Life after Utøya Massacre Survivors Struggle to Overcome Trauma and Guilt

As the trial of Anders Breivik gets underway in Oslo, survivors of the massacre he perpetrated are using a range of sometimes unique therapy methods to overcome their trauma. But, for many of them, the hardest question remains: Why did I survive?

Adrian Pracon, 22, is about to face his own shooting for the third time. This time, he wants to show his 28-year-old sister, Katharina, the place where he should have died.

Adrian only saw the killer's black boots in the moments before the shot came, but he knew the man wanted to murder him, too. "It's so strange how I remember the situation," Adrian tells his sister, sitting beside him in his silver Alfa Romeo. "It all happens as if it were in slow motion."

On this spring morning, the nearby mountain peaks still have snow, and the surrounding meadows are still brown. The siblings are running late, and the boat that will take them to the site of Adrian's failed execution is about to leave. He steps on the gas and the car races ahead, as if speeding to a point in time nine months past.

With his head half-hidden under his rain jacket, Adrian watched on as others were shot and killed on July 22, 2011. It all seemed to happen very slowly. Then he saw Anders Behring Breivik's boots approaching. "I could feel the heat radiating off the barrel of the gun," Adrian recalls.

From her side of the car, Katharina gazes at her brother in disbelief. She's never heard this story in all its detail. But now, on this car trip, her brother will be able to recount his story in full, and soon he'll be at the place where it occurred. He wants his sister to have a realistic image of the scenes that continue to haunt him to this day.

Setting Out for the Scene of a Massacre

Adrian is a young man with wavy brown hair, the son of Polish immigrants. He tells of the moment just before the shot -- of how his body simply quit trembling, his breathing stopped and the only thing he could feel was his heart pounding against the rock he was lying on.

The road curves, and Utøya -- the island on which it all occurred -- comes into view. The MS Thorbjørn, a small ferry with a little white captain's cabin, is waiting at the dock. On board, there are already three dozen young people in bright-red lifejackets.

Adrian pulls a lifejacket on, as well. "Lifejackets!" he says with an ironic laugh. "When it happened, I swam and nearly drowned."

The boat pulls away from the dock and sets course for Utøya. It's a Tuesday in late March and AUF, the youth organization associated with Norway's center-left Labor Party, has arranged for survivors and their family members to visit the island where Breivik, a right-wing extremist, massacred 69 people last summer.

The whole thing runs like a well-organized school trip. AUF volunteers sell tickets for the ferry ride. The young people on board run back and forth excitedly, talking at full volume and snapping pictures with their cell phones.

Many of them laugh during the trip to Utøya. But, when it comes time for the trip back, a deep silence will have fallen over the boat.

A Unique Form of Trauma Therapy

This journey back to the darkest moment in their young lives is a battle with images that won't leave their heads, a battle against a panic that still flares up inside, a battle against survivors' guilt. Why them, they ask themselves, and not me?

The trip is part of a unique form of therapy meant to help these survivors reconcile that day's events with the larger context of their own lives. Renate Grønvold Bugge, a 71-year-old psychologist with German roots, came up with the idea for these trips. The Norwegian government now funds the program, which includes regular visits for survivors and victims' family members to the site of the horror as well as national and regional gatherings aimed had helping them find shared ways of coping with their pain. When things get bad, each survivor has a contact person in his or her own community whom they can ask for help.

A research project is documenting the effectiveness of this trauma therapy and aims to provide a model for treating psychological wounds in future situations. "From the scientific perspective," Bugge says in a gentle voice, "the tragedy offers a unique opportunity."

Among those needing help with their grief are 700 family members of victims, 650 survivors -- of whom 66 were injured -- and their 4,500 family members. Then there are the doctors, medics, police officers and countless volunteers who participated in the rescue effort. These people live all over the country, and 165 communities have been tasked with looking after Breivik's victims.

Aside from the sheer scale, the particular challenge to treatment in this situation is the fact that the tragedy primarily affected teenagers. "That's probably the most precarious age in which to experience such a trauma," Bugge says. "The psyche is still seeking (and is) hardly settled."

Individual Coping Strategies

The survivors have all developed their own strategies for coping with the terror they experienced. For example, 23-year-old Simen Brænden Mortensen is on the next boat after Adrian. Mortensen was the guard who allowed the Breivik, disguised as a policeman, onto the ferry to Utøya.

