Secondary Trauma: Spouses and Couples of Law Enforcement

Police officers endures highly pressured incidents on a regular basis during their routine. For example, “a sudden death in the line of duty, serious injury from an officer-involved shooting, exposure to intense trauma on a call, a physical or psychological threat to the safety or well-being of an individual or community, regardless of the type of incident.” (Rousseau, 2021). Moreover, as explained in the incident involves any situation or event faced by police officers that causes a distressing, dramatic, or profound change or disruption in their physical. (Rousseau, 2021). Trauma can not only affect the officer themselves, but it can also impact those around them. For example, during daily routines an officer with a heightened sense and trauma may be triggered during an encounter, arrest, or stop and have the trauma affect their decision making. Such decision making can escalate encounters that did not need to result to in excessive or deadly force. There are multiple signs that may attribute to trauma that is fatigue, difficulty breathing, confusion, poor decisions, poor concentration, anxiety and much more. Therefore, it is hard for others to pick up the sense that an individual has encountered a life changing event and may be suffering from it. Specifically, it may be hard for a spouse or significant other to pick up that their loved on is suffering from trauma, especially if they have a career in law enforcement.

Photo by: Police life

            Although many research suggests that law enforcement professionals (LEP) are directly affected by trauma, few have focused their attention on the secondary trauma of their loved ones or spouses. A study was conducted, where an in-depth qualitative interview on eight spouse of law enforcement. In a summary, the results had shown that trauma creates a domino effect onto the spouse, however, the upside to this is that it appears that such couples show a strong bond and how they cope with the trauma.

            As stated, police officers encounter crime, violence, and life-threatening events on a daily basis. Because of the dramatic exposure such exposure can impact an LE spouse or family. “The investigations that have focused on LE spouses suggest that police work has a detrimental impact on LE spouses and that those in close contact with the traumatized person also experience symptoms of traumatization.” (Landers et. Al., 2020). “Family support is critical for reducing the negative impact” of stressful work in the criminal justice profession. (Landers et. Al., 2020). Moreover, it is noted that family members play a role to support their partner that is in the LE career. Such role may include, but not limited to, additional responsibilities, creating coping mechanisms, social support, and developing a great way to communicate. Interesting, it is encouraged for spouses and family members to be quite involved because the high prevalence of trauma and the idea that the spouse can help assist clinicians to better understand how trauma affects the couple relationship and how to reduce its negative impact. (Landers et. Al., 2020). However, secondary trauma is described as a natural consequence of behaviors and emotions resulting “from knowing about a traumatizing event experienced by a significant other-the stress resulting from helping or want to help a traumatized or suffering person.” (Landers et. Al., 2020). However, when a spouse wants to help their significant, they may to subject themselves to the secondary exposure to trauma. The reason for this is because family members influence the quality of family relationships. Spouses endure the challenges that’s comes with a significant other that works in a highly stressful profession. Behind closed doors, spouses are the ones that see their professional spouse through it all, mental breaks downs, anxiety, distancing and much more.

In a study, interviews of LAE spouses all had to think of an occasion when they had noticed their partner is going through a traumatic event and how it directly affected them. At the end of the study, it was shown that partners are exposed through many different types of traumas i.e. death, injury etc. However, it was also noticed that such trauma may cause a ripple effect as in the LE may begin to have mood swings, changes in behavior and that may affect the spouse. For example, one spouse stated that they fear every time their spouse goes to work and other states that if their LE doesn’t scan the room, then it feels as if she does because she adapted a sense of insecurity. But because of such issues and the domino effect of trauma, spouses have developed a sense to cope.

Coping mechanisms has allowed for spouses to develop better coping mechanism and provide mutual support by understanding each other’s position. For example, “if something bad happens, we get really cohesive.” (Landers et. Al., 2020). Open communication about the traumatic event exposure and the pressure of the trauma appears to be a very important coping mechanisms for a couple’s relationship. By tackling on LE family or spousal health it illuminates the importance of the supportive role that they play.

Landers, A. L., Dimitropoulos, G., Mendenhall, T. J., Kennedy, A., & Zemanek, L. (2020).Backing the Blue: Trauma in Law Enforcement Spouses and Couples.Family Relations, 69(2), 308-319. https://ezproxy.bu.edu/login?qurl=https%3A%2F%2Fwww.proquest.com%2Fscholarly-journals%2Fbacking-blue-trauma-law-enforcement-spouses%2Fdocview%2F2376234440%2Fse-2%3Faccountid%3D9676

Rousseau, D. (2021). Module 6: Trauma and the Criminal Justice System. Boston University Metropolitan College: Blackboard.

