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PTSD Resources for Survivors and Caregivers
|The credit goes to the person who's actually in the arena; whose face is marred with the dirt, sweat and blood; who knows great enthusiasm and joys. Who spends himself in a worthy cause, and whose place shall never be with those timid souls who knew never victory nor defeat."||
|With the terrorist attacks of September 11, 2001, the bombing of Pearl Harbor was no longer the deadliest day in American history. Over 3000 innocent people lost their lives. The world watched in horror as the twin towers collapsed entombing hundreds of police and firefighters who had rushed into harm's way to rescue the victims. These "first responders" would soon emerge as the real American heroes. The selfless acts of bravery witnessed by a stunned nation was not a new phenomenon. These unsung heroes who have been virtually unnoticed have captured the hearts of Americans if only for a brief moment. Unfortunately, the public's interest in the effects of traumatic exposure has waxed and waned throughout history. It seems to peak immediately following catastrophes like those of September 11th. Nevertheless, it is with this recent tragedy in mind, that the effects of traumatic exposure among law enforcement officers will be examined within the context of their twenty-plus years of public service.
There are over three-quarters of a million police officers in the United States today. Law enforcement is a highly stressful job where one continually faces the effects of murders, violent assaults, accidents and serious personal injury. Over 70,000 officers are assaulted each year on the job - more than 200 officers per day. (These are "reported" assaults to the Department of Justice. Many, if not most, actual assaults against police officers go "unreported.")
Unlike any other occupation, police officers are expected to die for the community they serve. It's an occupational hazard. They are expected to risk their lives every day to protect the citizens who, most often, do not appreciate them. Assaults against police officers are often not prosecuted even though a similar offense against a citizen would almost certainly result in an arrest and prosecution. Law enforcement, the media, and the public foster the myth that police officers can experience trauma and violence without suffering any ill effects. In fact, research has shown that when stressors are prolonged and overwhelming, individuals lose their ability to cope.
The traumatization of this profession uniquely and profoundly impacts not only the officers themselves, but their families as well. "Police Trauma Syndrome" (PTS) is a major public health problem among police officers worldwide. The symptoms of this syndrome can develop over time or acutely after a single catastrophic event.
The results can be seen physically, emotionally, mentally and behaviorally. The statistics are alarming: high divorce rates, suicide, domestic violence, heart attacks, stroke, cancer, depression, alcoholism and morale problems. All police veterans suffer in varying degrees from the syndrome. However, with education, intervention and support, the devastating effects of police trauma syndrome can be mitigated.
Law enforcement organizations and the therapeutic community should be aware of the complex type of posttraumatic stress reactions that occur consistently after prolonged, repeated exposure to violent assaults, murders, rapes, child abuse, natural and manmade disasters as well as on-going personal physical assaults.
The current definition of PTSD (posttraumatic stress disorder) is directed primarily to survivors of relatively circumscribed traumatic events such as combat, disasters or rape. This diagnostic category fails to encapsulate the symptoms manifested as a result of prolonged, repeated trauma in an occupation that refuses to validate that these events are catastrophic for those who are exposed to them. Hence, we devised the term, "Police Trauma Syndrome" to describe the condition that afflicts countless law enforcement officers as a direct result of their jobs.
In 1984, the Fraternal Order of Police Labor Committee representing police officers of the Metropolitan Police Department in Washington, D.C. began to address an alarming problem within the police department--- serious problems with overly aggressive police officers. The Labor committee's legal bills were escalating due to recurring problems of officers who were repeatedly in trouble for "overreacting." Paradoxically, these same officers had been productive and responsible but were now experiencing serious symptoms of stress and burnout. Simply providing legal representation for the officers was not addressing the root cause of the problem.
Apparently, the Union's dilemma was substantiated by the 432 police brutality suits brought against the District for the years 1984, 1985 and 1986. The District government was forced to pay out $5.4 million dollars for these suits against the police department. Similar problems existed in other urban areas in the 1980's. In the Los Angeles Police Department, applications for disability pensions increased by 82%. Sixty-three percent (63%) of disability claims were stress-related.
In November of 1988, under Article 45 of the collective bargaining agreement between the District of Columbia Government and the F.O.P. Labor Committee, a jointly sponsored Union/Management Program was instituted. The only program of its kind, the Metropolitan Police Employee Assistance Program was chosen as a model for all law enforcement agencies in 1991 by the United States House of Representatives Select Committee on Children, Youth and Families in the hearing "On the Front Lines - Police Stress and Family Well Being."
