To the Person Who Shared a 'Clever' Facebook Post Attempting to Dismiss Gun Violence

Dear Facebook friend of a friend,

As Facebook algorithms will have it, your post made it to my page.

• What is PTSD?

As my “friends” include those actively working to change gun laws, I presumed the post, with its unsettling image of an assault rifle, was made by one of them. But the I read to the end:

I kill 88,000 people in the United States every single year.
I kill 4,300 underage children every year.
I am responsible for 190,000 visits to the ER by people under 21.
Over 40% of all children in the 10th grade illegally use me.
I am the cause of 1.4 million acts of violence committed between strangers.
I am present in nearly half of all violent crimes up to and including homicide, rape, assault, and child abuse.
Each day I am used by illegal means 300,000 times but only 3,200 people are arrested.
My negative consequences cost the U.S. economy $250 billion a year.
I am alcohol.

What the numbers in your provocative post fail to acknowledge, in its “clever” attempt to dismiss the effects of gun violence, are the ripple effects of trauma that gun violence unleashes onto society. And the more we learn about trauma, the more we understand that its health toll can be far more pernicious than just stats.

Trauma results from an event, series of events or set of circumstances experienced by an individual as physically or emotionally harmful or life-threatening with lasting adverse effects on the individual’s functioning and mental, physical, social, emotional or spiritual well-being. People process a traumatic event differently because such events are faced through the lens of prior experiences. The effects of post-traumatic stress can have lasting effects on a person’s overall health and ability to function effectively.

We know that survivors, witnesses, first responders and victim families of gun violence endure symptoms of post-traumatic stress; symptoms that typically resurface with news of subsequent shootings.

What we are less cognizant of is that violent shootings are also trigger symptoms of PTSD in anyone who has experienced a trauma regardless of whether the root of their trauma stems from violence or something else such as a natural disaster. It’s the familiar and debilitating feelings of fear, dread, despair and panic that are resurrected.

Which begs the question, how many Americans have experienced  a trauma? Almost half of all American children have experienced at least some form of childhood trauma. This translates, according to a survey done by The National Survey of Children’s Health on Adverse Childhood Experiences (ACES) to an estimated 34,825,978 children nationwide. And that’s just kids. According to The Substance Abuse and Mental Health Services Administration (SAMHSA) 61 percent of men and 51 percent of women in the United States report exposure to at least one lifetime traumatic event, and 90 percent of clients in public behavioral health care settings have experienced trauma.

“Trauma is the gateway drug,” says Becky Haas, a trauma informed administrator with Ballad Health in Tennessee. “I feel, as we raise awareness and begin to reduce the effects of childhood trauma, I’m very, very hopeful we’ll start to see addiction, jail overcrowding, homelessness numbers in the next five to ten years start to decline.”

Each time someone is killed by a gun there are victims of trauma on the periphery; substantially more with mass and high profile shootings. A 2015 study presented by the British Psychological Society showed that among 189 participants exposed to violent news stories on social media, 22 percent scored high on clinical measures of PTSD even though none had previous trauma, were not present at the traumatic events and had only watched them via social media. “It is quite worrying,” remarked Dr. Pam Ramsden who conducted the study, “that nearly a quarter of those who viewed the images scored high on clinical measures of PTSD.”

Your post asserts the societal toll of alcohol, yet what is it that leads many down a path of alcohol abuse? The answer is trauma. People often turn to alcohol as a Band-Aid for the devastating consequences of trauma which include: an inability to sustain healthy relationships, anxiety, clinical depression, loss of concentration; an inability to be present and relaxed and a string of misdiagnosed illnesses.

And, like alcohol, trauma can kill.

California’s Surgeon General, Dr. Nadine Burke Harris, makes the connection between trauma and disease in her illuminating TED talk, “How Trauma Affects Health Across a Lifetime” which to date has over six million views. In her book, “The Deepest Well, Healing the Long Term Effects of Childhood Adversity,” Dr. Burke Harris writes:

“Most people wouldn’t suspect that what happens to them in childhood has anything to do with stroke or heart disease or cancer…Twenty years of medical research has shown that childhood adversity literally gets under our skin changing people in ways that can endure in their bodies for decades. It can tip a child’s developmental trajectory and affect physiology…”

How many children (and adults) are internalizing the fear and anxiety gun violence incites with little to no understanding of the effect it is having on their health? Exposure to gun violence no doubt qualifies as an “adverse childhood experience.”

