Dr. Krista Mehari
A Note from Joel Fein, MD, MPH, Co-Director of CHOP's Violence Prevention Initiative (VPI): Today we welcome a guest blog from Krista Mehari, PhD, a Psychology Fellow who works at VPI@CHOP as a facilitator on our school-based bullying prevention program. Dr. Mehari wanted to apply her training to help those in our Research in Action community to process and cope with the recent acts of gun violence in the U.S. Here is her perspective that we hope you find helpful:
The recent death of Philando Castile became the 559th death in which police officers were involved in the U.S. in 2016. His death was quickly followed by the deaths of five police officers caused by a sniper who was purportedly triggered by this event.
In response, our nation, our colleagues, and our neighbors are grieving, marching, and debating, and also brainstorming solutions to preventing further violence.
It is important to understand that these deaths, witnessed by millions of people on video, in addition to being heart-rending losses, can also constitute trauma to those who have heard about them and watched them.
Research shows that exposure to violence is associated with depression, anxiety, and symptoms of traumatic stress. Furthermore, people who are exposed to violence are more likely to engage in aggressive or delinquent behavior.
A constant fear of being unsafe or perceiving danger in the environment can accumulate over time and causes physical and behavioral health problems. This is likely true for both people living in communities or members of marginalized groups that have experienced a great deal of victimization, as well as for police officers who are frequently in critical incidents and unsafe situations as a requirement of their work.
Philando Castile’s partner and daughter, who were in the car with him as he died, no doubt experienced the most severe trauma. But so many others who identified with his death-- parents, partners, and friends of boys and men of color-- likely also experienced traumautic stress reactions upon hearing the news stories and seeing the YouTube videos.
So what can we do for us, our colleagues and members of our communities who have been experiencing these events as traumatic?
- Use trauma-informed practice with everyone with whom we come into contact, understanding that while our nation as a whole has experienced tragedy and horror in the past weeks and months, many of our neighbors have experienced traumas throughout their lives.
- Enhance our organization’s support for our colleagues who are experiencing stress. This includes compassionate supervision, debriefing meetings, and training and education regarding the emotional strain that we experience while helping those who have experienced tragedy.
- Integrate self-care into our daily lives: Seeking support from friends, exercising, eating healthy foods, and meditation or prayer; we know that self-care and spirituality can reduce distress.
- We can cope through positive activities such as political activism and collective dialogue. In times of high distress, talking to a professional counselor is more effective than alcohol or other drugs, which “numb” us when we really need to feel so deeply.
- Support those who are in distress by listening to what they are saying. Understand that they have a perspective that is based on their own experiences, which may be different from yours, and that may be okay.
- Reframe how we respond to heartbreaking events– moving from sadness and anger toward hope. This truly increases our resilience. We need to keep in mind that our daily work touches so many families in a positive way, making it ever so much easier to get through this together.
Access tips and tools for healthcare providers about emotional recovery from CHOP’s HealthcareToolbox website.
Read a previous blog from Meghan Marsac, PhD, who talks about secondary stress among healthcare providers.
1. Buckner, J. C., Beardslee, W. R., & Bassuk, E. L. (2004). Exposure to violence and low income children's mental health: Direct, mediated, and moderated relations. American Journal of Orthopsychiatry, 74(4), 413-423. doi: 10 1037/0002-94184.108.40.2063
2. Cisler, J. M., Amstadter, A. B., Begle, A. M., Resnick, H. S., Danielson, C. K., Saunders, B. E., & Kilpatrick, D. G. (2011). A prospective examination of the relationships between PTSD, exposure to assaultive violence, and cigarette smoking among a national sample of adolescents. Addictive Behaviors, 36, 994-1000. doi:10.1016/j.addbeh.2011.05.014
3. Cooley-Quille, M., & Boyd, R. C., Frantz, E., & Walsh, J. (2001). Emotional and behavioral impact of exposure to community violence in inner-city adolescents. Journal of Clinical Child Psychology, 30(1), 199-206.
4. Fowler, P. J., Tompsett, C. J., Braciszewski, J. M., Jacques-Tiura, A. J., & Baltes, B. B. (2009). Community violence: A meta-analysis on the effect of exposure and mental health outcomes of children and adolescents. Development and Psychopathology, 21, 227-259. doi: 10.1017/S0954579409000145
5. Mrug, S., & Windle, M. (2010). Prospective effects of violence exposure across multiple contexts on early adolescents’ internalizing and externalizing problems. The Journal of Child Psychology and Psychiatry, 51, 953-961. doi:10.1111/j.1469-7610.2010.02222.
6. Ducworth, M. P., Hale, D. D., Clair, S. D., Adams, H. E. (2000). Influence of interpersonal violence and community chaos on stress reactions in children. Journal of Interpersonal Violence, 15(8), 806-826. doi: 10.1177/088626000015008002
7. Cohen, K., & Collens, P. (2013). The impact of trauma work on trauma workers: a metasynthesis on vicarious trauma and vicarious posttraumatic growth. Psychological Trauma Theory, Research, Practice, and Policy, 5, 570-580.
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