The Tragedy at Sandy Hook Elementary

George A. Keepers, M.D.

The awful events of December 14 in Connecticut have profoundly affected the nation and amplify the fear and foreboding of our own Clackamas Town Center shooting. The rapidity, intensity and repetitiveness with which the news about these events has been spread are symptomatic of the deep wounds inflicted by this senseless violence.

The families that have lost their children and loved ones, the traumatized friends, townspeople, police and health care personnel are burdened with the unbearable.  Others who have experienced tragic losses struggle with re-awakened pain. And parents, sometimes overwhelmed with a sense of dread, try to reassure their children as they send them off to school while their heart’s desire is to keep them home and safe. What can anyone do in such tragic circumstances?

First, we can help the victims. The Connecticut Psychiatric Society (CPS) reacted rapidly and effectively to the tragic Newtown, Conn., school shooting. Within a few hours, 100 CPS members responded to CPS President Santopietro’s e-mail requesting volunteers to help in the stricken town.

By good fortune, CPS had conducted a disaster-response training session for members just a month before. By the afternoon of Dec. 15, working through the Red Cross and state and local health agencies, CPS arranged for at least two psychiatrists to be on duty with other mental health professionals for three-hour shifts from 7 a.m. to 7 p.m. at a crisis-response center in Newtown. On Sunday, Dec. 16, they met with more than 300 local children and adults and will provide much more help in the coming months and years.

We need to recognize that the victims of such events are not only local. The genius of our capacity for imagination and empathy carries with it a dark side — our ability to suffer emotionally when confronted with the suffering of others. A guide from the Center for the Study of Traumatic Stress can be a help to physicians dealing with patients and parents helping their children. I also urge parents to read Dr. Ajit Jetmalani’s thoughts. Those who have been more severely affected should not hesitate to ask for help.

Second, we can seek to understand. It helps us, in dealing with tragedy, to understand why and how it occurred. The focus we see in the media on the law enforcement investigation of the event, the search for background information on the shooter, the multiple radio and television interviews of psychiatrists and psychologists represent this deep need to understand and explain. In part, our desire for explanation helps with a sense of control. We know from studies of the victims of disasters, abductions and assaults that people will often blame themselves rather than accept the alternative that they were actually helpless to control what happened to them. The acknowledgement of helplessness and blamelessness is essential in resolving the guilt that survivors of an attack or disaster often feel.

It is also helpful to understand that our sense of vulnerability is not an accurate reflection of objective risks. Typically, we substantially overestimate the risks of events like shootings and plane crashes while underestimating the risk events that are much commoner such as automobile accidents. This realization can help to reestablish a sense of safety and trust in the environment.

Third, we can seek to prevent such tragedies. There is much to be done in this regard, some of it politically controversial, and much of it a question of societal priorities. But that is a discussion for another day. For now, we must grieve the dead, comfort the living and tend to our own emotional health.

George A. Keepers, M.D.
Carruthers Professor and Chair, Dept. of Psychiatry
OHSU Brain Institute