Are you plagued by thoughts of school shootings, terrorism, or other acts of violence? If fear, anxiety, and intrusive thoughts about violence permeate your dreams or waking hours, it’s possible that PTSD or what is unofficially termed Pre-Traumatic Stress Disorder is at work in your body and brain. Today’s episode with medical expert Dr. Nina Cerfolio will answer your questions about the causes and impacts of cycles of violence and acts of terrorism while also paving a road toward healing and improved mental health for us all. Join Dr. Carla and Dr. Nina as they explore the realm of violent events and the steps that can be taken to make the world safer and healthier. Topics covered include trauma, PTSD, 9/11, Ground Zero, social media use, bullying, mass shootings, school shootings, suicide, suicidality, schools, psychiatric illness, gun violence, parenting, mental health systems, school systems, anxiety, depression, stress, and the positive effects of small acts of kindness.

Please note that this episode contains sensitive mental health and trauma-related material including suicidality and suicide; listener discretion is advised.

Note: If you or someone you know needs immediate support, please call your emergency services. In the US, 24/7 help is available by calling “911,” “988” (Suicide and Crisis Hotline), or SAMSA (Substance Abuse and Mental Health Services Administration) at 1-800-662-HELP (4357). Additional links are in the show notes.

 

Books by Dr. Carla Manly:

Date Smart: Transform Your Relationships and Love Fearlessly

Joy From Fear: Create the Life of Your Dreams by Making Fear Your Friend

Aging Joyfully: A Woman’s Guide to Optimal Health, Relationships, and Fulfillment for Her 50s and Beyond

The Joy of Imperfect Love: The Art of Creating Healthy, Securely Attached Relationships

 

Connect with Dr. Carla Manly:

Website: https://www.drcarlamanly.com

Instagram: https://www.instagram.com/drcarlamanly/

Twitter: https://www.twitter.com/drcarlamanly/

Facebook: https://www.facebook.com/drcarlamanly

LinkedIn: https://www.linkedin.com/in/carla-marie-manly-8682362b/

YouTube: https://www.youtube.com/@dr.carlamariemanly8543

TikTok: https://www.tiktok.com/@dr_carla_manly

 

Book by Dr. Nina Cerfolio:

Psychoanalytic and Spiritual Perspectives on Terrorism: Desire for Destruction

 

Connect with

Website: https://ninacerfoliomd.com/

LinkedIn: https://www.linkedin.com/in/nina-cerfolio-md/

Instagram: https://www.linkedin.com/in/nina-cerfolio-md/

YouTube: https://www.youtube.com/channel/UCBVjXgAzd33-j18JocYUyDQ/featured

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Watch the episode here

 

Listen to the podcast here

 

Decreasing Bullying, Gun Violence, and Mass Shootings with Medical Expert Dr. Nina Cerfolio

Using Interpersonal Connection and Mental Healthcare to Reduce Acts of Violence

Are you plagued by thoughts of school shootings, terrorism, or other acts of violence? If fear, anxiety, and invasive thoughts about violence permeate your dreams or waking hours, it’s possible that PTSD, or what is unofficially termed pre-traumatic stress disorder, is at work in your body and brain.

Our episode with medical expert Dr. Nina Cerfolio will answer your questions about the causes and impacts of cycles of violence and acts of terrorism, while also paving a road toward healing and improved mental health for us all. We’ll focus on this reader’s real-life question. “I remember 9-11 like it was yesterday. I’ve never been able to get rid of the mental images from the news, even though I was seventeen.

Every time I hear about a school shooting, bombing, or random acts of violence like the 2017 concert shooting in Las Vegas, I get super anxious and I cannot sleep. Can I get PTSD just from watching the news?” With that question as the focus of our episode. I’m Dr. Carla Marie Manley and this is Imperfect Love. Please note, that this episode contains sensitive information. Listener discretion is advised. If you need support, please see the special links in the show notes.

 

 

I’m joined by a very wonderful guest, Dr. Nina Cerfolio, who will be sharing her expertise on trauma, terrorism, mass shootings, and school shootings. Welcome to the show, Dr. Nina. It’s such a privilege to have you with us today.

It’s so wonderful to be with you. Thank you so much for having me.

About Dr. Cefolio

You are certainly an expert in your field. Before we jump into that, could you tell our readers just a little bit about what makes you, you?

I am a psychiatrist. I’ve been a psychiatrist for I think over 40 years, which ages me. I would say that really what makes me, me is that I survived two terrorist attacks. I was the first responder at 9-11 and I subsequently developed breast cancer and had a mastectomy for that. I also did humanitarian work during the Second Chechen War in 2005. I went there to try to help what was a genocide actually of Chechens who are Muslim. It’s a part of Russia that really didn’t get any international or any type of news coverage because Putin framed it that this was a war against terrorists.

