Aftermath: Psychological Recovery


Extreme violence comes with a price for everyone involved: the suspect, the victim, the families of both, and witnesses in close proximity. Whether you were directly injured, survived physically unharmed, witnessed the attack, or simply are related to someone involved, it’s important to understand what you may experience moving forward. This is a complex topic to fully understand, but a basic knowledge of what may be experienced is so essential.

You’re Not Alone – No one leaves a violent encounter unchanged. No one. The degree to which you are affected may differ person to person, but no one walks away unscathed. I truly believe this is important to note to give yourself permission to feel however it is that you feel. You may feel embarrassed or ashamed for being affected, and it’s important to know you’re not alone.

Everyone Responds Differently – Along these same lines, it’s important to understand that however you’re feeling is normal. Not every person will respond the same way or be triggered in the same manner. There’s no “mold” to psychological trauma. Each person will respond differently, and be affected for different lengths of time and by different things. Whether it’s fear, anger, guilt, mistrust, depression, etc, your body is responding the way it believes is best for your survival. You should not allow yourself, or anyone else for that matter, tell you how you feel is wrong.

Here is a list of common signs and symptoms of a stress reaction:

  • Emotional: Anxiety, Fear, Guilt, Grief, Depression, Numbness and/or Detachment, Denial, Shock, Isolated, Unappreciated, Abandoned, Worry, Withdrawal, Anger, Irritability, Stubbornness, Mood Swings
  • Mental: Slowed Thinking, Difficulty with Decision Making and Problem Solving, Confusion, Disorientation, Difficulty Concentrating, Memory Problems, Flashbacks of the Incident, Distressing Dreams, Poor Attention Span, Preoccupation with the Event
  • Behavioral: Sleep Issues, Intensified Fatigue, Angry Outbursts, Suspiciousness, Withdrawal/Avoidance, Changes in Appetite, Increased Substance Use, Change in Activity, Hypervigilance, Overall Change in Health, Engaging in High Risk Behaviors

These emotional changes can cause physical reactions as well. The stress brought on by triggers can garner responses in all areas of the body:

  • Cardiovascular System: Rapid Heart Rate, Increased Blood Pressure, Chest Pain
  • Gastrointestinal System: Nausea, Upset Stomach, Diarrhea, Appetite Changes
  • Immune System: Increase in Colds and Other Viruses
  • Endocrine System: Thyroid Issues, Diabetes
  • Musculoskeletal System: Muscle Aches and Spasms
  • Central Nervous System: Anxiety, Headaches
  • Integumentary: Skin Issues, Hives

Guilt/Shame – This is a very common response of which I don’t think people truly appreciate the impact. It’s common to try and retrace your steps and analyze what you did and feel guilty that you didn’t do something different, or start to break down what you did into “right and wrong.” You may start to say, “If I had only done X, instead of Y, it would have been better.”  You begin to blame yourself for how things happened. Remember, you did not choose to be a part of a violent scenario: the attacker chose to murder people, not you. No one can make perfect decisions in these situations. Remember what we’ve highlighted throughout the entire book: you can only make the best decision possible, based off the information presented to you, and the knowledge you had leading up to the event. It’s normal to want to “Monday morning quarterback” the situation, but it can eat you alive. Try to understand that you did exactly what any person would have done in the situation you were in, armed with the exact experiences you have had.

Another form of guilt that can show is survivor’s guilt. If you were with someone—a loved one, friend, co-worker—and you survived instead of that person, you may actually feel guilty for being alive. This guilt is completely normal, whether you feel you could have done something to save them in the moment, or even just have sentiments of, “If only I had been there instead of them.”

Triggers Will Differ – Your body may develop certain triggers that will set off your emotional response. It could be a feeling, a person, a place, an object, etc. You may not be completely cognizant of these triggers, but identifying what they are and normalizing the fact they will happen can be very beneficial. Try to understand that no matter how random or odd the trigger may seem, it is in fact a normal response.

Seeking Help – Reaching out to others can be difficult. Whether you’re embarrassed, scared, or just sheltering yourself away, it can be very challenging to talk about these things or seek out professional help. Understand that there are many resources available to you and it’s absolutely encouraged to use them. No one should rush you to do anything immediately, you may need a little time to do so, but the sooner you are able to find those professionals, the sooner you may be able to move towards normalizing your feelings.

Here are a few resources to consider. Keep in mind some of these may vary in different states and cities, but programs like this are available in most areas.

