Rethinking Mass Trauma: When You Have a Personal Connection to Community Violence

Another day, another mass shooting. According to the Gun Violence Archive, there have been more mass shootings than days in 2023. A mass shooting is defined as an incident in which four or more victims are shot or killed. Just this past weekend, a man entered a mall in Allen, TX with an AR-15 killing at least eight people and injuring others.

• What is PTSD?

Like most Americans, I am exhausted from the violence and struggle to understand why nothing is being done about it. But I come from the unique place of having lived through the 2007 Virginia Tech shooting and other tragedies that occurred while I was in grad school. In 2007, mass shootings were uncommon. We were naive and thought something like that could never happen here in the small, quaint town of Blacksburg, VA. Sixteen years later, the landscape has changed, turning small towns anywhere and everywhere into scenes of mass violence.

With each of these incidents, there is trauma that reaches far and wide, prompting an overwhelming emotional response to the tragedy. No doubt those who experience the violence directly are traumatized. Psychologists refer to this type of trauma as “Big-T” trauma; it is the form of trauma that leads to post-traumatic stress disorder, PTSD. And there is no doubt that those who are distanced from the event also experience trauma, termed “Little-T” trauma. Little-T trauma, while not significant enough to cause a PTSD response, can have a cumulative negative effect on an individual’s well-being.

The people who get left out of the discussion are the ones who have a personal connection to the incident but who were not directly subjected to the violence. These are people like me who were not on campus the day of the shooting, who didn’t even personally know anyone involved, but who were connected in some way to the incident. In my case, the shooting took place in a building I had taken classes in and had even lectured in. My department lost several students and a faculty member, and I attended their memorial services, not knowing any of them personally. I watched the news closely following the shooting, but I didn’t experience the violence firsthand. The nightmares I had after the shooting were wholly unjustified. The hypervigilance that followed me into my career as a university professor was wholly unjustified. The flashbacks and avoidance and panic attacks were wholly unjustified. Or so I thought.

We tend to focus so much on diagnosis without consideration for the very real symptoms we experience. Like other mental disorders, PTSD is diagnosed using criteria in the Diagnostic and Statistical Manual, DSM 5. The DSM fails to acknowledge that post-traumatic stress (PTS) symptoms may still be present following trauma even though a person may not meet the criteria for PTSD. We can’t forget it’s an evolving science. A study of mass traumas like the 9/11 terrorist attacks, the Boston Marathon bombing, and the Sandy Hook shooting showed that repeated exposure to collective community traumas led to more severe acute stress symptoms among the general public. Another study showed that physical proximity was linked to worse mental health outcomes for the general public following school shootings. Because the DSM is written in cut-and-dry diagnostic language, we lose a lot of the nuances of real-life experiences. The reality is that trauma is messy and complex, and a lot of research is still needed, especially when we talk about community trauma. It is important that mental health practitioners understand this as well as the general population.

I was distanced from the shooting by not being on campus that day, and so I was certain I couldn’t have PTSD. Because I didn’t feel deserving of treatment, I suffered in silence until I began treatment for bipolar disorder in 2013 and my therapist picked up on how deeply the Virginia Tech trauma affected me. I had visions of shootings nearly every time I set foot in the classroom as a professor, and when a stranger entered my classroom in 2014, I was almost unable to teach the rest of the semester. My therapist led me through intensive exposure therapy exercises, which were effective, and I eventually walked away far more resilient and better able to perform my teaching duties. Had I not already been in therapy at the time, I’m not sure I would have been able to continue in my career as a professor.

I call the type of trauma I experienced “Medium-T” trauma — it is not the same as someone who experiences the violence firsthand, but it is more serious than someone completely disconnected from the incident and sees it in the news. People who have experienced Medium-T trauma have PTS symptoms, but we push them aside because we didn’t experience the worst of the violence. We deny ourselves treatment because of survivors’ guilt. We are the people who were lucky to be somewhere else on “that fateful day.” I want to tell these individuals that your trauma is real and your experience is justified. I want you to know that you don’t need a diagnosis to qualify your symptoms. I want you to know that therapy and medications can help, and it is possible to get better and move forward.

With the increase in frequency of mass shootings and other community-scale violence, we need to be far more mindful of the impacts of these events on the wellbeing of everyone, not just those most severely affected. Greater resources need to be made available for individuals and families affected by trauma, including trauma-trained therapists for people experiencing the Medium- and Little-T trauma when those folks are ready. Resources should be given to research to better understand community trauma and recovery. Additionally, communities need to be given the time and space to heal following this type of incident. It is my hope that lawmakers will eventually wake up and do something to stop the violence, but in the meantime, the best we can do is take care of ourselves.