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Entries categorized "Post-traumatic Stress Disorder"

This Time the School Shootings are in Texas

By Elayne Savage, PhD


#189 School Shootings Texas
© Can Stock Photo / ronniechua


I’ve been crying a lot lately since the Uvalde Robb Elementary School massacre of 19 students and their teachers ­­– and with every new report of those little 9 and 10 and 11 year olds calling 911 pleading for police to come to Classrooms 111 and 112 to rescue them. And no one listened.


And crying again, hearing about the little girl who smeared herself with her dying friend’s blood so she could play dead and survive even though she had bullet fragments in her body.


And tears came again upon hearing how the police did not enter the classrooms until 78 minutes after the gunman begun shooting – while children lay dead and dying from devastating wounds to their faces and heads from the assault rifle.


So writing this is a way for me to try to make some sense out of the senselessness that is so disturbing.


I’ve worked with traumatized children for several decades as a Child Protective Services Social Worker and I’ve seen the damage they endure.


As a psychotherapist in private practice I’ve seen the extent of these traumas over the long-term in the adults who come into therapy to work on the many repercussions from their early experiences.


We address the anxiety and depression arising from when the cortisol and adrenaline went haywire during those early scary times. And continue to go haywire again and again.


I cry when I think of the struggles these surviving children will be having in their future.


Dr. Roy Guerrero Uvalde’s only pediatrician foresees these overwhelming struggles as well in his CNN interview:

Here area few parts of Danielle Campoamor’s interview:

The only pediatrician serving Uvalde, Texas, revealed to "TODAY" what it was like to treat the wounded of the Robb Elementary School shooting. He shared their horrific survivor stories.


Dr. Roy Guerrero, who was born and raised in Uvalde and attended Robb Elementary School as a child, was at lunch with his staff Tuesday when he started getting frantic texts.


“I called the hospital, Uvalde Memorial, to ask if they needed me, and they said, ‘Yes, get over here right now.’” Guerrero raced to the hospital.


“The most horrible part, I guess, was just seeing parents I knew outside screaming, asking me to look for their kids. You never really get that out of your head.”


Guerrero treated eight children that day.  He lost five of them.


“The children were in hysterics at first,” he said. “But when they saw a familiar face — because I’ve known them for so long — I was able to calm them down. 


As Guerrero made his rounds in the hospital, treating the wounded and identifying the victims, he heard a familiar voice cry out to him.


“I heard, ‘Hey, Dr. G!” he said. Guerrero turned to find an 11-year-old girl he has treated since she was a newborn.


The young girl was in the fourth grade classroom where 19 of her classmates and two of her teachers were shot and killed. She had bullet fragments in her shoulder.


“She said she saw people being shot and falling dead. Her best friend was next to her, so she grabbed some of her blood that was coming out of her, smeared it on herself and played dead on the floor,” he said. “


As she’s doing this, her teacher ... who got shot and was throwing up blood, told her, ‘I don’t want to die, call 911,’ and threw the phone to her. I guess the guy saw the phone and shot the phone but didn’t see her move. So she continued to play dead.”


Guerrero saw the 11-year-old the next day for a follow-up appointment.“She was literally shaking,” he said. “She already has PTSD, and we just got out of this.”


“In clinic the next day, all I heard was: ‘I’m afraid he’s coming for me. I’m afraid he’s going to come get me at my house.’ The kids were telling me that. I was hearing that the whole day,” he said. “I’m telling you this is going to be a mental health crisis for our community.”


Guerrero worries that the child survivors will live in fear for the rest of their lives. It’s a fear, he says, that could even be passed down to their children if something doesn’t change.


Guerrero said the severity of the survivors’ wounds varied. There were minor cuts and bruises on children who climbed out busted-out windows to safety. Others had shrapnel injuries


As the hours went on, it became apparent that some of the parents outside weren’t going to find their children alive.


Guerrero was instructed to be in the front of the receiving area to immediately help the other patients the hospital was expecting.


“We were supposed to have 14 more kids show up, and they wanted me to triage them.”


The 14 children never arrived. “We knew what that meant.”


“I asked the hospital to show me the bodies,” The deceased children Guerrero viewed…will never leave his mind.


“It was awful,” he said. “It was a high-power rifle injury. These are war wounds. It’s as if things exploded once the bullets hit the bodies.”


What causes this rage?

I just received an email from a long-time reader, a teacher who was sharing her observations over 3 decades about angry, acting-out children.


She asks:  “What are the root causes of this "rage"? I am talking about kids who suddenly look like human volcanoes. Watching a nine year old with such uncontrollable anger, many of the teachers sometimes wondered if these children would someday return and "shoot up" the school.” 


I’ve asked myself this question many times.

And here’s what I come up with: ”Rage is Anger with a History”TM


Rage is beyond the experience of anger. Where anger reflects something happening in the present, rage reflects overwhelming feelings from the past which intrude into the present situation. 


A distressing event in the present becomes unbearable when it reminds us of painful experiences from the past. 


It Starts with Feeling 'Dissed' – Usually in the form of Bullying

Before we know it we're taking something personally. An out-of-control response gets triggered, and we find ourselves having runaway reactions to present day situations.  


When we're feeling vulnerable, or scared, or hurting, we often tend to protect ourselves by taking a tough stance. We puff ourselves up and sometimes engage in aggressive behaviors.


We act out our rage on the offending person who often doesn’t have a clue that we are most likely retaliating against all the bullies from our childhood. 