This unique, comprehensive psychological services program has provided counseling and critical incident debriefing for over 5,000 police officers and their families. It has provided training to over 10,000 officers, supervisors, recruits and family members. It has provided post-shooting debriefing to over 800 police officers who have used their weapons in the line of duty.
More than ever, the increase in violence in our society echoes throughout the law enforcement community with more use of "deadly force" and unprovoked assaults against police officers. Unlike combat veterans, who are often compared to the police, the traumatic experiences suffered by police officers are encountered day after day over a period of twenty-plus years. The traumas do not take place in foreign lands far away from family and home. In fact, police officers work in or adjacent to the neighborhoods where they live.
Each officer represents an investment of thousands of tax dollars. The effects of stress and trauma exact a high toll in lost dollars and inferior services rendered to the department and to the community. Let us now examine how trauma plays a role in the police experience.
"Nothing fixes a thing so in memory as the wish to forget it."
|The word "trauma" is derived from a Greek word, which means "to wound" or "to pierce." It is most often used to describe any sudden physical injury. The intensity or violence of the wound is such that the consequences are long-lasting. Just as the body can sustain a physical trauma that can devastate its defenses, so too, can psychological trauma overwhelm one's normal coping mechanisms. Long term exposure to traumatic events or "critical incidents" can and do have a negative impact upon police officers and their families. While the human response to trauma is consistent among all people, the job of policing separates law enforcement officers from the rest of society.
JOB STRESS AND THE LAW ENFORCEMENT OFFICER
Police work is highly stressful and is one of the few occupations where an employee continually faces the inherent danger of physical violence and the potential of sudden death. The police officer is continuously subjected to cruelty and aggression and is often called upon to make critical life and death decisions within seconds. Situational crises and traumatic experiences often wreak havoc with an officer's emotions. Being shot at, almost killed, viewing and handling dead, mangled bodies, dealing with abused and battered children or sexually molested children all exact a high toll on the police officer.
No other occupation so completely affects, not just the officer, but his or her family as well. All too often the police officer's life becomes chaotic and unmanageable. While it is easier to quantify the number of physical injuries and deaths as a result of police work, it's not so easy to enumerate the number of broken homes, broken hearts, and broken lives that are the direct result of the emotional toll on officers and their families.
Stress is naturally inherent to a police officer's job. During parts of any given shift he or she may simply be in a state of low-level readiness or "hypervigilance" patrolling a sector while monitoring assigned radio frequencies. Suddenly, an emergency call comes in and the officer responds totally with adrenaline racing, heart pounding, blood pressure rising, body tensing for action - ready for the challenge of what may follow. When the emergency is over, he can turn off his vehicle's emergency equipment but he cannot turn his body off. The "fight or flight" response, nature's way of dealing with stressful situations, continues to thunder. There may be no time to recover from this state of "alarm" before a second and third emergency occurs. This leads to exhaustion since the body cannot continuously be in a state of readiness. All too often, the police officer remains in a state of exhaustion for long periods of time. This physical and mental exhaustion leads to a less effective officer.
Unrelieved stress can result in high blood pressure, cardiovascular disease, chronic headaches, gastric ulcers, depression, aggression, irritability and burn-out. Burn-out is a progressive process of fatigue, lethargy and depleted personal resources marked by physical and emotional exhaustion, negative job attitude, and a loss of concern for the people you are supposed to be helping. It is caused by excessive and continued demands on one's energy and resources.
The police profession is plagued with "burn-out." Job-related stressors such as shiftwork, hypervigilance, poor nutrition, work overload, unpredictability, responsibility for people, and ongoing contact with stress carriers all lend themselves to high "burn-out."
Police officers respond on a "routine" basis to situations which are "emergencies" to those outside law enforcement. On the job, Police officers must suppress the natural human emotions such as fear, anger, horror, or sadness. This "image armor" that the officer wears "on duty" is very difficult to shed at the end of a shift.
A "burned-out" officer is not only a non-productive member of the department but also a human being in pain - perhaps a father and husband or mother and wife who becomes incapable of filling these roles effectively. "Burn-out" is a very counter-productive way of coping with occupational stress. The officer's coping mechanisms are no longer healthy and soon may include projection (blaming others), withdrawal, and detachment.
Officers are at high risk for developing negative coping behaviors such as gambling, overeating, smoking, spending sprees and excessive drinking. Instead of coping directly and internally with feelings of alienation by talking about them, emotions are hidden away. This psychological withdrawal from work and personal life is in response to excessive stress - moving from an attitude of empathy to apathy. All of these symptoms are a cry for help. It is encouraging to note that "burn-out" is treatable through intervention, education, and prevention.
