This story was originally published in The Bee on April 26.

In the approximately five weeks since Dr Jill Barron, a well-known psychiatrist who has worked with New York firefighters post 9/11 and other mass casualty incident survivors, began conducting a local critical needs assessment of mental health and support response, she has already arrived at some short-term observations.

And she is ready to begin offering the community some insights on how to begin coming to grips with not only the harrowing tragedy of 12/14, but the extreme diversity of feelings among local residents, school community members, survivors, responders, and even local medical professionals and clergy who are themselves working to try and heal or help their patients and constituents through the recovery process.

Speaking to The Newtown Bee this week, Dr Barron said what is often most distressing about a tragedy like the one that occurred in Newtown is the unpredictable nature of it and the way it threatens the sense of safety at the level of both the individual and the broader community.

“It is critical both at the individual and the community level to feel like one has regained a sense of control,” she explained. “Each individual finds that for themselves, at different times, at a different place. Those members, each of whom are at different places within the collective community coalesce to form a broader sense of control at the community level.

“A resilient community is a composite of resilient community members,” Dr Barron said. “Resilience is often defined by experts as the ability to bend but not break. Newtown will define for itself the elements that will be important for its community as it moves forward.”

In the wake of the tragic events of 12/14, Dr Barron has been hired to assess the broad needs of the community in the short, intermediate, and long run. To date she has been engaged in speaking with the various aforementioned groups, paying close attention to what the particular needs of each group may be in response to the trauma, and also to what the needs of the broader community may be.

Dr Barron, along with Health District Director Donna Culbert, will be implementing plans for the individual impacted groups in collaboration with their leadership that focus on the short, intermediate, and long term.

“The different impacted member groups have distinct needs,” Dr Barron said. “The needs of first responders will be different from the needs of primary care physicians, for example, which will be different from the needs of individuals in the broader community.”

Universal Themes Emerging

There are, however, common or universal themes that have emerged from the initial needs assessment. Dr Barron said.

These themes are important for the community at large to be aware of and  will inform the planning for the broader needs of the community at all stages of its recovery. These themes are consistent with what is know in basic trauma research.

Dr Barron has observed in her previous work, as well as her most recent interviews and meetings in Newtown, that all individual members are impacted when a tragedy occurs within their community.

“It is important for individuals, leadership of impacted groups, to be aware of what to expect from themselves and those that they care for in the wake of tragic events,” she said.

For example, she noted that it is not uncommon to experience irritability, sleep difficulty, trouble concentrating, difficulty remembering things, remembering the event itself, and a general sense of sadness.

While a lot of those feelings may be normal after a trauma, she said they are certainly not comfortable.

“Knowing what to expect from yourself, your child, your patients, your group members, can help to contextualize what you as an individual, as a parent, as the leader of a group are seeing,” she said. At the same time, not everyone who experiences the above will need to seek mental health treatment.

“But when any combination of those feelings persist, it impacts daily functioning or affects an individual’s quality of life, seeking further assessment may be necessary,” Dr Barron pointed out. “It is also important to keep in mind that each person will respond differently to a tragic event depending on a number of factors.

“Proximity to the event both emotional and physical, their coping mechanisms prior to the event, their level of support prior to the event, their history of exposure to trauma prior to the event, and their physical or emotional well-being prior to the event are all factors to take into consideration,” she added.

Risk Factors Important

Dr Barron said individuals at risk for having a more difficult time after a tragic event have known risk factors and are not always correlated just to their direct proximity to an event. So being aware of these risk factors are important

Taking all this into account, Dr Barron and Ms Culbert would like the community to keep in mind that events like the one experienced in Newtown frequently signal a feeling of a loss of control.

“They cause us to question our sense of safety and security,” Dr Barron said. “It is important to recognize that everyone is in a different place with regard to the tragedy,” the health district official said. “Some may wish to discuss it, feel the need to engage in advocacy efforts, feel the need to show through pins, stickers, their solidarity with the community.”

Dr Barron concurred, saying “There is no one-size-fits all approach with regards to how the individual responds to an event. It is, however, okay to say ‘No thanks,’ ‘I am not going to x event, sign y petition, or do z.’”

Guilt is another common emotion after a tragedy and takes many forms, Dr Barron said.

“This is normal, not welcome, wanted, or comfortable,” she said. “Some people feel guilty for being sad, for having trouble sleeping, for having a healthy child, for taking pleasure in an activity. But guilt hinders forward momentum and serves to keep you unengaged, unhappy and, well, feeling just plain guilty.”

She suggests those feeling a sense of guilt stemming from the events of 12/14 and its aftermath think about a way they can repurpose the guilt that makes sense.

“Many people will also express strong opinions about decisions you make, feel empowered to make the decisions that are right for you and your loved ones, whether deciding on how to engage in the community, with neighbors, at work, with family members,” Dr Barron said. “While you are part of a broader community, there are individual decisions that you will be making that are just right for you. Not everyone will agree with you, but trust your decisionmaking abilities you relied upon before the tragedy.”

She advises community members to think about “what positively nourished you physically, emotionally, and spiritually prior to 12/14” and rely on those mechanisms of support.

“Keep in mind that people tend to utilize similar coping strategies, have similar personality structures and defense mechanisms, after a tragic event that they had prior to an event,” Dr Barron said. “They are sometimes heightened or exaggerated after a tragic event, whether positively or negatively.”

Themes Of Recovery Emerging Post 12/14

According to trauma recovery specialist and Newtown mental health consultant Dr Jill Barron, there will continue to be many moving parts to a community’s collective approach toward healing and search for safety and control post 12/14.

Since the individual members of a community and groups within a community may each be at different “places” in their search for safety and control over what is difficult to control, there are key universal themes that are critical for forming a collective vision.

Those themes include:

*Recognizing that the locus of control or power rests within the community, meaning that the community, along with its leadership, should decide how it will regain control over the “new normal” that was created by the tragedy.

*Recognizing that the community and its members need to be empowered to make decisions for themselves.

*While outside guidance is important, the community needs to rely on their intimate knowledge of who they are collectively and what their needs are.

*Maintaining on open dialogue among members, groups with respect for differing opinions.

*Recognition that not everyone will be in the same place emotionally, physically, or spiritually and being able to capture that when making plans.

*Communication — trauma impacts our ability to remember information; repeating information is important and having simple streamlined means of communication is critical to facilitate community decisionmaking.