Losing Saffie: The agony and loss of a precious little girl who was calling for ‘mum’ when mortally wounded

8-year old Saffie-Rose Roussos killed in Manchester, UK suicide attack

There are few things that I do not believe I could emotionally survive, like the loss of my spouse, employment, and physical and mental vitality. Certainly, the death of a child is among the worst of all human experience for any parent at any age. This story is a heart wrenching, story of depravity and loss. To this day, the loss of one of my children would leave me shattered, angry, and helpless. I hope these individual stories will all resonate with our humility as human beings. 

The chaos and emotion evoked in mass casualty events such as the Manchester, UK bombing, Boston Marathon bombing and the Sandy Hook, CT Elementary School mass shooting leave searing memories that take months to years to process.  We are reminded of the overwhelming sadness we feel when looking at photographs of people we know are no longer with us. The loss of a child is among the more gut wrenching experiences families can ever endure. Meanwhile, members of law enforcement face multiple victims including young children like Saffie-Rose Roussos during large scale mass casualty events that forever leave their marks. I am working with a former paramedic which was dispatched to a motor vehicle crash in 1990 where a family walking across the street was struck by a vehicle being pursued by law enforcement. The first victim he came upon was a 4 year old girl who had obvious signs of death that he cannot shake 30 years on. These next stories are similarly evocative.

 I recently came upon the story of the death of this little girl in Manchester, England. Her name was Saffie-Rose Roussos. From the sound of the description of Saffie, she was a special little girl with an enchanting wit and precocious love of life. All children are special and we recognize the curious joy through which they live each moment and we cherish every nuance. 

On the night of the bombing, Saffie was attending a music concert with her mother and sister when a suicide bomber detonated his bomb in Manchester, UK.  To see Saffie-Rose, one is compelled to ask whether or not there is a higher power? and if so, how could he allow this little girl to be in harms way? Saffie Roussos died on May 17, 2017 asking for her mum and wondering aloud if “she was going to die?” What child should ever ask this question? It evoked in me a tortuous and unthinkable picture of helplessness. But it was far worse for those emergency responders who were called upon to care for Saffie as her life came to an end that night along with the 21 other victims of the terrorist attack. No person who has ever been dispatched to a mass casualty event, like the Manchester bombing, ever comes away without a substantive chink in the veneer of their emotional core. Many in EMS and cops alike quit after mass casualty events.

The story of Saffie-Rose Roussos brings together good and evil and the ruination of one tiny life, one family, one city, one country, and illustrated the abject courage shown by the youngest of 22 victims that night in May, 2017. For this reason, I am sorry for not just the victims of the blast, like Saffie-Rose, and her family. They are devastated to this day, as I would be. But the heroic efforts of first responders who were called upon to provide life saving measures for this child and the hundreds of others wounded in the bombing. Without a doubt, all experience the deep sense of loss and failure at not being able to provide advanced trauma care for Saffie, so that she might live. “Losing a child feels like the ultimate violation of the rules of life” according to HealGrief.org an organization that guides parents through coping with the death of a child. In this case, Saffie is said to have been conscious after becoming injured but could not be saved given the resources available in the chaotic aftermath of the explosion. The protocols call for rapid triage of the scores of people needing help and this is done in the minutes to hours after the event. It is very likely, Saffie did not have the advanced life support needed to manage the hemorrhagic shock she sustained from massive loss of blood. The human body will compensate for loss of blood only until, in shock, it can no longer maintain blood pressure. Survival is measured when fluid can be replaced and loss of blood can be stanched. In children, this compensatory window is much more tenuous and short lived. 

When I worked as a LEO we were taught techniques for trauma intervention that we were told might save our own life or someone else’s life one day in the event of a shooting or massive trauma resulting in life-threatening loss of blood volume. By using a properly place tourniquet, rescuers can stanch blood loss at times of massive trauma such as from a bomb blast that took the life of 8-year old Saffie-Rose Roussos of Leyland, Lancashire in UK. Saffie was killed while attending a concert in Manchester, England in May, 2017. She was the youngest of 22 people killed on the night of May 17, 2017 when a suicide bomber Salman Abedi blew himself up in the lobby of a Manchester concert venue. Terrorism. 

“Medically trained people were with her. And she was asking for help. She knew what was happening. And she bled to death.” BBC 2021. “How do we carry on living with this information? How can we carry on breathing with this information?” asked Saffie Roussos’s father Andrew Roussos. BBC Judith Mortiz report January 17, 2021

BBC Judith Mortiz report January 17, 2021

Saffie’s father Andrew described his described his daughter as a “perfect, precious, beautiful daughter” who “melted people’s hearts” with those big brown eyes,” adding: “It’s like the best artists got together and drew her from top to toe.” according to a story in the BBC that was published during the public inquiry into the bombing last year. It is likely that the Roussos family is feeling the injustice of Saffie’s death. Anger is part of loss and healing and often is unresolved years after the traumatic loss of a child. Especially given the despicable nature of what caused Saffie to become gravely injured.

 All bereaved parents lose a part of themselves and often require months or years to understand the extent of their grief and anger.

“I did die that day, inside I’m dead. My heart is so heavy, it weighs me down” said Lisa Roussos, Saffie’s mum, now 3 years on. The Roussos family feels the loss of Saffie-Rose every day. 

Lisa Roussos

The immensity of traumatic loss was never more palpable than in 2012 when the Sandy Hook Elementary School in Newtown, CT came under attack by 20-year old Adam Lanza. Lanza first killed his mother with whom he lived and next drove to the largely unprotected elementary school and opened fire, killing 20 first-grade children and 6 adults trying to protect them.