That the root of the alcohol-induced calamities you cite is often trauma is something we as a society are slow to recognize, even when it’s obvious.

Last September, the NYTimes published an article of woman who survived a 68 story climb down the steps of the world trade center where she had been working when the planes hit. Her years of alcohol abuse and other health issues were only now — 18 years later, diagnosed for what they actually were — the manifestations of post-traumatic stress disorder.

For those whom it’s not so obvious — who have no clear connection to or memory of a traumatic experience — the road to understanding that their present symptoms may in fact be related to an earlier trauma is especially confusing. Rarely do physicians think to ask, when a patients complains of depression, addiction, anxiety or other ailments, if they have a history of trauma or adverse childhood experiences

Though PTSD can be brought on by a variety of circumstances including natural disasters, an accident and death of a loved one, real world violence is particularly noxious as it ignites a sense of dread familiar to those who have had previous exposure to a violent incident; and, it’s relentless. When a person experiences a natural disaster or death of a loved one they typically are not exposed to it again and again as they are with a steady stream of reports of gun violence.

On September 11, 2001 I was living in New York City. Having experienced a traumatic event in childhood, the events of 9/11 impacted my health far more severely than many of my friends and colleagues. Dormant feelings of debilitating anxiety were resurrected despite the fact that I lived far from the towers and lost no loved ones. Though it would be decades before I or any clinician would understand my symptoms as a trauma response, access to sound therapy and helpful medication at the time made it possible to function and to effectively care for my children without turning to unhealthy coping mechanisms.

Millions of Americans do not have this kind of privileged access to quality mental health support. With news of each violent shooting, numerous men women and children who have endured trauma and/or adverse childhood experiences are re-symptomized. Given the prevailing stigma — not to mention, the anachronistic position held by most insurance companies around mental health — no doubt many symptomatic people are either misdiagnosed or are finding alternate ways (alcohol?) of coping.

Just who will develop post-traumatic stress after an episode of violence largely depends on variables such as a person’s history, genetic makeup, socioeconomic status and interpersonal relationships. While primary care focuses as it should on victim families and survivors, we know very little about just how big a segment of the population is immobilized by feelings of helplessness each time they hear about another shooting. Fear is a massive and contagious beast; silently and destructively working its way through families, communities and nations only to manifest outwardly in things such as substance abuse, rage, suicidality and frequently an irrational attachment to weapons

After the Sandy Hook Elementary School shootings, I took a job as a care coordinator for The Newtown Recovery and Resiliency Team. The team, funded by a grant from the Department of Justice, was tasked with helping victim families and Newtown residents find therapeutic support and navigate insurance needs in the wake of the tragedy. Many seeking help were teens and young adults with symptoms of trauma. They were often accompanied by parents at a loss for how to help. These young people expressed fears of going to the movies, to the mall, or quite commonly, away from home to college. Children who were in elementary school at the time of the shooting and who showed few to any signs of trauma at the time were hit with symptoms of PTSD when adolescence or other developmental stages kicked in. A visitor from Columbine shared that after the 1999 shootings at her school, a number of students who were fortunate enough to not have been in school on the day of the shooting nonetheless developed more severe symptoms of trauma than did some of the students that were inside the building. Both in and around the Newtown area, mail carriers, cafeteria workers, custodians, teachers and first responders were grappling with the toll post-traumatic stress was having on their lives. Each time news came of another shooting, we and other area clinicians saw a substantial rise in people seeking help.

And then there is law enforcement. What happens when we see the people tasked with protecting us also struggling with PTSD? Even without ever having dealt with the trauma of a violent shooting, symptoms of depression, suicide and PTSD are all alarmingly common among members of law enforcement. In fact, police officers are more likely to die by their own hand than are killed in the line of duty.