Traits that make for a good police officer aren't necessarily conducive to being a good family man or woman. Paranoid traits are healthy on the job - crucial even. However, the same behavior at home drives spouses and children away. So often wives recount how their husbands have changed: "We never talk anymore. He's always so angry. He won't talk to me about his feelings." Recently, one officer told me that after 15 years on the Department and two marriages, he doesn't feel anything - no pain, no happiness, no sadness. He asked, "What do you do when you just feel numb?" Let us now turn to several specific stressors encountered by law enforcement personnel. The stressors that seem to effect the greatest psychological damage are unique and segregate the officer from the rest of society.
WORK OVERLOAD VERSUS WORK STAGNATION
It has often been said that policing is "hours of boredom interrupted by moments of terror." While that may have been true at one time, it is not true today in cities like Washington, DC. Officers are called upon to respond to one emergency call after another with few breaks to rest. This requires that the officer be in a state of constant readiness or "hypervigilance." The need for police officers to be hypervigilant is well illustrated by the statement, "There's no such thing as a routine traffic stop until the citizen is gone and the police officer drives off." The first thing that a police officer does when he/she enters a new surrounding, no matter how benign it may seem, is to scan the scene, looking for "what's wrong in this picture."
When an officer is called upon to respond to a potentially life-threatening situation, his autonomic nervous system sets in motion the old "fight or flight" arousal- the body's immediate response to extraordinary demands made upon it.
The normal human response is the "fight or flight" reaction, which enables the individual to strike out against the stress agent or flee from the scene. Police officers responses must be measured; running away is not an option. However, "fighting back" must be a controlled response. Officers must control the natural "attack" response that is instinctual.
THE GENERAL ADAPTION SYNDROME
No living organism can exist continually in a stage of alarm - an agent so damaging that continuous exposure to it is incompatible with life. After prolonged exposure to any noxious agent, the body loses its acquired ability to resist, and enters into a stage of exhaustion. This third stage always occurs as long as the stress is severe enough and is applied long enough, because the adaptation energy or adaptability of a living being is always finite.
|Dr. Hans Selye|
|Defined by Hans Selye in 1936, this is the body's way of mobilizing its defenses against a perceived threat. It is a "whole body" response and involves all the resources the body can garner. Consider the following example: Officer Thomas is working the 3:00 p.m.- 11:00 p.m. shift. It is Saturday at 10:00 p.m. and he has responded to one run after another without a break. He has responded to everything from a "domestic" to a "breaking and entering" to a drug- related murder. Officer Thomas is standing in the Seven-Eleven store devouring two chilidogs, then washes them down with a 12-ounce can of Pepsi. He receives a radio call for a stolen vehicle. The driver has struck and killed two pedestrians, a mother and her toddler, and is now proceeding at a high rate of speed in Officer Thomas' direction. He answers the call and jumps into his vehicle with lights flashing and siren screaming. What is going on in his body is even more dramatic. Within seconds of the call, the General Adaptation Syndrome is in full swing.
ALARM REACTION STAGE
A small portion of the brain called the hypothalamus, a control center of the brain, has triggered the pituitary gland, located near the base of the brain, and the hormone ACTH (adrenocorticotropin) is released into the bloodstream. ACTH goes directly to the adrenal glands, intimately involved in the body's response to emotions, which then steps up secretion of three hormones that travel to different organs and control blood flow. They are adrenaline, epinephrine and corticoids. These hormones bring the body up to its arousal state. Within the first eight seconds, the bloodstream has carried these stress organizers into every cell of the body. At the same time, commands are traveling through the nerve communication system to alert heart, lungs, and muscles for action. The muscles are now more richly supplied with blood, as the thin vessels constrict and blood pressure increases. However, blood has been diverted away from Officer Thomas' extremities (if he sustains a wound, he would be less likely to bleed to death). His liver is working harder than ever to convert its stored glycogen into glucose which his brain and muscles will need in greater supply. Meanwhile, his breathing is more rapid and shallow, increasing the amount of oxygen in his blood thus enabling his muscles and brain to burn that glucose more efficiently.
His heart is pumping, sending an abundant supply of blood to the priority portions of the body. Epinephrine is released, causing his heart to speed up and increasing formation of platelets that induce clotting. His kidneys have increased their production of renin, an enzyme that restricts blood flow and plays a role in hypertension. His skeletal muscles brace, and, with the blood he needs in his stomach reduced in favor of these high priority areas elsewhere, he's going to have indigestion-payment for the chilidogs and Pepsi. Over long periods of time, Officer Thomas stands a greater chance of developing stomach ulcers and chronic digestive problems.