EMDR as Trauma Therapy

Currently, there are many different techniques that people can use to alleviate issues they are experiencing due to a traumatic event. Sometimes it can be overwhelming when you are already experiencing negative emotions from the trauma you’ve faced and now you are trying to seek help, but might not know where to start. I believe that Eye Movement Desensitization and Reprocessing (EMDR) therapy is a very beneficial technique that can be added to your regular therapy session. EMDR has been proven to alleviate stress and negative emotions associated with traumatic events (One80center, 2012). To help you better understand EMDR and its benefits, first let me explain what EMDR is.

EMDR therapy is a psychotherapy approach to trauma treatment that uses a series of bilateral stimulation, most common being eye movements, during regular therapy sessions. There are eight phases total in the EMDR process which consist of history, preparation, assessment, desensitization, installation, body scan, closure, and reevaluation (Rousseau, 2021). During the history phase, they discuss both past and present concerns and what they want in the future. They do this to identify and target the traumatic events that they need to process. In the preparation phase, the therapist and client identify a safe place for when the client experiences distress and they have to want to regain self control and a sense of stability (Rousseau, 2021). In the assessment phase, the therapist has the client start to recall the traumatic events while also identifying the negative views and beliefs they have about themselves because of the traumatic event. In the desensitization phase, the clients are now exposed to a series of eye movements or even clicks while they recall the traumatic events. This is supposed to help them reprocess the events (Rousseau, 2021). In the Installation phase they continue the same eye movement mixed in with regular therapy, but this time they are getting the client to focus on the positive beliefs about themselves in relation to the events. After this phase, they conduct a body scan to evaluate if the clients progress and to see if they need more sessions. As for the closure and reevaluation phases, these phases are conducted in every session. Revaluation phase/ process is done in the beginning of every session to see if the client needs to complete a desensitization or installation phase and closure phase/ process is completed at the end of each session so that they can review and it allows the clients gain a sense of safety/ control before leaving the session (Rousseau, 2021).

You might be saying okay I understand the phases, but how does EMDR work exactly? Dr. Andrew  M. Leeds, the author of A Guide to the Standard EMDR Therapy Protocols for Clinicians, Supervisors, and Consultants and who has also used EMDR in his therapy sessions since 1991, explains in an interview on all the current working hypotheses of EMDR, why EMDR is so effective. Dr. Leed brought up the REM, rapid eye movement or orienting response hypothesis as an explanation (One80center, 2012). The REM, rapid eye movement, or orienting response hypothesis has two parts. The first part discusses REM sleep. During REM sleep we lose the vividness of emotions and feelings in the memories we have and we only store the important information instead. This is combined with the second part, in which a therapist brings up the memories while also triggering the client’s orienting response by using rapid eye movement, allowing the client to associate the original stress and emotions from the situation as something from the past and less vivid, which makes the part of the brain that perceives the emotional parts of the event see it as boring stimuli, and then it is moved to the REM system. When they are  moved to the REM system, the memories are stored as less vivid and intense. This in turns helps the client move past their traumatic experiences (One80center, 2012). 

Though EMDR is commonly used for PTSD patients, EMDR has also been proven to work for many other stress disorders. In an article where they analyzed seven different studies that used EMDR therapy with cancer patients, 140 patients in total, they found that EMDR had lowered the stress levels of the patients and improved their overall quality of life (Portigliatti Pomeri, La Salvia,Carletto, Oliva, & Ostacoli., 2020). It was stated that this occurred due to the EMDR therapy alleviating the psychological stress that the patients were experiencing (Portigliatti Pomeri, La Salvia,Carletto, Oliva, & Ostacoli., 2020). 

Though everyone who experiences a traumatic event has a different response, I believe that EMDR is an effective tool that can help alleviate the stress and tiggers that come from the traumatic event. Over all, EMDR has been proven to be a great tool for those who have experienced traumatic events. With EMDR being effective for not only PTSD, but also other stress disorders, I believe that it should be used in regular therapy sessions more frequently. If you would like to see EMDR in practice or get more information check out the Lukin Center youtube page linked below! 

