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The ripple effect of trauma from gun violence

Reviewed by Brooks Baer, LCPC, CMHP

A water droplet breaks the surface of smooth water causing a splash

Please be advised that this article mentions suicide. If you’re in crisis, help is available now: Call or text the free, confidential 988 Lifeline at 988.

For weeks after surviving the mass shooting in Las Vegas on October 1, 2017, Emily Cantrell slept with her clothes and shoes on.1 “I felt like I always needed to be ready to run,” she says.

Cantrell struggled to sleep and to reacclimate into everyday life, and she was plagued by survivor’s guilt. “How was it that I was getting to go home when 58 people weren’t?” she says. “Those first few weeks were dark because I didn’t have a therapist, and I didn’t understand what was happening.”

Cantrell, her fiancé, and two friends had traveled from the West Coast to the Route 91 Harvest music festival on the Las Vegas strip, as they’d done several times before. “It was one of our favorite events,” Cantrell says. As the last act took the stage, she remembers hearing what she and her friends thought at first were firecrackers—until a woman to their right dropped to the ground, covered in blood. Then they ran.

Her group managed to escape without physical injury, but Cantrell says the emotional scars she brought home from that night have permeated her life and the lives of those around her.

With gun violence at an all-time high, more and more Americans are impacted by the ripple effect of trauma in their families and communities. These ripples carry with them a profound sense of fear, frustration, and sadness.

“People don’t know what to say or how to help”

Ted Hochhalter spent most of the day on April 20, 1999, trying to travel home to his family in Littleton, Colorado, to find out if his teenage kids had survived the shooting at Columbine High School.2 They were alive, but his daughter, Anne Marie, had been struck by a bullet that left her paralyzed from the waist down.

Helping Anne Marie heal physically and emotionally took a toll on both Ted and Carla, Ted’s wife of 22 years. Carla’s long battle with severe depression had grown worse in the years leading up to the Columbine massacre. Six months after her daughter’s shooting, Carla died by suicide with a firearm in a public space. She was a former teacher and a beloved member of the community, and the shock of her death extended far beyond her close friends and family.

Cantrell says her marriage ended in part because she and her ex-husband processed their trauma from the Las Vegas shooting in different ways, and friendships she once held dear have also disintegrated. “People don’t know what to say or how to help,” she says.

Among gun violence survivors, the issue of addiction comes up over and over again, particularly for those who lived through mass shootings before mental health resources became commonplace in the aftermath of these events.

Austin Eubanks, another Columbine survivor, spoke openly about his struggles with addiction and how his actions hurt those around him.3 He died of a heroin overdose just a month after the 20th anniversary of the tragedy that changed his life.

You can feel pain from far away

Imagine each mass shooting as the epicenter of an earthquake. People can feel the reverberation as far as hundreds of miles away—and while a slight shift under their feet is less dramatic than the full force, they might still fear for their own lives or their families’.

“One of the barriers to recognizing widespread trauma is this competitive ranking of whose pain is worse or more significant,” says Coni Sanders, LPC, whose father was killed at Columbine. “The reality is, there are some people who weren’t present and just heard about an event who have a more significant reaction than people who experienced it.”

Sanders, a forensic therapist who works with victims and perpetrators of violence, says everyone has their own level of trauma following these high-profile events. She uses a tool similar to the 1-to-10 pain scale to help her clients identify what they’re feeling. “I ask them to consider how much this trauma impacts their world. A 10 would be you can’t function and you’re thinking about it 24/7. I don’t care if you have that from watching television. We need to figure out how to manage that back down to a better level,” she says.

Even if they’re not glued to the news, young people are also suffering. This indirect exposure has left them scared and vulnerable: Research shows that Gen Zers worry about gun violence and mass shootings more than any other issue.4 When young people are exposed to gun violence, even indirectly, they’re more likely to abuse substances, engage in criminal activity, and face financial stress at home.5

Cantrell had experienced the ripple effect of gun violence prior to running for her own life in Las Vegas. “I was a news producer in Seattle, and we had a particularly rough couple of months,” she says. “I was producing multiple funeral specials for police officers who were shot and killed, and it just became too much.” Watching the raw footage and seeing the effects of those deaths on the families and her community overwhelmed Cantrell, and she wound up leaving the job.