The West, unfortunately, joined Putin with his efforts when it came out that Putin and KGB agents had planted the bombs that the Chechens were blamed for in the seven cities in Russia where I believe over 200 Russians were killed, civilians, and thousands were injured. That was his excuse to go into Chechnya, which brought him into power and president of Russia, and be killed. Over 300,000 Chechens are Muslim. I went there to try to help and I did. I provided medical care, psychiatric care, and psychological care to the Chechens at the time.

I was also poisoned by a KGB agent who was shadowing us and that’s the only way that we got into Chechnya. I almost died there. For three years, I almost died but why I’m bringing it up, and I love your show which is Imperfect Love because basically before I got really sick after being poisoned I didn’t know how to love myself. I was always pushing myself striving as was my upbringing and childhood to achieve, to jump higher. I was an elite endurance athlete. I did ultra marathons and marathons I even won the half marathon on the China wall.

I ran a half marathon because I was injured, but it was always like upping the ante. I played semi-professional tennis when I was 35. I had wanted to play when I was younger. I played first singles in high school and college, but it was always proving my worth, proving achievement. It just lasted not very long, as long as the achievement was over. I had to prove myself yet again. Actually poisoned with anthrax, it humanized me. I didn’t have a choice, it slowed me down. It was my nuclear bomb to learn how to accept myself with all my imperfections, with all my scars literally on my body, that I had actually fallen on the wall in China.

I still have a scar on my shoulder and just all my scars from reconstructive surgery for having breast cancer, it taught me how to accept myself as imperfect as I am. It’s an ongoing journey, as I’m sure you know, Dr. Carla, but I was able to let a man finally into my life. I’d always dated men and pushed them away. It was a tremendous gift, even though it was a really brutal gift, I would say, as I did almost die. Here I am, imperfect as I am.

Dr. Nina, thank you so much for sharing such personal and heartfelt information. I want to slow it down because I’m still processing everything you’re telling me. The piece about Chechnya. I appreciate you sharing that and what many people, readers, I’ll put a link in the show notes for you on that. If you’re interested, you can do a little bit of historical research on it. Yes, it was Putin’s foot in the door. Most of us know that Putin is not a good individual and is not doing good for humanity.

We can see that as its own separate issue, but I’m so sorry for what you endured there in 9-11. I had no idea. It’s so strange when I match up experts with a reader’s question. How many times has there been an intersection where I didn’t know the specifics about 9-11 and you? I knew some generalities, but how we can see there’s such a close association between what you experienced and the anxiety that our listener today is writing about? Also, I really appreciate how you brought in the piece, I’m so sorry about your cancer, and that you likely from what research tells us.

Many of the first responders in 9-11 have ended up with cancer in various forms. It’s under-recognized, under-reported, under-supported. Thank you for being at least a witness. I’m sorry for what you’re enduring, but I am so appreciative that you are sharing it with us so our readers can know someone in real life who has given so much. You were a first responder there, you witnessed. I cannot even imagine just hearing about it. The few visuals I saw were horrific. I chose not to expose myself too much to the images but thank you for your service. Thank you for what you did.

I am sorry for your health issues that likely resulted from that. The other piece that I really appreciate, and we’re not even really into the topic, but yet we are, the part about perfectionism and how you were, obviously, still are, a very high achiever, and how high achievers and perfectionism often go hand in hand and that often life gives us these wake up calls to say, “Look at what you’re prioritizing here being the perfect human, the perfect this, the perfect that, whatever it is.” Life does give us opportunities sometimes to wake up and say, “Is the perfectionism, is that next achievement, is that sense of superiority or having conquered the next thing?” Is that really what I want my life to be about?

Very true. I think it was a gift, even though it was a difficult gift, but it was a gift nonetheless. I still do, by the way, I love to champion the marginalized or the unseen, which has a lot to do with my work with mass shooters especially school shooters who are adolescents who are suffering and are unseen. I think a way tragically and not a healthy way but a way for them to be seen is to become infamous through their violence.

PTSD From Violence

Where you’re going straight into the heart of your book, and your book, Psychoanalytic and Spiritual Perspectives on Terrorism: Desire for Destruction. In reading it, I was struck by many things. Readers, prepare yourself for this one. This is a lot of what we’ll cover is not necessarily easy, but one of the things that is digestible but important to highlight. It’s from page 153 of her book. “A common denominator of these shootings is that many of these assailants have been bullied.” That’s a topic we’ll dive into in more depth. Another piece and I appreciated this, was when you were looking at the research from the retrospective observational study from 1982 to 2012, and often readers, if you’re thinking that’s a long time ago, that’s how these studies are done.

We have to do the retrospective study, pull the pieces together, and see what the commonalities and differences are. Of the 35 cases where the assailants actually survived, these are the stats from Dr. Nina, 87.5 had major psychiatric diagnoses, including schizophrenia, 56%. Delusional disorders and other diagnoses such as bipolar disorder. Just setting that as the stage for what we’re looking at when we often focus on it’s guns that are the problem. I’m not saying I’m pro-gun, or anti-gun.