Sources: 

Portigliatti Pomeri, A., La Salvia, A., Carletto, S., Oliva, F., & Ostacoli, L. (2020). EMDR in Cancer Patients: A Systematic Review. Frontiers in Psychology, 11, 590204–590204. https://doi.org/10.3389/fpsyg.2020.590204

One80center (September 6th, 2012). Q5: Can you tell us why EMDR works?- EMDR with Dr. Andrew M. Leeds Ph.D.- ONE80CENTER

https://www.youtube.com/watch?v=sWyDWvMEl1E 

The Lukin Center (2021, March 9). EMDR Therapy: Demonstration & Step-by-Step Walkthrough. [youtube]. https://www.youtube.com/watch?v=M2ra8p4MSOk 

Rousseau, D. (2021).Pathways to Recovery: Understanding Approaches to Trauma Treatment. [virtual lecture]. https://onlinecampus.bu.edu/ultra/courses/_75565_1/cl/outline

Politics and Policing

On January 6, 2021, several thousand supporters of former President Donald Trump gathered at the White House in attempt to overturn his loss in the 2020 Presidential Election to now President Joseph Biden. As a result, approximately 8,000 protesters stormed the Nation’s Capital in which the protesters condemned, vandalized, and looted. The US Capitol what is supposed to be one of the most secured facilities within our country was overtaken. The last time such a cataphoric event occurred was on August 24, 1812 during the war of 1812 between the United States and Great Britain when the White House was overtaken. Sadly, this feat which seemed unimaginable somehow occurred again, and this time by those who shamefully call themselves Americans.

On January 3, 2021 the information regarding this planned protest was provided to former Capitol Police Chief Steve Sund. Due to the possibility of the protest to turn to violent, which has been a trend in our country during 2020, Sund requested the National Guards assistance. Sund’s request was not approved by the Sergeant at Arms of the houses of Congress and Pentagon officials. According to the Post, Sund’s request was denied because officials were concerned about the visual of armed soldiers standing by police (Staff et al., 2021). The poor leadership ability exercised later caused destruction of the Capitol, death of civilians and police officers.

According to Merriam-Webster Dictionary, optics can be defined as the aspects of an action, policy, or decision (as in politics or business) that relate to public perceptions (Merriam-Webster). Throughout 2020, our country has seen a disgusting increased in concerns of optics demonstrated by law enforcement agencies. Mostly, these optics are not the fault of the men and women on the front lines, or command staff level administrators, but rather public government officials. This increased in concern of optics has led to further violence, death, destruction of communities, and significant trauma on officers.

Throughout 2020, police stations, precincts, and communities were frequently being burned to the ground by so called “peaceful protesters”. This destruction was not wanted by police nor those who reside in the communities. The lack of leadership of local government official’s negligence to take a stand negatively impacted those who they are elected to serve.  For example, this was demonstrated in Seattle, Washington when the autonomous zone was created. According to CNN pertaining to Seattle Washington, “The Seattle police chief is openly criticizing city leaders for evacuating the Third Precinct building in the city's Capitol Hill district. "You should know, leaving the precinct was not my decision," Police Chief Carmen Best said in a video addressed to the members of the department. Chief Best added that the city "had other plans for the building and relented to severe public pressure," and expressed her anger at how all this came about. She said officers spent days protecting the building before the city boarded it up (Andone,2020). Due to the poor leadership in the Seattle, the law-abiding citizens within the autonomous zone were not able to be provided to proper law and order which they are entitled to.   Seattle and the Capitol breach both demonstrate where those in position of power in public safety organizations lost the purpose of public safety, which is law and order.

Poor decisions made by command staff level and elected officials directly affect the mental well-being of those that serve under them. In this instance, the elected officials declined to activate the national guard and additional police because they were too concerned with the image of armed officers and soldiers. Not to mention, the elected officials were aware of the potential threat and they put their political agenda above the officer’s safety and American citizens safety.  Poor decision making directly affect the morale and trust officers have in their administration and ultimately their well-being. As a result of these decisions an officer was killed turning this catastrophic event into further trauma for those involved. The lack of proper management skills by elected officials will live with officers mentally and potentially cause PTSD.  Furthermore, instances like this create the do more with less mentality, lack of sufficient manpower for protests, which already cause a great deal of stress for officers.

References:

Andone, D. (2020, June 12). Seattle police want to return to vacated precinct in what protesters call an 'autonomous zone'. Retrieved June 20, 2021, from https://www.cnn.com/2020/06/11/us/seattle-police-autonomous-zone/index.html

Optics. (n.d.). Retrieved June 20, 2021 from https://www.merriam-webster.com/dictionary/optics

Staff, T. C. R., Chew, C. M., & James M. Hingeley and Gregory D. Underwood. (2021, June 20) Officials Feared 'Optics' of Deploying National Guard at Capitol Before Riot. The Crime Report. https://thecrimereport.org/2021/01/11/1189176/.

