“Dr. Mark Lerner is an extraordinary teacher and healer, caring deeply about the pain of others. His works are a road map toward recovery and

a path away from unjust suffering.”

— MICHAEL LEVINE

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Personal Psychological Injury

by Mark D. Lerner, Ph.D.

Personal injury has been defined as, "physical injury inflicted to a person's body, as opposed to damage to property or reputation." (Oxford)

Historically, psychological injuries—the negligent or intentional infliction of emotional distress, have been overlooked. These refer to psychological and functional problems caused by another person's or entity's actions.

Today, there is an increasing awareness of the impact of emotional distress, as evidenced by the following:

• The United States spends more to treat mental disorders than any other disease or medical condition.

• Anxiety disorders are the most common mental health illness in the United States.

• Depression is now the leading cause of illness and disability worldwide.

It is critical when addressing the needs of clients for attorneys to determine whether an individual is grappling with emotional distress.

Helping Ourselves Through a Challenging Experience

by Mark D. Lerner, Ph.D.

Although we can't change our circumstance, we can choose how we respond to it. While our physical condition may dictate which strategies we can use, following are twenty-five suggestions from the book CrisisNotes, Practical Suggestions for Living Through a Challenging Experience (Lerner)—there are hundreds more. Many people have utilized these suggestions while they are grappling with adversity.

1. Surround yourself with your family and loved ones.

2. Talk about what's happened, tell your story and allow yourself to feel.

3. Try to obtain facts about your condition.

4. Allow trusted family members or friends to help you make important decisions.

5. Spend time with people who listen more than they speak.

6. See your reactions as normal responses to an abnormal event.

7. Let yourself cry with a friend.

8. Never apologize for showing your feelings.

9. When you're feeling overwhelmed, take a slow deep breath, inhaling through your nose, hold your breath for five seconds and then exhale slowly through your mouth. Upon exhalation, think the word “relax.” Repeat this process several times.

10. Tell children the truth, at a developmentally appropriate level.

11. If you find it difficult to concentrate when someone is speaking to you, focus on the specific words being said, and slow down the conversation.

12. Know that it's okay not to be okay, right now.

13. Draw upon past experiences to help you to cope today.

14. When making decisions, try to keep yourself in thinking rather than feeling mode.

15. Know that you are not your body. While your body may be broken, it does not mean that you are.

16. When feeling emotionally overwhelmed, change what you are doing.

17. Recognize that what you think will affect the way you feel.

18. Avoid avoidance.

19. Know that others may say things to try to help you to feel better quickly. They may need to feel better quickly.

20. Remind yourself that you will get through this.

21. Listen to soft music.

22. Speak with a counselor or therapist.

23. Excuse yourself when people speak of others who have had the same experience.

24. Avoid people who have all the answers.

25. Realize that you are not your illness or injury.

10 Ways to Reduce the Frequency of Violence in America

by Mark D. Lerner, Ph.D.

There is no single solution to decrease the prevalence of violence in our nation's schools, universities, houses of worship, movie theaters, shopping malls, workplaces, and in our communities.

However, a multimodal approach, incorporating the following ten strategies, would reduce the frequency of violent acts:

1. Prevention must be a priority. People should learn about the indicators of potential violence (see below) and instructed with whom to share information. In nearly every violent attack, there was some form of “leakage”—someone knew something to suggest the realization of violence.

2. Law enforcement agencies should encourage people to report concerns about potential violent acts and take every report seriously. Investigators should do their due diligence and always err on the side of caution to avert a tragedy. It is well-known that the single greatest predictor of violent behavior, is past violent behavior.

3. Mental health facilities and programs must be expanded to help people who present a danger to themselves and others. While a relatively small percentage of individuals with mental health problems are violent, these individuals could benefit from evidence-based, anger mangement strategies, and potentially protect others from violent acts.

4. Depression is now the leading cause of disability worldwide, and suicide is the leading cause of injury death of Americans—surpassing automobile accidents. There is a strong correlation between suicide and homicide, as evidenced by the fact that most perpetrators of violent acts take their own lives or are killed while engaging in acts of violence. As noted previously (3), mental health programs must be developed and implemented to address anger and aggressivity.

5. As our world becomes increasingly technological, we must be aware of the fundamental breakdown in interpersonal, face-to-face communication. Efforts should be made to bring people together, absent technology, and engage interpersonally. For example, children could be taught social skills, such as empathy and assertiveness.