I don’t take stances like that on the show. When we look at a gun in the hands of somebody who has good mental health and takes really good care of that gun, whatever it is, is far less likely to do any damage than a gun in the hands of, especially now that people have the opportunity to make weapons with 3D printers. We have to realize no matter what the gun laws are, people are going to get weapons into their hands. We are far better served to focus our attention on the marginalized populations that are not getting the support, treatment, mental health, and physical health care that they need.

That’s what we’re weaving it back to our study that you reference in your book. There’s so much in your book that is worthy of diving into readers. If you want a very good deep read, you can find her link in the show notes. The link to Dr. Nina’s book. Dr. Nina, turning it back to you, when we look at this reader’s question, who’s saying that she is really worried that 9-11 seemed to have created this trauma and she’s asking. Let’s ask the expert. Can you get PTSD from watching or listening to the news?

Absolutely. Some of my patients were getting post-traumatic stress disorder just from watching the buildings collapse over and over and over again. I think the way our news works, unfortunately, a lot is that they cover cataclysmic events like 9-11. Often I would tell my patients, especially, I have a lot of patients that lost loved ones in the buildings and some of them were in the buildings and escaped. I would have to tell them, “You really should limit or not watch TV at all, especially around 9/11 because I don’t know how many times the news you would see the impact of the plane and the building goes both buildings go down.” You can be traumatized if you’re watching the news, yes.

Thank you for that succinct answer. I think about Hebb’s law in neuropsychology, the idea that use it or lose it, neurons that fire together, wire together. When I’m working with clients, I say it’s as simple as whatever you do more of, be it good or not so good is going to become more a part of who you are. If we’re watching a news clip and we watch it, as you said, again and again, and again, we don’t realize our brain is being wired in that process, being wired in this case, toward being anxious, stressed, fearful, terrorized in our own living rooms. It’s the same when we watch, and you’re right, the news channels, they go after cataclysmic events, they sensationalize the news, and that’s what draws our attention because we’re human.

We can certainly develop post-traumatic stress disorder. I completely agree with you. It’s one of the reasons that doom scrolling is so toxic that people get on social media and they don’t realize they’re watching negative image after negative image after negative image. No wonder they feel more stressed, anxious, depressed on edge because they filled their body, minds, and spirits with these images and all the emotions that come with them.

Yes. There’s an addictive quality to social media as well with them having the ability to wire you videos that you’re more likely to watch. There’s a very addictive destructive quality to social media, unfortunately, that is not healthy, especially for our young people’s developing brains. Often they’re bullied as well on social media, and there’s all this pressure to be the perfect person, the perfect child, the perfect adolescent, and it can be very stressful, as you say, and very unhealthy for our psyche.

Social Media

You’re giving so much great information. Let’s break it down. Let’s spend a little time on social media, then we’ll move to bullying. It’s so interesting with social media that more and more information and research is coming out, especially with the Facebook whistleblower and all of that, now being aware of the TikTok algorithms and Instagram that as you say, they are drawing us in.

The algorithms, they are drawing us in and they see you watch one thing and they’ll feed you more of that and keep you coming back. I’m thinking about my book Joy from Fear 2019, where I was already talking about this before the Facebook whistle. It was so obvious. You could see it. You see it with kiddos. You give them a device and they’re all in. I remember when I was doing research for that book, the American Academy of Pediatrics, I was so upset, had taken the age for giving a kiddo a handheld device and they lowered the age where they believed it was okay, right when that book was in process.

I was saying, “What lobbyists got to them? Who got to them to let them feel that they were okay to support giving a 2 or 3-year-old or a 4-year-old a handheld device?” It’s not good for the brain. You’re the doc. Talk about how, as you said, that highly impressionable brain. Tell us about what social media does to first off these little brains, and then the teenage brains, please.

There’s such an addictive quality to social media. Like you say, there’s an algorithm, and then they’re going to feed you those types of videos. You can just sit and spend all day, looking through various videos. For children in particular with their developing brains, it’s particularly destructive, not even to mention children that are bullied on social media that they have killed themselves or social media has a lot of speak about mass shooters that are school shooters go on sites like neo-Nazi sites, Hitler sites, far-right extremism sites, and they get radicalized online.

They often, children especially, but probably even adult mass shooters suffer from a sense of not belonging. These are people who are marginalized and often cannot hold jobs and are barely making a living to pay for their bills. Sometimes they don’t pay for their bills. Some of the young mass shooters that I studied were homeless by the time they were thirteen because their families often had a history of unemployment and couldn’t pay rent and then were dislocated often to various different houses.

By the time the children were thirteen, they were homeless. Surfing on various people’s couch and asking for food. On social media, especially on these sites where they get a sense of belonging and a sense that they matter, it’s particularly destructive. They get radicalized online to be a school shooter or a lot of them also will do an internet search on other school shooters and feel a kindred ship with other mass shooters. They’ll also post on social media as well, often under different names. It’s a real problem. Often the parents, the school, society, the FBI, and the police.

