Mass shootings in the United States have been an ongoing problem that continues to grow. Though these tragic events were few throughout the COVID-19 lockdown, ongoing efforts to reduce restrictions allowed large numbers of people to gather in public, which led to a spike in mass shootings throughout the nation. These events are defined by the Congressional Research Service as attacks that occur in a public setting where four or more victims are killed or injured from gun violence.
Since the start of 2021, there have been numerous incidents, including the highly publicized shooting that occurred at Atlanta-area spas that raised concerns of violence against women and Asian Americans. According to the Wall Street Journal, authorities in law-enforcement believe this influx of mass shootings may be attributed to growth in public gatherings, diminished mental health of Americans throughout the pandemic, attackers drawing inspiration from other events, and record sales of guns last year.
The impact of these events are far-reaching and while the media tends to sensationalize attackers, the effect on victims can be tremendous and their stories often go unheard. One lesser-known aspect of these occurrences is that survivors and those closest to them have a unique journey to healing that psychologists and mental health professionals are just beginning to understand.
We spoke with CalSouthern alumni, Deborah Vinall, PsyD, LMFT, a licensed therapist who developed a sub-specialty in treating victims of mass shootings as part of her doctoral project. Her own personal struggles inspired her to make a difference in the world by helping people overcome trauma. Dr. Vinall provided these valuable insights that can help other mental health professionals better support their clients who have experienced these kinds of tragic events.
1. Tell us about your practice and why or how you began to specialize in helping survivors of mass shootings. Why is this work important to you?
I specialize in treating people who have suffered psychological trauma in my private practice, incorporating EMDR and Brainspotting therapies. Because of this specialization and these certifications, I was contacted by the County of San Bernardino and contracted with them to provide trauma therapy services to survivors of the terrorist attack that took place on December 2, 2015 at a county employees’ holiday party. When the mass shooting at the country music festival in Las Vegas was perpetrated on October 1, 2017, several survivors were referred to me based upon my experience with this unique form of trauma. More recently, I also provided services related to the Borderline Bar massacre in Thousand Oaks, CA that was perpetrated on November 7, 2018, and to a survivor of the Los Angeles Jewish Community Center mass shooting that occurred in 1999.
Typically, when a mass shooting occurs, we focus on the body count, or perhaps the number of injured. We overlook the extensive direct and vicarious trauma that results from these atrocities, which has an enormous ripple effect. A shooting that occurred in a location with 100 victims, whether casualty or survivor, will cause direct and vicarious trauma that extends to the close friends and family members of those mortally endangered, with a true trauma count closer to 1000. Tragically, we seem to lack the political will to make substantial changes that will address the problem at its root, and so we are left to continue the work of bringing healing to the ever-increasing ranks of survivors of mass shootings.
2. How does the treatment of survivors of mass shootings differ from other forms of trauma?
In many ways it does not differ, while in some important ways it does. It is helpful to have a solid working understanding of the unique aspects of the trauma of surviving a mass shooting and the themes that are likely to emerge. Both EMDR and Brainspotting, sub-cortically focused trauma therapies in which I am certified, have produced excellent results with mass shooting survivors, both in my direct clinical experience and as reported by the dozens of clinicians I interviewed from across the country representing the treatment of over 200 mass shooting survivor clients from twelve major shootings. In these approaches, we create layers of psychological safety from which to directly revisit the somatic, affective (emotional), and visual internalized representations of the event that remain frozen in highly sensory forms, incorporating soothing bilateral stimulation, bypassing the prefrontal cortex to facilitate adaptive resolution in neural memory networks.
Surviving a mass shooting is an existential trauma, and as such has thematic components in common with surviving natural disasters such as hurricanes, wildfires, or even the Covid-19 pandemic. It shares the aspect of helplessness and unpredictability with such disasters, and for many, calls into question foundational spiritual beliefs, which can complicate healing.
