Listen. The most important thing for survivors to do is talk. "Talk about it over and over and over, ad nauseam. That seems to be the way the brain works through it," said Gail Hilton, manager of crisis services for Intermountain Health Care.

Realize that every case is different. Employees may not be ready to return to work when the mall reopens, although for some, facing fears may be the best remedy. Kids may not want to go to the mall. Talk about those things and try to find out what feelings are behind those ideas.

Nurture those who are suffering. Make sure they get enough sleep and healthy meals. ''All of those things are going to help them get through the situation,'' said Richard Hatch, director of adult services for Valley Mental Health.

Try to get back into a normal routine. ''It's important for people right now to put a context on things and realize that this was an indiscriminate act. Having a routine helps them realize they have control over their lives,'' Hatch said.

- Jennifer Barrett

Counselors and loved ones will offer lots of support, but they might not really know what the survivors of Monday's tragedy are feeling.

Stephen Young and Michael Hall do. They lived through a similar shooting eight years ago when a mentally ill man stormed the LDS Church Family History Library, killing two and wounding four before being shot dead by Salt Lake City police.

"When I saw the news, I started to see the library again," said Hall, a former Marine who was working as a reference consultant that day. He remembers the "pop, pop" sound and knowing immediately what was happening. He and Young, a library supervisor, mobilized to evacuate people from the building. When they came upon a woman's body, Hall grabbed her, cradling her in his arms. That's where she died.

"The image of that lady in my arms, that will never leave me," he said.

Young sought counseling. Hall talked to Marine buddies and neighborhood friends. They both shed a lot of tears.

Similar images, sounds and smells will stay with the dozens of shoppers who were pinned down inside Trolley Square while a gunman fired at will. Experts say they may need help dealing with it.

"The closer you are to the incident, the longer it's going to last," said Gail Hilton, manager of crisis services for Intermountain Health Care. "Every time they hear a car backfire, it's going to evoke a fear response. Your adrenaline starts pumping, you find yourself looking around, wondering, 'Am I OK?' and wanting to take cover."

That was the case for Hall, who said bubble wrap has become a special kind of torture. "None of those people will enjoy that sound again," he said.

Family members need to pay special attention, especially in the next week or two. Watch for signs that a loved one is struggling. Are they eating and sleeping normally? Are they ''hypervigilant,'' looking over their shoulder all the time? Are they crying a lot?

"If their daily living is being affected a week or two afterward, they probably need to get help. Call a doctor, get medication to help them sleep, maybe see a psychologist," Hilton said.

Most importantly be patient and encourage them to talk.

"Those people will want to talk," said Hall. "Don't force them. Just listen. If you're late for a meeting, so be it."

Children may also be traumatized, whether they were in the mall or heard about it on the news or the playground.

Ruth Wilson, director of children's services for Valley Mental Health, said kids who do not process their thoughts can have problems such as nightmares or bed-wetting, feelings of guilt, or acting out.

Parents and caregivers should be supportive and reassuring. Talk about the event, tell them that they are safe. Say it over and over again. Be patient, she said.

Most importantly, she said, be consistent with your family routines. "Many times children feel insecure or anxious and they start testing their parents. Being inconsistent can give our children the idea that they can't even count on us," she said.

Sam Goldstein, a University of Utah School of Medicine associate research professor and author of the book Raising Resilient Kids, warns parents to moderate kids' exposure to media, and to ask them what they have heard from friends or at school.

For both Hall and Young, the most lasting effect from the shooting they survived is a strange sort of guilt that they say they feel to this day.

''It played over and over and over in my mind. What could I have done differently? How could I have stopped him from hurting people?'' said Young. ''I've come to accept the fact that there probably wasn't anything I could have done.''

jbarrett@sltrib.com