A good example, for instance, is a Georgia high school shooter. He had posted on a site and took a Russian name for the Sandy Hook shooter and said that he was going to be a mass shooter. It’s such a tragic story. His mother was drug addicted, to methamphetamine, cocaine, and oxycodone, and so was a father. The mother threatened to kill this mass, I’ll just refer to him as the mass, Georgia mass shooter, threatened to kill him twice under a methamphetamine high. The boy became more paranoid because he felt unsafe, not surprisingly.

He ping-ponged back between the mother and the father, and the parents eventually divorced. At one point, Georgia State Child Welfare had been notified by a neighbor because the parents would fight in front of the kids, and the mother failed a drug test. There are three children he had two younger siblings were put into the home of the father who now had moved away to a different town in Georgia. Apparently, tied up her mother who refused to go with her to go get the children back and I guess beat the mother up and wrecked her house. She went to go get the kids, but the father wouldn’t let her into the house.

She keyed his car and then I guess she wrote that she was going to commit suicide and markers in her car. She had threatened again to kill the Georgia shooter, this little boy who was then thirteen. The boy’s paranoia increased, not surprisingly. He begged for mental health care. The grandmother tried to get him mental health care in the school, but the school counselors failed him as well. Eventually, the grandmother did get him inpatient hospital bed but then she fell and broke her fingers and then she had to get medical care.

She left it up to the father to bring him to get inpatient mental health care. Of course, the father dropped the ball. The father like didn’t even bring him to school the whole eighth grade. In literally a week before he was supposed to get admitted, he went to school and took a semi-automatic again from his father who owned it legally. She also mentioned the FBI was notified of his posting on social media that he was going to be a mass shooter and he denied it. The father said he would take responsibility for his son not having access to the guns which clearly was not true.

On that day, he went to school and took the semi-automatic weapon the father had. I cannot remember if the father bought it for him I think it was a father’s gun that shot and killed students at the high school. I think it was in the ninth grade and wounded other teachers and students. Here he’s posting on the web. The FBI apparently didn’t look into it. They also didn’t look at a post a picture that he took of his semi-automatic weapon and it was inside the father’s home that that indeed was a picture inside their home.

It’s all these dropped balls. It’s really us, society, filling these children. Often they’re notifying us on social media. Even that, like in school. On his computer at home, he posted child welfare dropped the ball. The FBI dropped the ball. School counselors dropped the ball. His parents obviously had their own psychological turmoil and trauma, but this poor child was abused and neglected and he felt he had nothing left to live for. I went off the question in part.

It’s okay. We’ll come back to it. When we look at the very sad, very tragic tale of this young man, and we can go back to the piece where we were talking about the impact of social media, but we can see from the tale that the true story that you’re giving us, that the lesson we can take away from that as clinicians, as individuals, as moms, dads, sisters, brothers, parents, teachers, school counselors, the idea that it’s important for us to pay attention and better to report something.

Better to lean in than to ignore it and go along and say, “I’m probably making too much of something because of our gut instinct, which we often forget about listening to. Our gut instinct when we see that kid, that kiddo who’s marginalized, that kiddo who’s obviously not coming to school in good form. We want to pay attention. We really do and we do want to go that extra step to make a report, to follow up on the report, to be that parent, to be that adult. I know as a clinician that’s how I am as a clinician. It takes a lot more work to be that vigilant, that attentive.

It's important for us to pay attention, and better to report something, to lean into it, than to ignore and go along. Share on X

That’s part of the job. It’s part of being on the planet that the more attentive we are, the more we put our heads in the sand. It’s a nice place to be. I get it. It’s nice to put the heads in the sand, but it’s also part of whatever it is when we put our heads in the sand about global warming, plastics in the environment, school shootings, and terrorism. Yes, on one hand, it does feel better, but if we take that anxiety that we feel, the stress, the depression, and we channel it into action, into being that person who calls the police, into being that parent who calls the other parent and says, “I don’t know if you noticed, but your kiddo seems ostracized at school.”

I want to go back to the piece that you said before I get back to the social media. Let’s just pause because this is a good spot where you’re talking about bullying. As humans, I often say we all have the need to feel safe, seen, and loved. It is one thing we all have in common. Besides being imperfect, we all have that in common too. When we look at that and see that often, especially for kids who are abused or kids who have really dysfunctional home environments, they might not be physically abused, but they may be emotionally abused or have nobody to who they feel connected.

 

 

They may look normal on the outside, but if you pay attention to the behavior, people do not thrive when they feel isolated, when they feel unseen, when they are bullied or made fun of in other ways because that goes back to the fact that we’re animals. We as animals like being part of a herd, we really do. When we know that if we’re outside of that herd, a wolf is likely going to eat us. We want to be included in the classroom. We want to feel normal. We want to feel okay. Now we can pivot back to the piece. Again, that goes back to your statistic about the common denominator in school shootings having been being bullied.

Mental Healthcare

I don’t know if I said this clearly, but this boy was bullied because he had poor hygiene, he had dirty clothes, and kids wrote bottles of shampoo at him. He just wasn’t even seen to the point where the day of the shooting, his mother called the school to say, “I think my son’s going to be a school shooter.” The administrator apparently got a different boy with a similar name. This is how unseen, how ostracized he was.