Adam Lanza, 20, committed one of the most hideous acts of murder in history and is forever described as pure evil. Yet he was evaluated at the Yale University Child Study Center in New Haven. He was seen by a clinical psychiatrist, the report states. Ostensibly, the evaluation “purportedly to determine if Lanza had Obsessive Compulsive Disorder in the context of a putative diagnosis of Asperger Syndrome” in a piece written by Aaron Katersky and Susanna Kim in 2014 about the Newtown Massacre. Adam Lanza’s own father said “you cannot get any more evil” when talking about his son in the months after the shooting. Lanza openly wished that his son had never been born, raising an ironic specter between the loss of a child and being unable to love a child who commits unthinkable violence and died in the process. What possible conciliation may be find in his public statements months after the massacre? There is no denying that the Newtown shooting is among the most horrific and despicable violent crimes of the 21st century. No one will ever forget that December morning and the disbelief and horror it instilled. Other acts of violence toward children are documented. This is by no means a complete chronology.  

Perhaps the greatest sporting event in the United States takes place every April, ending on Boylston Street in Boston, Massachusetts. Martin Richard, 8, a child watching the Boston Marathon in 2013 was killed by a pressure cooker bomb filled with ball bearings, marbles and other shrapnel that was a homemade bomb made to kill and maim unsuspecting families watching the annual running event. Hundreds lost arms and legs in the two bomb explosions. 

Martin Richard, age 8

Martin Richard was a special child.  He is not shown in these bombing photographs. His parents have gone on to honor him with annual community events geared toward raising funds for parks and other community projects. In all, over 300 people were injured in addition to the initial 3 people who died in the bombing – including Martin. “The minute the defendant fades from our newspapers and TV screens is the minute we begin the process of rebuilding our lives and our family.” according to a Richard family statement in the Boston Globe as the Marathon bomber Dzhokhar Tsarnaev was being tried for the murder of Martin and 2 others on Patriot’s Day in 2013. For their part, the Martin family spoke out against the death penalty which was handed down to the surviving marathon bomber who was captured in Watertown, MA after a 4 day manhunt just a few miles from where they murdered MIT Police Officer Sean Collier in their effort to escape. 

We are all enormously impacted by events such as these and are left feeling sickened by the shear numbers of injuries and deaths.  Saffie-Rose Roussos, Martin Richard, and 20 kids at Sandy Hook Elementary School, 17 teens at Stoneman Douglas HS, and 32 students and faculty at Virginia Tech were all victims of violence and we should never forget these events and so many more, in human history.  The families remember the names and the horrors of the day.  The sadness of these losses makes our heart’s bleed and ache for all those who have lost a loved one to violence.  Even when you are the angry parent of a child you wish had never been born, a further violation of the rules of life.  No person who has ever been dispatched to a mass casualty event, like the Manchester bombing, ever comes away without a substantive chink in the veneer of their emotional core.

___________________________________________

AARON KATERSKY and SUSANNA KIM (2014) 5 Disturbing Things We Learned Today About Sandy Hook Shooter Adam Lanza. November 21, 2014

Family Of Martin Richard Opposed Death Penalty For Dzhokhar Tsarnaev, 2015. CBS TV Boston TV July 31, 2020.

What are protective factors in law enforcement: Ballistic vests notwithstanding

vest.jpg
Officer wearing ballistic vest

A new paper was just published in the Journal of Police and Criminal Psychology that has to do with high rates of depression in some police officers. It is written by Emily Jenkins (2019) who is a biostatistician and epidemiologist at the National Institute for Safety and Occupational Health in Morgantown, WV.  Her co-authors include John Violante who himself is an epidemiologist and former New York State Trooper now researching police officer health and suicide.  Basically, the authors say there are factors in personality and behavior that serve to reduce the new incidence of depression in LEO’s and to reduce the associated physical debility that may be co-occurring in cases where a history of depression was previously reported. One might see this protection as a ballistic vest for emotional health and career hardiness. High resilience leads to career success, satisfaction, and reduced likelihood of developing depression. Resilience refers to adaptability and flexibility in dealing with stressful situations.  Resilience officers are able to tolerate highly stressful situations without becoming debilitated by stress and negativity.

I find the study interesting but it doesn’t connect with the troops in the field. For example, one feature listed as helpful against depression is “active coping” that includes things like agreeableness, conscientiousness, and having social support. Understanding protective factors leads to understanding who is most at risk of developing depression.  The goal is to reduce depression among LEO’s and lessen the long-term impact of depression once it has been diagnosed.  The paper cites links to depression and poor coping skills to personality features such a high neuroticism and low conscientiousness and low extraversion.  These variables may lead to higher risk for substance abuse, reduced hardiness, and a host of physical signs and symptoms.  These personality features are the biomarkers of chronic stress and its harsh consequences. They make sense to me but I rarely encounter a police officer, or anyone else for that matter that actively thinks about the core set of personality features that have defined them throughout life.

Officers across the country are being trained in peer support and crisis intervention training. At the Direct Decision Institute we are providing a variety of training programs designed for this same issue – increased officer hardiness and reduced risk of burnout, depression, and suicide. These are intuitive concepts and when talking with active duty LEO’s, I feel like the rank and file understand the words they hear but rarely will an officer offer up a personal example of times he or she may have had behavioral health issues. I have heard officers become very emotional when telling the stories of friends who have suffered with mental illness but rarely a personal story.

Two recent exceptions to this notion are Sergeant Mark DiBona, a recently retired sheriff’s department officer from Florida and Joe Smarro, an officer from Texas who is recently featured in an outstanding documentary entitled Ernie and Joe released in May, 2019 with great acclaim.  It should not be this way and there is still great secrecy behind the veil of police service.  It takes great courage to share personal struggles and one’s private experience.  Police officers are most uncomfortable with this. Officers who are signing up for CIT and peer support courses are carefully chosen and may be more open to personal self-disclosure exhibiting greater positive coping skills, hardiness, extroversion and emotional resilience.