Officer Thomas' brain is busy with preparations for violent physical action - one reason why he is unable to think very effectively on an abstract level during this alarm stage. He is joined in the high-speed chase by several other police cruisers. They stop the vehicle and apprehend the suspect. Based on our knowledge of the "fight or flight" response, Officer Thomas' natural response would be to "fight." However, because he is a law enforcement officer, he must exert considerable energy to restrain himself from using excessive force.
Following the "Alarm Stage" comes the critical stage called the "Resistance Stage." It is during this time that the body attempts to adapt to the situation. If the stressor has disappeared or been overcome, the body tries to reverse the alarm reaction. If the exposure to the stressor or similar stressors continue, the body attempts to replace emergency bodily changes with adaptive changes. In other words, certain bodily reactions become fixed. Chronic muscle tension is a good example of this kind of adaptation. The problem is that it requires a great deal of energy for this kind of resistance. Hence, the final stage, exhaustion, results if the stressor continues or if other stressors follow at close intervals.
Even before this extreme stage has been reached, excessive hormonal secretions may result in severe physiological damage that Hans Selye termed "diseases of adaptation," in the form of, ulcers, high blood pressure, and coronary artery disease.
Officer Thomas no sooner leaves the scene after the suspect is arrested than yet another call comes in, activating the alarm stage cycles all over again. How will Officer Thomas cope? Will he adapt?
Another difference among police officers is that they remain in a state of a constant readiness for whatever may happen. They become so accustomed to this low-level alarm reaction, that it becomes a part of their personalities, causing them to remain jittery, irritable, impatient and incapable of relaxing. However, the hypervigilance becomes an important defense because people are able to influence the nature of stress through their ability to control and anticipate events in the environment. Hence, to always be ready, decreases the chance of "shock." The unanticipated event often has the greatest deleterious impact on an officer and leaves the most persistent aftereffects. This was especially true in the case of the Air Florida Tragedy.
Wednesday January 13, 1982 was a bleak, snowy day, in Washington, DC. An Air Florida jet crashed after take-off into the Fourteenth Street Bridge with 79 passengers on board. Within minutes it sunk into the icy waters of the Potomac River taking all but 5 passengers. Four people on the bridge were also killed as the jumbo jet careened over cars, crushing them on its tragic descent. Traffic had been at a standstill in the snowstorm and officers who were ordered to the scene were completely unprepared for the carnage. Many officers have relived in nightmares the scenes of mangled bodies and crushed vehicles with blood dripping from the wreckage. The scene has remained an undigested image impossible for the officers to weave into the fabric of their lives. So many learned the danger of being emotionally unprepared for that experience.
Even now, twenty years later, talk of "Air Florida" triggers strong emotional reactions for the officers who were on the scene. The following is one officer's account of the Air Florida disaster.
Wednesday, January 13, 1982
I was assigned to the Third District's Drug Enforcement Unit and was gathering intelligence for a narcotic search warrant on Sixth Street, N.W. It was late afternoon by the time I had worked my way into the vacant rowhouse that had served as my observation post for the past several days. I usually had my partner as company on these forays, but he was in court on this frigid winters day. Instead, I carried an extra revolver as my companion. Over the years I had learned that there is no such thing as backup when you venture into abandoned buildings in inhospitable territory.
MPD, Washington, DC
We are growing in our understanding of the physical and emotional impact of traumatic exposure. Reactions to the trauma, memory distortions, and increased vulnerability are a whole "mind/body" phenomenon.
The human body is a fine-tuned and complex system of pathways. Each of its 100 billion nerve cells has 200,000 synapses. The brain interacts with the endocrine system (pituitary, thyroid, adrenal) activating them to secrete hormones which are in turn carried by the bloodstream throughout the body. When hormones reach a certain level, they turn off the brain's activating brain cells. This is called a negative feedback loop. In order to understand the psychobiology of trauma, one must learn about the body's metabolism. Psychobiology is the study of chemical/structural changes in the brain that relate to changes in behavior and emotions.
Bessel van der Kolk, M.D. (Traumatic Stress: The Effects of Overwhelming Experience on Mind, Body, and Society) a noted researcher, trauma psychiatrist, and theorist describes the impact of trauma on the mind and body with the phrase "the body keeps the score" (1996). Studies have consistently shown a positive correlation between the severity of a stressor and the level of cortisol in the bloodstream. A severe stressor increases cortisol levels. Traumatic exposure that is chronic and cumulative produces chemical and biological changes that may be permanent.