A girl who sat next to him said, “I don’t even know how his voice sounded. He was not included or part of anything.” In fact, he felt he had nothing to live for. He was, as you said, unsafe. His mother had threatened his life. The only ones who seemed to really care actually were his grandmother, maternal grandmother, or maternal aunt who tried to get him help but then got resistance also from unfortunately the way mental health is often that the parents have to admit the child.

I ran a psychiatric emergency room at St. Vincent’s and a psychiatrist can admit anyone against their will if they’re psychotic or homicidal or suicidal. That’s always a possibility. With this child, he should have been admitted years before it culminated in a mass shooting. He was severely bullied and ostracized and felt unsafe, as you said, and wasn’t seen at all. Wasn’t seen at all until he became a mass shooter.

That goes back to two things that set me on fire a bit. The state of our mental health care system in the U.S., in many countries, it’s not just the U.S., where people often are not given the care they need unless you have oodles of money, and even then sometimes, but so many people are going without the mental health care that they need and that they deserve. Our school system, yes it has become a place where many children are raised and where they get pseudo-parenting. It is difficult to educate children, but also raise them at the same time. It is part of what our school systems are doing right now. Bringing in mental health care into the school systems in a curricula that really address these specific issues of bullying, of being inclusive.

Such a perversion of our society. Many of these mass shooters in school shooters belong to their high school gun club. We’ve identified disturbed psychotic children who are ostracized, marginalized, bullied, abused, and neglected often by their families. We’re teaching them how to load a gun and shoot a gun. I don’t need to say this, but there’s easy access to guns in our country as opposed to other countries.

Not providing mental health care to a child who is psychotic, homicidal, suicidal, and all of them are suicidal. Usually, they’ve attempted to kill themselves and then they’re homicidal, the majority of them are psychotic. We’re not treating their mental suffering. We check children’s eyes and ears in school. We don’t provide mental health care in the public school system in our country. To me, that is child abuse.

If a child is having a heart attack or a stroke or a seizure, you bring them to an ER and they get medical care. We need to educate parents that if their child is psychotic, homicidal, or suicidal, it sounds basic to us, but that they have a responsibility and a duty to bring their child to an emergency room to get help. Biden is even saying, that we have to hold parents accountable if their children get their guns and become mass shooters. I feel, about us in society why we don’t feel more responsible for our part in contributing to these children’s violence. We all play a part.

Whether as a parent, a teacher, an aunt, or an uncle, we do often have to be that squeaky wheel and that’s okay. Better to err on the side of being cautious, being vigilant. Again, using the anxiety to foster change.

That anxiety to reach out to the child. Better yet, even if you reach out to them in an act of kindness to ask how they’re doing, to give them food, to ask if they need a place to stay that’s safe, to give them clothes. There is a Ted Talk by Aaron Stark that’s called, I Was Almost a Mass Shooter. He tells the story of his life, which was he was homeless by the age of thirteen. His family was abusive. I think he saw his father rape his mother. All the cases start blending together. They’re so similar. It’s like the same story over and over again.

He wasn’t dressed properly. He wasn’t fed properly. The father couldn’t hold a job. They’re frequently dislocated, and thrown out of like apartments because the father didn’t pay rent. He was overweight, he was bullied at school for not smelling well. Of course, he’s not going to smell well. He’s homeless. Kids thirteen, he’s going from his friend’s house trying to sleep on their couch. He went to say goodbye to a neighbor. The neighbor, his friend said, “You don’t look right, come in, I’m going to give you something to eat, sit down.”

Gave him a place to stay. He said that one act of kindness, just one act of kindness, stopped him from being a high school shooter. I would ask people even to see that TED talk. It speaks to the need not to stick your head in the sand, like you’re saying, and to reach out if you’re scared, maybe just say hi to a person, how you’re doing. That small act of kindness is recognizing that person’s suffering and humanity. It can be just that one act of kindness can be enough to stop the violence.

 

 

Absolutely and you’ve given me so many images. I imagine it’s the same for our readers. These are very stark sad images and I think of the one where you’re talking about the young man and they were the Georgia shooter and bottles of shampoo were thrown at him. Some adults saw that.

This all happened in school. What’s so ironic in these cases is that the other kids see them the other kids will say, “He’s a mass shooter.” Like with the Parkland High School shooter, he blended into the kids who were fleeing the high school. They asked, they said, “Do you know which student did it?” All the students knew. It was this child. Other children notice the suffering, the bullying, the marginalization. They can see it, but ironically, we, the adults, the teachers, the FBI, child welfare, and sometimes even mental health counselors are called in and then sign off with the case.

A lot of these children are expelled from their schools as if that’s going to somehow help with suicidal homicidal ideation. All it does is exacerbate because the whole situation, the whole volatility of the situation, because the school shooters, these adolescent shooters are not getting the healthcare that they need. It’s true too with the adults as well, but the adult mass shooters, then they’re responsible for themselves to get it. These adolescents, these young kids and younger are not being given adequate psychiatric care.