In order to reduce stigma associated with law enforcement behavioral health issues all members of the police service need greater self-awareness, openness to self-disclosure, and understanding of the effects of repeated exposure to violence and its broad ranging vicissitudes. This is nothing new and is being taught in academy training. Police psychologists who provide pre-employment screening should analyze the test data carefully and avoid selecting men and women who are most at risk of developing depression and who are outgoing, confident, and emotionally sturdy.

Profiling a package bomber

OKC bombing
 

Alfred P. Murrah Federal Building in downtown Oklahoma City

 

WESTBOROUGH, MA March 22, 2018 The recent spate of explosive attacks on apparently random victims continues as of this blog post.  People around the world are speculating about the psychological underpinning of a person or persons who can create a bomb and deliver it to some intended victim without being caught.  The explosion at the FedEx depot is something new as compared to the first 4 blasts.  So far 2 victims have been killed by the bombs.  The initial victims were African-American and Latino raising the specter of the bombs being a hate crime.

What does the bomb say about the bomb maker? Bomb construction thought to be a characteristic of underlying ideology and may be linked to motivation.  Certainly explosive devices range in their level of technology and sophistication.  In 1995 Timothy McVeigh created a powerful bomb made out of a deadly cocktail of agricultural fertilizer, diesel fuel, and other chemicals that killed 168 people at the Murrah Federal Building in OKC including many children at a nearby pre-school.

The type of bomb in Austin, TX has not been described by police or federal agents but the frequency of the attacks is unprecedented.  It may suggest that more than one individual is working to produce the explosives and make deliveries or the devices were constructed to stockpile before deliveries were made. The bomber likely lives alone or has a shop where the devices and their components are stored for assembly. His keen interest is in making people afraid and keeping a city in lock down. McVeigh was a former munitions soldier in the Army and may have learned his technique in the process of training with the U.S. Army.

If the Austin devices are the work of a single serial bomber than the frequency and recent change in method of detonation raise the bar in terms of sophistication of delivery but the risk of being caught or making a mistake may also be accentuated.  The police chief in Austin reportedly said that by using FedEx for shipping the explosive the likelihood of capture in short order was increased. An image was obtained of a man at FedEx that eventually became a person of interest.

The person who is behind this seige is likely an angry and detached with few friends.  Being marginalized lends both to his stealth and fuels his anger and resentment.  He may be suicidal and ultimately he final blast is to be part of his exit plan. He quite likely enjoys the sadistic control and media attention he is getting.

The fact that there are so few deaths – versus a massive splash event is not quite clear.  It speaks to ambiguous planning and perhaps unclear motive and may signal the growing disorganization associated with his terminal event. Additional personality features are uncovered with each action.  These are kept from the public domain.  My analyses are conjectural.

Michael Sefton, Ph.D.

Behavior regulation and fire: an overlooked sign of inner conflict

Playing with fire can be the most dangerous of all childhood behavior and a sinister expression of rage among adults with severe psychopathology. It is often overlooked as an expression of emotional problems among persons of interest with whom the police encounter. Early in my career at Boston City Hospital I was a member of the Juvenile Arson Program that evaluated children who were referred with fire setting as the primary sign of distress.  I worked with Inspector Al Jones of the Boston Fire Department and Dr. Rita Dudley at the Center for Multicultural Training in Psychology (CMTP) at BCH.  Rita was instrumental in growing the program into a regional center for the assessment of juvenile arson.  Inspector Al Jones of the Boston Fire Department was our liaison with front line investigators.  It was a fast paced program that got kids in for assessment and treatment quickly because we knew that some of the children we were seeing were at high risk of repeated fire setting and some were merely curious with their match play.

During my fellowship year I evaluated 49 children who were sent to us by fire departments in the Boston area.  I worked with Dr. David K. Wilcox, a Boston area practitioner and Dr. Robert Stadolnik, then at Westwood Child and Family Services, as key colleagues in my development and expertise in this area of psychology.  Bob published Drawn to Flame, a book about childhood firesetting in 2000.  The key for those of us involved in the program was to identify individuals who were most at risk of repeated fire setting and determine the underlying cause of their immense emotional turmoil.

The expression of underlying anger using fire is a malevolent sign conflict and detachment – sometimes psychosis and delusional thinking.  It represents inner conflict and emotional turmoil as I mention in a post published in 2013. Although quite rare, fire as a symbolic expression of delusions is documented. More commonly though, fire is a signal of emotional dysfunction in the life and family of a child or adult who is suspected of arson.  To what extent it represents underlying trauma requires a comprehensive psychological assessment and careful history. In the most dangerous cases, hospital care is required for the safety of the child or adult with firesetting behavior.  In the adult, arson for hire or an insurance scam represents a large proportion of those arrested for fire-related behavior.

Fire as an expressive behavior

Fire is instrumental in the expression of culture, ritual and is symbolic of great emotion and excitement. Its use at public events, celebrations and parties is commonplace.  People enjoy the dramatic sensory experience associated with seeing and feeling fire.  At what point is it a sign of conflict or burgeoning emotion? The expression of anger may be something as subtle as burning one’s own clothing in a small ceremonial fire in the living room fireplace.  Who would do that you might ask and why?  One example is a person who has lost a large amount of weight may exemplify the accomplishment by burning the larger clothes.  It is a symbolic way of saying goodbye to the old habits that may have caused the weight gain. Ok – that is plausible.  Another person might burn clothing as a way of undoing internalized feelings of shame and self-hatred engendered by early childhood trauma.  Also a plausible explanation of hidden psychopathology that often has deadly results. Some firesetting may represent a preoccupation with flame as an expression of fear and dread coming from exposure to violence within a dysfunctional home. This is a larger subset of persons than one might think and represents a sign of growing emotional lability.

