Before it Happens Again Part I: How To Address Mass Shootings Using Dialectical Behavioral Therapy & Radical Acceptance

During a check-in and debriefing with my Pepperdine University students about the recent violent shooting in Thousand Oaks, California, one Master’s level student glibly remarked, “It’s just going to happen again. I’m not even surprised by it anymore. It’s sad to say, but I think it’s just trending.” While I didn’t like his words, I knew he was right … in all the wrong, worst ways.

As a clinician and professor, I had to accept that the generation behind me has, quite literally, grown up thinking massacres are a part of life. While everything in me fights this offensive and terrible reality, it is true. From GMAC (1990) to Columbine (1999) to Borderline Bar (2018), there have been 98 mass shootings where three or more people have been murdered, hundreds injured and thousands traumatized during the life-span of this Millennial generation.

They have grown up on gore.

And while I hate this fact with every fiber of my being, there are certain things we can draw on from therapy practices to address this terrible state of affairs as a country and as individuals in 2019 and the years ahead. Dialectical Behavioral Therapy (or DBT) teaches that there are four ways to address any problem

  • Solve the problem

  • Feel better about the problem

  • Accept the problem

  • Or last, stay miserable

First, we could solve it: No guns for anyone all the time or guns for everyone so we can protect ourselves. But since neither of these extremes is going to happen in the United States, let’s look at some other options.

To feel better about the problem we could post political views about gun laws on social media, talk about how awful it is and reiterate what we already know (we all abhor the mass killings, but don’t know where to start). But when we blame politicians, mental illness and legislation for mass shootings, for all intents and purposes, we stay miserable about this horrendous problem. Not much gets done as we roll this reality around on social media and news channels.

Currently, we just accept the problem. This is hard to see when it’s happening, but let me assure you it is. Every time you watch the fallout after another bloodbath on the news and not in person, we all (let’s be honest) feel relieved this was “them” and not “us.” Don’t get me wrong, we still feel quite badly for “them,” we continue to watch news stories about the incidents and even talk about it at Einstein’s or Starbucks, but really, until “they” becomes “us,” we will continue to feel thankful it wasn’t “us” and not change-focused.

In short, we won’t take the necessary steps to stop this sort of unconscionable thing from “trending.”

Last, we could radically acceptthe state of our nation and say, “It is what it is, now let’s change it.” Until we can accept, from a radical position, that our nation has now raised a generation of young adults on this sort of violence, we won’t be able to make meaningful changes. Why? Because if we do not accept that it is actually true, we will stay stuck in blaming others (politicians, the NRA, mental illness, legislation) and avoid problem solving.

DBT teaches that radical acceptance can help us. The beauty of radical acceptance is that it opens the door for change. Once we acknowledge that the problem truly is what it is, and it’s as bad as it is, we can stop living like it’s a one-off and treat it properly: Violence—mass, bloody, senseless, random violence is not only trending, it’s our new reality.

If we were to accept that this is now our “normal” (not even a new normal), what might we do to change things? Here’s a few ideas.

Columbine shooter, Dylan Klebold’s mom, Sue, in her now famous Ted Talk, shared that her son actually struggled most with self-harm (cutting) and suicidal thoughts years before he became a mass shooter when he was a young teen. Early on, his primary desire was to die, not to kill. But through a complex web of trauma, friendship and access to firearms, he became one of our country’s most infamous young perpetrators of suicide-murders.

There was a progression of his mental illness. Can we stop future progressions like Dylan’s?

What if we implemented workarounds to what typically keep people away from mental health services when they’re young. Sue Klebold says that people with suicidal and aggressive tendencies are in a “Stage 4 medical emergency,” but when I look up the phrase “medical emergency” all that comes up are actual physical emergencies (chest pain, shortness of breath, severe bleeding, etc.) which are all reasons to go to the ER but nothing, as in nothing, regarding mental health emergencies was listed under a general Google search.

It’s a bit harder to find clear, straightforward information about mental health emergencies. For example, an actual mental health emergency could include anything from acting on a suicide threat, self-injury that requires medical attention to severe impairment from drugs and alcohol or an inability to care for oneself due to symptoms from the illness.

And right below a mental health emergency is a mental health crisis. A mental health crisis is a non life-threatening situation in which an individual is exhibiting extreme emotional disturbance, is disoriented or out of touch with reality, talking about threatening behavior, isolating oneself for days on end or an inability to eat or keep food down. While this is not a complete list of reasons to be very concerned about a loved one with mental illness, it is a start.

What if we had mental health only Emergency Rooms in every county in our country? And for kids like Dylan Klebold, we had pediatric mental health emergency rooms. They would be staffed 24/7 by pediatric psychiatrists, nurse practitioners and therapists to help get these kids stabilized and placed at the proper level of care.

Now obviously, my grand plan is not going to change our country. There are so many barriers to mental health care such as lack of money and insurance to pay for care, poor education in homes, schools and communities, and the social stigma of mental illness to name a few. But what if we had the money?

Recently I was at the Getty Museum. It is a lovely collection of buildings, artwork and gardens in the hilltop area of Los Angeles. Only problem for me … there were guards every ten feet inside the museum portions of the tour. It was annoying. The Getty has beautiful works of art, but as the wealthiest museum in the world, it was a bit over the top. And while I believe it is essential to guard our history, it is even more essential to guard our present and our people for they are our future.

What if the present $6.6 billion Getty endowment were to offer one-third of its wealth to immediate prevention strategies like money to hire armed guards for every school in the US and another third to empathy training and mental health readiness in schools and violence prevention for every grade schooler, what difference might this make a generation from now?

And what about mental health triage sites at every school? If a teacher or a student sees something, they say something. Here’s why: mental illness has markers in the young. But even if the more straightforward signs are not there, here is a list of harder-to-notice commonalities in those that can become ill, such as a highly sensitive personality (very shy, low tolerance for pain, cries easily, feels feelings more deeply), an abusive or absent home life, or bullying in person or on social media, among others.

Also, instead of throwing open the doors of counseling clinicsafter a mass shooting as most universities do, what if we threw them open before? Preventing things like child abuse, domestic violence, neglect and bullying might, just maybe, prevent the young men of our country from becoming active shooters and stop mass shootings from trending.

If every school had a mental health team that focused on early intervention, funneling these kids into wraparound care and following them long-term, before they act out, we may be able to finally stop the “trending of violence.”

Cindy Finch, LCSW

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Before it Happens Again Part II: Could a Casserole Stop Suicides?