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Virginia Tech -- Bereavement Counseling

Dr. David Schonfeld
Director, National Center for School Crisis and Bereavement
Tuesday, April 17, 2007 1:00 PM

Dr. David Schonfeld, Director of the National Center for School Crisis and Bereavement, was online Tuesday, April 17, at 1 p.m. to discuss how the survivors of the Virginia Tech shootings will cope and grieve, and what can be done to help them.

A transcript follows.

Schonfeld told The Post's Laura Session's Stepp that: "In his view, students should be encouraged to return to classes after a reasonable period but with counseling support and a lenient attitude on the part of their professors."

Schonfeld, a developmental-behavioral pediatrician at Cincinnati Children's Hospital Medical Center, first developed a school crisis bereavement program in 1991, to help train educators in how to respond during and after a tragedy. He's worked extensively with the New York City Department of Education and with schools in Tokyo and Osaka, Japan. He's also created guidelines for talking with students about 9/11, war, death and other serious topics.

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Arlington, Va.: I am so sad about this terrible tragedy. My question is about discussing yesterday's events with my own children, who are 8 and 5. The 8-year-old, in particular, is very interested in the newspaper and will read/hear about the shootings. I would like to be able to discuss it with her in a helpful way. Sometimes the realities of this world are inexplicable to adults, let alone children. Any suggestions on how to handle this conversation?

Dr. David Schonfeld: While it is true that sometimes the realities of the world are inexplicable to adults, often what children need most in times such as this is our support and assistance -- they don't expect us to know all the answers.

I would start by asking your children what they might already have heard and understand about the event and questions that they have. Remember, children's concerns may be very different than those of adults. Try to identify underlying concerns, questions or reactions. Most importantly, let them know that you are there to support them and are ready to talk with them when they are ready. Limit the amount of graphic details and exposure to media -- if you do wish to share some of the news coverage, consider taping it beforehand so that you can preview the material; watch along with your child and pause periodically to help them process what they have seen.

This is an opportunity to help your child learn how to adjust with difficult situations. You don't have to know the answers, but you should be willing to engage in the conversation.

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Takoma Park, Md.: Thanks for taking these questions. I am a Tech alumni and still am in contact with some undergraduates through my service fraternity, although I do not know any of them especially well. How can I best help them? We are supposed to have an alumni banquet in two weeks (in Blacksburg) -- how should we expect the undergrads to be handling things by then and what should our behavior be? Thanks.

Dr. David Schonfeld: As an alumni of the school, you may find yourself more personally impacted than others in your community. Your desire to learn more about how to be helpful to the current students is admirable; helping others in times of disaster is also one of the best ways to help ourselves deal with tragedy.

I would suggest you begin by connecting with those that you already have a relationship with at the fraternity. Let them know that you are concerned and want to help. Begin by listening to them about how they are doing; try not to hold expectations of how they should be doing or acting. In the aftermath of a disaster, the range of reactions can be quite wide -- some will be in disbelief, others will be shocked, some will be sad, some will be anxious, some will be trying to act as if they are over what has occurred, some will not yet understand the full magnitude of the event, etc. Meet them where they are without trying to change their feelings or behaviors, unless you learn of behaviors that may put them in danger (e.g., excessive drinking and driving; suicidal ideation, etc.) -- these are rare reactions.

Personal connections with concerned individuals that are willing to be with us when we are in distress can be very helpful. People in these situations often find that individuals try to "cheer them up" by pointing out how things could have been worse (this is often not well received), or encourage them to cover up their feelings (e.g.,"try to be strong for those around you") -- you may wish to try to avoid these kind of responses.

Remember that you can invite people to talk, but they may not be ready to accept your invitation right away. Offer to follow-up with them and set up a time to call back again. If you leave a blanket offer for them to call you "whenever they want to talk," they may not take the initiative to call you back.

Good luck

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Vienna, Va.: I have a friend of mine who goes to Virginia Tech. Today he told me that he knows 11 people that were shot. What can I even say to that?

Dr. David Schonfeld: It's hard to listen to friends who are suffering. I'm not sure that your friend is looking for more than your friendship and general support -- that is what you can provide best and what will be most of value. I would start by saying that I am deeply sorry. Let your friend do much of the talking. I wouldn't tell him you know how he is feeling (because it is hard to know how others are feeling) or you bet he is feeling a certain way (e.g., "you must be angry") -- let your friend tell you how he feels. And let him know it is okay to share these feelings with you -- you will still be there for him and are still his friend. Don't try to come up with the perfect response or the response that will "make everything alright" -- it doesn't exist. Remember, he spoke with you because you are a friend; you've obviously been able to provide support to him before and I'm sure will be able to do so even in this setting.

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Washington, D.C.: No question really, just a comment that I hope the leaders of our nation, schools, institutions, etc. realize that the outpouring of anger directed at VT administrators is a natural lashing out of grief which is human nature to want to blame someone/thing tangible.