6. The media must stop showing the faces and reporting the names of alleged perpetrators. Our increasingly technological world, including internet news sites, social media, streaming video, and television, is providing an indelible "stage" upon which disturbed individuals perform. Focusing inordinate attention on perpetrators and their actions increases the frequency of violent threats and acts. We must turn off the spotlight and stop glorifying and reinforcing maleficent conduct.

7. We must utilize our greatest resources to protect “soft targets,” such as our nation’s schools and universities. Consideration must be given to employing retired law enforcement personnel and our veterans who have demonstrated exemplary performance and are well-trained and experienced in the use of firearms. A calculation could be developed for various venues, such as one armed “protector” per every specific number of people in a school.

8. We must not rely on arming our teachers and school personnel. Their knowledge, education, skill, experience and training is in teaching, mentoring and providing support for our children. Educators have overwhelming responsibilities, and should not be placed in situations where they are called upon to draw a weapon and make a choice to use deadly force.

9. While it is virtually impossible to eliminate every assault rifle, there are certainly reasonable and responsible mechanisms that could be put into place to prevent these weapons from getting into the hands of the wrong people. This could be implemented by considering variables such as age to purchase and own, and enhanced background checks, including a waiting/processing period.

10. There is considerable focus today on wellness: preventing illness, keeping people healthy and improving the quality of life. Greater attention must be given to a key component of wellness that is often overlooked, Emotional Wellness: an awareness, understanding and acceptance of our feelings, and our ability to manage effectively through challenges and change. It’s time to foster Emotional Wellness in America!

Identifying People At-Risk for Violent Behavior

by Mark D. Lerner, Ph.D.

The best way to prevent a violent act is to identify individuals who are at risk of danger to themselves or others. Immediate action should be taken to investigate whether a potential perpetrator has a plan or the means of harming oneself or others.

Following is a checklist of warning signs. The great the number of endorsed items, the greater

the risk for violent behavior.

❐ has engaged in violent behavior in the past

❐ expresses self-destructive or homicidal ideation

❐ has described feelings of hopelessness

❐ has a history of self-destructive behavior

❐ gives away possessions

❐ articulates specific plans to harm oneself or others

❐ appears withdrawn

❐ appears/acknowledges feeling depressed

❐ exhibits signs of antisocial behavior

❐ engages in bullying others

❐ evidences a significant change in mood

❐ has difficulty with impulse control

❐ experiences sleep and eating disturbances

❐ evidences significant changes in behavior

❐ has experienced a traumatic event

❐ engages in substance abuse

❐ has been a victim of child abuse

❐ has become involved with gang activity

❐ has experienced a significant loss

❐ evidences a preoccupation with fighting

❐ has a history of antisocial behavior

❐ frequently watches programs/movies with violent themes

❐ evidences a low tolerance for frustration

❐ evidences a preoccupation with games with violent themes

❐ externalizes blame for their difficulties

❐ evidences a preoccupation with guns and other weapons

❐ has harmed animals

❐ has access to a firearm or other weapons

❐ has engaged in fire-setting

❐ has brought a weapon to school

❐ evidenced frequent disciplinary problems

❐ exhibited poor academic performance

❐ talks about not being around

❐ has been truant from school or work

REDUCING THE FREQUENCY OF

DISTURBING THREATS IN OUR SCHOOLS

by Mark D. Lerner, Ph.D.

In the aftermath of highly publicized tragedies, we experience a dramatic increase in the frequency of disturbing threats, particularly in our nation's schools and universities. The impact of these threats must not be underestimated. For example, when a bomb threat is telephoned, emailed or written on a bathroom wall, there is an enormous impact on the school community. The potential need to evacuate a school building under such circumstances presents a host of complex decisions for school administrators and police agencies. Ensuring the safety of the school family and preventing further disruption of the educational process is imperative.

Many feelings are generated from observing police comb a school. I recall one principal's description of how traumatized he, his students and staff were after standing outside of the building, for hours, while dogs searched the building. He indicated that when they reentered the school everyone was anxious, hypervigilant and startled by every closing locker.

In speaking with school administrators, we hear of other disturbing threats such as "hit lists" and threatening graffiti. For example, the traumatic stress endured by fourteen students, teachers and school administrators specifically named on a poster that was placed in the entrance area of one high school was profound. The poster described how each of them would be harmed. Furthermore, the fear that was experienced by another school family after the statement "Everyone will die on February 15th" had a far-reaching impact upon the entire community. After the building principal informed parents of the threat, nearly all of the eighteen hundred students were absent from school—many roamed the streets of the community.

