Michael Jellinek
Just as surely, there will be questions about whether mental illness or developmental disorders are linked to these horrifying incidents of violence. The fact that the perpetrator in Newtown has already been described in the media as having been diagnosed with Asperger’s disorder ensures that many families, especially those raising children with developmental disabilities, will have questions about any association. We as physicians must be clear that only clinicians who personally evaluated or treated this young man can speak to any of his personal problems or diagnoses. More broadly, there is no predictable association between acts of mass murder and psychiatric illness or developmental disorder. Indeed, it would be a disservice and counterproductive to increase the stigma and social isolation that already make it so difficult for so many to seek psychiatric help.
On a final note, adults as well as children should be encouraged to consider appropriate, meaningful action they could take in response to this event. Whether they want to try to demonstrate compassion to the families of Newtown, work to improve safety in their schools and communities, be activists for gun regulation, or support improved mental health care, they should be encouraged to channel their emotional responses constructively. We can teach our children that there are inevitable small risks that are part of growing up, that we can only control so much of our future, and that we need to tolerate these risks – try to minimize them when it’s possible and to grieve and recover when we cannot.
It seems that not a week goes by without the occurrence of a heartbreaking or terrifying event that gets exhaustive coverage in the news. Although overwhelmed adults can choose to take a hiatus from media or emotionally distance themselves from events, parents quickly learn that children come to them routinely with questions about something they saw, heard, or read about in a newspaper, online, on the radio, on television, via social media, or just from talking with a friend at school. Without imposing restrictions that would severely limit the child’s appropriate growing autonomy, there is simply no way that parents can fully control that to which their school-aged children are exposed.
Talking about the news-based facts of life poses challenges for most parents. It is unlikely that any parent woke up on the morning of Sept. 11, 2001 ready for the questions their children would come home from school with that afternoon. School and mall shootings and deaths from child abuse can be especially frightening for children and parents alike. Even natural disasters or accidents can be terrifying in their randomness and heartbreaking in their consequences. Should parents offer blanket reassurances? Can they speak honestly about the bad things people do or the uncertainty and vulnerability that are (often unacknowledged) facts of life?
The first thing you might offer a worried parent is the reassurance that the good news is that their children are asking them these questions at all and that children cope with troubling news. The fact that they bring their feelings and questions to their parents is a great marker of their judgment and trust. Remind parents that if they simply welcome these questions, are curious about their children’s thoughts and feelings, and remind their children to never worry alone, they will have done a great job at handling these types of questions.
Beyond welcoming difficult questions, there are some strategies to share with parents to help them handle these types of questions well. If at all possible, the parent should "strike while the iron is hot" and find the time and privacy to have these conversations when they arise. But if they come up in a busy public setting, such as the check-out line at the grocery store, it is probably best to respond that this is a very important question that deserves their full attention. They can talk about it once they get back in the car or can sit down at home together.
The conversation should start by gathering more information. What got the child thinking about this topic? Did they see or hear or read something about it? What was their response to this? It is important that parents remember not to assume that they know what their child is actually asking or worried about. What might worry a parent about a plane crash or a mass shooting may be different from what worries a child. What may be on the mind of a first grader could be quite different than a sixth grader. Often, children will want to gather information also. They may have a lot of factual questions about an event that they have heard about. It is natural for parents to want to protect their young children from material that is scary or sad, but it would be harder for these children to overhear this material or have to navigate it alone. Therefore, acknowledging what is true about what the child has heard is appropriate.