In some ways the experience is similar to that of those with trauma from a battlefield, but it is heightened by the unpredictability and intrusion on “safe” every-day life, which compounds the difficulty in separating or containing the trauma. As with survivors of other disasters, mass shooting survivors have others with whom they have experienced the trauma. My research identified critical differences in those that survived a mass shooting in an intimate setting (i.e., where they know many of the other survivors and perhaps the shooter, such as in a workplace or school) and in a public setting (such as a grocery store or theater). Those that were in intimate settings often experienced compounded trauma as a safe, frequently visited location became unsafe; they were more likely to have experienced the death of a friend, colleague, or family member; and they experienced fracture in their support system just when it became most urgently needed. In my research, the value of social support systems was underscored, but the confidence of mass shooting survivors in reaching out and relying on friends and family was frequently eroded, compounded with fears of burdening or triggering such people if they were survivors themselves. Those whose support systems were not connected to the shooting often withdraw due to the belief that they would not be understood. This finding emphasizes the importance of therapists becoming familiar with mass shooting fallout as the need to feel they will be understood was emphasized by many as a prerequisite to opening up.
3. What are some key findings in your research and practice that has helped you be successful at treating trauma survivors?
Some of the key findings in my research highlight the universality of Post Traumatic Stress Disorder (PTSD) in mass shooting survivors, often accompanied by additional disorders such as Substance Use Disorder, Panic Disorder, Specific Phobia, Social Phobia, and Major Depressive Disorder. Major themes were revealed in my research, consistent with my practice experience, of patients struggling with survivor guilt (guilt at having survived while others perished), nightmares and sleep disturbances, and a hypervigilant fear of recurrence.
Those that survived a shooting in an intimate setting had a greater sense of responsibility, such as feeling they should have done more to stop the shooting or to rescue others, and more often struggled with the added element of grief due to personally knowing casualties. A unique finding in this population was that the typical PTSD symptom of numbing or dissociation tends to be absent, with hypervigilance remaining acute at all times.
Approaching patients with a foundational knowledge of the event and likely symptoms and reactions while maintaining a no-assumptions stance of receptivity to their unique personal experience allows me to meet the survivor where he or she is at. Understanding the significance of impacts to people’s varied belief systems, as well as the importance of such meaning-making constructs as revealed in my research, guides me to cultivate space for clients to discuss and explore these aspects and to incorporate their belief systems and faith, as well as the blow to these spiritual aspects, in their trauma processing. Recognizing the impacts on and yet the importance of social support networks guides me to direct attention within treatment to supporting and addressing these aspects of the survivor’s experience.
4. What advice do you have for individuals who have experienced a mass shooting who are hesitant to seek help?
Know that seeking help does not make you weak, nor does it signify that you are broken. There is no value to ranking your exposure to the shooting nor whether you “should” need help. Many survivors rank the merit of their trauma based upon injury, proximity, loss of loved one – and that only serves to prolong your pain. You feel what you feel, and there is no right or wrong way to react. Surviving a mass shooting is similar to being in a war zone, but without any training, defenses, or anticipation as a soldier might have. It is an innately traumatic experience, and again: being impacted does not mean you are weak. It takes true strength to face the feelings of vulnerability that such an experience brings up and to allow yourself to remember, so that you can release your trauma.
Quality trauma therapy isn’t just talking about what happened – something you may feel reluctant to do. Through EMDR or Brainspotting therapy, the part of the brain that processes memories and emotions is engaged, so that the brain region that was hurt is where the healing happens. Healing is not easy, but it IS possible. You do not need to suffer flashbacks, nightmares, and intrusive memories forever.
My research also revealed significant findings demonstrating that the sooner you begin treatment, the fewer the number of sessions before you experience relief. Don’t delay in reaching out for help. Healing is possible.
For the next installment of this interview, Dr. Vinall shares how to support loved ones who experienced a mass shooting and advice for mental health professionals looking to better support their clients.
To learn more about Dr. Vinall’s valuable work, visit tamarcounseling.com.