The question for psychologists and police officers is how to identify persons of interest with the emotional coping deficits that place them at risk for using fire as an expression of their feelings and conflict. “The underpinnings of violence are often present in some form or another and may be represented by a marginalized demeanor and extremist views” according to Michael Sefton, Ph.D., Director of Psychological Services at Whittier Rehabilitation Hospital in Westborough, MA.

“The inconsistent and unpredictable exposure to violence contributes to excessive and unpredictable behavior” according to Michael Sefton in a 2013 blog post

The treatment model involves individual and group therapy to assit patients in the identification of inner emotions and feeling states.  I have worked with pediatric patients whose behavior is totally unregulated and unpredictable and yet when you ask them what they were feeling at the time of the fire they cannot tell you. Fire may result in a discharge of emotion like lightning. In the same way some persons are physically abusive – others set fires to release their strong emotions. The current reality suggests that errant use of fire material represents one of the most lethal expressions of underlying emotional turmoil and unbridled conflict in people. There are few programs equipped to understand and treat people with these behaviors and firesetting is often an exclusionary behavior  for entry into treatment programs everywhere.


Sefton, M. Juvenile Firesetting, blog post:  https://msefton.wordpress.com/2013/12/10/juvenile-firesetting/,  taken January 14,2017

DVH in MA: 4-year old child begs father not to murder his mother

  • “… He stood in the doorway with a loaded gun and talked about killing himself and/or children and myself. He was bringing up old verbal threats and I thought they were going to come true”

Amy Lake – July 2010

The words above were taken from a requested order of protection in the state of Maine in 2010.  The threats upon this victim and her family became a reality exactly one year to the day after this order was put in place in 2011. Amy

IMG_0771-1
Michael Sefton

Lake and her two children were murdered by her husband Steven Lake who killed himself as well. Immediately following the killings a Maine district attorney said “there was nothing we could have done to prevent these killings”. These were the words that triggered a team of professionals including myself to research the sequence of events that lead to this event.  A formal psychological autopsy was undertaken in 2011 following these murders and over 50 recommendations were generated (Allanach, et al 2011).

I am sick to my stomach as I write about another senseless killing of Wanda Rosa in Methuen, Massachusetts in late summer 2016.  The case resembles so many cases of domestic violence homicide – manipulation and control.  Ms. Rosa had a permanent order of protection but had recently modified the order to allow Emilio Delarosa to see the child they had in common. Why in the world would anyone allow Delarosa to see his son? He is no role model and the potential for terminal violence was readily apparent as depicted in the order of protection.  He expressed his intent to kill his girlfriend on more that one occasion.  Delarosa’s history of intimate partner violence had risen to the level of a permanent ban – signaling that the pattern of violence was undeniable and the red flag indicators for domestic violence homicide (DVH) were apparent in the eyes of the police and judiciary when the permanent order was granted.

Permanent orders of protection are rarely granted unless the pattern of violence was so prevalent and unremitting that the potential of harm or death to the victim and her family was unsurpassed as in this case.  It is known that Delarosa was manipulative and controlling of his girlfriend getting her to drop charges over and over and later alter the terms of the restraining order – ultimately resulting in her death.  Secondly, the person against whom the stay away  order is granted must have demonstrated a blatant indifference of the order of the court by having recklessly violated the order over and again. It should not have been altered.  In the past 18 months cases meeting these requirements (such as this one) have resulted in intimate partner violent deaths.  The Jarod Remy 2013 murder of Jennifer Martin is a despicable reminder of the need for change in cases of DV. Remy killed his girlfriend by stabbing her multiple times as the couple’s 4-year old child bear witness. In spite of laws designed to reduce the likelihood of DVH Rosa was not adequately protected.

Rosa’s boyfriend Emilio Delarosa is on the run as of September 20.  He is accused of murdering his former girlfriend after years of abuse, strangled her to death as their 4-year-old boy pleaded with him to spare her life, according to court records. “No Dad” the child was heard to say over and over. As in the Remy case, the 4-year old witnessed his father choking  Wanda Rosa until she was dead.

“I suspect there is a strong likelihood that he too will be among the deceased in the coming days as is the common eventuality among those who commit the unconscionable, violence that manifest in this terminal event” according to Michael Sefton, Ph.D., director of psychology and neuropsychology at Whittier Rehabilitation Hospital in Westborough, MA.  When some men violate the permanent protection order it is the result of unbridled rage and defiance against a “system” they believe has failed or unfairly humiliated them said Sefton in a release. They are murderous and often turn their rage inward in an act of suicide. I would look for the triggers of what set Delarosa’s terminal rage into action.  It could be something as simple as being told he needed to have monitored visitation with is son or learning that the female was seeing another man – both conjectural on my part.  After the alleged killing Delarosa was heard to say “It’s over, it’s over, it’s over” when speaking to his sister.

