Recovering from community trauma

In the midst of Park Rapids' recent drive to become a trauma-informed community, the surrounding area has learned a lot about trauma firsthand.

On Feb. 14 in and near Nevis, three shooting deaths deprived 10 local children of a parent. On March 18, a mother and her two children were victims of a murder-suicide in White Earth Village.

In response to these open wounds, the Enterprise asked several clinical professionals and support groups in the area for advice about how local people can help each other move forward, heal and, perhaps, better understand how personal crisis can become public tragedy.

Stories need to be heard

"I believe that if we're going to take something away from any unplanned and catastrophic event, it's that connection is incredibly important," said Dawn Pappas, a clinical social worker with GroupWorks Wellness. "So often in events that result in tragedy, like those in our community recently, there emerges a theme of isolation and disconnection."

Pappas said that often, in looking at events like this, "we forget that they involve a progression of events. They may look sudden and unexpected on the surface, yet so often a story unfolds - and the stories go back days, weeks, years, even decades; generational stories."

On a basic level, she said, many crisis situations develop because "we don't feel we have permission, or we don't take permission, to tell our stories. That's one of the things that makes connections so important. The more connected we are, the more likely it is that we share our story."

Pappas said that using a cookie-cutter approach to interpreting unusual events isn't as reliable as would hope. "The reasons things happen are complex. We want to have it make sense, and yet, it often goes back to the story, the parts not told."

So it often comes down to our relationships with others, she said. "People who are connected often talk earlier. People who talk earlier often don't suffer as long. People who don't suffer as long, often recover more quickly. Recovery is often less difficult, with fewer setbacks and ripples."

Possible signs of people whose stories are not being heard include "changes in behavior; changes in sleeping, eating, interacting, the quality of their relationships, what's going on with them at work, what's going on with them in the community," she said.

How intensely they react to stressors in their lives, and whether their reaction resolves itself, depends on each person's coping skills.

Connection, she said, is a large factor. Pappas encourages those concerned to "try to stay connected with people. Reach out when they seem to be pulling away. Ask questions like, 'What's happening in your life?' or 'Do you need help?' or 'Can I help?'"

Pappas noted that many people keep issues bottled up because they perceive a stigma about seeking help.

Grieving, for those who lost loved ones in a tragic event, is also a story that cries out to be told.

"I believe there is going to be a tremendous amount of grieving," Pappas said about one of the recent events. "Grief takes time, support, grace, conversations, understanding and curiosity. 'Help me understand. Tell me more.' Taking time."

She noted that, for those who are uncomfortable with behavioral healthcare, there are alternatives such as peer support groups - among them, Al-Anon, originally designed for family members of alcoholics - as well as the services of local clergy and church members.

There's also a grief support group in town run by CHI St. Joseph's Health, Pappas added.

"Be very aware of self-care," she advised, describing "psychological first-aid" procedures like watching for changes in sleep, mood and physical symptoms and seeking medical care if problems persist.

"Don't stop talking about the things that are bothering you," she said. "Seek support. If you get told no, seek another support system until you find someone willing to talk to you."

Regarding those who have suffered a trauma, Pappas said, "think about reaching out and truly being curious about how people are doing. I believe when we can bring those who are struggling out of the darkness, there is hope."

Ripples of grief

There is bad news and good news, according to Paul Nistler, behavioral health director at Sanford Behavioral Health in Bemidji: "There will be some people who will never heal from this." On the other hand, he added, "Time itself has a tendency to heal."

Nistler likened the emotional impact of a public trauma to a rock splashing into a lake.

"You have the initial splash; that's the trauma event itself," he said. "But then, that rock being thrown in the lake creates little ripples along the way. Those ripples are different stages of the initial impact - what I call the stages of shock and healing."

Regarding the first, acute phase, he described "the denial, the shock, the disbelief - 'Why did this happen?' - and that's usually from the time the incident occurs to about the next week to 10 days to two weeks."

Echoing Pappas, he said, "The big thing is listening and having people tell their stories because every story is different; giving people time to talk because there is some fear, anxiety and feelings of helplessness and hopelessness when these issues occur. Simply assuring that there's help for people, that's a good way of letting people know that people are out there who are willing to listen. I have found over the years that most people are willing to talk. (What's needed is) having the person on the other side who is willing to listen, giving people the time to share their stories."

The second, intermediate phase, Nistler said, "is characterized by fear, anger, depression and disturbance of sleep."

Sleep is important, he said, because it helps the brain move your experiences from the level of conscious thought, where it is constantly in focus, to memory, where it becomes part of your "new normal."

Finally, Nistler said, "We move into building more supports."

For people whose feelings of anxiety or depression persist, he noted that "some very adequate mental health professionals are at work in Hubbard County and in Park Rapids" and Bemidji.

One option that may help is cognitive therapy. "That's talk therapy," said Nistler, calling it "one of the best ways is to talk through that anger, fear, anxiety and depression."

If the need becomes more urgent, he advised, "seek out your emergency department. We have a mental health crisis team that provides crisis therapy to people in their homes, at the hospital or at their work site, if needed."