Understanding what causes or contributes to the surge of disturbing threats in our nation's schools in the wake of well-publicized tragedies may help to reduce the frequency of this behavior in the future.

The reasons why some students choose to make bomb threats, develop "hit lists," or write threatening graffiti are complex, and ultimately research will help us to understand the relationship between these threats and such variables as domestic violence, sexual abuse, substance abuse, violent interactive computer games, chronic teasing and tormenting, bullying, etc. Following is a theoretical perspective based on three decades of working with children and adolescents, as well as my interpretation of extant literature.

Why is this happening?

There are a significant number of young people who are feeling alone and powerless in our rapidly changing world—a world marked by huge technological advances, communication and information overload, and an expectation of increased productivity. When these individuals observe the tremendous and overwhelming attention following highly publicized dramatic events, many of them identify with the aggressor(s). They fantasize about an opportunity to overcome their feelings of aloneness, inadequacy, weakness and powerlessness. They envision themselves acting-out, and perhaps overcompensate for their uncomfortable feelings. Fortunately, relatively few students act on these violent impulses with significant magnitude. Apparently there is enough impulse control that prevents them from going to the extent that perpetrators of violent mass casualty incidents ultimately manifest. However, in their minds, they see an opportunity to take action, of a lesser magnitude, and still draw a great deal of attention.

In reflecting upon disturbing threats experienced in our schools, we must ask ourselves why some schools experience many threats, why others experience few, and why others seem to escape such experiences. I hypothesize that the climate established by the school administration and the professional staff is directly related to the frequency of disturbing threats.

Educators must be careful not to challenge disturbed young people with statements like, "Our school is a safe place and we will not experience the kinds of events that you heard about yesterday...." Such statements may serve to create a double bind—a challenge for these individuals. These words may incite these students to try to disprove authority figures, to make themselves feel more powerful, and to help them to compensate for their feelings of inadequacy and weakness. On the other hand, educators that ignore highly publicized tragedies occurring in our schools are missing a critical opportunity to help young people articulate disturbing thoughts and feelings and to learn healthy, more adaptive coping strategies.

What can we do to decrease the frequency of disturbing threats?

If indeed the type of individual(s) who generate threats are trying to overcompensate for feelings of aloneness, inadequacy, weakness and powerlessness, we must work toward helping these young people to understand that the effect that they are trying to achieve by making a threat (i.e., to overcompensate for these disturbing feelings) will not result in the attainment of their perceived goal (e.g., to feel more powerful). Rather, the result of the threat may likely cause them to be arrested, feel extremely alone and scared while incarcerated, more inadequate, weaker and truly powerless. If in fact we focus our attention on helping young people to understand and observe the CONSEQUENCES of disturbing threats, the frequency of such threats may be dramatically reduced.

How can we focus our attention on the consequences of being caught? The responsibility here lies at a number of levels. For example, legislation must be enacted that would make bomb threats a felony in all states. In addition to prosecuting perpetrators, these students should face significant school-related consequences, including expulsion. Schools should establish clear policies whereby all lost time due to disturbing threats would have to be made-up. Parents should be held financially responsible for the municipal costs of responding to threats. And the media should invest more attention in showing alleged perpetrators being led in handcuffs to police vans, and less time on pictures of adolescent killers sitting and smiling among their peers.

The bottom line is that we must take steps to help young people to understand the consequences of disturbing threats by focusing attention not on the glorification of such acts, but on the reality of their actions.

SUICIDE: WARNING SIGNS

by Mark D. Lerner, Ph.D.

Suicide is now the leading cause of injury death in America. The following WARNING SIGNS may suggest that someone is contemplating suicide. If you have concerns, speak immediately with a member of the person's family, with a healthcare provider, an educator, or member of the clergy. Always err on the side of caution:

• has previously attempted suicide
• has a history of self-destructive behavior
• is talking or writing about suicide
• has a specific plan
• has access to a gun or other lethal means
• has harmed others
• is suffering from depression or other mental illness
• has experienced a prior tragedy (e.g., suicide of family member)
• is involved with alcohol and/or other substance
• has harmed animals
• describes his situation as “hopeless”
• has sleep and/or eating disturbances
• is talking about “not being around...”, saying good-bye
• is grappling with sexual/identity issues
• gives away possessions

• will not "contract for safety." (i.e., promise to not harm oneself)
• demonstrates a marked change in mood or behavior