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Key Factors in PTSD

Starting in 1980 the science (the "soft science") of psychology "discovered" Post Traumatic Stress Disorder.  Soon PTSD became the rage of modern maladies faced by anyone in high stress or high risk situations.  It has become so loosely defined and commonly diagnosed that today the individual that experiences a high stress event and doesn't suffer from PTSD is often considered in denial or abnormal!

What are generally normal human responses to trauma or tragedy become labeled a disorder and the person diagnosed now becomes a patient constantly reflecting on how they feel or should be feeling and reflecting over and over again the triggering event.  Today in law enforcement agencies we spend so much time talking, planning, worrying and thinking about PTSD it seems we can get it just sitting in briefing!  But what if it isn't permanent, inevitable or disabling?  What if we can do a few things to help mitigate post-traumatic stress, or better still, what if we might prevent it all together?

These simple things help even if you are currently suffering PTSD or one of your friends is.  This plan is based on teamwork and not going it alone or letting your buddies deal with it alone.  In fact, the whole healing part is keeping faith with one another. 

There can be no doubt that humans have had to deal with horror throughout our whole existence.  So how did we ever get along before Freud?  For one thing, we stuck together; families, friends, comrade-at-arms, we all hung in there.  We didn't go on administrative leave, we didn’t abandon each other.  Those who went to war spent weeks if not months going to and from the site of battle; the stories of ancient warriors singing songs of lamentation and poems for their fallen as they openly wept are common among the records of war.

In World War l the British Army experimented with ways to heal soldiers suffering from "Shell Shock," the term used to describe PTSD in that conflict.  Some were left with their units behind the lines to heal in the company and support of their friends, most of whom were from the same village or area as they were.  Others were returned home to be treated with the new science of psychology.  Guess who got well.

For law enforcement the issue is not so simple.  Most critical incidents require review and investigation and a mental health professional is standing by, often one of the first to talk to the officer or officers involved.  That complete, the officer is put on administrative leave for a period of time...separated from comrades.  There is no question the psychologist has a place in the event but focusing on "feelings" alone isn't the whole picture. 

A law enforcement officer is a part of a close fraternity just as a soldier is and the fear of separation is a powerful element in the suffering felt following a crisis.  Supportive camaraderie is essential to prevent or mitigate PTSD and this is where those who can be supportive must be supportive.  Simply reaching out and reaffirming your friendship can be one of the most healing events an officer can experience.  This should be done as an affirmation and support not commentary on the event.  If the officer wants to talk about let them but your contact is about them and their still belonging to team, the family.

Also, finding meaning in a terrible event helps a great deal.  Instead of focusing on "why me?" focus on "this is what I do, what I was trained for!"  We always say we "run to the sound of the shots," but we need to internalize exactly what that means emotionally.  Homilies don't help us prepare, mental training does.  Visualize critical incidents over and over.  Remember, your brain doesn't separate an imaginary event from reality which is why visualization works, but so does worry.  So don't worry about critical incident train your brain for them.  It is a form of inoculation and make us more resilient to PTSD.

Finally, right now reaffirm you sense of mission.  Believe what you do matters, that you matter.  A sense of mission in life is not only essential it is literally the key to that quality of "spirit" so many survival specialists talk about.  It is the core of hope, the engine of our soul and too many officers are living like the walking dead because their spirit has been beaten down.  You matter, we need you, a free society is dependent on a strong trained, honorable constabulary and that is you!

Not long ago, Dr. Sally Satel, famous for healing veterans of Vietnam, shared with me her formula for dealing with and preventing PTSD.  I want to finish with her list and have you think about how you prepare yourself and help others.  We are our bothers’ and sisters’ keepers.

First, believe in your mission, the importance of what and how you do your service to the community.

Second, train hard, train realistically and emotionally.  Reflect on exactly what you are preparing for when you train on the range; and what it will be like after you win a real confrontation.  Finish with mental rehearsals of confrontations start to end and remember, you always win!

Third, never stop being a good friend or seek out your friends when you need them.  Supportive camaraderie is such a powerful cure for the injured spirit and yet we often hesitate to reach out because we just don't know what to say.  Just say you're there for them and let them talk, laugh, cry, or be still, everyone is different.

Finally, find meaning in what has happened.  That is sometime the toughest of all for us.  Our cynicism can run pretty deep and silver linings aren't our specialties, but this step is truly powerful and can help anyone through their darkest hour.

None of the above precludes the need or value of a trained therapist, but the lessons of history have shown us there is much we can do for each other and ourselves to cope with or even prevent PTSD.