Treating vs. Curing

When trauma is commonly thought of most would expect that it results from war or other instances involving numerous encounters of overwhelming stress. Although these instances certainly pose a significant risk of trauma, trauma can be more easily obtained by numerous different types of events and is encountered frequently on a regular basis. About 6 out of every 10 males and 5 out of every 10 females will face trauma at least once some point in their lives (National Center for PTSD). In addition to that, about 7 to 8 percent of the population will have posttraumatic stress disorder (PTSD) at some point during their lives (National Center for PTSD). Trauma is defined as “an emotional response to a terrible event like an accident, rape or natural disaster.”  (American Psychological Association). Due to the ability of trauma to affect so many people not only in the U.S. but worldwide it is important to understand neurobiology and the effects such events have on the brain. Understanding the neurobiology of trauma is a must for treating such trauma medically and will aid in teaching coping methods to those suffering from these traumatic events. With that being said, the developed understanding of the neurology seems to successfully identify the parts of the brain that are stimulated and associated to disorders relating to trauma yet medicine fails to permanently cure the issue and only keeps those under balance while on the medication. Considering that a lack of medicine can leave one defenseless if not taken or forgotten should medicine be an approved or considered a reliable form of treatment to trauma?

“When someone experiences a traumatic event or experiences extreme fear, brain chemistry is altered and the brain begins to function differently--this is called the "Fear Circuity" and it is a protective mechanism which we all have inside of us.” (University of Northern Colorado). Knowing that a traumatic event can alter the brains chemistry leaves an open door within neurobiology to examine and treat the lasting effects. “Sertraline and paroxetine are the only antidepressants approved by the FDA for the treatment of PTSD” (Alexander, 2012). To this date there is no known permanent treatment of PTSD by prescription drugs and all are needed to be taken regularly and prescribed a dosage. Medications work by altering neurotransmitter production and transmission (Rousseau, 2021). However, other methods like yoga “can help to redirect the firing of neurons, or even create new neurons through two processes, called neuroplasticity and neurogenesis.” (Rousseau, 2021). Suicide rates of those dealing with PTSD is as much as thirteen times as many as those not dealing with PTSD (Gradus, 2017). Since a medical form of treatment cannot be relied on if they are not obtainable at all times it poses a clear significant risk to those dealing with PTSD. As pointed out in the film “Healing a Soldier’s Heart” there have been over 110,000 suicides since the Vietnam war which is almost twice as many casualties during the war of 58,000 (Healing a Soldier’s Heart, 2013). With this in mind, unless a more sustainable one time treatment becomes an option, teaching coping techniques should be more of a recommended form of treatment.

Of course there are extreme cases where teaching coping methods are not sufficient enough and the use of medication is needed to support the healing process. The message here is not to discredit current medications but to raise the concerns on its reliability and support future alternative methods that provides more of a cure than a temporary fix.

Works Cited

Alexander, W. (2012, January). Pharmacotherapy for Post-traumatic Stress Disorder In Combat Veterans: Focus on Antidepressants and Atypical Antipsychotic Agents. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3278188/

Gradus, J. (2017). PTSD and Death from Suicide. Retrieved from https://www.ptsd.va.gov/publications/rq_docs/V28N4.pdf

Neurobiology of Trauma. (n.d.). Retrieved from https://www.unco.edu/assault-survivors-advocacy-program/learn_more/neurobiology_of_trauma.aspx

Olsson Stephen, & Cultural & Educational Media (Producers), & Stephen, O. (Director). (2013). Healing a Soldier's Heart. [Video/DVD] The Video Project. https://video.alexanderstreet.com/watch/healing-a-soldier-s-heart

Rousseau, D. (2021). CJ 720 Module 1. Boston University. https://learn.bu.edu/ultra/courses/_75565_1/cl/outline

Trauma and Shock. (n.d.). Retrieved from https://www.apa.org/topics/trauma

VA.gov: Veterans Affairs. (2018, September 13). Retrieved from https://www.ptsd.va.gov/understand/common/common_adults.asp

