How Knoxville therapists are helping Covenant School responders process unthinkable trauma
Just days after three 9-year-old students and three adults were killed in The Covenant School shooting on March 27, two Knoxville trauma therapists were leading a team in Nashville to provide support for the first responders who were on the scene that tragic day.
Lynn Smith and Bonnie Barclay saw the news about the school shooting and immediately began mobilizing the East Tennessee Trauma Recovery Network, a network of therapists who specialize in gun and interpersonal violence and in helping emergency workers process trauma.
“We had therapists from Knoxville, Chattanooga, Nashville, New Jersey, New York that came in to help,” Smith told Knox News at her Mind Body Knox wellness center in April. “It was a remarkable team.”
The team of nine therapists worked with the first responders in group and individual settings, utilizing eye movement desensitization and reprocessing techniques, also known as EMDR therapy.
EMDR enables people to heal from the symptoms and emotional distress that are the result of disturbing life experiences, according to the EMDR Institute. And early intervention is key.
“If you eat a large meal, it's harder for your body to digest it than if you eat an appropriate portion. It's the same thing with (trauma); it's just too much for the brain to process," Barclay explained.
"So, by doing early intervention (with EMDR), we can break it down into smaller bites and then it can digest and move forward."
The East Tennessee Trauma Recovery Network offers up to 10 pro bono sessions following mass tragedies like the Covenant shooting. Individuals can continue treatment through insurance or other arrangements.
Smith and Barclay spoke in-depth with Knox News about the trauma that first responders face and EMDR therapy, and they shared strategies everyone can use to cope with mass trauma.
This Q&A has been lightly edited for length and clarity.
How were the first responders when you first arrived in Nashville to offer support?
Lynn Smith: Anytime there's an exposure of this nature, it's gonna be held very differently than just a typical day-to-day trauma that a first responder will experience. So, we would expect to see a lot of shock, especially after the dust begins to settle, a lot of emotion.
Bonnie Barclay: The thing I think about first responders is that, for us, we can go home and leave work pretty easily. But because something is more than the brain can digest in that moment, then sometimes the body sensations, that hyper-vigilance and adrenaline at the time, is still there. Some of the images from the event can come up no matter what role they were in. That can be different for each person, which is the nice thing about the group protocols, that their unique experience is still addressed in a group setting.
But you're gonna have the feelings, the body sensations, the images, the thoughts at the time of the event, which is why early intervention is so important. We want to get in there before any maladaptive information sets in. We want to move it toward health, and allow the brain to process it.
How are first responders impacted by traumatic experiences? Does it differ from victims and witnesses?
Smith: The initial hit of adrenaline is: Get the job done. That's what they're trained to do. It's often not until several days later, weeks later, that some of the more painful parts of the experience that begins to thaw and they begin experiencing that overload again. If you can imagine there's a trunk full of trauma and then you layer this huge trauma of a mass casualty situation, particularly involving children, and those who are most vulnerable and most innocent, and we layer that on top. A lot of times it’s too much. It's all of a sudden; it's overwhelming. So, we're gonna experience a lot of symptoms of acute stress disorder. This can be really varied and all types of anxiety. We see depression. We see panic disorder and hypervigilance, isolation, avoidance. A lot of times individuals are going to struggle going back to work, particularly, if there's no treatment or they're expected to go immediately back to work, which a lot of them are.
Barclay: The other piece that I see a lot is issues around responsibility. These are people who are supposed to serve, protect, help, rescue. So when something happens and they couldn't stop it or they couldn't do something about it, I think they grapple around the issues of responsibility, and that's why getting in there so quickly is to help them see where that expectation of responsibility is healthy and unhealthy.
Do you regularly work with first responders here in Knoxville?
Smith: I treat a fair amount of different types of first responders in my practice. It's one of my areas of specialty. It's really a different approach in a lot of ways because these are individuals who are extraordinarily high-functioning and can manage extraordinary exposure to trauma, and so treatment needs to be very specialized. Simply just talking about it may not be effective. EMDR therapy is a way that we work with the brain's own healing processes, which are innate and built in, and that way we are able to really help individuals heal faster and continue to do the work that they love without having this heavy weight of baggage that they're carrying around.
Barclay: I do mostly other trauma work. But I also think that some of that is needing to increase, the awareness and availability of this type of therapy, the effectiveness of it, and coming from a departmental level for this to be something that is helpful and not a sign of weakness. It's not something that may put them in a position to question their fitness for duty. It will actually enhance their fitness for duty.
Unfortunately, we hear and read about school shootings or mass shootings regularly. How are we coping collectively with these tragedies?
Smith: Not well.
Barclay: It's important to be informed, but when you are consuming something too much, you can develop vicarious trauma and still have to cope with those images and all the things as if you were there. It’s really finding that protective boundary of where you're informed but you're not consuming too much information to trigger your own nervous system.