With something like this there is but one person at fault -- the shooter.

My hope is that our leaders and people in the position to change policies, security measures, etc., understand this so that we don't continue to bunker ourselves down so deep that we will forget what freedom feels like.

Dr. David Schonfeld: Guilt and anger are common reactions to crisis situations, so I am glad that you brought up this point. We would like to believe that things such as this could never occur, if only everyone did what they were supposed to. In an attempt to reassure ourselves that it won't happen again, we look to see whose fault it might be. Unfortunately, there rarely is a simple answer.

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Washington, D.C.: When my friend died suddenly several years ago, I had a hard time processing it. For months I kept thinking I saw her, or heard her voice in a crowd. And I'd often think things like "I'll have to tell Jane about this when she gets back." Only, she wasn't coming back. I knew she wasn't, but some part of me thought of her as just being away temporarily. I had to keep reminding myself she had died. Is it normal for your mind to play such tricks?

Dr. David Schonfeld: When we lose someone we care about, it is very common to think you still see them, hear them, or sense their presence. Your reaction is extremely common, but it still can be quite unsettling. Often it catches off guard -- a parent may buy food in the grocery store for a child that died and not realize it until in the check out line, and then feel overwhelmed with grief. It is important that this is part of the painful process of grieving.

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Parkville, Md.: I was rather disgusted at a particular gory picture that Fox News posted on the front page of their Web site yesterday, a couple of hours after the shootings had taken place. That sort of thing can't possibly be helpful to the families, can it?

Dr. David Schonfeld: While I didn't see the picture you mention, graphic images and detailed descriptions of disasters with gory details are generally not helpful to anyone. Just because we CAN see something, doesn't mean that it is helpful to do so. Everyone should monitor their viewing of media in the setting of a crisis and parents should help limit their exposure to children.

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Valdosta, Ga.: Given that there is significant data which show conflicting results with crisis counseling and if it works, and for whom might it work -- is it necessary for the flood of counselors that is being sent to the campus?

Or perhaps people should let the campus grieve alone for a while, yet supported from a distance. Which side of the traumatology debate are you on and why?

Dr. David Schonfeld: My general recommendation is that counseling support can be very helpful to students and staff, but that it is best provided by those from within the community. Since the professional staff of the school and community are also directly impacted by the same event, it is very helpful to draw on the assistance and expertise of others who are experienced by not as directly impacted. It shouldn't, though, feel like "a flood." People need to remember that individuals react to a crisis over time -- often over a long period of time. The problem is that there will be an ongoing need for support that will likely last longer than the initial "wave" of professionals that you are now characterizing as a "flood." That is why I try, whenever possible, to build on the natural and enduring support systems within the school community and local community -- it has the highest likelihood of providing the type of long term and natural support that people may need in this type of situation.

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Sending our condolences:: Is it appropriate to send a card to a student at Tech? I don't know anyone who attends but would love to send a card but not sure how it would be received. Would they be appalled or relieved?

If yes, where would I send it to?

Dr. David Schonfeld: Genuine acts of kindness and concern are rarely, if ever, perceived as appalling and often are very appreciated. I don't personally know where it would be best to send your card though. Please remember that the students and staff will be responding to this event for quite some time -- they may need your condolences and well wishes even more in the future, when less attention is being paid to them and they feel that people have forgotten about their tragedy or directed their attention elsewhere. So there is probably more than enough time for you to find out where to send the card or how else you can be of assistance.

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Washington, D.C.: Several years ago we went through something like this on a much smaller scale.

Back then I worked at a neighborhood bar in Northeast DC and one of the other neighborhood bars was the victim of a triple homicide in which three employees of the other restaurant lost their lives.

The restaurant/bar community is a tight knit one, especially when in the same neighborhood, and all we could do at my restaurant was offer a place of refuge for employees, friends of the victims to congregate, cry, talk, yell, drink, and generally just work through the emotions of the experience together.

There wasn't much else we could do except be there for them. Sometimes all that meant was standing there silently together sipping a beverage.

But I promise they got through it and one way or the other; the sun found a way to come up each and every day since then.

Dr. David Schonfeld: Truly being with someone who is grieving is not an easy task, but can be a profound demonstration of friendship/love/concern. I'm not surprised that it was helpful to the community.

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Washington, D.C.: My son is a sophomore at Virginia Tech, and is fortunate to have been in his off-campus apartment when the events occurred. As this terrible tragedy continues to unfold and names are released, it is possible that he knew some of the deceased victims. How do I help him cope with this and help him stay focused on continuing his studies -- especially since finals at VT are still two weeks away?

Dr. David Schonfeld: Trauma and grief both have significant impacts on the ability to concentrate, sleep, sustain attention and learn, among other things. It will be important for individuals who have been impacted by this event to hold realistic expectations for short-term academic productivity. Hopefully, the school will make some accommodations. In high schools where there have been school shootings, school administrators have even prepared letters explaining the situation and the profound impact it has had on the students and staff to accompany transcripts sent to colleges. While it may be tempting to try to "forget" about what has occurred until after finals, it is rarely possible and often not useful.

