Dr Pamela Prince Pyle

A Physician Reflects on the Uvalde Massacre: Responding to Those Suffering Grief Caused by Violence

Dr. Pamela Pyle


The Uvalde school massacre arrests our hearts and screams for our attention.  We cannot un-see the horrific recordings of grieving families juxtaposed by images of innocence—nineteen children and two teachers to be exact.

Safe public places are now a misnomer. School buildings have become targets rather than training grounds.

These out of order deaths marked by violence create a unique and complex grief.. The horrific nature of their death eclipses all. Survivors are forced to live without a loved one and the haunting of evil surrounding their family member’s final moments. 

Personal factors including baseline emotional regulation, secondary stressors, prior history of trauma, and access to support will play a major role in how each person responds.

Mourning parents and loved ones are forced to divide their attention between their pain and the indirect consequences of death by violence. Working with the police, the media, and the curious invade the sacred space of their acute pain. The pain of grief is coupled with anger, blame, regret, and unforgiveness. 

For those who care for those affected, acknowledge that each grief journey will be different, even for each family that has experienced death by the same shooter.  Be willing to tread in the waters of your own discomfort and fears. Don’t be tempted to offer platitudes for their pain. 

Grief after a violent death shares many characteristics with grief from other kinds of death; however, the following reactions may also be expected: shock with manifestations of anger, despair, disbelief, survivor’s guilt, fear, and anxiety.  

Physical manifestations of restlessness, loss of concentration, insomnia, sleeping excessively, and symptoms associated with panic attacks are common. Irrational thoughts and actions bleed into nightmares. Fear of being alone may drive behavior or isolating to grieve alone can both occur. 

Ultimately, understand that those who grieve now have the experiential knowledge of an unsafe world. Prepare to enter that world with them. 

Given the unique grief of those who have lost a loved one to violence, it is important to have an accurate window into the shock and trauma they are trying to navigate. Imagine each of these statements as expressions of grief to help guide you to empathetic compassion:

  • I am in shock. I don’t know what to say and I know you don’t know either. Please sit with me; when I am ready, I will speak.
  • I am in shock. I just want to go to sleep and wake up to a different reality. For now, can you sit in the other room so that I may rest?
  • I am in shock. My mind is fearful, anxious, restless. Please get a doctor.
  • I am in shock. I cannot believe he/she is gone. I am in denial. I need to see them, touch them, and say goodbye.
  • I am in shock. I can’t plan a funeral, take care of my children, or do the everyday aspects of my life. Please help me.
  • I am numb and in a daze. I cannot remember yesterday, and I can’t think about tomorrow. I need someone who understands.
  • I am in despair. I imagine all day what their final moments were like. I have nightmares all night. I need a counselor and/or a grief group.
  • I want justice. I need you to fight with me for justice. 
  • I am afraid. If this could happen in my safe world, then my world is no longer safe. What if this would happen to another family member or to me? Help me take the necessary steps to feel safer.
  • I am alone. No one understands. That’s why I isolate myself and don’t call you back, or go to the store for groceries, or do any of the things I once loved to do. I need you to break through these barriers that I keep creating.
  • I am not okay. Don’t keep asking me if I am okay. 
  • I am alone. I need to be with others who have also suffered this same fate, so that I may live. Help me find them.
  • I am alone. I need to talk about my loved one even though it makes me cry. I need to remember who they were, not what happened. Will you sit with me and look at pictures and videos? Will you go with me into their room, which I am afraid to enter?
  • I am alone. When you send me a card, a note, or a letter, I treasure it—even if I don’t mention it. It is comforting. It shows me you care.
  • I know it has been a month, a year, ten years, thirty years. Don’t tell me that I should get over my grief. It is the expression of my love. 
  • I grieve my loss of years ago. Do not be afraid to talk to me about my loved one. It is okay. 

Reflecting on these emotions will give insight into the many faces of grief experienced by those who have had traumatic loss. Professional counselors, grief support group leaders, clergy, and victim advocates will also help navigate the grief that accompanies traumatic loss. The best professionals take special care to watch for and treat symptoms of complicated grief, depression, and PTSD. 

One of the best resources for grief of any kind is The Dougy Center (Portland, Oregon). Its online presence addresses all forms of grief. It  have many resources including care for those who have lost a loved one due to violence and mass school shootings. 

Grief and loss have no timestamp. Grief never goes away, nor is a problem to be solved. It is a pain to be carried. Help by bearing a portion of the shifting weight of the pain. Love by being present. Care by observing cues. Remember when others forget.   

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