Let’s pause so our readers can A, process everything we’re talking about, and catch up a bit. B, we take it back to the listener’s question and think about this person who’s anxious and I keep talking about, “Okay, you can take that anxiety. You can dial down watching social media. Dial down your tendency to watch the news. Get your news.” I say a lot of this in Joy From Fear. It’s important to stay abreast, but get your news in non-sensationalized doses. I won’t give the outlets I listen to, but I do listen.

I do my news updates every morning. They’re either paper, they’re either print, so they’re not seeing the images, or it is a short trustworthy podcast. I’ll give mine just because I really like it. It is The Economist, World in Brief, gives lovely snapshots that are not sensationalized. You can do things like that, readers, to stay abreast of the news, but not be traumatizing yourself. Second, and I really want to emphasize this Dr. Nina because you made such a good point, that if you see something or you have kiddos who you think might be seeing something, train them, train yourself not to intervene if we don’t feel safe.

Sometimes we don’t feel safe, we think the person’s dangerous. Absolutely listen to your gut instinct if it doesn’t feel safe, but make a report. Make a report to the school principal, to the teacher, make a report to child protective services, make a report to your police department, your sheriff’s department. Why? Because A, you’re doing good. B, you’re not being passive and feeling like you’re part of being a victim of all of this. See and this I think it’s the biggest piece, the more aware we are, the more we stand up for what we believe in.

Like you were saying, do an act of kindness. Volunteer at the Boys and Girls Club. Volunteer in Scouts. Do something. Use all of your energy, not to sit there and be anxious and stressed and woe is the state of the world, but be the change. Be part of that change that you want to see. I actually keep that right here on my desk. It’s the change you wish to see in the world. I think that was Mahatma Gandhi.

When we realize we each have the power to do that, it doesn’t have to be in huge, magnificent ways. It can be making an extra batch of cookies and giving some to the kid on campus who seems like they don’t have any friends. It can be inviting people into your circle who you see where they’re not. We’re talking about people who tend to be want to be a little more on their own. Maybe they’re more introverted and want to be in the library a bit more. We’re talking about the kids who are obviously feeling isolated, unwanted, unseen, unloved.

I would add to you if you do report something when you see it to make sure you follow up because so often in so many of the cases that I’ve studied tragically, there were mix-ups with the FBI following up, the police following up, mental health counselors following up, the law following up, the FBI following up. It’s tragic because it’s a multi-system failure, but there needs to be a follow-up here.

Also, there needs to be communication between all these systems, which we really don’t have right now. If you report something and you continue to see it hasn’t changed, I would say make sure that you follow up with whichever system you’re reporting it to because often those systems, unfortunately, are overwhelmed. I think part of them also wants to stick their head in the sand and minimize or deny the problem.

Dr. Nina, thank you so much for that incredibly important reminder because you’re talking as you said, multi-system failure. We as humans, do our work during the day, we’re exhausted, and we don’t want to use whatever energy we have left to call the police department, call CPS, or do all the follow-through. Remember, it is much like when you have a medical issue and you’re calling and you’re trying to get seen here or there, trying to get your child seen here or there, you keep notes, you follow up, you follow up, you follow up until you get what you deserve, what you need. It’s the same with issues like this. Take the name of the school counselor you spoke with.

Take the name of the secretary, the principal. Take screenshots of when you log into the FBI website, the cyberbullying website. Hold people accountable. That is the only way we are going to see systemic change is by being these tiny squeaky wheels that add up to a nice loud screech and people start paying attention because often after events of mass shootings, or terrorism, we’re sitting there feeling like what could I have done? At least if we know we did something, even if we’re working on the other side of the country, we can still feel that tragic sense of loss and failure of the systems, but we also know that we are putting that stress, that anxiety, that depression. We’re channeling it into a place where it can eventually make a difference.

The only way we are going to see systemic change is by being these tiny squeaky wheels that add up to a nice loud screech and people start paying attention. Share on X

I think the more we see these tragic children and adults, and the more we can report them and follow up with reporting, and if you feel comfortable reaching out and just showing an act of kindness, the stronger our society will be. I feel like all the violence in our society is just an indication of how healthy or sick our society is and all the divisions in our society. It’s just a reflection of the indicator of the health of our society.

All the violence in our society is just an indication of how either healthy or sick our society is. Share on X

Protecting Our Children Online

In many ways, our society is doing well and in many ways, it could certainly use some big shifts and big boosts. Dr. Nina, I’d love to continue to explore with you. I know we promised to weave it back briefly to social media. Just to help the question of the day, but also the readers know, what are some steps you feel they can take with social media use? Not only to shift their anxiety, their stress, their depression, but also, on a personal level, but also if they have kiddos, cousins, nieces, nephews, or grandkids, what might some changes? What might you offer that would help?

