Editor’s note: The epamphlet on mass disasters, trauma and loss is also available in Spanish, Arabic and Chinese. For more information see the JTS virtual issue on trauma in the context of mass shootings and ISTSS briefing paper on hate-based violence.
Violence in religious spaces, unfortunately, seems increasingly frequent, both nationally and internationally. A 2018 New York Times article described some of the deadliest mass shootings in U.S. houses of worship over the past few years. Although these incidents occur less often than other types of traumatic events, their impact is pervasive and detrimental. Existing knowledge of best practices for coping with mass disasters and trauma provides insight for religious communities about how to respond to such tragedies, although specific cultural contexts should be considered.
How is Religiously Associated Trauma Different?
ISTSS’s public education pamphlet on responding to mass disaster, trauma, and loss describes the emotional, cognitive, physical, spiritual and interpersonal changes that may result from exposure to mass trauma. It highlights past trauma exposure; chronic physical and/or mental illness; intense emotional demands; extreme fatigue; and extended exposure to danger, loss or emotional strain as factors that increase vulnerability to lasting mental health consequences after trauma exposure. Trauma that occurs in a place of worship compounds the complexity, affecting a potentially strong component of identity; as a result, individuals with and without these other risk factors may be particularly vulnerable to posttraumatic stress symptoms. Dr. Heather Davediuk Gingrich, a professor of counseling at the Denver Seminary and the author of numerous books on complex trauma and religion, describes this impact as follows:
“Violence in a religious space is likely to elicit not only posttraumatic psychological symptoms, but may also shake the foundations of survivors’ spiritually, which in itself, can be experienced as traumatic. In addition to struggling with such existential angst, the sacred space has now been violated, potentially resulting in posttraumatic symptoms of avoidance of future communal worship or intrusive re-experiencing symptoms if they do attempt to reenter religious spaces. According to my colleagues in Sri Lanka, this has been the case in that country in the aftermath of the Easter Sunday church bombings. Even Christians who were not direct victims are often still terrified to attend church services, while those who witnessed the carnage are inundated with intrusive symptoms when they attempt to worship in the sanctuary where they witnessed horrors. Not only the individual congregants, but also entire faith communities have been severely impacted.”
Approaching Reminders of Trauma
Religious community members, as well as community leaders, affected by these tragedies may be hesitant to broach the topic of the trauma. However, it is noteworthy that in most religious faiths, great meaning is often found in specific markers of time (e.g., holidays, historical anniversaries). Most evidence-based treatments for PTSD (cognitive processing therapy, prolonged exposure therapy, cognitive behavioral therapy, and eye movement desensitization and reprocessing) involve exposure to memories of the traumatic event, and research suggests that talking about trauma can promote psychological healing. Even though individuals may experience hesitancy regarding talking about these events, memorializing rituals such as vigils and community events can strengthen identities, sense of relatedness and remind community members of their core values. This approach may actually be familiar for members of a religious community, and research suggests that it promotes growth and healing (Walsh, 2007). Dr. Celene Ibrahim, the Muslim Chaplain at Tufts University, shared the following with this author: “In my work as a university chaplain, I have found it helpful to convene vigils in the wake of tragedies. Vigils are a time to come together to grieve but also to reaffirm the resiliency of the human spirit.”
Media coverage after instances of mass violence also creates a pervasive reminder of the traumatic event. While this may foster a sense of social support, research suggests that checking social media during times of distress can exacerbate psychological distress (Jones et al., 2017). Additionally, studies of the Boston Marathon bombings and Pulse Nightclub shooting demonstrated that trauma-related media exposure predicted posttraumatic stress symptoms, and researchers suggest that individuals who do feel distress may seek out trauma-related media consumption, fueling a cycle of distress and re-exposure (Thompson et al., 2019). Some journalism research suggests that communities may feel anger at the media for covering an issue without sensitivity or for intruding on private communities (Kay et al., 2010). Although some media consumption could provide useful information, it may be beneficial to provide psychoeducation to religious communities regarding the potential distress associated with media consumption and to promote positive outlets for social support.
In religious communities, exercises such as active-shooter drills or discussions about community safety, while of utmost importance, may be distressing for community members in the wake of recent trauma. A study by Kataoka and colleagues (2012) suggests that framing safety drills as a reminder of how to keep a community safe may ease their emotional impact. In trauma-focused therapies, grounding techniques for dealing with extremely distressing emotions are taught before clients engage in discussion about their traumatic experiences. This may be beneficial for religious communities as well, in preparation for events or discussions that bring up reminders of the trauma.
What Helps?
