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Tuesday, April 9, 2019

Book Review: Healing a Community

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When something as devastating as a mass shooting occurs, it is hard to know where to begin the process of healing. With so many people affected on such a mass scale, there is chaos, uncertainty, confusion — even for mental health providers.

“Despite their best intentions, most clinicians are not adequately trained to work with people suffering from complicated grief and complex trauma, the psychological phenomena that often result from these tragedies,” writes Melissa Glaser.

In her new book, Healing a Community: Lessons for Recovery after a Large-Scale Trauma, Glaser, who coordinated the Newtown Recovery and Response Team that responded to the Sandy Hook shooting, offers a practical guide designed to help clinicians, communities, and families cope in the wake of a mass trauma.

“The unfortunate lesson I learned in Newtown, Connecticut following the Sandy Hook School shooting is that every community needs to create a mental health recovery plan so that its leaders, therapists and families know what to do if a large-scale tragedy occurs,” writes Glaser.

Glaser describes working with a family in the immediate aftermath to help them break the news to their children that their son had been killed in the shooting. After spending four hours working with the family, holding space and allowing the heart-wrenching and raw emotions to flow, Glaser saw the family at an event three months later and, after some debate, decided to say hello to them. To her shock, the family had no idea who she was.

She writes, “This is what trauma looks like and how deeply it affects the brain. Post-traumatic stress often results in cognitive and behavioral changes and deficits. Emotional flooding transfers into a breakdown in cognitive processing including absent or diminished recall of the event and the most painful experiences connected to it.”

The only choice is to meet families where they are. Some families will require non-traditional or more layered approaches. Some families will be more affected financially than others.

Describing the approach after Sandy Hook, Glaser writes, “Our program combined intimate individual assistance, small and large-scale education, and training. This unique mix was critical to our success.”

One crucial first step is to survey the needs of the community. “Remember that you will work within a traumatized environment, which breeds confusion and chaos in and of itself,” cautions Glaser.

Understanding the emotional, physiological and neurobiological effects of trauma is another instrumental component of recovery, and equally important is having realistic expectations for recovery.

Glaser writes, “Recovery and resilience is not a return to how you felt before the incident. It is moving through the trauma and grief, finding a healthy and acceptable way to resume your life without being consumed by adverse symptoms.”

People are affected by trauma psychologically and physiologically, and by understanding the way trauma impacts their brain and nervous system, they can better understand why they feel the way they do so they can find acceptable ways to express their fears, vulnerability, pain, guilt, and grief.

In inexplicable traumas, as much as the brain tries to make sense of them, there is no language to describe or understand what has been experienced.

“Trauma creates an assault on (those) neurotransmitters which can result in chaos in the brain,” writes Glaser.

Talk therapy is often wholly ineffective. Glaser describes using alternative treatment modalities such as acupuncture, art therapy, emotional freedom techniques, equine and animal-assisted therapy, neurofeedback, somatic experiencing, and yoga to help the families of Newtown re-regulate.

However, when a community is shaken to its core, trust and security are diminished, and when services are delivered in the public eye, they are judged, challenged, and highly scrutinized.

“I quickly realized that my team would need a high tolerance for public scrutiny,” writes Glaser.

Beginning with an assessment of the immediate and ongoing community needs, Glaser notes that the keys to her program’s success were building relationships with community organizations and treatment providers and developing a team of care coordinators complete with tested wellness and therapy resources.

Not only should healing treatments be tailored to the unique needs of the community, they should also be prepared to remain in place long after the trauma response team is gone.

Moreover, there is no way to predict the magnitude of a mass-scale trauma or the way it affects each individual family. Glaser writes, “Every family was different in its level of grief, supports, and awareness of the ways trauma had impacted their lives. Some families stayed silent, some were outspoken, and most only sought assistance once a level of trust was established.”

Healing from a mass-scale trauma cannot be accomplished without first understanding the impact of trauma, or the unique needs of the community affected by it. What Glaser offers is a thoughtful, comprehensive, and sensitive approach to healing a community. Healing a Community is a book that, especially today, should be on every clinician’s shelf.

Healing a Community: Lessons for Recovery after a Large-Scale Trauma
Central Recovery Press, February 2019
Paperback, 304 pages



from Psych Central http://bit.ly/2I7hUzi

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