After the 2014 fatal shooting of Michael Brown and subsequent riots in Ferguson Missouri, mental health experts cautioned that these events likely placed people at risk for developing PTSD. Among residents of Ferguson and the surrounding area, 34 percent reported symptoms that exceeded the threshold that would indicate probable PTSD in a clinical setting. Among police officers, that rate was 14 percent. Witnessing or being unable to prevent a violent shooting is deeply traumatic for those who see themselves as protectors and who fear not being able to stop the next shooting. “So, again, we have this recipe for disaster,” says Marva Robinson, the president of the St. Louis Association of Black Psychologists. “You have people who are fearful out of what occurred last time, and you have them being policed by people who are fearful of what happened last time.”

While statistics on can offer some insight in regard to trauma and gun violence, they have yet to tell us what is bubbling up inside our current generation of schoolchildren. I recently came across the following post on Twitter:

“I was buying {my child} school shoes and she told me she didn’t want a pair of light up shoes. I figured it was because she’s going into 5th grade and they felt childish to her. She said, ‘what if there’s a lockdown drill or school shooter? Light up shoes would make me stand out.’ We have officially failed as a country when a 10-year-old doesn’t want light up shoes because she’s afraid of being a shooting victim.”

According to the Education Department’s National Center for Education Statistics, nearly every American Public school now conducts lockdown drills. Law enforcement officials and many school administrators say they are crucial for preparing and safeguarding students, but methods vary widely and now include drills that child trauma experts say do little more than terrify already anxious children. After the shooting at Marjory Stoneman Douglas High School in Parkland, Fla., nearly 60 percent of American teenagers said they were very or somewhat worried about a mass shooting at school, a similar proportion as parents, according to a survey by the Pew Research Center. How many kids will internalize that fear only to have it bubble up and later erupt in the form of depression, isolation, rage and…alcohol abuse?

The University of California’s Center for Healthy Journalism recently published an article titled “How Active Shooter Drills are Traumatizing our Children.” A Facebook comment in response to the piece read:

“I’m from the generation that started the trauma. We had Columbine, 9-11 lock down, the DC Sniper (lived in DC metro area). My entire school life was drills and codes. I don’t go into any public place without assessing my exit strategies and I’m 31 now.”

A reply to the comment stated: “This is a trauma response.”

When Senator Kamala Harris asked the students in the audience at the Tonight Show whether they’ve ever had to learn how to run, hide or fight in the event of a mass shooter at their school, nearly every student raised their hand. “We are traumatizing these kids,” tweeted Harris.

In August, scientist Neal DeGrasse Tyson tweeted a statistic on gun violence in an effort to illustrate the disproportion between people’s angst and the actual numbers of people killed in the U.S. each year. As a fan of Tyson’s and deeply cognizant of the need for sound science in the age of Trump, I understood his reasoning. The response nonetheless was swift and furious; and for good reason. (Tyson later apologized.) Tyson got scolded not as much for the data (though one victim of gun violence is one too many) but more so for minimizing the impact gun violence has on our collective psyches — in other words, the trauma.

And then there is the emerging field of epigenetics. Can adults inadvertently pass on symptoms of trauma to their offspring? Though too soon for researchers to make any definitive correlation, there is emerging evidence from animal studies indicating that a parents’ emotional trauma may change the biology of their child. “If you’re asking, ‘Does the experience of the parent influence the process of development?’ the answer is yes,” says epigenetics researcher Michael Meaney at McGill University in Montreal, Canada, “The question [is] how.”

It’s been said that one indicator of a person’s future mental health is whether they believe that a better future is on the horizon.

Comparing the “negative consequences” of gun violence against the negative consequences” of alcohol isn’t fair. We may not yet have the solution on how to fully heal addiction and trauma, but we do know how to curb gun violence. Not only are the needed measures painfully simple, but I suspect the ripple effect such measures would have on decreasing instances of trauma and subsequently, alcohol abuse, would be profound; possibly just as if not more profound than the ripple effect gun violence is presently having on the spirit of our nation.