Solutions to Stress From Traumatic Incidents - We Must Be Proactive

We must be proactive.

While officers and the public rarely question physical injuries sustained while on-duty, the disabling effects of job-related trauma are not always readily visible. Having a traumatic reaction, or the fear of even acknowledging a traumatic reaction, is somehow seen as a weakness. We need to accept that a reaction may occur. Preparing for it is a fundamental duty.

Typically, law enforcement supervisors are at a loss for words following a traumatic event involving their personnel and simply choose to say nothing. This act alone may be a defining point for managers and can be easily conceptualized as lacking empathy and understanding.  Most new officers cannot truly understand the magnitude of the impact of exposure to critical events, and even veteran officers can succumb to cumulative effects of prolonged exposure to tragedy and loss over time.

Post-Traumatic Stress
Post-Traumatic Stress Disorder is defined by the Diagnostic and Statistical Manual of Mental Disorders as the development of specific characteristics after being exposed to a traumatic stressor. It occurs from direct exposure to an event that involves actual or threatened death or serious injury, or witnessing such an event with another. Symptoms develop due to an inability to adapt to the event and the event, regardless of the type or severity, overwhelms an individual's ability to cope.

Not every incident will result in post-traumatic stress. Not every officer has a propensity for developing a stress-related disorder. There are factors within the law enforcement profession as well as individual officer characteristics that make them more susceptible. Without proper preventative measures and post-incident intervention and support, that risk increases exponentially.

Following a traumatic incident, an officer may experience many of the common trauma symptoms, including sleep difficulties, disturbing memories that create anxiety, inability to concentrate, and emotional numbing. Though the officer experiences the symptoms, they directly affect family members as well. Officers may be easily aroused and have difficulty calming down.

In addition, they may be more irritable or show frustration with even minor issues. Police officers may not always have positive support and commonly turn to maladaptive coping mechanisms such as alcohol or drugs to disengage from reality. The concern is that law enforcement also has a very high rate of suicide, which is related to job stress, though not yet accepted as such.

Primary Source of Support
Law enforcement personnel experiencing these life-altering events will likely use, or try to use their primary source of support - their family. Although family may be the first choice for support, they can inadvertently exacerbate the problem through misunderstanding and unknowingly incorrect approaches. During these highly emotional periods, officers are vulnerable and give their friends and family members a sort of unwritten authority for helping.

Family, co-workers, and close friends will seemingly provide comfort and recommendations similar to counseling, but lacking in any foundation beyond the typical intuitive conviction. Even with the best of intentions, laypersons tend to provide opinions and extemporaneously relay a similar experience in their life as a means of lessening the traumatic shock. Although they may feel they are trying to lessen the burden of the pain by sharing their own experience, it is not always interpreted as intended.

Positive social support is a very prevalent means for coping with the stress of trauma. Law enforcement co-workers can be a detrimental part of the social support system, providing advice is given sparingly with proper empathy. Fellow officers typically want to show their support to their troubled comrade and continuously offer guidance, words of encouragement, and their willingness to help.

Again, though admirable, they may overwhelm the officer and create additional stressors particularly if they have to explain or repeat details of the traumatic event. Those who indulge their own curiosity by questioning them about the event, even supervisors, may further compound the trauma response. It is also not appropriate to assume just because a person may have experienced a similar past traumatic event, they can fully appreciate the other's experience or their feelings are even similar.

Critical Stress Debriefing
Many of the emergency professions utilize Critical Incident Stress Debriefing (CISD), which is a semi-structured method for managing critical incidents through group sessions designed to normalize the emotions that follow a critical event. CISD is a great tool for educating and keeping the work family together and validating each of their feelings and concerns.

One of the known factors that can contribute to an officer externalizing distressing events is their perception of a traumatic event coupled with their previous experience. The CISD can be beneficial in validating their feelings as well as correcting any misperceptions they may have about the event.

While the family bond within law enforcement does serve as a very important emotional support, the close bonds an officer develops with co-workers during this emotional period may inadvertently force a disconnection and withdrawal from using their family for support. Officers commonly tend to feel those outside of the law enforcement community cannot understand their work or what they have been through.

Share Versus Alienate
Furthermore, officers make a conscious choice to not share things with their family in an attempt to "shield" them from exposure to their work-related trauma. The exclusion of the victim's natural support network is one drawback of CISD and can inadvertently further alienate family at a time when it may be at its highest need.

Another drawback to CISD is that information shared during the group process is not always protected information that can prevent officers from sharing openly. Often times, facilitators are from outside agencies and while conducting the debriefings, they are fully aware of the grieving process. Unfortunately, the facilitator may lack a full understanding of acute trauma as well as stressors specific to law enforcement including the jaded and at times, distrustful environments in which they work.