While we do not understand fully the complexities of trauma-related changes, it is clear that a major mind and body pathway for reactions to stress becomes disordered. The result is a lowered tolerance to stress. Elevated levels of epinephrine and norepinephrine (stress hormones) in the bloodstream may cause anxiety, panic, and agitation in the aftermath of traumatic exposure. Also prevalent in individuals post-trauma is a form of adrenal hyperactivity that appears to be associated with hyperarousal, hypervigilance, anxiety, panic, irritability, and rage.
Stress-induced analgesia (numbing) can occur when there is an increased release of endorphins in response to stimuli resembling previous traumas. In persons suffering posttraumatic reactions, studies have also shown increased thyroid activity. Some researchers believe that sensitization of areas in the brain by traumatic stress can eventually lead to "kindling" or autonomous electrical activity in these areas which then causes intrusive thoughts and flashbacks. MRI studies have also revealed structural changes in the hippocampus which may be permanent. The hippocampus is involved in learning and memory, particularly explicit memory for events. (There are two types of memory: explicit memory and implicit memory. Explicit memory refers to recollections of facts and events. Implicit memory refers to memories of skills, habits, reflex actions and emotional responses. Knowledge expressed in performance like riding a bike is an example of implicit memory).
Difficulties in learning and memory are also prominent features in individuals suffering from traumatic exposure. Researchers have also discovered proof of changes in cerebral blood flow and brain activity due to trauma. Neuro-imaging techniques such as PET scans (positron emission tomography) show increased activity which provokes traumatic stress reactions by "telling the story." Conversely, Broca's area, which is involved in speech, is deactivated. This may explain the difficulty some officers have in verbal expressions of the trauma in addition to distortions of memory.
Individuals suffering from traumatic exposure also experience medical problems to include: migraine headaches, irritable bowel, early adult-onset diabetes, immune system problems, arthritis, and coronary artery disease. It is not surprising that traumatic exposure can have an impact on the body's immune system. In fact, police officers suffer many stress-related illnesses that are often left untreated. Police officers are very good at taking care of others. They aren't so good at taking care of themselves. Education is the key for understanding the mind/body connection in traumatic exposure among law enforcement officers. What an officer doesn't know can hurt.
ROLE CONFLICT & THE POLICE FAMILY
"In street police work, where you're exposed to a certain amount of violence and inhumanity on a daily basis, you come to realize that there are two different worlds. One world is the world where you work and the other world where you have your family and friends. But the worlds are a couple of light-years apart and you find yourself, especially in homicide, unable to tell family and friends about the other world because they can't comprehend it. I worked a lot of hours and had trouble differentiating between the two worlds."
The "image armor" that police officers develop is a defense mechanism that works well for the officer's survival. Unfortunately, it does not come without a price to be paid in terms of failed marriages, poor relationships with children, and family violence. The traits that make for an effective police officer do not necessarily make for a good spouse or parent.
Let us consider the role of the average police officer "on the street." Police officers have tremendous power. They have the authority to take away one's freedom. They are viewed, by the public, as protector and problem-solver. They must be "in control" at all times. An officer can never show that he is afraid or uncertain. He must control his own emotions when the normal person might falter. Sometimes, especially in cases involving children, an officer's "image armor" can shatter.
The following is an illustration of such an event:
|Detective B was a member of the Department's elite homicide squad. He was highly respected by his peers because of his skills and his excellent closure rate, and he was respected by his peers as a hard-driving, hard-working, hard-drinking cop who was "tough as they come."
He was ready to call it quits at 7:00 a.m. after working 16 hours straight. It was one of those steamy mornings where the previous night's heat had given no reprieve from the scorching day that had preceded it.
The Captain walked in with an ashen look on his face and announced that there had been a mass murder in the upper northwest in a large rowhouse. Detective B was never known to say "no" to the Captain no matter how fatigued he was.
When he arrived on the scene the reporters and news cameras blocked the entrance. They clamored for his attention but he made his way through without speaking.
The gruesome scene inside assaulted every cell of his already worn body. Blood and brain matter dripped from the walls. Bodies of men, women and children riddled with bullets lay in unnatural poses around the house. Already numbed out he went to work.
Several hours later, the last of the bodies was being removed and Detective B opened the cellar door to escape to the cool dampness that struck his face.
As he walked down the steps he felt the tenseness leave his body escaping the silent clamor of activity. The basement was barely lit from one small window and his eyes had not yet adjusted to the dark when he spotted a deep basin sink before him. He would wash his hands and face.
As he turned on the water and felt its coolness, he reached for a string that dangled from a dirty light bulb and pulled it down. (It was already 2:00 p.m. and his wife, Pam, would be leaving for work at the hospital. He hadn't seen her in two days. He pictured her teasing him about her cycle and that the time was right for them to "make a little jimmy." After five years, still no children; but Pam wouldn't give up).