"Logically, I know anyone would have let him through because, damn it, he really did look like a policeman," the young social worker says. "But I still spent weeks feeling guilty." He sees a psychologist every Friday and, until three weeks ago, he only worked half-time.

Then there's Caroline Winge, a 19-year-old from Trondheim, who asked to visit a police shooting range so she could get used to the sound of gunfire and being around police officers.

Or there's 32-year-old Khalid Taleb Ahmed, who takes pills to banish the image of his dead brother, Ismail, lying at the foot of a cliff with his dyed blonde hair red with blood. His psychologist has taught Khalid to view the trauma as a gate that he can walk through. She has taught him that there's a film running in his head, and that he holds the remote control he can turn it off with.

Trapped in Time

Some are doing better, but many continue to struggle. Marte Fevang Smith, an 18-year-old from Tønsberg, sits across from her mother Monica on the midday ferry. She's a radiant young woman, with thick blonde hair and bright blue eyes. Her mother says her daughter was just starting to really "blossom" last summer -- until a bullet struck her head on Utøya. She survived only because it missed her brain by two millimeters (0.08 inches).

This trip to Utøya with the other survivors is hard on Marte. On the ferry ride back, she spends a long time sitting in silence. Home is the only place she feels safe now, and her bedroom is strewn with clothes, DVDs and makeup.

Whenever she finds herself in unfamiliar rooms, Marte says she's always looking for an escape route. She can't imagine getting on a crowded bus because it's "a situation I absolutely can't control." Since Utøya, she hasn't gone out dancing because it would remind her of Maria. The evening before the massacre, the two of them danced in front of the stage on the island. "Datarock was playing," Marte says, referring to a Norwegian band. "When I hear them on the radio now, I immediately switch it off." Breivik also shot Maria, but she didn't survive.

Marte hasn't been able to go back to school yet. "Unfortunately, it's just not possible," she says. In August, she tried to start the new school year as usual. That was a milestone that Renate Bugge, the psychologist, looked forward to with hope and trepidation. "School offers a daily routine, a structure that provides something to hold onto," Bugge says, adding that all the current research points to this -- and that it's more important than any session with a therapist.

Too Traumatized for School

But just days after Marte's school year started, a balloon burst on a birthday cake some students had baked. "I ran out of the room," Marte says. As she fled, she made out the teacher saying, "It's a good thing we don't have any students who were on Utøya here."

No one had told the teacher that Marte had been at the island, on the "Love Rocks," a hill on the south of the island, where she was forced to watch Breivik shoot and kill 10 people.

A few days later, Marte was in psychology class when she started imagining that blood was streaming down the teacher's face. Fellow students found Marte in the bathroom and held her in their arms in an effort to stop her shaking. "Luckily," Marte says, "my friends always have extra makeup-remover with them, and they were able to wipe away my runny eyeshadow."

Marte could no longer concentrate in class, and letters simply swam around in her head whenever she tried to read. She eventually gave up and now works two days a week at a preschool near her apartment.

The Battle against Memories

Psychologists recognize these phenomena in trauma victims as classic symptoms of post-traumatic stress disorder. Everyday noises, such as a door slamming loudly, can set off flashbacks and trigger precisely the same cascade of emotions in the brain as the original traumatic experience did.

The mind circumvents logic, which would recognize the false conclusion being drawn. Instead, the part of the brain that controls emotions kicks into gear and flips the panic switch. The blood pressure rises and the heart pounds, and the individual begins to sweat.

In the acute post-traumatic phase, Bugge explains, it's typical to have only fragmented, jumbled memories of the event. "The brain hasn't yet managed to put things in chronological order," she says, "and to establish distance between the shocking experience that happened then and what is happening now."

In other words, in Marte's memory, it's all become a nightmarish mishmash of images: the many tiny frogs she saw hopping across the campsite on the morning of the massacre, the shots and screams, the chance glimpse of a TV in a shop at the hospital days later on which she read the number of dead. Under these conditions, the brain isn't capable of performing complex tasks. "When it comes to writing an essay for school, which requires linking various thoughts in the memory, one's concentration fails," Bugge says.

This leaves schools with the tough job of keeping tabs on the survivors. Teachers must approach these students and direct them toward psychological help if their performance in class starts to slip. This national safety net is meant to ensure that nobody falls through.

Rewiring the Brain

At first, Marte wanted to get by on her own. She tried to free herself of the horror by writing a blog. But, once winter arrived, she gave up her resistance to psychological help.

