Anatomy of Post Traumatic Stress
* Assault from a Suspect or Assailant
* Police Shooting
* Serious Vehicle Accidents
* Natural or Man Made Disaster
* Wartime Combat Duty
Phase I : Days After the Incident
The hospital stay can somtimes be percieved by us to be the one of the worst situations of Phase I, somtimes even more than the injury itself. It is clear that embarrassment, pride, or denial of the full extent of the injury will cause us to want to "hurry and get out" so we can do our own healing at home. Quite honestly, why wouldnt we want to be fully taken care of in this critical time? But, in most cases the officer wants to be discharged and exit as fast as possible. If the officer has more more outward physical injury that people can see, the officer tends to accept the medical attention easier than those that have more internal or obscure injuries. Perhaps this is because we are so dependent on what WE THINK other People Think.... strange isnt it?
We as a Police Officers are likely to have multiple mechanics of injury. Police symptoms may begin immediately or not surface for six months, a year, or even longer.
Severe anxiety, avoidance of conflict and social issues may be only a few of several symptoms. The officer will have recurring images of the traumatic event, often with the same degree of anxiety as during the event itself. Or, the officer will suddenly feel as though the event is occurring in the present.
NIGHTMARES of the incident are usually quite powerful and realistic and typically start immediately. The nightmares create additional anxiety, or depression and often disturb our sleep. This can lead to insomnia or the officer not wanting to sleep. We tend to fill that "down time" by playing video games, internet activites or some other forms of distractions rather than rest. This condition propogates additional stresses and fatigue that ultimately impact our mentall ability to concentrate or the ability to remember things. As a police officer we dont have to dig too deep to find the impact that will have on our job performance and our relationships.
Since the impact that this stress has on our bodies is usually relative to TIME, it is important for us to identify it in this mental stage as quick as possible. This is, in our experience, the best time because as we tend to replay the event in our minds, trying to "find out what happened" or "what went wrong". Starting almost immediately we will spend a large percentage of our time and mental energy "working it out", so to speak, not realizing or caring that we are withdrawing from the real world. Daydreams and fantasizing will impede on our free thought. Familiar things and people who once were very important to us will tend to take lower priority to make way for things and people who will not see (or care) our uncertainty, pain, or aggressive and depressive behavior that is slowly taken hold of us.
Since most of the time the department, co-workers and family are totally unprepared to respond they tend to support us by either complimenting us on our strength or ignoring it altogether to prevent embarrassment of us, or them. On one end they may give positive reinforcement or praise for our ability to survive or the courage to "get back into the saddle". Both are very damaging in the fact that it will give us a false sense of security. This security in that very stage that if left unchecked ultimately can prevent us from acknowledging, accepting or seeking out support. It will be difficult because of the embarrassment of perceived impression to those who praised us that perhaps were not as strong as they thought we were. It also will begin to fortify a wall that will prevent us from trusting our friends with our feelings.
The department shrink, as they are referred are rarely trusted or respected by the troops because of their misuse by the department for it's own ends. For instance. sending officers to see the department psychologist because of a formal complaint they made regarding sexual harrassment. Or forcing an officer be evaluated because a commander doesnt like an individual. I know, this would never happen, right? It does. It's no wonder why when were in need that we wont trust our commanders and the department with our problems.
I remember clearly a female officer who had been shot by her own firearm in a struggle by an assailant. After the incident in the training office there was a color copy of a picture of the officer with the words, "Those who dont learn from their mistakes, are doomed to repeat them.". Although I agree with the statement would you agree that it did not create a safe, comfortable and trusting environment for her to benefit? On the contrary, not only did it stigmatize the officer it created a condition that made it difficult or impossible for her to ask for help, because of a severe breach in trust. In fact, a year later the stess which could have been managed early on, disabled her.
With that being said, it is then the departments responsibility to create an enviroment that is safe, comfortable and trusting in order for the officer to benefit from any intervention. This will be the crux that will determine whether the stress progresses rom just a 'stressful event' we are able to overcome, or festers and errodes into PTSD that will try and disable us.