“Domestic violence is not random and unpredictable. There are red flags that trigger an emotional undulation that bears energy like the movement of tectonic plates beneath the sea.” according to Sefton.  A psychological autopsy should be undertaken to effectively understand the homicide and in doing so contribute to the literature on domestic violence and DVH according to Michael Sefton who with colleagues published the Psychological Autopsy of a case from Dexter, Maine where a father murdered his child, estranged wife and ultimately himself (Allanach, et al, 2011).  In the days preceding the murder there are usually red flags or pre-incident indictors that people see that signal the intentions of the murderer.  These clues provide police and the judiciary with data to craft protection plans and are the commonalities found in cases of DVH across the state and across the world.  Some red flag behaviors signal the emergence of imminent terminal anger that can be seen in the social media accounts of intimate partners who go on to kill their spouses.  I am quite interested in the compelling reasons that Delarosa may have argued that resulted in the change in the permanent order of protection.  The outstanding Boston Globe article about the slaying is a sad reminder of the early warning signs of DVH.  All the red flags were present.  In a blog published in 2013 I list the tell tale warning signs of intimate partner homicide and the need for tougher bail conditions (Sefton, 2013).

The impact on the child will be lifelong. At age 4, children are developing their sense of gender identity in the setting of developmental growth, cognitive maturity, social functioning and continued individuation. Imagine the child who is reunited with his parent after a period of mandated protection due to DV.  He is now able to see his family and may be fraught with both excitation and fear.  It would be normal for the child to have fantasies of reunification of the family and perhaps self-blame for not having stopped the action of his father. Just like the daughter of Jennifer Martin and Jarod Remy this 4-year old boy will forever be reminded of the life he will not have.

Ronald Allanach et al., Psychological Autopsy of June 13, 2011, Dexter, Maine Domestic Violence Homicides and Suicide: Final Report 39 (Nov. 28, 2011), http://pinetreewatchdog.org/files/2011/12/Dexter-DVH-Psychological-Autopsy-Final-Report-112811-111.pdf.

Sefton, M. The red flags of intimate partner violence. Blog post taken October 2, 2016.

Sefton, M. Prior history of crime not predictive of DVH. Blog Taken October 2, 2016. post: http://enddvh.blogspot.com/2013/07/prior-criminal-history-used-to.

Are childhood sports becoming venues for expression of unencumbered anger?

WESTBOROUGH, MA January 20, 2016  “Childhood sport represents an opportunity for children to learn the value of teamwork, sensible competition, winning, and loosing. Some important lessons in life emerge from the spirit of youth competition,” according to Michael Sefton, Ph.D., Director of Psychology at Whittier Rehabilitation Hospital in Westborough.  “I have coached youth hockey up through high school-age boys and have found 99 percent of the families I worked with to be very reasonable and respectful,” remarked Sefton in preparation for the blog post.  Just as importantly the games must be fun or children will not want to play. In recent years there has been a growing notoriety of fan behavior while attending the sporting events of children.  It is almost a “mob mentality” as parents shout at referees over botched calls, yell at other players, and become obstreperous toward the opposing fans.  Sometimes this becomes violent as it did in Reading, MA in 2002 when two men squared off and fought over a youth ice hockey practice resulting in the death of one.  “The fight was less about hockey than about the loss of control and unencumbered anger” according to Sefton. For his part, Thomas Junta who outweighed the victim by over 100 pounds was sentenced to 8 years for manslaughter.  He was released from the state’s prison in Concord, MA in 2011.

Social scientists have been interested in mob behavior for years and when it comes down to what the underpinnings of fan behavior experts cite alcohol, adrenaline, and blind team loyalty as primary culprits. But as far as parent behavior at childhood sporting event goes some parents become delusional and behave out of some overdriven striving on behalf of their child. Some parents see scholarship money in a child as young as 5-years old when in actuality only 2 percent of athletes will ever receive scholarship funds for playing football for example, according 2008 NCAA published data – most receive only a partial scholarship package and not the coveted “full ride” – published in the NY Times.  As a parent I took my children to an NCAA ice hockey playoff event that was so much fun. The kids were given ice time to skate with coaches and players from the playoff teams.  During this time I attended a parent education seminar on scholarships and the lengths to which some parents will go to get their child athletes noticed.  How is it possible that an angry father might physically attack a volunteer referee over a missed call or become enraged at a youth coach over the amount of playing time a son or daughter receives?

According to Brooke De Lench, Mom’s Team executive director, parents lack the basic coping skills to respond to the ups and downs of their kid’s competition and are injured when their child does not succeed. De Lench seeks a shift from an adult-centered model to a child-centered philosophy as a way of eliminating unruly and sometimes outrageous fan behavior. When fans loose control the results can be deadly. “We lose ourselves when we watch our children play sports” said Sefton who regularly attends high school parents’ night in Massachusetts speaking on concussion.  But becoming lost as children play youth soccer or football must never include losing control as it sometimes does. Because for some parents, a child’s failure, or even the perception of failure may evoke strong emotions.

In 2002 during a youth hockey practice 2 children jostled and battled for the puck.  One parent, confronted the coach, whose son it was involved in the on ice scrap.  He objected to the rough play during the on ice scrimmage.  A shouting match ensued followed by the 270 pound Thomas Junta, 45, jumping the much smaller Michael Costin, 44, and punching him violently and killing him in front of his child and other players in the ice arena in Reading, MA.  Junta was charged and served 8-10 years in the state’s prison for manslaughter.  The lives of both families were destroyed by this event.  Both Junta’s and Costin’s boys have grown into troubled men and have themselves served time in prison.  This sensational story left quite an impression on me as an outrageous exemplar of state of the art parenting.

Most of us know there is much psychology in youth sports including developing core beliefs about winning and loosing, team cohesion, mastery of physical skills, and the growth of healthy competition. Balance is needed pushing children to become something for which they are may not be physically or emotionally equipped. Just as important parents must recognize their own feelings at their children’s games and accept that some things should not be worthy of the fight to end all fights.

Dr. Michael Sefton is a neuropsychologist and former police sergeant in Westborough, MA .  He along with 3 colleagues published a psychological autopsy on the Dexter, ME domestic violence homicide from 2011 and presented the research before the Domestic Violence Homicide Review Board at the state house in Augusta, Maine in November 2011.

via Are parents at kids’ sports games harmful? (Opinion) – CNN.com.

