What Cops Should Know about Posttraumatic Stress Disorder

Posttraumatic Stress Disorder (PTSD) is a formal psychiatric diagnosis. At the risk of stating the obvious, a key component to PTSD is exposure to traumatic stress. I bring this up because virtually all police officers are exposed to traumatic stress but not all develop PTSD. Traumatic stress is an occupational inevitability for cops. PTSD on the other hand is an occupational risk. Some research suggests police officers have an increased risk for developing PTSD at some point during their career.

There are a number of complicated variables that affect how we respond to traumatic incidents, some of which are dimly understood. For example, if an officer experienced childhood abuse which he or she successfully suppressed from memory, those memories may re-emerge upon exposure to a traumatic incident later in life. I’ve had clients painfully describe how previous traumatic memories have resurfaced after the incident that brought them in, like candy spilling out of a piñata.

Some of us are more vulnerable to post traumatic symptoms than others. Importantly, our increased vulnerability is not the result of mental weakness. They include constructs such as temperament, early childhood experience, social learning and coping styles.

Don’t try and diagnose yourself with PTSD. Leave that to the professionals. When is it time to seek professional help? If you’ve been exposed to a traumatic stressor and after several weeks,

1. You continue to have sleep problems (e.g., difficulty falling or staying asleep, sleeping too much).

2. You over eat or have difficulty keeping food down.

3. You continue having trouble with your mood (e.g., irritability/anger, sadness/crying,

panic response like your heart’s going to jump out of your skin).

4. Co-workers, friends or family members are expressing concern about you.

I shudder to think of how many police officers who know something is wrong with them try to white knuckle their way through PTSD. A recent study by the San Francisco Veterans Affairs Medical Center found veterans with PTSD were twenty five percent more likely to die within a year after surgery than non-PTSD veterans. This, despite the fact that the veterans were younger in age at the time of surgery and even after they had long separated from military service. The point? It ain’t goin’ away.

PTSD has an impact on entire families. It’s been described as ‘the gift that keeps giving’.

PTSD isn’t like the West Nile Virus or Yellow Fever. It’s a treatable condition. You cannot be treated for PTSD (or any other serious medical problem for that matter) unless you seek help.

As cops we pride ourselves in having common sense. We use reason instead of blind emotion, voodoo or tea leaves to arrive at the best ‘thing to do’ in any given situation. The greek philosopher Epicurus wrote,

Chance seldom interferes with the wise man; his greatest and highest interests have been, are, and will be, directed by reason throughout his whole life.

If you think you may have PTSD what do you think the wise thing to do is?

Next week I’ll end “The Body Keeps the Score” series with a discussion of how to strengthen our emotional kevlar for future exposure to traumatic stress.

"The Body Keeps the Score:" An introduction to psychological trauma for cops. Part Two

Stress and Traumatic Stress

Imagine your neighbor knocking on your front door. He’s irritated. The neighbor says your son, who’s been playing football with his friends in the street, hit his car with the ball. In this case you would likely experience stress.

Now, imagine your neighbor pounding on your door. He’s panicked. The neighbor says your son has been hit by a car and is badly injured. In this case you would likely experience traumatic stress.

It’s the experience of helplessness and horror that define traumatic stress. Exposure to traumatic stress is an occupational inevitability for police officers. Think of a horrifying event. Any event. Now, ask yourself, “would there be cops there?” Probably, right? We’re always at the horror shows, and all too frequently we experience as sense of helplessness about our ability to make it right.

The fact that police officers aren’t allowed a normal human reaction to traumatic stressors makes things worse. Let me tell you about an experiment done by Robert Sapolsky, a stress physiology professor at Stanford University.

He showed two groups of people a gruesome video (a leg amputation) and then measured their stress response after seeing it. He showed the video to the first group and measured them. As expected, their bodies were pretty jacked up. Then he showed it to the second group. However, before they saw it, the researchers instructed the group that they were to have no reaction whatsoever while watching the video. The stress reaction in this second group was significantly higher. Makes sense.

Chronic exposure to traumatic stress, if not actively managed can very bad for us. It resides in the body and will stay there if not worked through in some way. Trauma guru Bessel van der Kolk writes, “the body keeps the score.”

Some of us believe getting good and drunk after “one of those days” will help us deal with traumatic incidents. This is a dangerous and wrong path. I’d recommend participating in a Critical Incident Stress Debriefing or other means of emotional/social support. Talking it out usually doesn’t, as some suggest, make people worse or symptomatic. The vast majority of cops need to talk more, not less, about the emotional piece of this job.

Next week we’ll cover the best known and least desirable outcome of traumatic exposure: Posttraumatic Stress Disorder.

New Facebook Page

The good news: Police Mental Health now has a Facebook page. I'd like to encourage you - yeah YOU - to share what works and what doesn't work to improve police officers' lot in this world. So don't be a frickin' lurker.