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Arlington, Va.: If you were in charge of the counseling at VaTech, what would be the first few steps you would take?

Dr. David Schonfeld: There are a number of "first" steps:

I would aim to establish supports for those who are part of the natural support systems for students at the school (resident assistants, teaching assistants, school counselors, coaches, etc.) -- provide them with additional training and support from professionals who can help answer their questions, as well as help them adjust personally to the event.

I would normalize the process of accepting assistance. Let people know that we all, at some level and perhaps in different ways, have been impacted by the event. It can help to have someone to assist you with this process.

Share information prospectively and openly about what you are doing within the school community to ensure their safety, answer their concerns, and provide support. Invite questions, comments, and concerns -- and then address them to the best of your ability.

Students and staff will do best if they feel they are part of a supportive and concerned school community that cares about and can address their needs.

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Loudoun County, Va.: Are there any signs that parents and guardians should look out for in their high school teens as they talk and learn about the events at Virginia Tech? I imagine that many D.C.-area teens have friends and family at Virginia Tech and may even have plans to go there after graduating. Are the local high schools doing anything special for these students?

Dr. David Schonfeld: Teenagers often turn to peers to discuss issues of concern to them; it may feel at times that they do not want or need adult support. But in times of crisis, often they do need and even want that support, even though it may not be right away. Remind them you are present and available and invite them to talk to you, but let them accept the invitation when they are ready. Open communication is the best approach generally, and is better than trying to guess who they are doing by observing their behaviors. Parents and other caring adults tend to underestimate the degree of children's distress and adjustment problems after a crisis event -- it's hard to figure out how someone is feeling if they don't tell us and don't show us. Some potential signs would relate to change in behaviors such as changes in sleep pattern (too long, too little, or irregular), irritable behavior or mood changes, signs of alcohol or other substance abuse, academic failure, declining interest in activities that used to be enjoyed. Of course, this may be signs of distress unrelated to events at Virginia Tech, but they are still signs that you should explore.

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Fairfax, Va.: Thank you for fielding questions. Is it possible to use humor to help people get through this horrible event ? After all, isn't laughter supposed to be the best medicine ?

Dr. David Schonfeld: Humor is often used by people to help them cope with difficult events. The tricky thing is that some people are not ready or able to make use of humor and may interpret humorous comments as sarcastic or insensitive, even when it is not intended to be so. I tend to minimize my use of humor unless the other person demonstrates that this is a useful coping mechanism for them. I also make sure that my comments are never able to be interpreted as making light of the tragedy or critical of others. Of course, if individuals choose to go to a comedy or seek entertainment that is funny as a way to cope, that is a very different situation -- that may be very adaptive for them.

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Chicago: I just learned this morning that the killer was Korean and I'm feeling some misplaced guilt myself. I'm worried about how Koreans/Asians will be perceived, and possible outbursts of racism. And being "blamed." How do I deal? Thanks.

-A worried Korean college student with friends at VT

Dr. David Schonfeld: The concerns that you raise were very prevalent after Sept. 11. Anger is an unfortunately common reaction -- we often look to understand what occurred and to try to figure out how to make sure it never happens again. This may involve blaming others. In this particular situation, it is not as likely that many individuals will blame a racial or ethnic group for this event -- it is pretty clear that this was the result of an individual who happened to be of Asian descent, but who also happened to be male, of a particular age, living in a particular community, etc. In my experience, very many people feel guilty when a disaster has occurred -- even when there is absolutely no reason why they should feel guilty; we often look for how we might be responsible. Feeling guilty doesn't mean you are guilty. Your response may be a demonstration of your concern. If you are able to recognize this, you may be less likely to continue to feel guilty.

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Kalamazoo, Mich.: Is it really responsible for news media organizations to be asking questions like, "What were you thinking?" or "How do you feel?" to grieving, traumatized students? These people are in the beginnings of GRIEF which takes months and years to integrate into one's life experience. Also, statements about Virginia Tech coming together and "healing" from the tragedy in such a short time frame seem to fly in the face of bereavement research. I'd appreciate your comments.

Dr. David Schonfeld: Let me try to answer this as the last response.

You are correct that grieving is a long-term process. And it often is not helpful to the individual to ask them probing questions in the immediate aftermath of a disaster.

I also will comment that while I have often heard that we "grieve as a community" or "we all grieve together as a country" that in reality, at some level, grief is an individual process. Yes, we can support each other and should do our best to do so. We can acknowledge common feelings and reactions and derive support from the acknowledgment of the common experience. But we must realize that this is a painful and long-term process that each of us must do, at least in some part, on our own. We must remain tolerant that we will each do it in our own way, and on our own time frame. Only in this way can we truly be of support to each other.

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