It’s difficult to quantify the ripple effect of gun violence, but experts are starting to build a connection. In a first-of-its-kind study, researchers tried to measure the impact of a mass shooting on the broader community by looking at data from the Crisis Text Line after the 2022 mass shooting at Robb Elementary School in Uvalde, Texas.6, 7 The data showed an increase in demand for crisis services related to grief around the event.

Is the ripple effect connected to PTSD?

One of the defining symptoms of posttraumatic stress disorder (PTSD) is intrusive memories or flashbacks. If someone doesn’t witness a violent event directly, Sanders says, the ripple effect of trauma is not often diagnosable as PTSD.

Although those core memories may be missing, Sanders says, the brain can create and latch on to something just as strong: imagined possibilities. “It’s normal within trauma to place yourself in the event. So when you’re thinking, ‘If I lost my daughter…,’ there’s a piece of your brain that goes to that dark place of imagining what that would feel like,” she explains, and those thoughts can be just as intrusive.

Either way, Sanders feels hopeful that the way we think about the indirect effects of gun violence will change. “We’re always looking for a diagnosis, but I think one of the things that people need to focus on is that it doesn’t matter what the diagnosis is,” she says. “If you’re suffering, we need to work with the symptoms.”

Building a bubble around your mental health

At times, it can feel like another mass shooting is always just around the corner. When you get overwhelmed, Sanders recommends building a protective bubble around yourself. Here’s what that might look like:

Expand your support network. Ideally, we all have a tight personal network of support. But sometimes you need to be held in a communal embrace, especially if your town has experienced a shooting.

In her role as the chief elected official of Newtown, Connecticut, Patricia Llodra was responsible for shepherding 28,000 citizens through the days right after the 2012 shooting at Sandy Hook Elementary School.8 “I cannot overstate the importance of natural conveners, such as civic and social groups and the religious community, in healing from a mass shooting,” she says.

Learn your trauma activators. Recognizing when you might be in trouble is an important part of managing your trauma. “I have a problem with gyms,” says Sanders, “so I do some deep breathing and other exercises to really prepare before I can walk into one.” Likewise, Cantrell can’t be around fireworks. Once her favorite holiday, Independence Day now leaves her shaking with fear. She plans a trip out of the country at that time each year.

Find a trauma-trained therapist. As society seeks to understand different forms of trauma, the number of mental health professionals trained to work on trauma is growing. Cantrell says she tried a range of therapists and found amazing support from a combat-trained military veteran. If you’re looking for a therapist who specializes in trauma, search our directory to find a licensed professional near you.

However you build your bubble, Sanders says, one thing is certain: You shouldn’t feel guilty for using it to protect your mental health as needed. “We’re in a society where there’s a lot of judgment about grieving,” she says. “There is no wrong or right way to grieve or process, and nobody gets to define what trauma is for any other individual.”

Turning trauma into action

On her flight back from Las Vegas, the day after surviving one of the worst mass shootings in American history, Cantrell decided she would channel her trauma into advocacy.

“I could have sworn I’d been shot or that I felt a bullet whiz through my hair,” she says. “It’s a sickening game of millimeters that I’m still alive, and I thought: If I’m one of those who gets to go home, I’m going to dedicate the rest of my life to trying to make this world a better place.”

About the author

Amye Archer, MFA, is the author of “Fat Girl, Skinny” and the coeditor of “If I Don’t Make It, I Love You: Survivors in the Aftermath of School Shootings,” and her work has appeared in Creative Nonfiction magazine, Longreads, Brevity, and more. Her podcast, “Gen X, This Is Why,” reexamines media from the ’70s and ’80s. She holds a Master of Fine Arts in creative nonfiction and lives with her husband, twin daughters, and various pets in Pennsylvania.

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