Medication management is available for some conditions, he said, adding, "If people are able to talk through this and not suppress their feelings, the success rate for a community or an individual is much higher."

An option for people concerned about a friend or relative who seems to be having trouble coping is to ask law enforcement to do a welfare check. Nistler said law enforcement does follow up on those calls and can take that person to a place where they can get a mental health assessment.

"At times it feels like - I hear this a lot - 'I've been dealing with this for a long time.' Well, you're going to continue to try to deal with it for a long time because it's something that happened. You're never going to forget about it. But the goal is to put it in a place where you can function, and you can continue with your daily routine in life."

He called for the community to recognize that "people will have good days and people will have bad days. You just have to let people have their bad day, and move through that, because tomorrow there's another day."

A hard truth to accept, he noted, is that the world does not stop because one tragedy happened. There's always "another call to law enforcement, another call to EMS, another call to the school district, for someone else. Everybody is asking you to be on top of your game."

Because it's so easy to start feeling left behind, he said, "We have to talk about it when things are tough."

Help available 24 hours

Stellher Human Services offers a mobile crisis line, 1-800-422-0045. "It's 24 hours a day, seven days a week for adults and youth," mobile crisis coordinator Brina Ellison said. "If an adult or child is experiencing a mental health crisis, give us a call. Often people are just looking to talk to someone, get some guidance or referrals. We're always willing to help."

Calls go to a dispatch person who then pages on-call staff in the county who have special training in mental health to respond.

Callers "can call back if the situation changes and they start to feel different about their ability to handle it," Ellison said. "We want parents, foster parents and grandparents to know we are here for support and are willing to come out anytime."

No one is turned away, regardless of whether or not they have insurance. "We do ask for insurance, but if you're uninsured, the services are free because it is funded by the Department of Human Services," she said. "There is no co-pay."

Referrals are also made to Stellher Human Services by parents or school staff.

"Anybody who is experiencing any type of mental health crisis, including healing from these types of tragedies, should reach out for help," she said.

Helping kids cope and heal

Amber Larson is the coordinator of school-based mental health with Stellher Human Services. When children are dealing with a traumatic event in their life or in their community, she recommends adults monitor the situation.

Their team went to Nevis School following the shootings in February as well as to Ogema after last week's tragedy in White Earth.

Larson said parents can reassure their children by listening to their fears and addressing them.

"I think one of the most important things is honesty," she said. "Don't try to cover it up. Listen to kids, let them talk and ask questions, and reassure them they are safe."

She said consistency and routine in the home are important to help kids feel normal and safe.

"Don't have these stories on the news so children hear about events over and over again," she said.

She said if children are still showing signs of distress six to eight weeks after an incident, parents should contact a mental health service provider.

"For parents, another resource that I would really recommend is helpguide.org," she said. "In the search box, type in 'helping children cope with trauma,' and there is an article that lists behaviors you might see at each age range, along with suggestions for supporting kids who have experienced trauma."

She said getting teenagers to open up and share can be difficult. "Let them have opportunities to bring things up and reassure them that you want to know the things they are dealing with," she said. "It's also important to just listen to teenagers and not always be giving advice. Kids aren't always looking for an answer. Sometimes they just want to talk about it. That's a big key, to let them know you're there to listen. Give them those opportunities. Families get very busy and we can find that communication is rushed or cut off. Remind them of adults in their lives they can reach out to if they're not feeling OK."

Peer support can help

Joel Maxwell with the Lake Area Al-Anon Family Group added that peer-driven support is available.

"Our original purpose and primary function is families of alcoholics," he said. "That being said, there isn't anybody anywhere who doesn't have a family member or friend who has a problem with alcohol. In that context, we teach how to control our own lives and to make our own lives better - how to deal with ourselves in relation with the addict or dysfunctioning person."

Maxwell emphasized, "A lot of times, we learn bad ways of dealing with things in a crisis, and then, once the crisis is gone, we still have the bad habit. So, what Al-Anon does is teaches us better ways to deal with life and with the people in our lives."

Maxwell said Al-Anon uses the same 12 steps as Alcoholics Anonymous, as well as such A.A. hallmarks as the "Prayer for Serenity."

"It's learning what things we can change and improve, and what we have power over," he said. "A lot of times, we think that we are powerless, when in fact, there are a lot of things we can do to make our lives better, no matter what the other person is doing."

Devoted primarily to supporting family members of alcoholics or other addicts, Al-Anon is "good for anyone who has a family member that's dysfunctional, for whatever reason," said Maxwell.

Al-Anon meets at 6 p.m. every Tuesday and noon every Wednesday at the GroupWorks building, where it rents space. For more information, call Peggy M. at 612-730-6691 or Wayne P. at 218-820-0223.

[SIDEBAR]

'Prayer for Serenity'

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. Living one day at a time, enjoying one moment at a time; accepting hardship as a pathway to peace; taking, as Jesus did, this sinful world as it is, not as I would have it; trusting that You will make all things right if I surrender to Your will; so that I may be reasonable happy in this life and supremely happy with You forever in the next. Amen. - Reinhold Niebuhr