It is advisable for departments to refer officers to a state or federal agency for counseling the officer for the reason that it will be easier for the outside counselor to overcome the barriers of trust and time. This is because with an outside agency, in my case seeing the Pshychologist in the State Police, I was assured that what I said was completely confidential. I was shown what he would report to the department and what he would not. Trust was gained very quickly. The problem was that I had already went through 4 other psychologist before meeting him. He really had his work cut out for him.
In my instance I had been beaten unconcious and almost dead on the street during the last traffic stop of the shift. 10-12 gang members in an ambush that occured during a shift change on a bright summer day. My physical battle was fierce as I struggled to retain my weapon and to work my way back to my patrol car. Suspects in the back covered me with hands hidden in their jackets hopingand taunting for me to draw while the others attacked, unarmed. In desperation I gave up my cufffed prisoner in a failed attempt to escape. I soon was surrounded and fear began to set in. I was only able to disable a few of themin the front. I felt no pain, only pressure from the boots and fists against my head and face as I fell with one hand to the pavemen,t losing my ability to see and think. The last thing I remember before darkness took me is their laughter and the feeling of the rough pavement underneath my one hand feably supporting my body. As the edges of reality began turning black I had a fading wish I could have took them all with me. Witnesses reported that this continued for several minutes, even after I was unconsious and face down.
I regained consciousness sitting in the patrol car and a plain clothed officer over me. Everything was attenuated and blurred. I looked down in my and a message that later shook the very foundation of truth in how we as police are conditioned.
In the hospital, It took about 2 days for me to remember totally who I was and what had happened to me. My ears swelled shut and the concussion I had pecisely recalled every blow. My heart rate raced at 120 BPM for the first 24 hours, doctors unable to slow it down. The scramble of officers coming in and out asking questions I did not know, was paralizing.
I tell you this so you know I speak through honest, personal experience and not just from education. Yes, there is more to the story and we will tell the rest of it soon. But for now, what is your story? I feel it is impossible to heal if we cant tell our story. The path to freedom is paved with the courage to face our fear and acknowledge that it isnt "us" that is or was the problem, it's what happened to us. This is the first fundemental step toward our goal.
TIMING AND TRUST
It is important for us to understand that although everyone will want to help and everyone want's us to get well, that not very many of us knows or knew what to do or say to help. Therefore, our friends and family somtimes do nothing or ignore it. Most the time we ignore them when they do try to connect.
First of all, make sure that nothing was missed as far as treatment goes. Especially whether or not there ever was or still is a need for medication. Sometimes law enforcement officers, especially men, are loathe to take meds. But they need to understand that PTSD may actually irrevocably alter the way their brain functions. Research into this is fairly new, but this is what the evidence suggests. Most people reluctantly accept when they've had a serious injury, say to their back, that they may never quite be the same again. But to think that the stress of a critical incident can essentially injure the brain so it will never return to optimal functioning is a horrendous thought. And it may be true.
We know that the efficacy of serotonin in the brain is drastically effected by stress, and by PTSD, which alters the receptor nerve cells. Medications like Prozac, Zoloft, Paxil, Wellbutrin, Celexa, and more recently Lexapro are often recommended and used very effectively to help people through rough times. They help the brain return to normal by making the neurotransmitters work the way they're supposed to. If the officer was on them after the incident and they seemed to help, but he stopped using them in the hopes he wouldn't need them anymore, and the symptoms returned, he should probably start using them again. And if he never was on them, family members should urge him to see his doctor to discuss a trial of at least two months.
I wouldn't recommend any drastic life or career changes for an officer until he (and again, it could be a female officer too) has had some therapy, and when appropriate some couple sessions with the spouse. Some officers do quite well when they move out of law enforcement into something completely different following a critical incident that resulted in PTSD, but because law enforcement is as much of a "calling" as medicine or the clergy (or therapy), it is not a decision to be taken lightly. And it is never too late to start.
In closing, the good news for those who suffer directly from it, and those family members who suffer indirectly, is that PTSD is very treatable like most police stress.
If you have a special need that is not life threatening, email us at [email protected]
For more information on PTSD E-mail: [email protected]