 

“To say that it is because they lack training in techniques of crisis de-escalation is short sighted” Sefton 2015

WESTBOROUGH, MA  October 28, 2015 “To say that it is because they lack training in techniques of crisis de-escalation that some deaths may have been prevented is unfair and short sighted.” This quote was first published in the summer 2015 when people (perhaps in the media) first started calling for police officer training in mental health awareness and de-escalation training for police officers. One source actually suggested providing more training in mental health de-escalation and less training in the use of force – including firearms. Some wrongly believe that this “sensitivity training” will reduce the number of officer involved shootings with those who are known to be mentally ill.  Unfortunately police shootings of mentally ill suspects has been on the rise in the past 12-18 months.  Yet the use of force in police work continues to enter the collective consciousness when images of police officers acting aggressively toward defiant high school student go viral on social media.

SRO aggression
School Resource Officer take down of resistant student from posted You Tube video

Arguably, when the police are called to keep the peace or investigate a violent person call they are required to meet this threat with heightened vigilance for personal and citizen safety.  When a violent person is encountered the use of force continuum comes into play.  In the case of the Columbia, SC high school student who was aggressively choked and slammed to the floor while seated at her desk, the school resource officer was rightfully fired. The student posed no immediate threat such that hands on tactics were required to control a menacing suspect. In this case, the student was angry at being told she needed to put away her cell phone and was defiant to teacher direction. The police were called to the classroom as a show of force when neither the teacher nor the administrator could redirect her behavior.

If the violent person is actively aggressive or menacing with threat of lethal injury to the police or others than there is unlikely going to be any successful de-escalation until the threat of lethal force is eliminated.  If the violent person responds to officer directives to cease and desist all violent action and submit to being taken into protective custody or arrest – only then can mental health assessment be initiated. At the moment of crisis the need for public safety in all violent situations supersedes the individual need for care of a mentally ill person.  In the case of the South Carolina high school student no such threat existed but non-physical tactics were ineffectively deployed. The officer may have been able to diffuse the situation with empathy, understanding, and firm authority. The arrest could not be made without a higher degree of force for an actively resistant student that first punched the police officer.

Sefton, M. (2015) Blog post taken 10-28-2015 https://msefton.wordpress.com/2015/08/23/calling-for-de-escalation-training/

“Under the Hitler Cross: The story of one woman’s life-long conscription”

President Paul von Hindenburg
President Paul von Hindenburg

Lena told me she grew up in East Germany – behind the iron curtain from which she escaped when she was 33.  Her best memories were from a time when Hindenburg was the country’s president.  She lived in East Prussia near the Polish-Lithuanian border where most East Germans were Lutheran.  As children, they were made to stand under the “Hitler cross” each day before school and recite the Socialist pledge for nationalism that she cannot forget. She recites the narrative for me in her native German – translating the final few words into English – “the flag is more important than the dead” she mocked shaking her head. Lena had an unexpected and compelling history about which her doctors seemed unaware.

They were driven from their homes by the advancing Red Army during WW II in the 1940’s as millions were.  Yet, these East Germans were subjected to despicable atrocities most people are not aware of during the evacuation. “They took our homes. The banks were all closed. We had nothing” becoming tearful.  I bear witness to Lena’s personal memories – the narrative of her life living under the Hitler cross and the journey to America.

Now 91, she lives alone since her husband died over a decade ago. She lives 70 miles from her daughter.  I was asked to interview Lena and determine if she was capable of returning to her home alone after she sustained a fall and broke her humerus – the long bone in her arm. It was the second time she had fallen in the past year. I reviewed the chart and her nurse commented that she is noncompliant and suspicious somewhat randomly.  It was my role to provide an understanding of Lena’s cognitive status for the treatment team with some pithy explanation as to why she keeps falling and whether she can go home again.

Lena is frail in appearance and has a small frame.  Her eyes are hard and I cannot tell what color they are.  Her white hair is wispy, thinning.  She is sporting a blue sling that keeps her shoulder from moving. It is her dominant arm I note with some reluctance. Sadly, I wonder if the traumatic recitation I am now hearing may be a sign of the psychic unraveling that some elderly trauma survivors experience shortly before death.

As a consultant I try to remain dispassionate.  I need to determine her orientation, awareness of illness, capacity to concentrate, and review her gait training, balance, and daily carry over.  I find Lena hard to redirect but I need to respect the urgency of her thoughts while she painfully unburdened herself.  I am not optimistic about her returning home.

Moments of pleasure

Lena wants to go home so she can maintain her small garden in which she plants tomatoes and colorful flowers each year.  “People admire my yard and sometimes stop to take pictures of the flowers” she reports with a slight and hopeful smile.  She even boasted a one-handed technique used to plant her garden last year after suffering a shoulder injury in her first fall.  With her left arm she dredged an orifice just large enough for the seedling.  Then with the heel of her foot she covered and packed the plant with great acumen and apparently admirable results.  Resourceful and independent, I thought bringing new meaning to the green thumb adage.

Unfortunately for Lena, there is more than just making her garden she worries about. She is afraid about what might happen to her home when she isn’t there. There has been vandalism – “they painted the Hitler cross on my mailbox and house and broke my windows” she reported indignantly. “What can you do” her voice trailing off.  Once, she paid some boys to shovel the driveway.  They convinced her to pay them before the job was done and ran off taking her twenty dollars leaving only the snow behind.  The same thing happened with the landscapers who she had hired to rake the leaves this fall.  Can she go home again?  I could derive little experience of joy in her history – often an outward sign of depression.