As he looked down into his hands reaching for some soap he froze. Lying in the deep tub was the blood-spattered body of a baby no more than three months old. A wave of nausea came over him and he began heaving the contents of his stomach until all he could get up was bile and acid, burning his throat as they passed through his mouth.
|One might think that Detective B would share this experience with his wife or another person close to him. More often, however, officers are reluctant to talk about the horrors they see. As one officer put it: "I'd find myself sitting at the dinner table with nothing to talk about that didn't frighten my wife." There are several theories as to why this is so. I shall offer the following for the reader's consideration:
1. Police officers take their roles as "protectors" very seriously. Losing one's innocence through traumatizing events is bad enough without exposing one's family, those dearest to the officers, to the trauma.
2. It is easier, in the short run, for officers to "stuff " their pain. Why talk about it? Talking about it brings back images and pictures that arouse pain and hurt feelings about the traumatic incident. The officer may feel guilt that he was unable to save a victim. "If I had only gotten there sooner," is an often-heard phrase.
Because spouses do not understand this aspect of policing, so often they misperceive the officer's sullen moodiness for other things. "Maybe he/she doesn't love me anymore. Maybe he/she is having an affair and doesn't know how to tell me." Remaining aloof, unfortunately, is one of the few responses that becomes tenable for an officer. In order to remain unaffected by the suffering and pain an officer confronts on the street, it becomes necessary to keep feelings and emotions under rigid control. So often officers who enter therapy express their long-held fear that once they let their emotions flow, they will be unable to control the deluge that would follow. The "wall" that officers build around themselves soon becomes impenetrable. Even the officers themselves are unable to get past it. One release is in the use of the grotesque humor that becomes so much a part of the police mentality.
"You make cruel jokes. You make light of the fact that people are dead. But you wouldn't last six months if you didn't do something like that," says Detective Joe Quantrille.
Police officers become more comfortable with anger and humor, less comfortable with tenderness and displays of affection. Often they may replace "requests" with "demands." For instance, an officer might order his child to "buckle up your seat belt or we're not going anywhere." What motivates this show of anger? The officer cannot relate to his/her child stories of dead children pulled from car wrecks. He cannot communicate to his child how frightened he is at the thought that this could happen to his child. Police officers know that horrible things happen to good people - not just to strangers one reads about in the newspapers. Officers are more apt to command, order, and direct and less apt to discuss and request with their spouses and children. Wives complain that their husbands sometime speak to them as though they were criminals. Children relate how their police officer parent is unapproachable and distant. To separate the role of "cop" from that of "parent or spouse" is a monumental task at best. Far too many officers succumb to this role conflict.
It is little wonder that police marriages suffer as they do. Healthy human development requires balance - so do human relationships. Virginia Satir, experiential family therapist, stated that, "Communication is to relationships what breathing is to life." Unfortunately, the quality of interactions with spouses in police marriages is sorely lacking. They are of short duration, sporadic and with faulty or poor communication. The couple grows apart leaving the spouse of the police officer feeling unimportant and rejected. How can an officer switch roles after eight hours of being a cop, especially if he/she has just watched someone die."
In 1991, I testified before a House Select Committee on Children, Youth and Families regarding stress and police families. Among the many professionals who testified was Lenore B. Johnson, Ph.D., associate professor of family studies at Arizona State University, who reported the results of her study "Work-Family Stress among Police Officers." The study was conducted in the early 1990's and is the only empirical study regarding police families in recent years. In the study, Johnson surveyed and interviewed 728 officers in two East Coast police departments and 479 of their spouses. Seventy-seven percent of the spouses were above the scale mean in reporting stress from their mates' jobs. Coping problems included alcohol abuse, divorce, family violence and suicide. Alcoholism rates for police officers exceeded the mean by 17%. Forty percent of the police officers surveyed reported that within the six months before the survey, they had behaved violently toward their spouses or children.
Johnson offered the following factors as contributing to family strain:
ROTATING SCHEDULES: "Not surprisingly, 71 percent of the spouses believed that the police administration does not take family life into consideration when making policies which may affect families and 51 percent agreed that a police officer's career could be hurt if his family voices any special needs or frustrations.
HOME LEADERSHIP STYLE: The spouses complained that officers were unable to leave the job at work. Instead, they expected the last word in family discussions and were seen as overly critical.
EMOTIONAL AVAILABILITY: Many spouses reported that the officer did not communicate his/her feelings.
IMAGE ARMOR COPING STRATEGIES: The rugged individualism, being tough, was seen as a typical coping strategy that often leads to depersonalization of citizens. It's equally detrimental to marriage and family life.