I think it depends on the child’s age, but I think that parents need to either limit or not give their child a phone before a certain age. Let’s say if they’re twelve and they’re given a phone for emergency services for the parent to limit the amount of time that the child is on social media, also to know what the child is doing on social media in so many instances of these adolescent school shooters, they’re online.

They’re announcing that they’re going to be a school shooter, they’re radicalized online in neo-Nazi websites, for right websites, and the parents are oblivious. Sometimes they log into the school and will post on websites in school, it’s not monitoring them. I feel like we have to not only limit how much our children are using their phones and are on social media but also be hyper-vigilant and know what your child is involved with and what’s going on if they’re being bullied or if they’re bullying.

All these things are so important to let your child know that that’s not okay and to get your child help if they feel like they’re being bullied because often this will lead to children feeling suicidal. Unfortunately in some cases killing themselves. This is also preventable if we’re aware of what is going on with their children and being hyper-vigilant and if they’re suffering or being bullied getting them the mental health care that they deserve. I think it has a lot to do with parents being more involved and aware.

I just want to say parents remember, caregivers remember whatever kiddos are in your life. There’s a lovely uptick in the sale of old-fashioned flip phones. If you’re afraid that your kid is going to school and you want them to be able to call you, get them a phone where they can call you. They don’t need to be able to Instagram and TikTok and research. I know I’ve talked to many people where they ultimately found out that their kid had 2 or 3 accounts so the account that the parent was aware of, the superficial account where everything was okay, was not the account the kiddo was really using.

There Is Help

You’re right, we want to be aware. We want to put down our own phones, and our computers, and talk to our kids. Talk to our teens, play with them, get them out in nature, wherever that might be. A city park, wherever you are. Engage with the kids in your life. Spend time with them, and play with them, good for you, reduces anxiety, and decreases stress. When you get into that flow, cook together, play together, laugh together, read together, all of those wonderful things. It’s a win-win. Dr. Nina, as we wrap up, are there any other pieces you’d like to cover?

I just hope that my book really was a labor of love, and helps one person. If my book helps one child who is thinking about becoming a mass shooter or killing themselves or someone else, that will be worth everything to me. We’re all in life at some point or other marginalized and criticized and maybe even bullied. I experienced bullying growing up and being criticized and it’s okay. It’s okay you’re going to get through it and to know that you can get through it and that it’s not the end of the world.

It’s just a small moment in your life and your life is bigger than that moment. That you count and that you’re worthy. That there are people like me and Dr. Carla who care about you and want to help you. If you reach out to an adult that cares, you can get the help that you need. If I help one person through my book, then it will be worth all the labor and effort.

I just want to touch on something you said, because I remember as a kiddo must be so common. I was bullied too. I wore glasses and I remember getting bullied for wearing glasses and other things. More important is, when you’re a third grader or a kindergartner or a sixth grader or a twelfth grader, or a forty or fifty-year-old, right? Being bullied doesn’t feel like a moment in time. It doesn’t feel like it’s going to go away. It feels like it’s forever and that you’re not wanted and not loved.

If it continues, and this is where it gets really sad, because the younger the brain is, the more susceptible it is to all of these thoughts of, “Nobody loves me the all or nothing. I will never be loved.” That can certainly foster really significant mental health issues. Caregivers, any kids that are reading, anybody who’s reading, please heed what Dr. Nina said. Bullying, even though it will generally pass, you will generally get out of that situation, it feels like it’s forever. If you’re a parent or a caregiver and somebody’s telling you they’re being bullied, please don’t tell them it’ll pass because their brains don’t process it that way.

At a young age, that brain processes it. It will always be this way. Remember, the human brain is not fully myelinated until age 25. That higher level processing is not occurring when they are 5, 10, 15, 20, or even 24. We want to pay special attention. Please don’t ever tell a child, “It’s okay. It’ll be over.” No, lean in, and support that child. Get a hold of that school. Get a hold of the cyberbullying. You’ll find it in the show notes. No bullying is ever okay. Ever. Hard stop, never. That’s my thing. What do you say, Dr. Nina? You can tell I get pretty upset about that one.

I agree. I think it is upsetting. It’s never okay. For a child, it feels it’s shameful and catastrophic and it’s never going to end. Often if you’re being bullied in school, there is no end to it. Parents need to intervene, an adult needs to intervene, and children aren’t equipped to stop bullying, they see it, they identify it, ironically, and it’s society and adults who are failing these children. If we can just reach out to them and even show an act of kindness, not even if you’re trying to get them the mental health that they deserve and that they need. Just showing that you care can make a difference in their life.

If you're trying to get the children the mental health they deserve and need, just showing that you care can make a difference in their life. Share on X

Readers, please look at the show notes. I will have plenty of links because sometimes when somebody is being bullied, child or adult, it’s so hard to realize there are resources out there. You’ll be able to find them in the show links. Dr. Nina, you are such an amazing guest. You have so much to offer. Your book, readers, you’ll find the link to her book in the show notes again at Psychoanalytical and Spiritual Perspectives on Terrorism: Desire for Destruction. It is not your traditional read. It is a really fascinating dive into the experience. I don’t want to give it away. It’s a fascinating book, well-researched from the heart. Dr. Nina, where can our listeners find you?

