The Sin of Survival: Mass Shootings, Moral Injury and Suicide

April 01, 2019 - by Mindy Keenan - in Moral Injury, PTSD, Suicide

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As the frequency of mass shootings grows everyday, so does the need for comprehensive, community based and longer term mental health services. Traumatic events of this nature create a ripple effect which touches many lives and can last for decades. Last week three of those touched by these tragedies took their own lives. Jeremy Richman, whose six year old daughter was killed at Sandy Hook Elementary, and two Parkland High School survivors Sydney Aiello, 19 years old and Calvin Desir,16 years old.

Survivor guilt is a ubiquitous part of trauma and is a deep, lasting injury to our sense of right and wrong and our sense of humanity. It is a moral injury.

Questions such as:

  • “Why did I survive when others did not?”
  • “She was so much (better, worthy, nicer….) than I am…she should’ve lived not me.”
  • “I should have done X, or I shouldn’t have done Y.”
  • “I should have tried harder to save others.”
  • “Am I a coward?”
  • “Maybe, if I’d been there with him, I could have kept him alive.”

It can feel to survivors that they have sinned against the victims because they did not perish or do enough to stop the deaths or help others, that is the “sin of survival.” Also referenced as survivor guilt.

Lowe and Galea (2017) conducted a meta-analysis of research conducted following 15 mass shootings. The group of studies concluded that the survivors and community members most directly affected by the violence showed signs of post traumatic stress injuries and depression. The studies also highlighted two prime risk factors for suicide. Individuals with the closest proximity to a shooting, such as a survivor or a family member who lost a loved one, are at greatest risk to experience persistent, long-term mental health issues and are at a greater risk for suicide.

If we are to prevent the on-going suffering of these survivors we must move past a “symptom reduction” approach and address the lasting core issues of unresolved loss, guilt and shame carried by these individuals. Many of the survivors, during interviews or posts after the tragedy, reference well-meaning mental health providers who arrive on scene shortly following the event, but that these services quickly dry up as the initial shock of the event fades in the public's eye.

At the Center for Post Traumatic Growth we believe that moral injuries of this nature must be treated long-term and two conditions must be met for healing to occur. First, the therapy must address the broken bonds between people to fully heal these injuries and second the healing must be done in a group of worthy others who have survived the same experiences. Groups are our main therapeutic modality. One cannot truly understand this type of trauma unless you have lived it. We have developed a three-phase, intensive group therapy program to address these deep emotional wounds and moral injuries. The program reconnects these individuals to each other, to themselves and their communities. Until these deeper injuries are healed, we believe, we will continue to have people who turn to suicide to alleviate their anguish.

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