events. And understanding if you have the time and the capacity in your own resiliency, to be able to help lead other people through it.

Katie Vernoy 32:57
I think that’s so important. I think the big piece that I’ve seen is that there are so many people who, clinicians, colleagues who are very called to help in the moment. And I think that can be part of this post traumatic growth, it can be part of our own resilience, I think it’s it really, you need to have a very careful assessment of what you’re able to do. And I think part of this could be consultation, part of it could be in your own therapy, processing how you’re feeling about what’s happened. But I think being able to offer these services can be amazing and very needed, I think it’s just really looking at because you’re a professional, even though your heart’s in the right place, if you are not at a place where you can provide competent services because you’re so severely impacted by what is happening, you need to assess that. You need to know that.

Curt Widhalm 33:45
And this is the point that I was saving from earlier is that you also need to have a really honest view of what your own clinical skills are, even if you are in a healthy place of being able to tell the difference between clients who say, Oh, I’m fine, who are actually fine, versus the ones who are saying that in a passive sort of haze of really moving away, and really understanding that you can have a very detrimental impact or a very positive impact in the way that you go about clinically treating people and this does go to the consultation, it does go to supervision. But learning for the first time in the immediacy after these kinds of events does not do the people seeking services, any favors. So being really honest and assessing your skills.

Katie Vernoy 34:35
And I think some therapists become very called to reach out to Red Cross or World Health Organization or those things and they do have trainings and I think a lot of them are for your low cost to be able to get the psychological first aid or you can jump into some of these other trm crm TRM CRM, which is trauma, resiliency and community resiliency models. You can feel called to jump into those things but right recognize that the Red Cross is not going to say sure come on down, they’re going to say, Okay, go ahead and go to the training. And then we’ll let you know, it could be a month long process to be able to be on call for these things. And if you are calling and bugging them or coming down to scenes without being trained, you’re actually getting in the way. And I know that that’s really hard to hear when you’re really ready to go. But I think if you’re feeling called in this moment to be available to help, check into some of these these programs so that you can have the actual tools to be able to help on site and/or to actually treat, you know, kind of survivors in your office.

Curt Widhalm 35:35
Last point for me is taking care of yourself.

Katie Vernoy 35:39
Absolutely.

Curt Widhalm 35:40
That you know, we have a number of episodes on burnout, compassion fatigue, this is right up that alley.

Katie Vernoy 35:46
Yeah, we got a great episode from Laura Reagan on vicarious trauma.

Curt Widhalm 35:50
And really making sure that you’re taking care of yourself so that way you can take care of others. And I can’t speak enough to that.

Katie Vernoy 35:57
And I think we as helpers and healers are more likely to sacrifice ourselves in these times because we are going to have it from all angles. If we look at our friends and families asking us what’s going on how can this happen? What does it all mean? How does your profession fix it if we’ve got our clients coming in and grieving are afraid because they identify or are connected to these events when we’ve got our own responses and our own unique histories that are impacting how we physically respond and emotionally respond and spiritually respond. I think that it can feel very incumbent upon us to continue to move forward because our clients, our communities, our families need us, but put on your own oxygen mask first you need to you need to recognize that in these moments you will be called upon, you will be seen as the space of healing, the person who knows the answer, the person is that who’s the rock. And if you don’t actually take a moment, take a breath and really assess your bandwidth it can really leave you with without a lot of gas left in your tank.

Curt Widhalm 37:06
Once again, check out our show notes at mtsgpodcast.com. We mentioned a number of resources in there today. And until next time, I’m Curt Widhalm with Katie Vernoy.

Katie Vernoy 37:19
Thanks again to our sponsor Center for Discovery.

Curt Widhalm 37:22
Center for Discovery provides evidence based treatment for eating disorders, binge eating disorders, mental health, substance use and co-occurring conditions nationwide. Discovery offers gender inclusive and gender specific treatment with separate programming for adolescents and adults. Programs have a high staff to client ratio because individualized attention is critical when it comes to providing effective and efficient treatment. Center for Discovery is a preferred provider and in network with all major insurance companies.

Katie Vernoy 37:50
Learn more about these clinical programs at centerfordiscovery.com. Discovery offers free resources including weekly support groups, a recovery app, free evaluations and treatment scholarships. Learn more about Discovery’s free weekly support groups for those struggling and loved ones at supportandrecovery.com.

Curt Widhalm 38:08
Also, thank you to our sponsor My Solution Services.

Katie Vernoy 38:11
My Solution Services is more than your typical VA. With over 13 years of experience in mental health they specialize in working with professional clinicians all over the US and Canada.

Curt Widhalm 38:21
My Solution Services offers phones and scheduling, certified professional coaching, co-writing and blogging, website maintenance, admin assistance, newsletter building, EHR and HR setup and much more.

Katie Vernoy 38:33
And they have a special gift just for you, our listeners: The Ultimate Guide to Outsourcing in your Private or Group Practice. With over 200 items here you don’t have to do the daily tasks of running your business on your own ever again, check out mysolutionservices.com/ultimate-guide. That’s my solutionservices.com/ultimate-guide.

Announcer 38:53
Thank you for listening to The Modern Therapist Survival Guide. Learn more about who we are and what we do at mtsgpodcast.com. You can also join us on Facebook and Twitter. And please don’t forget to subscribe so you don’t miss any of our episodes.

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