Lena was raised on a farm, I learned. But she had a brief childhood marred by atrocity and abject savagery.  She was one of 9 children.  “We had horses and cows and an orchard” she reminisced. Lena was brought up Lutheran but had Jewish ancestry. “Her mother was very religious” she described.  Because they had property, landowners were expected to attend regular community meetings during which her father often spoke out against the government – against Hitler.  “They had an eye on him when he came home from the war” she reflected. “They came and beat him up once, she remembered – somebody told on him” referring to the time he spoke out against the war at the community meeting.  His battered and bruised body “looked like a rainbow” when describing his wounds. “Hitler did not grow up a German – he moved from Austria and promised to spread the ‘German way of life around the world'” she mused.  “All he did was invent the autobahn”, now her bitterness and mistrust began to show.

Traumatic Losses

Lena saw 15 members of her immediate family murdered.  Her father was shot to death in the orchard behind the family home when she was 9 years old by the German secret police because he spoke out against Hitler at a local meeting of property owners.  Her 7-year old brother was made to watch.  Her 4 older brothers were conscripts and died in the war. Lena said that her grandmother married a Jew.  He was very nice, she pleaded. Later, the family home was taken from them and the animals were killed during the evacuation of East Prussia late in the war.  By then she had already lost her parents.  Neither the Germans nor the Russians were humane to the native population of Lutherans and Catholics, and Jews.

After being forced from their farm, Lena was committed to a warehouse to live.  It was one big room.  She was made to sleep between similarly damaged souls – many who succumbed – leaving their postmortem remains for others to see.  She and her sisters were raped.  Elderly women were raped and murdered.  “People don’t know” she grieved now bearing witness to spectacles no person should ever see.  She described the dreams she has to this day – of being trapped in a room with no escape but would go no further.

I return the next day to see what carryover she has of our first emotional conversation.  I notice Lena sitting next to others in the community room – intrepid – yielding no outward sign of her inner torment.  She spoke to no one with a glower on her face that could dissuade even the most confident salesman.  She nodded and smiled slightly – faint recognition, I predicted. Uncertain. We agreed to meet again later in the day after bingo.  I had been strongly impacted by her disclosure and felt I needed to hear more.  What had happened to Lena since coming to America? Was she a member of her community? What kind of life had she built here in New England?

The promise of a better life brought Lena and her husband to America in 1952. She had one daughter.  Her Lutheran beliefs taught her the importance of helping others in her community – even neighbors on Cape Cod, MA where she still lives. But the efforts made by she and her husband were often not returned in kind.  People were not friendly and welcoming so soon after the war.

“My husband was a teacher in a technical school (in East Germany) and used to help the man who lived behind us when his car would not start” boasted the frail woman with a strong German accent.  Here she expressed her bitterness at being persecuted by those who were ignorant and prejudice against people who are different – perhaps more so toward immigrants from Germany when they first arrived after WW II. “Kids don’t know about it today” she complained.  She worried that the abject trauma she experienced during the second World War would one day become irrelevant – forgotten.

Secondary Trauma

The pain she felt in Germany was not eased by the democratic change of scenery. In fact, Lena herself was accused of killing Jews by a neighbor simply because of her country of origin.  Her daughter was bullied and abused between school and home.  The child’s principal refused to allow her to come and speak to the students to help them understand that she too had Jewish blood and had suffered unspeakably at the hands of the Nazi’s and those who drove them out.  She wanted to protect her only daughter from the hatred and vitriol and suffering she had endured.

“I am responsible for what happens here in school,” said the child’s principal, “not for what happens when she leaves the school grounds” in a despicable collusion of denial and lack of courage. More than anything Lena wanted to shelter her only child from the same truculence she endured and make a better life than the one she knew. She didn’t even know Hitler” she cried, now rocking slightly.

Lena described a time when her husband was burned by acid that had been mixed into the water he used to wash his hands while working a stint in a local automotive garage.  Afterward, he was sent to a physician who indicated the condition of his hands was a disease brought with him from their country in an outrageous distortion of the truth.

“You can complain to nobody” she bristled.  “The police don’t do anything” she bemoaned.  After her home was vandalized, one officer asked “What do you expect us to do sit in the driveway?”

Can Lena go home again?  I am sure Lena would love to return to the idyllic family farm with the orchard and horses the way she remembers it before the Hitler cross flew above her school yard. To visit with her large family before the time when her father was murdered and her windows were broken and her mailbox was disgraced with the Hitler cross. Who can you tell, nobody knows what happened anymore?

I cannot envisage a life-like the one Lena has had with its childhood trauma, loss, and recurring prejudice and persecution. Yes, I would expect that Lena is suspicious and mistrustful but she is not paranoid.  What would anyone do if they experienced the life events and atrocities experienced by this woman?  The emotional resilience Lena has shown raising her daughter and making a home for her family has inspired me to look at her differently than others might have done in my position.

Lena should go home and yet she is at risk of falls when alone. She has fallen and broken both the left and right shoulders – unsteady on her feet.  Her fear and anxiety stem from an underlying sense of vulnerability based entirely on her history of personal trauma and abuse while living under the Hitler cross. The reason for her noncompliance and emotional detachment are the predictable product of her early beginning in East Prussia near the border with Poland. It represents her fiercely stout-hearted spirit and enduring strength – features of the emotional veneer that are the underpinning of her being.  It would be wrong to remove her from her place of safety and take her from the garden she loves that brings her a few moments of joy each summer.  She feels pride in the tomatoes and colorful flowers she has grown for others to stop and see and sometimes even take pictures.