The bad news: At present, the URL for the page is ridiculous: http://www.facebook.com/pages/PoliceMentalHealth/138185609550421?ref=ts

Apparently, if x number of people go to the page and hit "like" I can
abbreviate the web address to something more normal. So, can you
go there and, even if you think it's the dumbest thing you've seen in
awhile, hit "like."


Work, work, work...

I am so so sorry, that I haven't written earlier. I've got so much work and many problems to solve. Although I haven't been writing it doesn't mean, that I haven't been shopping :) There was sales time, and new collections arrived so now it's time to show my treasures and new looks! But first - I wanted to show you my next publication. It's in Shopper Magazine, based in Beijing, China. They are a printing mag (monthly issued), focusing on high-street brands, young fashion style, fashion business and pop culture of China and abroad.  Please contact outsideralice@gmail.com if you're interested in their magazine.

In English - it's the original interview:
1. Name, age, location and occupation.

My name is Natalie, I’m 20 and I’m a photographer.

2. How do you describe your own style? And how fashion express your
personality out of the way it keeps inside your heart?

My style is indescribable. I am inspired by everything around me:
people, movies I watch, music I listen to... For example: if I listen
to ‘The Like’ I wear romantic flower dresses, and if I listen to ‘The
Kills’ or ‘The Black Keys’, I wear jeans, t-shirts and converses.

3. You said that you started to care about fashion since childhood and
your family business were related to the fashion industry, so how did
these experiences influenced you for years, and what inspired you
mostly on making clothes by yourself? Does the childhood influence
from fashion to you last till today?

My experience with fashion in childhood made me fashion conscious and
my fashion taste became more sophisticated. I always believed that I
will be a trendsetter and will design clothes that a lot of
people will love to wear. Being so close to fashion for that long made
me more self confident in that industry.

4. What was your goal of fashion? And how did you make it come true?
What's your biggest obstacle at this moment or in such process?

I dream of having my own store and selling clothes for chic women. I
can’t draw well, I hope that my new school will help me with that.

5. You said you could not stick with only one style, but on the other
hand you are very much in love with the sort of rock, 80's, vintage,
rustic, a little sporty but also romantic and chic style, would you
agree that there's a certain connection between your style and your
personality? What impression do you want to give people, is it that
you're very changeable and constantly different?

Yes, your exactly right about that! I am very unstable, changing all
the time my interests. That’s why I used to have a nickname ‘oxymora’.

6. And what fashion really brings you to your life? what do you hope
to give people with what you do?

Fashion makes my life complete. Without it I definitely wouldn’t be
who I am now. I want to inspire people with what I wear, what I adore,
what inspired me.

7. Please list 10 essential things in your daily life. (Any clothes,
habits or important things you couldn’t live without)

1. My beloved fiancée <3
2. Tic tac’s and lip balm
3. Black in clothes or accessory
4. Check my private and business email
5. Facebook and Lookbook
6. Do something creative and earn money
7. Listen to good music
8. Watch a movie
9. Have a good sleep
10. Look well

8. Who is your fashion icon and what type of people are most appealing to you?

There are many people inspiring me. I love latest Kristen Stewart
looks. I am also observing Zooey Deschanel, Kate Moss and Alison

9. List some your favorite magazines and interesting books you read recently.

Elle, K MAG, FineLife.pl. I don’t read a lot, but I am in love with
the Twilight series :)

10. Tell me about your other hobbies/interests apart from fashion, or
something else you're very good at, and do a lot.

I am a photographer. I run my own photography and CG agency. I also
own a modeling agency. All is combined with fashion :)

11. Where do you like to travel this year? What’s the most interesting
experience about fashion in Poland?

I am cosmopolitan and I don’t feel good in Poland. I think that polish
style (not only in fashion) is a combination of everything else, what
Poles have seen abroad. There’s nothing inspiring here for me.
I’ve been in Fuerteventura, Spain. It’s so beautiful. But my biggest
dream is to come to some small town in Toscany, Italy and go on a
roadtrip with my friends in the USA.

New clothes:

Lace blouse from Bershka

dark garden

Gorgeous asymmetric military dress from ZARA %

dark garden

Black open back dress from ZARA %

dark garden

Denim 90's shirt from ZARA

dark garden

And some old ones with fresh summer look:

dark garden

dark garden

dark garden

I really, really can't wait till Autumn! New collections are so inspiring! I am also starting design school in few weeks - a new life coming along! ^__^

“The Body Keeps the Score”: An introduction to psychological trauma for cops.

Can you imagine being a police officer and having no real knowledge of or interest in how to use a hand gun? Can you imagine a colleague saying, ‘I’ll figure out how to deploy my firearm if or when the time comes’?

