Residents of Sutherland Springs who were not directly affected by Sunday’s church shooting nevertheless could experience a heightened sense of post-traumatic stress because of the close-knit nature of small towns, according to a clinical psychologist at St. Edward’s University.
“When events like this happen in a small town, it’s more akin to something happening to a family member — even if you don’t know the person affected — because of the sense of community and closeness in a town with a small population,” said Tomas Yufik, an associate professor whose research focuses on post-traumatic stress disorder, or PTSD, and personality assessment.
“In a town like Las Vegas or New York City, there’s a lot more lack of connection between residents — not to say they won’t be impacted, but it will be a different type of severity,” said Yufik, who has worked for many years at mental health treatment centers, including clinics operated by the U.S. Department of Veterans Affairs, treating patients for PTSD and other conditions.
Residents of a small town also are more likely to be familiar with or pass by the location of a traumatic event.
“It feels more like a personal assault even though you weren’t directly involved in the experience,” Yufik said.
The federal Centers for Disease Control and Prevention defines PTSD as “an intense physical and emotional response to thoughts and reminders” of an event that causes a lot of stress.
Some research suggests that 30 to 40 percent of direct victims of disasters — including mass shootings, terrorist attacks, plane crashes and natural disasters — develop PTSD. “It can sometimes take weeks or a month to set in,” Yufik said.
For some, the condition manifests in the form of flashbacks, a sense of re-experiencing the event. Others can become emotionally numb, losing their usual response to things they previously enjoyed.
Other symptoms, Yufik said, include a sense of shame, also known as survivor’s guilt; hyper-vigilance, in which the nervous system overreacts to common events like the honking of a horn; and avoidance of things that remind the person of the traumatic event. Some people in Sutherland Springs, he said, might not want to attend a house of worship again because the shooting took place in a church.
“About half of those with PTSD recover within three months without treatment,” the CDC advises. “If you suspect that you or someone you know has PTSD, talk with a health care provider or call your local mental health clinic.”
The science-based treatments for PTSD include exposure as a way of essentially rewiring reactions, Yufik said.
“You do that by slowly exposing the person to what they’re most afraid of,” he said. “It’s a little bit counterintuitive.”
For example, a person afraid of big crowds might start by simply thinking about crowds, then venturing into a setting with just a couple of people before gradually increasing exposure to larger groups over time. This is not a do-it-yourself job of recovery, Yufik said: “It should only be done in therapy with a proper mental health professional.”