DENVER –– Reliving an event over and over. Avoiding people and places. Feeling numb. Not sleeping.

These symptoms, among others, can be indications of post-traumatic stress disorder.

Following traumatic events, such as the shootings that killed 12 and injured dozens at Century Aurora 16 movie theater July 20, many will need psychological counseling in their journey toward healing.

“In general, one should consider counseling if symptoms of distress do not go away over several weeks,” said licensed psychologist Kathryn M. Benes. “And (if symptoms) significantly interfere with family life, school or work.”

Benes is the director of Regina Caeli Clinical Services, a comprehensive, psychological service ministry of Catholic Charities of the Archdiocese of Denver.

In the days following the theater shootings, the agency received an increasing number of calls from people affected by the events, she said. “We expect the number of individuals directly impacted by the shooting, and those affected in an indirect manner, to increase significantly over the next few weeks.”

Benes explained there are two primary stages of post-crisis response: crisis intervention and psychotherapy.

“(With) the first stage, crisis intervention, the goal is to stabilize the impact of the trauma,” she said, “thus preventing or reducing severe psychological impairment.”

Crisis intervention takes place soon after the event and is generally provided by responders such as city employees and law enforcement officers.

The second stage, psychotherapy, is reparative and usually occurs several weeks, or even months, following the crisis event – when people do not feel they are in immediate danger.

It is directed toward reducing the symptoms of trauma.

“Therapy may last for weeks or months,” she told the Denver Catholic Register, newspaper of the Denver Archdiocese.

Some people, though not directly involved in the Aurora shootings, may seek psychological assistance following such an event.

“These individuals may have experienced a previous trauma event, such as the school shooting at Columbine, wars in Afghanistan and Iraq, or 9/11,” explained Benes. “In addition, some people suffering from (prior) depression, anxiety, psychosis, or marriage and family stressors may be affected.”

Their need for help can be triggered by the public nature of the event, including ongoing news coverage, which can “increase an individual’s distress level.”

Sometimes symptoms associated with trauma do not occur for weeks, months, or even years afterwards.

“Because of the distance in time between the trauma and symptoms,” she said, “people may not always connect the symptoms to the trauma.”

She described several signs that may indicate post-traumatic stress disorder:

  • Reliving an event: People may need to re-tell what they experienced multiple times. During the re-telling they may vividly recall the sights and sounds, as well as experience emotional anxiety.
  • Avoidance: Avoiding places and people that remind them of the event. For example, people who were in the theater, and even those who were not, may avoid going to movies, or any place where they cannot escape easily.
  • Suspicion: People who have lived through a trauma may be overly suspicious of strangers, and avoid places where there might be a lot of people unknown to them.
  • Numbness: Individuals may lose interest in people and activities they once enjoyed.
  • Hyper-vigilance: People may be hyper-vigilant for any potential danger. They may also have difficulty relaxing, sleeping and concentrating.

“The journey to healing after experiencing a traumatic event is not just physical, cognitive, emotional and behavioral,” she said. “The spiritual journey lies at the heart of true healing from trauma.”

When sorrow and fear are overwhelming, she said, “it is not unusual to be angered at God and ask how he could allow such evil to occur.”

“Often, there is no human reason that adequately explains evil,” Benes said. “It is the spiritual journey to the foot of the cross that makes us realize that God shares in our sorrow, and it is only through his divine love that genuine healing can occur.”

Filby is a reporter at the Denver Catholic Register, newspaper of the Denver Archdiocese.