[U73]University Of Virginia Tech

32 precious lives are ended on a college campus by a shooter who seems to have "chosen" his victims at random. A 15 year old boy dies after being stabbed at a late night house party in the inner city. At NASA, a professional engineer takes two people hostage and kills one of them and himself when he gets a bad job performance review. In all these recent situations, people woke up in the morning planning an ordinary day, only to have their lives ended or turned upside down. As witnesses to these events, we are left with our grief, outrage and questions: "How did this happen?" "Why did it happen?" and, "What do we do about it?" These are special events that echo the more chronic violence in Iraq, Afghanistan and in our inner cities.

The 24-hour news cycle assaults us with evidence that we are not safe, that the world is not the orderly place we want it to be. Our healthy ability to push away thoughts of danger is challenged. What do we do? How do we cope? I propose that we have a startlingly beautiful model to guide us: the Serenity Prayer, popularized by 12-Step Programs:

God, Grant me the Serenity to accept the things I cannot change,
The Courage to change the things I can,
And the Wisdom to know the difference.

The prayer is deceptively simple, but terribly complex and profound. It first tells us to accept what cannot be changed. We want with all our might to jump right in and fix things. In our frantic effort to believe that everything can be controlled if only we thought ahead, if only we had acted, if only, if only. We try to fend off feelings of impotence. The media fans these flames by looking for blame, looking for someone's head to roll: maybe the college president should resign, maybe Security was lax. On and on went the shrill cry for scapegoats.

In working with people in tragic situations over the years, I have come to believe that people will go to great lengths to hold onto the illusion of control. We want so much to control our world that we would rather believe that we (or someone else) failed than to accept that we are helpless. If something could have been done, but wasn't, isn't that proof that we can avoid such horrors in the future? At least that is how we think. Failure is somehow preferable to helplessness.

The next line in the prayer asks God for courage, knowing that even where there are actions that can be taken, that action is not going to be easy. The first and most important thing to do is take care of yourself. Mental health professionals call the secondhand exposure to violence "vicarious traumatization" and are trained to cope with it because it is so much a part of their jobs. Self-care is an important skill.

One way to care for yourself is to recognize symptoms of stress. As with the period after 9/11, we "witnesses" may find ourselves reacting in a variety of ways. We may respond with general worry about our safety, desire to be with family, teariness, irritability over little things, or physical symptoms (headaches, insomnia, or loss of appetite). This will be even truer for people closer to the center of the event. In the Virginia Tech shootings, for example, this may extend to college campuses across the country, and communities who lost a neighbor.

First things first: return to basics. During such a stressful period, get extra sleep, eat healthy, exercise, take vitamins and pray. Limit the amount of media coverage to which you expose yourself and your family. Reassure your children that you love them and that they will always be taken care of, even when you are not with them.

Be with people! Talk! Avoid sensationalism, but nevertheless, talk. Contrary to popular belief, simply talking about an event will not re-traumatize us; it helps us grieve. Make no mistake, what we are experiencing is grief. So grieve as you normally would: cry, talk about how terrible it is, gather with others, commiserate, pray, and reflect on what positive changes you can make to give meaning to this loss. Salvaging good from evil is healing. Community is healing. That is why I am so heartened by the decision of most Virginia Tech students to stay on campus; the sense of community will be healing for them.

This can be an occasion for spiritual strength, or doubt. Wrestling with doubt can lead to stronger faith. Trauma raises questions about God's presence and willingness to allow evil. It also reminds us of the power of goodness: the heroism of ordinary students and professors, for example, when terror struck. Their courage is inspiring: feeling as afraid as they did, they still tried to help others.

Trauma makes us feel helpless and out of control (as discussed above), so do constructive things to help you regain a sense of control. Contribute to national or local relief efforts. Resolve to spend more time with family and friends, to be friendly to strangers-then follow through. If you are more ambitious, volunteer for civic activities to enhance your community's safety or quality of life.

Despite these efforts, some people will experience strong emotions and difficulty functioning long after the event. Most people at risk for a prolonged or severe reaction are people who have experienced the trauma directly (those who were on the campus or knew victims personally), those with histories of depression or anxiety, veterans, and people who have experienced severe trauma in the past, even seemingly unrelated trauma If you are still having difficulty functioning or managing your emotions several weeks after a trauma, consider consulting a therapist.

Unfortunately, there will be other national (or local) tragedies that will trigger the intense, complex feelings that 9/11 or the Virginia Tech shootings did. The Serenity Prayer can again be a guide, gently reminding us that there are things we must accept as unchangeable (by us, at least), but there are constructive things we can do if we remain calm and united, and draw on our inner courage to take positive steps, one at a time.