WASHINGTON (CBSDC) — Gun violence has taken center stage in America once again following the deadly shootings at a Planned Parenthood clinic in Colorado Springs, Colorado, and at a company holiday party in San Bernardino, California.

CBSDC spoke to Laura D. Miller, a clinical social worker and psychotherapist, on how mass shootings are having an affect on Americans on a daily basis.

CBSDC: Do these mass shootings take a toll on Americans’ psyche? And if so, how?

MILLER: The upsurge in the frequency of mass shootings can definitely have an impact on the American psyche. Safety is one of the most basic human needs and the repeated occurrence of such attacks on helpless, and often arbitrarily chosen victims, takes away from people’s ability to trust that they will be relatively safe as they go out into their world.

The collective trauma that many Americans have experienced in bearing witness to such tragedies in schools and other public spaces that either are part of their daily environment or resemble them closely has caused many people to develop an ongoing defensive stance that can resemble the post-traumatic response of actual trauma survivors. Many people have understandably become more hypervigilant, less trusting of strangers, more isolative, more easily startled and even more paranoid in spaces they once associated with safety and a positive sense of community. The rage and helplessness that are engendered by such acts of senseless violence, especially when they are in the news with increasing frequency, are difficult to resolve due to the relative powerlessness of individuals to make changes that can make them safer without totally isolating and paralyzing them.

When people can no longer presume relative safety on a daily basis, they may relate differently to others internally, become numb, or become preoccupied with preparing themselves for survival. Survival and self-protection are healthy natural instincts, but most of the time in non-traumatic lives they are not called on daily because they make it so difficult to be present for the other aspects of life and keep the mind/body in a hyper-sensitive state. While not all Americans feel this way as a result of the shootings, many may feel subtle changes in that direction that may not even be conscious, as traumatic responses often are not in full awareness.

CBSDC: Will these mass shootings start to affect the everyday lives of Americans?

MILLER: Mass shootings have affected the lives of Americans in both tangible and intangible ways. If a critical mass of Americans are psychologically impacted and see their communities as unsafe as a result, they will naturally prepare for the perceived danger. This can impact the culture as people relate to each other differently, since no one knows whom they should trust and people feel at least subconsciously on edge.

We are also impacted concurrently through shooting drills in public spaces in which people are reminded of the need to prepare for an attack. While this preparation helps people feel more protected and in control, it also reminds them of the looming danger. They are asked to visualize their worst nightmares and this can flood them with emotions that are difficult to process when nothing has actually happened to them directly.

Discourse about mass shootings has become ubiquitous, which can join people together in collective mourning, but also makes people more cognizant of the ever-present danger. It feels more emotionally near even though it is still so statistically unlikely.

CBSDC: Can someone who wasn’t involved in these mass shootings start suffering from depression or other sorts of mental illness after seeing all the news coverage?

MILLER: People who have gone through trauma themselves are the most likely to have their mental health impacted in a significant way by bearing witness via the news to so much suffering. Seeing such unexpected trauma happen to so many people can be very triggering, even if their trauma was of a very different nature.

People with a tendency towards anxious or depressive thinking may also be particularly vulnerable, as such shocking events may compound with their belief systems, for example that the world is a cruel and/or dangerous place, that positive change is hopeless, etc.

While people are unlikely to become mentally ill purely as a result of viewing the horrifying footage of mass shootings, it can certainly be triggering to see them. They can also contribute to paranoid delusions in those already predisposed to think along paranoid lines and this can be very destabilizing for those with serious mental issues.

CBSDC: What sort of mental toll do these mass shootings take on victims and families?

MILLER: Mass shootings are incredibly traumatic for the victims and their families. The arbitrary nature in which victims are selected by mass shooters makes it difficult to ever feel safe from harm anywhere. And how does one even begin to make sense of such an event? It is a fundamental part of human nature to try to make meaning of one’s life, but impossible to answer the question, “why me?” This often means that the traumatic memory is cut off from the rest of the mind because victims and their families can not integrate it into their life narratives in a way that makes sense. That is the nature of trauma that often leads to a part of the self feeling deadened, cut off and unverbalizable.

It can make victims and their families feel fundamentally different and symptoms of trauma may emerge unexpectedly as trauma is often remembered more by the body (physical fear response) and blocked out in the conscious mind because it is too overwhelming. Victims and their families may feel hopeless, numb and alone as they struggle to cope with something that is too much to bear. However, victims and their families are often very resilient as a result of being survivors and accessing strength they may not even have known they had. Trauma has the potential to bond families and communities if people can face it together. Psychotherapy can be an important tool in grieving the losses associated with trauma and working through the experience.

CBSDC: As a mental health professional, do you agree with House Speaker Paul Ryan that mental health laws are “outdated” and Congress needs to act on them?

MILLER: I think that mental health care should be more valued and available to Americans. More funding should be given to mental health programs, research, and preventive services. At present, clinicians in the best position to notice the earliest signs of psychopathology that might lead to mass violence are often underpaid and overworked. It is unclear how many mass shooters would end up utilizing mental health services and not all shootings should be seen as a failure of the mental health care system to catch and prevent the such tragedy. But ready access to good mental health services would certainly be a benefit to both perpetrators of mass violence and victims.

CBSDC: Should someone who has ever had mental health issues ever have access to buy a firearm?

MILLER: I think that it is difficult to say if all people with a history of mental health issues should be barred from owning guns. For example, should a person who has had a past depressive episode or struggled with anxiety in college 30 years ago be disqualified? The answer seems to be that it depends on how that mental health issue manifested itself. And a serious argument can be made that if such a screening can prevent even one mass shooting, it may be very much worth it.

However, discrimination based on illness is always a tricky thing and it is important that restrictions in general based on mental health history not have the reverse effect of deterring people from seeking treatment. Serious thought should be given to what the screening procedures will be and how they are administered. Stricter screening and gun laws in general are important for everyone’s protection.

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