LACK OF SOCIAL SUPPORT: The absence of social support from all sources (squad supervisor, spouse, and friends) has an influence on police stress. Dr. Johnson's data suggested that those officers who did share work problems with their spouses or non-police friends had lower burnout. While this was true for male officers, it did not hold true for female officers who were married to non-police officers. They claimed that their husbands did not want to hear about their wives' jobs.
In reporting individual and family pathology, Johnson stressed the seriousness of the problem whereby nearly 90 percent of the police spouses felt that the police department should provide for the officers and their families both marital and psychological counseling, while 75-82 percent felt that alcohol rehabilitation and stress reduction programs should also be provided.
All available data continues to support the belief that what happens to police officers on the job very much affects their families. Dr. Johnson's study did not include interviewing the children of police officers. However, in 1992, the Metropolitan Police Employee Assistance Program joined with the National Institute of Mental Health's Laboratory of Developmental Psychology, funded by the MacArthur Foundation Research Network on Early Childhood Transitions, to study the effects of parental post-traumatic stress disorder (PTSD) on the children of police officers.
The phenomenon of "secondary post-traumatic stress disorder" wherein family members, including children, develop symptoms consistent with PTSD, was found in families of combat veterans who were themselves suffering from PTSD (Rosenheck & Nathan, 1985; Scaturo & Hayman, 1992). Children of holocaust survivors have also fallen victim to this "secondary" traumatization as reported by Fryberg, 1980; Kar-Venaki, Nadler & Gershoni, 1985; Perskin, 1981. Similar findings have also been reported by White in 1991 in treating parents of children who were severely traumatized.
In our work with police families, we are finding high rates of this secondary traumatization in children of police officers with PTSD. Many of these children are manifesting serious conduct disorders and high rates of attention deficit hyperactivity disorder (ADHD). This project investigated the possible contributions of parental PTSD to various behavioral and adjustment problems in the children of police officers. The first empirical study of its kind, the results of this project has helped us understand the effects of severe occupational stress that exists in law enforcement. Trauma is contagious and not easily forgotten no matter how hard we try to defend against the aftershocks.
Let us now turn to other factors that contribute to create "overload" for police officers. They are shiftwork, midnight work, and the responsibility for people.
" the human adult is an animal whose body is tuned by evolution and training to go about its business during the hours of daylight and sleep during those of darkness. Ask it to work at night and sleep during the day and it does both rather badly." (Wilkinson, 1970)
In order for an officer to meet the demands we have discussed thus far, he/she is expected to be in the best physical condition. Unfortunately, officers do not always eat the right food and, more often than not, do not get proper rest and relaxation.
Working the midnight shift exacts a heavy toll on police officers. Since human beings are not nocturnal, staying awake through the night requires suppressing nature's cycles. This requires energy. It should also be noted that daytime sleep in controlled laboratory testing has been found to be qualitatively different from nighttime sleep and less satisfying (Kroes, 1976). Shiftwork, especially rotating shifts, though a necessary part of any law enforcement organization often wreaks havoc on the officer's body including adjustments in circadian rhythms. As much as shiftwork is difficult for the officer's biological and social adjustment, it also infringes in drastic ways on the lives of his/her family members.
Let us turn to the complicated problem of shiftwork and the difficulty officers have adapting their physiological and psychological rhythms to a new sleep wakefulness cycle.
The 24-hour cyclical rhythm has been given the name "circadian rhythm." If the cycle follows the 24-day/night pattern, it may also be called the diurnal pattern (Kroes).
Circadian rhythms are seen in fluctuations of body temperature; urine flow; renal excretion of sodium, potassium, and phosphates; metabolism; heart rate; skill conductance; cortical and medullary production of adrenal hormones; sleep cycle; and overall mental and physical functioning. Research has shown that practically all physiological functions show circadian rhythm cycles. As one can imagine, shift work conflicts with these circadian rhythms. How negatively this will affect the individual will depend on several factors:
In our society, almost all communal activities take place during the day - working, eating, shopping and socializing. When an individual deviates from this societal norm, he/she is cut off from the normal avenues of social interaction. For the young officer who works midnights, there are special problems. It's not easy to pick up his date after he gets off work at 7:00 a.m. When the officer has a family, children are cautioned not to make too much noise; the phone must be answered on the first ring or taken off the receiver. And, of course, the spouse and children are left alone at night. When the officer works 3:00 p.m. to midnight, he/she will only see the children on weekends during the school year.