Either can I.

We better know how to use our firearms because our life or the life of another may depend on it. Now, let’s introduce a talking point from Lt. Col. Dave Grossman. In On Combat he writes,

The stress of combat debilitates far more warriors than are killed in direct hostile action.

Hmm. By ‘stress’ Grossman here refers to cumulative stress, posttraumatic stress and critical incident stress, all of which I’ll define momentarily. For now let me ask, what do you know about these? If you’re like most cops the answer is ‘not much’. Either you’ve never given them much thought or you figured you’d learn about them if you got bit. Or, you’ve already been bit and you’ve learned all about one or more of these the hard way.

Traumatic stress is an occupational hazard for cops. You really need to get this. Moreover, traumatic stress in its various forms can be deadly. You wouldn’t wish the bad shit associated with trauma (co-morbidities) on your worst enemy.

Because trauma is located in the shadowy realm of human psychology, law enforcement has kept away from it. While this may sound unfairly harsh, police officers (who later become police executives) know about stuff we can put our teeth into, like how to clear a hard corner in a room search or how to safely approach the occupants of a vehicle during a car stop. We know all about the hazards associated with these because,

  1. We talk with each other about them.
  2. We consult tactical experts and utilize our own in-house experts.
  3. We regularly pose scenarios to ourselves and our partners...‘what if...?’
  4. We mentally attend to these potential hazards which gives us two extremely powerful tools for managing risk: prediction and control.

When we begin talking about psychological risk, cops start fidgeting in their seats. Why? Most police officers don’t know a ton about psychology so we feel vulnerable; never a good thing for cops. We want to avoid feeling vulnerable so we avoid the topic.

By avoiding (minimizing, de-valuing, ignoring) the impact psychological trauma has on individual officers, their families, the police agency and the community, we have unwittingly allowed our brothers and sisters in blue to suffer in silence. We need to stop doing this.

Okay, you don’t know much about trauma. You don’t feel comfortable talking about it. I don’t feel comfortable talking to my pre-teen son about safe sex and drugs, but I do it anyway. I balance the discomfort I feel on the one hand, against the potential destruction that may happen on the other. Fuck it, I guess I’m gonna feel a little awkward.

In this series of posts, I will attempt to get you to appreciate how important an understanding of police trauma is to you.

Some mental health problems are easy to diagnose and treat. Trauma isn’t one of them. In order to give you the best, most up-to-date and accurate information available on police trauma I’m going to break this down into bite sized morsels. Don’t ask me how many bite sized morsels there’s gonna be because I haven’t written them yet.

I hope to answer the following questions (among others):

Why does one person need to drink himself to sleep every night after a critical incident, while another sleeps like a baby?

What’s Posttraumatic Stress Disorder and how can I avoid getting it?

How does traumatic stress manifest in the body?

What does it do to the brain?

How does a traumatized cop impact the family?

What are the co-morbid conditions associated with untreated trauma?

How do you fix or treat traumatic stress?

Stand by.

Watch me

Schadenfreude and Encouragement (part two of a two part series)

Nice job

Good stop

Wow, you did a great investigation

Great arrest...good work

Not much rocket surgery in there.

It’s a curious phenomenon, this idea that we could probably dramatically improve officer’s wellness by the simplest of habits, like verbal encouragement. But when we consider the fact that the ‘work environment’ (especially ‘the administration’) usually tops officer’s Gripe List, it’s clear we’re not doing such a good job.

We blast our supervisors and administrators for their lack of support, but those lower on the food chain aren’t exempt from their roles as encouragers. So what’s the significance of ‘encouragement’ for police officers?

This is not an area I need to reference research studies or my clinical experience. I want to talk about providing encouragement here because it’s very easy to do, it makes you (the encourager) feel good, and it improves the morale and overall wellness of those you encourage.

In child rearing, a basic principle is that you should seize any opportunity to encourage your child. “Wow, Tommy, your such a good [fill in the blank]!” As parents, we offer these words not randomly or disingenuously, but in response to a job well done. Encouragement is like watering a plant, or emotionally feeding a child.

In the same way, encouragement just plain makes people feel good about themselves. Cops have enough nitpickers, paper shufflers and ass kissers to deal with. By providing encouragement to others you neutralize the toxic air that seems to pervade police buildings.

You don’t need to be a supervisor to tell a fellow officer “good job!” And when you tell them “good job” tell them what about it was so good. Be specific. Management 101 tells us that folks are way more likely to continue doing a good job or even want to do a better job, after being complimented. Conversely, negative feedback, while intended to change behavior, doesn’t seem to work so well. Weird that so many supervisors and administrators haven’t figured this one out.

Since you’ve read this week’s blog you now know you have the power to think globally and act locally. Go ahead and tell someone they did a kick ass job, it won’t kill you.