Friday marks two years since the shooting at Marjory Stoneman Douglas High School in Parkland.
For survivors of trauma this time of year, stories on the news, images and sounds can trigger painful feelings and sometimes symptoms of Post-Traumatic Stress Disorder, or PTSD.
Healing is an ongoing process. To understand how this is affecting the MSD community, WLRN spoke with Dr. Jessica J. Ruiz, the Chief Psychologist and Director for Behavioral Health Associates of Broward, the Counseling Centers of Goodman Jewish Family Services.
Dr. Ruiz is trained in trauma therapies and has been working with people affected by the tragedy since it happened. She continues to offer counseling in the community.
A note: If you are hurting and need to talk with someone now, the National Suicide Prevention Lifeline has people available to talk, free and confidentially 24/7. You can reach the hotline at 1-800-273-TALK (8255). You can also find phone numbers and links for local mental health services available across South Florida – many of which are free – here.
The following interview has been edited for length and clarity.
WLRN: Today is a really difficult day for so many people who are connected to Parkland. What's helpful to say to people?
RUIZ: It's important to kind of check in with ourselves and see how we're doing. If you know that somebody was affected, say, 'Hey, I'm wondering how you're doing today. Just know that I'm here, If you need someone to talk to.'
Two years later, what are you seeing people need from a mental health perspective?
We are still working with individuals who came in, for example, to see us early on. And what we're seeing with individuals who maybe did not reach out for services early on and are coming to us now, we are seeing more severe [Post-Traumatic Stress Disorder], more significant depression.
We've seen some individuals that, because of the chronic symptoms that they might have been experiencing through time, they might have developed some other challenges, like substance use disorders.
We're seeing increases in divorce within our own practice that we've noticed. When we're in chronic stress mode it's harder sometimes to process, and to think through, and problem solve. We might have difficulty communicating with our loved ones in a particular way, or being able to manage challenges because we're worried about our children or we're worried about our job or worried about finances.
As time goes on, sometimes we think people get better. But, for the person who has experienced trauma, it doesn't really go away.
In my own reporting over the last year, I've had survivors tell me that they get told in a lot of different ways to, sort of, 'move on' or they get asked if they've already 'moved on.' Almost like it's a surprise to people outside of this community that survivors are still coping with what happened. Why do people ask those kinds of questions?
I've also received the same comments from MSD survivors saying, 'This person just came up to me and told me, well, you know, you just have to get past that. You know, it's been a year now, now we're at the two year.' So these are common statements that come up.
I would say that's one thing you can avoid, sending a message of 'You should be better' or 'Things should be OK' – more so being able to say, 'I'm wondering how this is affecting you today.'
And for individuals who haven't experienced trauma before, important to note: trauma does have lasting effects in ways that maybe we wouldn't realize early on. So not everyone, for example, will have some of the symptoms, classic symptoms of PTSD like flashbacks, for example, or nightmares, but they might still feel really fearful being around crowded places.
What are the dangers of that mentality? Why is it important to stress that healing doesn't have a timeline?
The damaging aspect is that survivors of trauma start to feel very alone and isolated. Often times that will happen anyway due to trauma –trauma disrupts connections. It disrupts connections with self, but also with other people like, 'I'm different somehow,' or 'This happened to me and other people won't understand.' And that gets cemented when other people don't understand.
So, it can have some pretty damaging effects in terms of alienating somebody versus letting someone know, 'Hey, I'm here if we need to talk.'
What are some ways parents can talk with their kids about how they're feeling, not just today or this week, but throughout the year, especially as they go through events like active shooter drills at their schools.
If having conversations becomes a regular routine, it's easier. So a child doesn't feel, 'Oh, I'm just being asked today because there was something on the news.' Start to set a routine of, 'Hey, we do check-ins, family does check-ins.'
Especially if you notice somebody... threw the book bag on the floor in a particular way, he seems kind of upset, literally saying, 'Hey, you know, are you alright today? You know, you seem a little bit frustrated. You seem upset.'
And then some of the tough questions. Also make sure to find the time – when there's privacy, when there isn't a lot of people around and you're able to have that sit down, eye-to-eye conversation – asking questions like, 'You know, I know when we feel down, sometimes we might have thoughts that scare us. And I'm wondering, have you ever had thoughts of hurting yourself?' People are scared to ask that question. And it's an important one. And being able to say, 'Hey, you know, it's OK to reach out for help,' especially if you could say, 'I've done that before too,' or, 'Hey I'm in therapy.'
Luckily, it's becoming more and more talked about. I think we're doing better at breaking the stigma about getting help. I think we have a long way to go. But one of the messages I always try and send is there's really no need to suffer alone. There's help out there. And there are people that can help you identify tools for coping and identify ways of managing. And if there's trauma, how to work through the trauma and process it.
You know, all of us can have a bad day or a bad couple of days. But if it's lingering and you just can't shake it off, if sleep is being disrupted, if it's becoming harder to concentrate, if you're feeling sad, if you notice, you're just not doing the things you used to do before and they're not interesting you – Those are the times to say, you know, maybe this is a good time to go talk to somebody.
How can people who are having trouble affording counseling find something?
We've been very lucky and fortunate due to a generous grant through Parkland Cares to make sure that those who were affected and don't have the resources to pay can get services.
2-1-1 Broward is an excellent resource of all of the various agencies that are around, especially those that provide subsidized counseling. Parklandcares.org – If you go on their website, you also will see a list of the organizations that they fund. Those I think are fantastic resources to just see what's out there now, what I might be eligible for in terms of assistance and funding.
Are there still resources that you and other psychologists may need to provide support services?
Especially for those that are having challenges with affording services: funding. So that they can continue long term. Clinicians need continued training on trauma and evidence based interventions. But, I know in this county in particular, we understand given what happened at MSD, we understand the importance. I think a lot of efforts have been moved in that direction.