With changing or rotating shiftwork, the problems associated with physiological adaptation increase. It takes approximately two weeks for the average individual to re-adjust his eating and sleeping patterns. For the officer on a two-week rotating shift, no sooner does he/she adjust, than he/she is forced to change gears to a new shift. William H. Kroes, Ph.D., reported the following results of research conducted with police officers: 93 out of 100 police officers surveyed mentioned disruption of eating habits as a problem resulting from changing shift routines. Over 30 percent reported sleep problems.
There are some officers who enjoy the permanent midnight shift. However, very few of officers are not adversely affected physiologically and psychologically by the midnight shift.
While there are those who would argue that many people work midnights or evenings and that these individuals lead productive, healthy lives, it must be remembered that for police officers, work schedule is only one of the major stressors. In fact, these occupational stressors taken one-by-one may not be so overwhelming; but taken collectively, in addition to typical life stresses, they can be very harmful to officers and their families.
RESPONSIBILITY FOR PEOPLE
Responsibility for the welfare of others, for making "life or death" decisions within seconds, takes a heavy toll on police officers. For an officer who is the first to arrive on the scene of a serious accident or fire, the actions he/she takes may drastically affect the lives of others. To watch human pain and suffering on a daily basis is tremendously draining - although you probably will not hear an officer say these words. More often you may hear an officer assert that it's all part of the job - no big deal. In fact, you may even hear him joke about the atrocities that he must witness on the job. This "emotional numbing" is a defense mechanism that prevents officers from going to pieces.
While officers may seem hard and cold, I have found them to be deeply concerned and caring individuals who internalize the human misery and tragedy they face in their jobs. There are situations for police officers that are emotionally overwhelming.
One patrolman saw a three-year-old child who had been catapulted through the windshield of a car and decapitated. He went on a three-day drinking binge as a result of the experience, and when he returned, he was disciplined. He would not explain why he had been absent for three days because it would have required acknowledging that he had been deeply moved by the experience. And the department didn't know why he had behaved that way. (Kroes, Society's Victim-The Policeman, Pg. 64).
Here is the reaction of a young officer just out of the police academy:
|My first radio run that day was to investigate a sick child emergency.
Upon arrival at the residence, several people met me in the front yard and, in a frantic state, said that an infant had just stopped breathing. Upon entering the residence and first observing the blue-cast skin on the three-month-old infant, I immediately called for the life squad and initiated mouth-to-mouth and nose resuscitation. After arrival of the life squad and their attempt to mechanically resuscitate the infant to no avail, it was my duty in inform the parents the child was deceased and take their child from them to the morgue and handle all necessary paperwork.
To make matters worse (mentally for myself) five months previously, I had become the proud father of a baby girl. And for weeks after this incident, besides not being able to eat or sleep, It tried to rationalize why this had to happen and not being able to help. I believe my religious belief was the biggest help in helping me pull myself together and face the real world. (Kroes, Society's Victim-The Policeman).
|While over a period of time most police officers learn to deal with many of life's tragedies, the exception to this is the anguish that an officer feels whenever he must deal with a child tragedy. Among these are situations like telling a mother of her child's death, having to take a dead child to the morgue, being called in on a child abuse case, or having to clean up a body after an accident.
How does the officer make sense of all this? How does one go on living in a world when so many terrible things happen? In the words of one young officer, "What's the point?" Emotional reactions to life's atrocities are normal. The following is a list of coping techniques that don't work as well as those that do:
TECHNIQUES THAT DON'T WORK
CRITICAL FACTORS IN COPING
©2002 Dr. Beverly J. Anderson & Gift From Within
Dr. Beverly J. Anderson is on the Board of Gift From Within. She is the President of The American Academy of Police Psychology, Inc., and the Director of the internationally acclaimed Metropolitan Police Employee Assistance Program in Washington, D.C.
Read Beverly Anderson's articles:
POLICE SUICIDE: Understanding Grief & Loss
Confidentiality in Counseling: What Police Officers Need To Know
Life After Breast Cancer: Surviving & Thriving
Reintegration & Readjustment Program for Iraqi Veterans
for officers returning from the war in Iraq
Police Officers: Traumatic Spending: A Reaction to Critical Incident Stress
Janis Leslie Evans, M.Ed., N.C.C., L.P.C.
For Police officers and their families, this project is designed both to honor officers for their service and to help those coping with work related stress. The disc includes the song Heroes Unsung, two poems - A Police Officer's Prayer & Tears On The Wall written and read by officers, and an affirmation. The recording also includes an instrumental arrangement for guitar and keyboards, and accompaniment track version of the song. The packaging contains an article about the stress police officers face on their job, a lyric reprint, and a listing of resources for those dealing with Post Traumatic Stress Disorder.
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