Editor's Note: Frank Ochberg is Clinical Professor of Psychiatry at Michigan State University and former Associate Director of the National Institute of Mental Health. The views expressed are his own.
By Frank Ochberg, Special to CNN
I write this on a sad Sunday, December 16, 2012. The nation is in mourning for little children, six and seven years old, killed by a young man for senseless reasons. Because I helped other communities recover from similar tragedies, I have been a "media source," speaking to reporters, and through them, to anxious parents and frustrated citizens in America, Canada, Britain and South America. The questions are sober and sensible. "How do children who saw this happen ever recover?" "What should parents do if their children see images on television and get frightened?" "Why does America tolerate such easy access to lethal weapons?" I do my best to answer.
Children, for the most part, are resilient. First graders don't fully understand the meaning of death. But the classmates in Connecticut who lost their friends and whose teachers will never be the same will learn, sooner or later, that they survived when others did not. They may or may not develop post traumatic stress disorder, the invisible injury we associate with combat veterans and rape survivors. They may or may not feel "survivor guilt," a pattern of remorse and responsibility that haunts many who live through a catastrophe when others perish. Children who are emotionally traumatized by direct exposure to scenes of horror may regress. This means they act and feel as though they were a year or two younger. A child who was toilet trained may wet the bed. The ability to speak clearly or to play confidently with others may be impaired. These are usually temporary setbacks. I'll predict that most of the children in Newton will feel the love of family and community members, and will be reassured of their security and their place among caring, competent adults. Those who seem troubled a month or more after the shooting will benefit from interactions with a trained therapist.
Child therapists know how to engage young children in play-therapy, and how to use coloring books and a sand-box to elicit feelings and fantasies. Through play at the child's level, fears are worked through and confusion is clarified. Often, kids blame themselves for the anger or depression they see in their parents. Professional child workers face this challenge effectively whether the cause of emotional difficulty is a traumatic event or an illness or a troubled family with marital discord.
In some cases, a professional child care worker may concentrate on intervention with a parent, helping an anxious mother learn how to be assertive and effective - or how to help an angry father control his temper and create a safe environment for a vulnerable son or daughter.
The most important medicine for the children of Newton Elementary School is the love that they receive from their families. And, in general, from the messages we have received from the media, the prognosis in this regard is excellent.
What about children across America and in other countries who are learning about murder in supposedly safe school?
My grandson, age six, learned of the shooting and developed a super hero fantasy that he could rescue any classmate and conquer any villain. But when his four-year-old sister saw their dad in tears, she cried, too. Children surprise us with their range of reactions, but most are exquisitely sensitive to the feelings of their parents. And parents cannot fully shield their emotions from their family members. So why not cry? It is OK for your children to see you in tears. But reassure them at the same time: "I'm sad because something sad happened today, not here, but far away. You didn't make me sad. I love you."
My daughter, whose children are 9 and 7, asked her older boy if he wanted to hear about a sad thing that happened to children far away. He said he didn't. I thought she was wise to ask. But when a child does want to know, or learns from other children and asks Mom or Dad to explain things, it makes sense to respond with age-appropriate detail. If your six year-old wants to know if children in Connecticut were in pain, you can say, "Not for long." We do know that much from authorities on the scene.
If your children want to know about the brave adults in the school who saved many children's lives, you can, truthfully, talk about the way teachers helped children hide and then guided them to safety. Turning the narrative toward escape from danger is consistent with fairy tales and adventure stories that young people have already encountered, and that are part of normal child development in every culture.
You certainly can protect your young child from an overdose of trauma imagery. The media is not at fault for saturating the air-waves with explicit information from a terrible tragedy. We do have a need to know details, as details emerge from a critical incident that affects a sacred place -- the school where our children and grandchildren spend five days a week. But when we have digested enough detail, it is up to us, the members of the audience, to limit our exposure. The cumulative effect of televised violence, trauma and grief can be debilitating. It takes less of a dose to upset a child.
Kindergarten and first-grade teachers may be nervous, returning to class this week. They are not trained therapists, and they may not know what to expect or how to respond to a six year-old who has a vague idea - or an informed idea - of what occurred in Connecticut. Since children are comforted by continuity and routine, it would be sensible to stick to the lesson plan. Don't raise issues that the children themselves are not raising. There may be a temptation to send messages of support from one elementary school to another, but this could turn your classroom into a grief support session. That is not a comfortable role for a teacher or a very young student.
Most schools have well-established programs for individual students of any age who become distraught during school hours. These should suffice whether a youngster has a problem related to TV coverage of tragedy in Connecticut or a personal issue having nothing to do with that school shooting.
There are people who identify closely with victims of violent events. The terms vicarious traumatization and compassion fatigue refer to conditions affecting people who develop symptoms that may resemble PTSD because they absorbed the trauma of others.
Whether you are a parent, a teacher or a news consumer who cares deeply for those directly impacted by the Newton Elementary School disaster, your grief is normal. But if images persist and you become numb and anxious you may need some assistance. The website that I know best is http://www.giftfromwithin.org and it is full of useful information for those who face the lingering effects of traumatic stress, including vicarious victimization and compassion fatigue.
And what about the American gun law dilemma?
Many of us are not only experiencing grief, but are frustrated to the point of anger. I am deeply troubled by our collective inability to address an outrageous American fact. We have more civilian death from guns than any other advanced nation on the face of this planet. We expect to have mass shootings at schools and malls and places of business. "Going postal" is an American phrase.
Every foreign reporter who interviewed me this week asked about this phenomenon. They do not understand why we tolerate such a hazard to our collective health. And this does make me angry.
My anger is not directed at the NRA or the 2nd Amendment or anyone who supports our right to bear arms. My frustration comes from our national refusal to consider rational ways to reduce gun deaths. We are polarized and we are paralyzed. The search for remedy has been politicized. Our elected leaders have chosen to ignore this issue.
Let's concentrate on school shootings, not on all the other forms of gun death. These are almost always due to young men who have access to arsenals of weapons. Often, the shooter is mentally disturbed. Frequently, the disturbance has been noticed. In the case of the Virginia Tech killer, Mr. Cho, his illness led to an out-patient civil commitment. That means that both medical and judicial authorities were "on the case." And still, he managed to find sufficient fire power to kill 32 people on campus.
I did suggest an approach in a previous CNN essay here.
Can the members of the Natinal Rifle Association, good people who believe in America, address this issue? Can the urban and rural political leaders, compassionate elected officials, come to the table together? Can we stop insulting one another because we have different legacies of gun ownership and address gun safety?
We can and must find ways to keep lethal weapons out of the hands of individuals who are dangerous to themselves and others. This will involve legislation to assure responsibility. It need not threaten the policy positions of the major political parties.
We are on a fiscal cliff and that demands attention. But we are on a moral cliff that imperils American children.