Are we becoming desensitized by a consistent number of incidents? And how is EMDR a healthier solution?
Barclay: When you say the word “desensitize,” EMDR therapy is removing the reactivity to the situation, whether that reactivity be hyperreactivity, hyperarousal or a numbness where they're shutting down because the system is so overwhelmed. I think there's a little bit of a different component to that level of numbness and EMDR doesn't create that same sensation. The mechanism is different. It's an adaptive desensitization, not a numb and detached desensitization.
Smith: We're working with the brain's own innate qualities in order to help digest this information to move it in an adaptive way. When we're watching something over and over again on the news, it may have a desensitizing quality to it. However, it is not necessarily adaptive in nature because we have an increasingly high number of individuals suffering from anxiety disorders, depression, a wide range of mental health disorders. The idea that (multiple mass shootings) is desensitizing in that way, I don't think so. I think that, in fact, it's contributing to a lot of anxiety and fear, and we're really creating a culture of fear.
How can we remove the political debate around guns and focus on mental health solutions?
Smith: In our culture, we're far more polarized and pitted against one another and I think that we all have the same goal here, which is to protect innocent people. And until everybody comes to the table together and says, this is the goal: We don't want to see dead children. We don't want to have school shootings. We don't want to have mass casualties and shootings in any circumstances and the loss of lives. I think that setting aside politics is going to be in order.
Barclay: I talk to clients all the time, whether it's a couple or parent-child, "Do you want to be right or do you want to be in relationship?" Sometimes you can't be right and be in relationship. If everybody wants to be right, we're not going to get to a place of compromise and community,
What are things people can do when a tragic event happens? How can we help each other?
Smith: One way is to really destigmatize mental health. If you're struggling, ask for help. It's not a sign of weakness. Everyone has anxiety. Everyone has depression. These are universal human conditions. The more we can destigmatize that and say you're not alone in this, in your suffering. Listen to our friends, listen to our neighbors, our community members. “Are you struggling? Let's find some help." There's a lot of organizations locally (such as) the Mental Health Association of East Tennessee and other organizations. Coming together in community groups, whether that be a group, or a church or any kind of community involvement to kind of bind together and say, “Hey, we're all here to help each other.” There's not a shame in that; there’s no stigma about that. It’s not a sign of weakness; it’s a sign of strength.
Barclay: It's more productive to be talking with someone. So, it's limiting that media exposure, social media exposure that is kind of faux connection, if you will. Good sleep, eating healthy, drinking a lot of water. That's good for us any day, but when something like that happens, then we get those stress hormones released in our body, we have to attend to ourselves with more care. I think it's important to recognize when we see something, our nervous system takes on this perspective that it's happening right now. So, as we distance or have balance with social media or television, I think it's really important to ground ourselves to our current present safety in the moment.
As mental health professionals on the frontlines of trauma, how do you cope?
Barclay: Just thinking about Nashville, after we were done, we had a debriefing ourselves where we check in with each other, we talk about it. And I think that's a wonderful thing about our community of EMDR therapists here. We do care support group meetings, case consultations. So, we really help each other all along the way.
Smith: And we do EMDR, too. Sometimes, I go like, “Hey you wanna do some EDMR?”
Barclay: We practice what we preach.
Smith: We do get the front line of everybody's worst day. And that's one of the reasons why we developed Mind Body Knox here, because we have incorporated yoga and mindfulness meditation into our practice.
Barclay: We added massage at my place and I do a massage once a month. It's taking care of and releasing that tension and things that we hold in our body. It has to be done in a lot of different ways.
Smith: Wellness! It’s the full spectrum. It's not just one thing; it's a combination of things.
Is there anything else our readers should know about healing from traumatic events?
Smith: The East Tennessee Trauma Recovery Network is available to help in these sorts of situations and mass tragedies, and that EMDR therapy is more than just trauma therapy. It's a complete therapy that addresses a wide spectrum of mental health issues.
Barclay: Anxiety, depression, phobia, trauma. And it is different than talk therapy. I've had clients that have been to therapy before and may be frustrated that, in session, they cognitively understand how to cope or how to do something outside of session, but when triggers hit you on a full-body nervous system perspective, that thinking brain goes offline. With EMDR therapy, when you change things on a brain level, then you can hold on to the thinking brain and respond to triggers more effectively.
Smith: And early intervention is key.
Barclay: People have this mantra: Time will heal all wounds. Or let's just wait and see if it gets better. We don't want to wait because then it's more complicated. No, time does not heal all wounds, especially when it's something big.
Devarrick Turner is a trending news reporter. Email devarrick.turner@knoxnews.com. Twitter @dturner1208.
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This article originally appeared on Knoxville News Sentinel: Knoxville therapists helped Covenant School responders process trauma