I return yet again to visit Lena and clarify some of her story and see how she is progressing. In what city did she live?How had she coped with the trauma of her life?  When I enter her room I notice an aide rounding up the sheets and blankets from her bed.  “She has been transferred to a nursing home,” he remarked without emotion. She had been discharged only a few minutes before I arrived.  Her doctor believed it was the safest thing to do. Her daughter agreed I suppose.

For whatever reason Lena felt safe enough in my presence to share the narrative of her life over the course of a couple of weeks.  I made an effort to deconstruct the mistrust she projected and summarily to lessen her emotional burden.  Arguably, I was unable to extract a pithy aphorism that would send her homeward based on my impression.  Yet I wanted to explain the rationale for her transfer.  I am sure she was dispirited about not going back to the Cape.  Again conscripted into battle over personal control and humility forced to sleep once more among the damaged souls. “Nobody knows what happened” Lena might say – but I do now.

IMG_4112
Michael Sefton, Ph.D.

The force of life and the fears that go along

Another look at the mind body dialogue.  The force of life lies within our body bringing forth our human energy.  Those energy traces forge the bonds that form meaningful relationships in time and space and sustain us. The force of life starts with a tiny heart’s beating and does not stop until life’s last day when the heart no longer makes its inimitable squeeze.

The meaning of what is human is derived from the social appetence inscribed into it by mentors and those who tend to its garden from early on.  Human growth stems from a carefImageully crafted blend of biological gifts and environmental design shaped over time. This may be lost without the core ingredients and nurturing bond that nourish it.  In their absence, the vessel becomes incapable of tolerating life’s abject aloneness and may become diseased.  The heart is a muscle that does not tire and yet it must be sustained or it quickly loses it lean and supple appearance slowly requiring more energy to power its life long lub-dub, lub-dub while still perfusing the body.  Arguably, the interaction between one’s heart and one’s head is undeniable.  What we do and how we think has much to do with the health of the body and ultimately, our life force.

Finding balance

It takes time to establish the human contacts needed to trust another person and put yourself in the hands of another with complete emotional certitude.  The fundamental appetence for living is shaped by the relationships made during life.  Those relationships that nurture and sustain may extend ones years of viability.  Those relationships that suppress the normal, effusive, life force are detrimental to health much like a toxin.

Juvenile Firesetting

Godzilla
Drawing produced by child being evaluated for firesetting

Fire sometimes symbolic of internal chaos

NEW BRAINTREE, MA  It was once believed that playing with fire was a normal, developmental curiosity and could be expected.  Fire is a tantalizing and visually captivating phenomena.  It was once espoused that firesetting was symprtomatic of psychopathology that included cruelty to animals and enuresis.  This triad of emotional indicators was thought to symbolize unmet needs and perhaps frustrated infantile drives states.  The current reality suggests that errant use of fire material represents one of the most lethal expressions of childhood emotional turmoil and unbridled conduct.  Depending upon the age of onset using fire as an expression of internalized conflict suggests a serious emotional disorder in need of expert assessment and treatment.  The drawings of some children reveal an chaotic emotional development that may be portrayed by the violence among characters as shown in the drawing here.  Each animal is drawn shooting fire or electric rays. The two main characters shown are Godzilla and Raptor who are engaged in a confrontation.  Each character brings his crew to help eliminate the opponent using fire and electricity.

Exposure to fire and role models

What happens when the child turns one? His parents plop down a birthday cake with a burning candle set alight.  While singing Happy Birthday the toddler sits transfixed as the waxy, flickering bulb melts before his eyes.  Some believe early exposure to fire coupled with significant role models who use and misuse fire material cast the first spark of interest in fire.  Curiosity in fire may be a normal childhood attraction.  But in most cases the normal enchantment with fire represents one of many normal wonders that parents may introduce to children as they grow and mature.  Meanwhile, just as one would not give a loaded firearm to a toddler, one cannot permit an unsupervised child to handle matches or lighters.  The interest in fire becomes a parents responsibility to nurture and polish with age.  This normal interest then foments in homes where the prevailing affective conditions permit – decreased emotional warmth, access to fire starting materials, an absent parent, and frequently domestic violence.  The inconsistent and unpredictable exposure to violence contributes to excessive and unpredictable behavior.

Psychologist are frequently asked to differentiate children who light fires because of normal curiosity versus those who light fire out of a more pathognomic underpinning.  I was once asked to evaluate a surviving 3-year old who lit a house fire killing his 4-year old cousin.  The tragedy of this case transcended 4 generations living in one household and rendered them emotionally overwrought. “Just as we will not put a loaded firearm into the hands of an untrained child, so too must we guard against the unskilled, misuse of fire”, according to Michael Sefton, Ph.D.

Juvenile arson is a serious crime and has life threatening consequences.  The cost to insurance companies is measured in the hundreds of millions of dollars across the country.  The loss of life even more costly in terms of the human toll enacted upon families where children light fires.  The truth is that all “fire play” may be hazardous and life threatening when fire gets out of control so access to fire materials like lighters and matches should be carefully limited.  Just as parents kid proof their house when the baby is born so too should they make a house or apartment fire safe from the curiosity of a precocious child.

The most ominous case of juvenile fireplay occur in homes with one or both parents absent from regular, direct nurturing of the child. Why children choose fire play over other forms of acting out is not clear. There tends to be two peak ages where the incidence of fire play is peaked: 3-5 years and 12-15 years. It is far more common in boys than girls but girls tend to light fires that include personal belongings, Any use of combustibles or incendiary devices is highly significant and requires professional assistance. Programs such as that offered by YOU, Incorporated in Central Massachusetts have clinicians who understand the dynamics of fireplay and can help families deal with the risks. See the link below for a sensitive look at one particular story from the midwest.

http://www.traumaburn.org/prevention/seanstory/misuse/index.shtml