We become outraged, then enraged. One minute feeling like a victim. The next, becoming victimizer. Wanting to get back at the person who is treating us badly. Trying to out-bully the bullies.


Holding grudges is especially eroding. This kind of resentment takes up so much space in personal or work relationships that there is no longer room for connection.

Before we know it, behaving badly. How can this be happening? How can we be behaving so outrageously? 


We might ask:

Why are young adult males more impulsive, reckless and and prone to violence then other age groups?   (See Washington Post link below)

Does being mistreated as a child breed the desire to do the same diminishing/scapegoating behavior to someone else?

What does it take for anger to turn into rage-filled violence?

Does it feel empowering to humiliate and bully others through violent, brutal acts?


Early negative events collect in our memory. Old injustices stockpile into a repository of rage, just waiting to be disgorged.


When a similar event happens in the present and awakens similar feelings, the stockpile ignites and you are having an intense reaction against those past injustices.

Before we know it, we are overreacting and feeling out-of-control.


So what we know about Salvador Ramos’ early history illustrates these ideas.

Family and friends have also said that he had a difficult home life, that he was bullied over a childhood speech impediment and that he lashed out violently towards both friends, strangers, and his mother – both recently and over the years.


They recall: in middle school and junior high for his stutter and lisp. Considering himself Ramos’ best friend in eighth grade, Stephen Garcia said he had a difficult school experience.


“He would get bullied hard, like bullied by a lot of people,” one friend  told The Post. “Over social media, over gaming, over everything.


They played shooter - survivor video games such as “Fortnite” and “Call of Duty.”


His mother remembers around five fistfights involving Ramos in middle school and junior high. Any friendships he managed to form didn’t last long, she added.

She said he once told a friend who wanted to join the Marines that he only had that goal because then he would be able to kill people. The boy ended the friendship then and there.


Rage is 'Anger with a History'TM

Rage is an emotion beyond the experience of anger. Where anger reflects something happening in the present, and reflects ‘now’ feelings, rage reflects overwhelming feelings from the past, which intrude into the present situation. 


I can’t help but wonder if Salvador Ramos was bullied in elementary school as well as in Middle School and High School that his friends describe. Maybe had the same lisp and stutter back when he was 10 years old.  Could his elementary school years have been at Robb Elementary?


On a personal note:

I’m experiencing a massive dose of PTSD as my memories resurface again of spending many early morning hours on the radio with Denver/Boulder residents processing and mourning the Columbine school massacre 20 years ago.


And the visceral anxiety happened again, 10 years ago, Sandy Hook Elementary School and again 4 years ago with Stoneman Douglas High School.


Sharing some quotes which have been helpful:


Uvalde native Jon Voight visited and said:

“This is not about healthy human beings serving the country with arms to bear or even the right of this constitution for bearing arms … We must identify every individual for their credentials, for their mental capacity to bear arms."

He continued, "There should be proper qualifications for gun ownership and proper testing. One should only own a gun if they’re qualified and schooled …”

Uvalde native Matthew McConaughey also visited:

“Once again we have tragically proven that we are failing to be responsible for the rights our freedoms grant us,” McConaughey wrote. “The true call to action now is for every American to take a longer and deeper look in the mirror, and ask ourselves, ‘What is it that we truly value? How do we repair the problem? What small sacrifices can we individually take today, to preserve a healthier and safer nation, state, and neighborhood tomorrow?’ We cannot exhale once again, make excuses, and accept these tragic realities as the status quo.”


Thom Hartmann wrote on Memorial Day: “The soldiers we remember on Memorial Day fought and died to protect freedom for Americans. A nation cowering in fear of mass shootings is not free.”

A Nation Cowering in Fear of Mass Shootings Is Not Free


I find hope in Vu Le’s writing about coping with pain and despair:

"How do we grieve when every week there are multiple mass shootings? The pain and injustice has been relentless.


"I know so many of you are also feeling hopeless and despondent right now. We are not built to endure this much despair for this long.


"I find comfort in these words below by poet, author, and psychoanalyst Dr. Clarissa Pinkola Estés. I appreciate the whole essay, “We Were Made for These Times,” and recommend you read it in its entirety. But these sentences in particular spoke to me:

'Ours is not the task of fixing the entire world all at once, but of stretching out to mend the part of the world that is within our reach. Any small, calm thing that one soul can do to help another soul, to assist some portion of this poor suffering world, will help immensely. It is not given to us to know which acts or by whom, will cause the critical mass to tip toward an enduring good. What is needed for dramatic change is an accumulation of acts, adding, adding to, adding more, continuing. We know that it does not take everyone on Earth to bring justice and peace, but only a small, determined group who will not give up during the first, second, or hundredth gale.'"


And I see humanity in what a San Antonio friend just told me about Dr. Roy Guerrero: He has provided space in his pediatric office for a counseling center to offer grief counseling in Uvalde..


Some Facts According to CNN:   

The massacre marked the deadliest US school shooting in nearly a decade and was at least the 30th school shooting at a K-12 school in 2022. And where active shooter attacks jumped more than 50% last year


More from Uvalde's only pediatrician:


More about Salvador Ramos childhood/family:


Why Many Mass Shooters are Angry Young Men


It's Not Easy Being Green - The Heartache of Being 'Different'


Fear, Anger, Outrage


What Happens When Kids Experience a Traumatic Event?


The Many Faces of Survivor Guilt


© Elayne Savage, PhD


Welcoming your observations and feelings and comments . . .

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Until next month,


February 29, 2024

April 30, 2023

November 30, 2022

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August 31, 2020

February 28, 2019

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