A number of factors are protective against psychological distress following exposure to mass shootings, including self-efficacy, sense of meaning, spirituality and social support (Lowe & Galea 2017; Grills-Taquechel et al., 2010). The burgeoning field of posttraumatic growth also suggests that taking action following trauma exposure can promote new benefits such as an increased appreciation for life, new possibilities, relating to others, personal strength, and spiritual growth, (Hobfoll et al., 2007). Mental health professionals would likely benefit from a better understanding of these protective factors and an increased competency to consider spirituality and religiosity in their clinical work. David H. Rosmarin, PhD, Assistant Professor at Harvard Medical School and Director of the McLean Hospital Spirituality & Mental Health Program shared with us as follows: “Spirituality/religion is an aspect of human diversity and we owe it to our patients to be competent in this area. Given the nature of this domain, that may include integrating spiritual/religious values, beliefs, and behaviors into treatment. In some cases this can be done through collaboration with religious leaders. In other cases though, clinicians can explain secular interventions using spiritual/religious idioms, address spiritual beliefs, encourage positive aspects of religious coping, and help patients to navigate spiritual struggles.”
In summary, what we know about coping with mass trauma suggests that talking about the trauma can be helpful and that it is important to approach reminders of the trauma with sensitivity and intentionality. Specifically, community members more prone to psychological distress may benefit from grounding techniques before exposure to reminders of the trauma. Social media can provide support in the aftermath of trauma, but it may be important for individuals to monitor their social media use, as such use may also promote distress and anxiety. Lastly, as clinicians, we need to continue to understand how the intersection between diversity factors, including religion, and responses to trauma are intertwined with psychologists’ responsibility to respect and promote human rights. Additionally, clinicians can serve a vital role in dissemination and promotion of the aforementioned information regarding violence in places of worship. Greater awareness of intersectionality and an understanding of best practices may promote healing for not only individuals, but also entire communities after violence in places of worship.
For more information about seeking professional help after mass trauma, see ISTSS’ epamphlet on mass disasters, trauma and loss.
About the Author
Sophie Brickman is a third-year PhD student in the clinical psychology–trauma emphasis program at the University of Colorado in Colorado Springs. She earned her bachelor’s degree at Brandeis University, double majored in Psychology and Health: Science, Society and Policy, and completed her undergraduate thesis on posttrauma adaptation following the Boston Marathon bombings. Prior to beginning graduate school, she spent time working at the Israel Center for the Treatment of Psychotrauma in Jerusalem and McLean Hospital. Her research and clinical interests include evidence-based trauma treatment, posttraumatic growth, emotion regulation, cognition and memory in posttrauma adaptation.
Grills-Taquechel, A., Littleton, H. L., Axsom, D. (2010). Social support, world assumptions, and exposure as predictors of anxiety and quality of life following a mass trauma. Journal of Anxiety Disorders, 25, 498-506. doi:10.1016/j.janxdis.2010.12.003
References
Hobfoll, S. E., Hall, B. J., Canetti-Nisim, D., Galea, S., Johnson, R. J., Palmieri, P. A. (2007). Refining our understanding of traumatic growth in the face of terrorism: Moving from meaning cognitions to doing what is meaningful. Applied Psychology, 56, 345-366. doi:10.1111/j.1464-0597.2007.00292.x
Jones, N. M., Thompson, R. R., Dunkel Schetter, C., Silver, R. C. (2017). Distress and rumors during a campus lockdown. Proceedings of the National Academy of Sciences, 114, 11663-11668. doi:10.1073/pnas.1708518114
Kataoka, S., Langley, A. K., Wong, M., Baweja, S., & Stein, B. D. (2012). Responding to students with posttraumatic stress disorder in schools. Child and adolescent psychiatric clinics of North America, 21(1), 119–x. doi:10.1016/j.chc.2011.08.009
Kay, L, Reilly, R. C., Connolly, K., & Cohen, S. (2010). Help or harm? Journalism Practice, 4, 421-438. doi:10.1080/17512780903429829
Lowe, S. R., & Galea, S. (2017). The Mental Health Consequences of Mass Shootings. Trauma, Violence, & Abuse, 18(1), 62–82. https://doi.org/10.1177/1524838015591572
Thompson, R. R., Jones, N. M., Holman, E. A., & Silver, R. C. (2019). Media exposure to mass violence events can fuel a cycle of distress. Science advances, 5(4), eaav3502. doi:10.1126/sciadv.aav3502
Walsh, F. (2007). Traumatic loss and major disasters: Strengthening family and community resilience. Family Process, 46, 207-227. doi:10.1111/j.1545-5300.2007.00205.x