FBI Office of Victim Assistance – The OVA is there to help victims of any federal crime. Terrorism falls into Federal Jurisdiction and in most cases, any situation deemed an “active killer” will as well. Whether the FBI is the lead, or is assisting on a task force, these services are good to know about. All of the fifty-six field offices in the US have a Victim Specialist available upon request. Those specialists are not only there to help you directly, but are also a great resource for seeking further help locally, as they are familiar with the programs in your state.

State Programs – In recent years, a trend has been growing in states to allot a budget toward counseling and victim services. California and Ohio were the first to develop very large programs to help with counseling, legal advice, and much more. Each state is different, but thankfully, in this day and age, a simple online search can bring up a large list of programs. Many of these programs are geared towards victims of domestic abuse, sexual violence, and other serious crimes because they are more common than mass violence situations. That being said, in most cases, acts of mass violence fall into the category as well.

Hotlines – Suicide and support hotlines are available in every city and state. The ability to be able to reach a caring support person with a simple phone call can be absolutely crucial. These lines are staffed with people who are there to listen and help you in those times of need.

Universities – Many universities have a department on campus to help students deal with the everyday stress of college and life in general. These groups are also there to help victims of violent crime. If you are attending a university, take the time to locate these services and know how to access them.

Counseling – Whether it’s supplied by the city/state/federal government or you seek out a professional on your own, counseling can be a great resource. The ability to find a good resource will depend on what is available in your area, but a quick online search can yield a list of possibilities. Keep in mind, not all groups are trained to deal directly with victims of violent crime, so try to be up front about your needs when talking with them. It’s also important to note that many insurance programs will not cover counseling. Ask whomever you are planning to visit if they know of any financial programs to assist, or see some of the resources we mentioned above for possible assistance.

Support Groups – Being able to open up and talk with others that have been through a similar experience can be very helpful. Whether these groups are in person or online, sometimes having a sounding board is just good. You may all have been together in the incident. In any case, this is another option for you to pursue to discuss things with people who may be dealing with similar issues. Keep in mind, as we mentioned earlier, everyone will respond differently, so don’t be surprised or taken aback if you are reacting differently than others. Each of your responses is normal and there to help you survive.

Books, Presentations, and Videos – There are many people that have survived violent encounters that have gone on to publish books, do interviews, or film videos about their incidences and how they are progressing in the aftermath. Some even travel the US giving presentations. These may be helpful for you. Their stories may inspire or help you with your story. Keep in mind that reliving their experience may force you to relive yours and may trigger an emotional response. It’s something to be aware of and is completely normal.

Supporting Loved Ones:

You may not be the one experiencing the emotional aftermath of the event. Maybe you weren’t even there. If someone you care about is experiencing this stress, it’s natural to want to help. It’s also natural, over time, to be frustrated, to be anxious, and to not understand or be able to relate to them. This can be a short or a long process. It can be something that sneaks up out of nowhere. It can be insanely taxing on not only the victim, but also the victim’s family and friends. Here are a few things to consider if you want to help your loved ones:

  1. Be aware of how you communicate and how they communicate. Make a note of what is helpful for them. In most cases, we tend to be more focused on what helps us, so you must be aware of what helps them and communicate in that manner.
  2. It’s okay to ask them how they’re doing. It allows them an opportunity to say what they feel. How little or how much they say is up to them.
  3. If they are sticking to themselves and not interacting much, it’s okay. Try not to pry. Simply make it known that you are there to talk when they feel ready.
  4. Tell them that you’re sorry that they’re hurt and/or suffering, but you’re glad they’re alive.
  5. It’s okay to remind them that how they are feeling is normal, no matter how confusing those feelings may be.
  6. Be willing to say nothing at all. Oftentimes, just being there is a huge help.
  7. Don’t be afraid to encourage them to seek professional help.
  8. Be willing to support them and join them, if they want you to, in any meetings, court hearings, investigations, etc.
  9. Don’t attempt to give your explanation of why this happened.
  10. Don’t say things like, “It’s okay,” “Everything is okay,” or, “I know how you feel.” Even though these may seem like caring things to say, to them, they don’t feel okay and you likely don’t, in fact, know how they feel.
  11. Don’t tell the person to move on or insinuate that they’re only a victim if they make themselves a victim. These are quite possibly the worst things you could say to someone battling these issues.
  12. It’s okay to continue to do things you enjoy in life. Just because you may feel a bit of joy, doesn’t mean you don’t care. It may actually help relieve pressure knowing that you’re still taking care of yourself.
  13. There’s no perfect thing to say or do. Be there, be willing to listen, be willing to help with anything they need. Be patient.


*excerpt from How to Survive an Active Killer: An Honest Look at Your Role in the Age of Mass Violence

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