The therapist Marte now sees began an esoteric-sounding form of treatment with her known as "eye movement desensitization and reprocessing." In this approach, the patient is asked to call up memories of traumatic scenes. At the same time, the psychologist moves an object in front of the patient's face and asks the patient to follow it with his or her eyes.

This motion of the eyes supposedly allows the extreme emotions triggered by the act of memory to gradually level out. Though it has yet to be explained how this method works, numerous studies confirm its efficacy. German soldiers traumatized after serving in Afghanistan have also been treated this way.

Marte is skeptical, saying, "I don't really believe in it." But she still hopes the therapy will work.

This February, Marte looked Breivik in the eye again for the first time since the massacre. When the killer was led into the courtroom for a preliminary hearing, he looked over at Marte and the other survivors on the visitors' bench. He struck her as immature, she says, and then there was his "Smurf-like" voice.

Marte collapsed before the hearing was over. She had hoped that seeing Breivik in handcuffs would make her feel safer. "I'm sure I won't have to face him again when I take the witness stand," she says. "My lawyer has petitioned to have him taken out of the courtroom beforehand." Lost in thought, Marte plays with a cord on her hood.

Tension as the Trial Starts

Breivik's trial, which started this week, has put Norway's crisis psychologists on high alert. The fact that parts of the trial -- though not ones involving Breivik's testimony -- will be broadcast live throughout Norway will test how far the victims have managed to process the trauma.

According to estimates by the Center for Crisis Psychology at Bergen University, half of the Utøya survivors have made use of psychological treatment. "That aligns with findings from large-scale tragedies around the world," says Atle Dyregrov, the institute's director. He figures that at least 30 percent of them will remain in treatment for an extended period of time, adding that the length of time could be determined by "how well we do our jobs in the coming weeks."

Research also shows examples of people who emerge from a traumatic experience stronger than before. There are various theories as to why this is so. Men manage it more often than women, and it helps to have previously overcome another life crisis.

Psychological Resilience

Adrian Pracon also has a good chance of managing it. His face is flushed as he leaves the ferry from Utøya, stepping off the dock in his white canvas shoes with his arm around his sister, Katharina. "The rock I lay on wasn't underwater this time," he says, and he was finally able to show it to his sister. "I think I felt more distance," he adds.

The young man has achieved a degree of fame in Norway. "Hjertet mot steinen" ("Heart against the Stone"), written by author Erik Møller Solheim after long conversations with Adrian, has just been published.

The first months were difficult, and Adrian was plagued by depression. But, he says, "during those long conversations with Erik, the confused episodes in my head started to come together."

Adrian believes he truly has reconciled what happened on Utøya with his own life. He waits tables in a bar and draws a salary from AUF, and he plans to finish his degree. Later, he hopes to go into politics. "I think I can close the chapter on this part of my life," he says, while gazing at some roses wilting on an improvised memorial stone along the road leading to Utøya.

Resilience is the scientific term for this power of emotional resistance that some people possess. As Adrian puts it, "When you reach a point where you can't even imagine the sun rising again, there's nothing more wonderful than waking up in the morning and seeing it shining."

Survivors' Guilt

Still, there is one question that will continue to trouble him. "Sometimes I couldn't think about anything else for days," Adrian says. "Why didn't he shoot me?"

Breivik set his sights on Adrian twice. The first time was on the island's beach at the beginning of the massacre. The attacker was suddenly there on the shore, felling one teenager after another with mechanical precision.

When he reached Adrian and took aim, Adrian cried, "Don't shoot!" Breivik simply lowered his weapon and turned away. As if rooted to the spot, Adrian stood there in water running red with the blood of his friends.

The second time, the shooter didn't spare him. Adrian was lying on a rock under his rain jacket, pretending to be dead. This time, Breivik pulled the trigger. "The noise the bullet made was incredible," he says. But it missed his head and only penetrated his shoulder. "I didn't feel any pain," he says.

Nearly all survivors feel guilt at some point simply for having made it out alive. For Adrian, the matter is further complicated by the fact that the attacker consciously chose to spare him the first time around.

In the police files on the case, Adrian found a statement by Breivik that might explain his behavior. In them, Breivik says he spared a 14-year-old girl on the island because she had yet to be overly "brainwashed." Perhaps he didn't shoot Adrian because he also looks younger than he is.

Adrian will also give a statement at the trial. But he's not sure if he'll ask Breivik why he didn't shoot him the first time. "I don't know if I'll dare," he says.

Translated from the German by Ella Ornstein
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