CISD is one of many different treatment modalities. However, it is not a stop-gap mechanism that once completed, allows administration to "wash their hands" of any further obligation to their officers. Nor should they be utilized as the sole means of intervention. Debriefings can be a starting point for early trauma intervention and can also be utilized to prevent the development of long-term stress disorders. Unfortunately, studies suggest that those attending a CISD may not be any better off than not attending at all.

Process of Early Intervention
Police agencies need to set goals and practices to deploy in the event officers are exposed to trauma. First and foremost, police administrators cannot assume their past is an accurate way of measuring what officers are experiencing. If a CISD is used, it should be voluntary and not the mission end for assisting the officers in the agency.

The agency should have a process for early intervention by having field supervisors better trained to identify some of the stressors accompanying a traumatic incident. Supervisors and managers should not only be able to discern with the issues of stress, but make a conscious effort to contact the officers regularly after an incident.

It is not only a matter of saying something wrong, but saying nothing may carry a far greater danger for your role as a leader. It is not uncommon for officers to say they are doing fine and that they do not need additional assistance; however, that does not mean they are providing an accurate account of their feelings or level of functioning.

Field supervisors who know their officers well are in a position where they can discuss their observations with officers rather than having it appear as though they are badgering their subordinates with a barrage of questions about the incident. Supervisors who are trauma-informed and know their officers can have unrelated conversations while drawing conclusions in reference to the traumatic incident.

Benefit from Others' Stories?
Some key points to remember when confronting officers are that they are not necessarily emotionally able to hear or benefit from the personal stories of others. Comments made that frequently focus on "how it could have been worse" or "I know how you feel," while perhaps genuine and made with the best of intentions, can make the victim feel worse. Comments of that nature can feel like attempts to minimize the event and can be perceived as more of an insult than supportive.

Supervisors should be able to see some of the most common symptoms associated with trauma such as social isolation and wanting to spend more time alone; lack of self care or change in uniform appearance; poor concentration or memory; agitation or irritation over simple issues; or change in communication pattern (less talkative).

The long-term effects of allowing stress to continue unmitigated may ultimately create problems even with outstanding officers. An initial untreated or mismanaged traumatic incident can easily spill over into other problem areas within the agency and can create unpredictable liability issues.

Operating under the auspice of "It will not happen here" or even, "We will cross that bridge when we get to it," will only exasperate the problem and could result in the officer leaving the agency, the career, or developing full-blown stress disorder. If agencies do not properly and continually support their officers involved in traumatic incidents, they are not absolved from responsibility for future difficulties. Officers may have other unrelated issues that arise as they unsuccessfully attempt to cope with ongoing stressors in isolation.

Seek Professional Help
The next crucial component to managing officers involved in a traumatic incident is providing them with a professional mental-health care worker. Agencies should consider having a mental health official on the payroll but not under their control. The counselor should not be required to report any of the results of a session with victims unless it may be deleterious to the agency or the person.

The mental health counselor could ride with officers and spend time with the agency to have a better understanding of those personnel within the agency. This would also help employees build a rapport with the counselor. However, following a traumatic event, employees should be encouraged to speak with the counselor and not forced unless no other option exists.

Positive Preventative Steps
Essentially, we not only have a duty to ensure our officers are cared for following their exposure to a critical incident, but our responsibility starts even before a critical incident occurs. With the proper choice of a mental health counselor, they could be required to provide annual education on the normal reactions to stressful situations.

We must be proactive and implement preventative techniques to minimize the potential for long-term stress disorders, which includes having solid policies and procedures in place that are utilized consistently for every traumatic incident as well as policies specific for repeated traumatic incidents involving the same officer.

Continual supervisory training will allow for more accurate assessments before seeking outside help from a clinical professional. To have the greatest impact, we need to develop and implement an integrated approach that includes preventative techniques, appropriate screening, and evaluation practices as well as ongoing follow-up and services.

It is imperative that administrators provide full support and commitment throughout the entire process. Treatment should include interventions as well as an educational component and should be both flexible and responsive to the individual officer's needs. We must assure that intervention occurs immediately following the event and before any symptoms emerge.

Family, as well as the officer's natural supports should be included, as they may need advice and guidance in their vital role in the officer's healing process. It is even more imperative that we implement better prevention techniques to ward off the effects of prolonged exposure to trauma as well as to prevent long-term stress disorders.

We never seem to have issues with responding to, and correcting, the physical trauma our officers receive. It is the invisible scars of trauma that we seem to mismanage. Doing nothing has never been an option, especially under circumstances that may affect the lives of our officers. If you have had traumatic events in your agency, and meet the officer in the hallway, you should at least know what to say.

Rodney Stearns is a Lieutenant with the Field Services Division at the Eau Claire County, Wisc. Sheriff's Office. As a crash reconstructionist, he responded to many fatal crashes. He is an instructor for various colleges in criminal justice. He has a Master's Degree in Human Development - Family Studies, concentrating in mental health. He can be contacted Photos by Mark C. Ide.

Published in Law and Order, Dec 2012

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