Wednesday's Words of Wisdom: Dr Barbara Lavi: If America Came to My Office, Here's the Diagnosis, Treatment Plan and Prognosis I would Give for Her Future

Thought for the Day: I had a very busy day yesterday & was unable to post. I am still giving a lot of thought to the issues I raised on Memorial Day Monday: What You Can Do If You Are Angry About the War Raging in Our Streets. If you missed my post please take a look, read, comment, share and take action. If you are tired of watching news reports of shooting rampages and loss of innocent lives in school, colleges, malls & cinemas followed by memorial services of distraught families and friends, it can give you some ideas of what to do.

Today's post is raising additional questions about the alarming rise in violence in our nation. After the fact, as we try to make sense of what has happened, the news media reports profiles of the shooters' lives and mental health histories. Books have been written to look for commonalities between the angry young men committing these horrible crimes. Since the rampages often end in the attackers committing suicide, if they are not killed by the police, much of the analysis is based on a kind of psychological autopsy and comments from teachers, family and friends about their troubles lives. In today's words of wisdom, I raise a different explanation which could lead to a different way of treating the issue and hopefully helping to prevent additional attacks.

"If America came to my office, my diagnosis would be PTSD (Post Traumatic Stress Disorder). When we focus on the shooters most of whom are dead and cannot be treated, we may be missing the underlying causes and therefore, lose sight of potential preventative treatment options."

Read on to see why this hypothesis may help understand the significant rise in violence, depression, suicide and mass attacks...

Here is a brief summary about PTSD, an anxiety disorder some people get after living through a dangerous event:

Anyone, at any age, can get PTSD. It can impact on war veterans and survivors of physical and sexual assault, abuse, accidents, disasters, and many other serious events. Even people who have not been present during traumatic events can suffer from PTSD. Some people develop symptoms after hearing about a friend or loved one's traumatic experiences or learning about the sudden death of a loved one. The incidence of symptoms tends to be higher among high risk populations. Children, lower socioeconomic groups, survivors of abuse are at high risk for PTSD. 

Multiple symptoms arise due to PTSD. According to NIMH(National Institute of Mental Health), they tend to fall into the following three categories: 1)Re-experiencing symptoms: Flashbacks—reliving the trauma over and over, including physical symptoms like a racing heart or sweating; having bad dreams, or frightening thoughts...2. Avoidance symptoms: Staying away from places, events, or objects that are reminders of the experience; feeling emotionally numb, feeling strong guilt, depression, or worry; losing interest in activities that were enjoyable in the past; and having trouble remembering the dangerous event... and, 3. Hyperarousal symptoms: Being easily startled; feeling tense or “on edge;” having difficulty sleeping, and/or having angry outbursts."

You may be wondering, how is PTSD related to the current dilemmas facing America? Bear with me as I make the analogy. Every citizen of the United States (and of the world for that matter), has been exposed to increasing incidences of traumatic events. Some of us have been present at these events, others have seen them on the news, in movies, television shows, and violent video games. 

What are the symptoms of a nation suffering from PTSD? I would propose that they correspond to the symptoms that individuals experience, leading to an increase in symptoms across the country. The rise in incidence of anxiety and re-experiencing symptoms can lead to distorted perceptions of the world as a dangerous frightening place, leading to panic attacks, night terrors and frightening thoughts. The young men who carry out these attacks often have felt abused or mistreated by peers, teachers or see society as cruel and uncaring, justifying their murderous intentions. 

If PTSD is the diagnosis for our nation, one would also expect to see an increase in avoidance symptoms, i.e., avoiding situations, emotional numbness, phobias, depression, lack of interest in enjoyable activities and a rise in drug and alcohol abuse to try to avoid the negative feelings. How many of these symptoms have you heard the shooters described as having been loners, outcasts, depressed, suicidal on the news? PTSD may also lead to people around the country feeling a need to arm themselves with weapons, thinking that it would make them safer. Sadly, the likelihood of self harm or haring of family members is increased exponentially by owning a gun.  

If PTSD is rampant in our society, a statistical increase in the numbers of suicides and homicides could also be expected.  A rise in hyper-arousal and/or angry outbursts would also tend to be seen. Are we not seeing this in not only mass murders, but statistically around the country? Each additional traumatic event triggers more and more incidents of PTSD with a ripple effect impacting more and more people around our great nation.  If the disease is not treated properly, the prognosis is poor. Are we failing to see the writing on the wall as children and young adults arm themselves and attack schools?

The literature on PTSD may shed some light on the possible solutions and treatment plans for our nation. There are studies which elaborate what helps prevent PTSD and can engender resilience following traumatic events. Countries like Israel, whose citizens have been the target of war and terrorists attacks since Isreal's inception in 1948 have implemented programs which are in place year round to help all citizens. Many of the programs are aimed in particular to help children. The kinds of educational programs that work are an integral part of the school curriculum nationwide in times of calm and after an attack. They are available to children and their parents. Teachers are trained to identify at risk students as early as possible. Mental health services are easily accessible, both in school and through the national medical insurance. There are educational programs teaching children how to interact and solve problems without using physical force. Although almost every adult has been in the army and knows how to use firearms, there is a low incidence of murder in Israel. It is beyond the scope of this post to examine why and how a nation like Israel has avoided national PTSD, but is well worth thinking about and learning from them about resilience in the face of trauma.

If we are to get a handle on the problems, we must take a global preventive stance and find ways to implement programs across the nation. To prevent re-traumatization, journalists need to be trained and become sensitized to use less sensational graphic details of traumatic events. Film makers and game companies also need to reduce the amount of violent material aimed at children our most precious resource for the future who are at the highest risk of being traumatized. Teachers need to be trained and programs must be developed to help teach children to resolve differences and prevent bullying. They also need access to mental health programs for students who appear to be showing signs of disturbance, ie. angry outbursts, obsession with guns or violent games, depression or social conflicts. 

These and my ideas from Monday are just some of the possibilities. I would love to hear your thoughts, comments, suggestions. Do you know of programs to recommend? Please share them. We must not avoid the issues if we are to resolve the problems and treat the national PTSD.