You can find me on www.NinaCerfolioMD.com. I’m also on LinkedIn, Facebook, Twitter, and Instagram.

Readers, Dr. Nina, the spelling on that beautiful last name is Cerfolio. It’s Dr. Nina Cerfolio. You’ll find it in the show notes as well. Dr. Nina, thank you so much for sharing your time and energy with us. You are amazing. Thank you for being a light in the world and really shining such expertise on this tremendously important topic or topics we’ve covered so much.

Thank you so much, Dr. Carla, for having me and spending time on your show, which is such an incredible show. You do so much good and provide so much light. Continue the good work that you do and I’m blessed to have been with you. Thank you so much. Your books are wonderful as well.

Thank you. Readers, thank you for listening, and for sharing your time with us. Do look at the show notes. There will be plenty of resources and I so appreciate you and your support and your interest in making the world a better place. This is Imperfect Love.

 

Important Links

• Dr. Nina Cerfolio
• Psychoanalytic and Spiritual Perspectives on Terrorism: Desire for Destruction
• Joy from Fear
• LinkedIn – Dr. Nina Cerfolio
• Facebook – Dr. Nina Cerfolio
• Twitter – Dr. Nina Cerfolio
• Instagram – Dr. Nina Cerfolio
• Nina Cerfolio MD – Approach
• Mental Health Hotline – PTSD Hotline
• NIMH – Post Traumatic Stress Disorder – PTSD
• SAMHSA – Find Help 988
• NAMI HelpLine
• Stop Bullying
• Stop Bullying – Ge Help Now
• Psychiatry – One In Three Students Impacted By Cyberbullying

 

About Dr. Nina Cerfolio

Nina Cerfolio MD, Assistant Clinical Professor of the Icahn School of Medicine at Mount Sinai, is an internationally recognized expert on trauma, mass shootings and terrorism and a board certified, psychiatrist and psychoanalyst in New York City. In practice for 30+ years, Nina’s success rests in her unique approach, which integrates traditional psychiatric training with her decades of spiritual training.

She has been published in prestigious peer-reviewed journals, and presented her original work on the psychological influences of spirituality, trauma and terrorism nationally and internationally, and featured on numerous TV outlets. Her thought-provoking new book, Psychoanalytic and Spiritual Perspectives on Terrorism: Desire for Destruction (Routledge, Dec, 2023), weaves her team’s cutting edge research with her extraordinary first-hand experiences of being a first responder and unique real-world trajectory to explore a more expansive understanding of the origins of terrorism while highlighting an overlooked spiritual lens as a powerful antidote for healing from trauma.

After completing a two-year fellowship at Memorial Sloan-Kettering Cancer in Consultation / Liaison Psychiatry, where she received a grant from the American Cancer Society, Dr. Cerfolio was an Attending Consultation / Liaison Psychiatrist at NYU Medical Center. She was also a Human Sexuality Fellow at Weill Cornell Medical Center. After graduating from St. Vincent’s Hospital and Medical Center psychiatry residency, Dr. Cerfolio returned to St. Vincent’s Hospital as Chief of the Psychiatric Emergency Room and Walk-in Clinic. While in academic medicine, Dr. Cerfolio taught and supervised residents and medical students to psychiatrically evaluate patients who were hospitalized for surgical and medical reasons and manage psychiatric emergencies. Completing her psychoanalytic training at New York University Postdoctoral Program in Psychoanalysis, Dr. Cerfolio is currently in solo private practice.

In recognition of Dr. Cerfolio’s professional excellence throughout the years, she has been honored with awards, including winning the Journal Prize for best paper published in Psychodynamic Psychiatry in the last two years, 2022 – 2023, Leading Physicians of the World, America’s Top Psychiatrist, and Top Psychiatrists in New York. She has been recognized with numerous Patients Choice Awards and America’s Most Compassionate Doctors. She is a Distinguished Fellow of the American Psychiatric Association and Fellow of the Academy of Psychosomatic Medicine.

Dr. Cerfolio has served on numerous boards, including The Tristate Community Advisory Board of Education Broadcasting Channel Thirteen/WNET since 2003. She has served on the board of the Ethics Committee of NYU Downtown Hospital from 2005 to 2013 and St Paul’s Center of New York from 2007-2009. From 2004 to 2009, she served on the Board of Advisors of the Achilles Track Club.

Dr. Cerfolio remains active in the American Psychiatric Association (APA). She was Chair of the Committee of Women of the New York County District Branch of the APA from 2000 to 2004 and member of the Executive Council of New York County District Branch of the APA from 2000 to 2006. She has published in The New York Times, The Daily Beast, The Detroit News, numerous peer-reviewed journals, and presented her work nationally and internationally. Some of her appearances on television include Inside Editi0n, Channel Thirteen / WNET, WNBC NEWS, NBC, ABC, Fox News and CBS.