Restitution and Victims of Child Exploitation

Years ago, while working as an analyst processing evidence in child exploitation cases, I met a victim of one of the most widely circulated child pornography series to date. While the abuse occurred when the victim was ten and eleven, I met her right before she started college, after her fugitive father was arrested and finally prosecuted for his crimes. She recounted how the abuse was traumatizing enough, but later discovering her father traded images and videos of the abuse online was almost too much to bear. She also discussed the long-term implications from that knowledge, fearful that every person she encountered might recognize her from those images of the worst moments of her life. Knowing that so many individuals took pleasure in her pain was also something she couldn’t comprehend. Meeting her was surreal, as I viewed images of her abuse in nearly every case I examined, and I could not even fathom what she had experienced in her young life. This encounter was almost 15 years ago, and it still has a great impact on me, and I am devastated for her (and all victims of this sort of crime) that those images are probably still being circulated every day, with the victim never being able to escape the daily reminder of the abuse.

Although I am no longer certain if this is the norm, when I worked in that field, it was a requirement that the identified victim of child exploitation be notified every time their image appeared in a case, with some victims potentially notified multiple times a day, every day of the week, due to the frequency their images were traded. While I understand the intent behind this requirement, in reality, it meant the victim faced a constant reminder of the abuse, impeding their ability to move forward. Due to this reason, some of the victims assigned an intermediary to receive the notifications, as they could not handle the constant influx of notices.

Assisting victims of crime and trauma is a challenging situation, as there is no way to erase the impact of what happened to them. “Trauma impacts the individual, his or her relationship with family and friends, his or her ability to hold jobs, and the way he or she interact with the world around him or her. It can change life paths, alter personal abilities, and cause physical and neurological damage that may or may not be repaired” (Rousseau, 2021, p. 8). Every person handles trauma differently, and every case is different, with some offenders penalized to the maximum extent of the law, while others get no penalty. The concept of restitution continues to be brought up when discussing victims of crime, although there are advocates both for and against employing monetary compensation for crime victims. "Restitution means restoring someone to the position occupied before a particular event took place,” while the “purpose of restitution is to make a victim whole” (Boe, 2010, p. 210). Forcing an offender “to pay a monetary fine, often in addition to serving a prison sentence, forces an individual defendant to address the harm his crime has caused to the individual victims of his crime and to society. Victims, especially victims of child pornography, frequently suffer both financial and emotional losses because they have to seek counseling or medical services for the rest of their lives” (Boe, 2010, p. 211). While money will never make a crime victim “whole” again, and will never be able to “restore” them to the person they were prior to the traumatic event, monetary compensation can help alleviate some of the financial hurdles they may face with seeking treatment or account for some of the financial losses they may have incurred due to their trauma.

However, one challenge surrounding restitution is assigning a financial sum commensurate to the impact on the victim, which is seemingly impossible, as the full impact can never fully be accounted. “Knowing that thousands of individuals possess images and video of oneself being raped and sexually abused in humiliating fashion can inflict deep, life-lasting trauma that extends well beyond the initial sexual abuse. This emotional trauma results in economic burdens,” including psychological counseling costs and lost income (Cassell et al., 2013, p. 73). Additionally, “determining each victim's losses requires a careful analysis of how each victim's life is impacted by child pornography,” which includes economic, emotional and physical losses, with restitution payments providing “not only psychological counseling, but also vocational and educational training to move forward with their lives” (Cassell et al., 2013, p. 74).

While I don’t have any concrete ideas regarding a “just” way to compensate various victims of crime, I do think some sort of financial reimbursement is warranted to cover some of the long-term medical, legal and therapeutic expenses, which can accumulate quickly. An additional challenge also arises when trying to recoup money for the crime victim, especially if the offender has no financial means to repay the victim. A victims’ compensation fund has been discussed, as have many other ideas, but the practical enforcement of restitution might also impact a victim long-term, if they are additionally traumatized by the justice system. Overall, I find the idea of restitution a fascinating and relevant topic concerning crime victims and the impact of trauma, although there is no easy solution when figuring out how to implement it. For me, meeting the victim was a huge reminder that we never know what anyone else has gone through or is currently going through, as looking at her on the surface, no one would have ever guessed what she was battling under the surface. Overall, it reminded me that when discussing some of these issues regarding restitution, or punishment or rehabilitation, a real-life victim is on the other end, and the human impact element is always the one that needs top consideration.


References

Boe, A. B. (2010). Putting price on child porn: Requiring defendants who possess child pornography images to pay restitution to child                     pornography victims. North Dakota Law Review, 86(1), 205-230.

Cassell, P. G., Marsha, J. R., and Christiansen, J. M. (2013). The Case for Full Restitution for Child Pornography Victims. George                            Washington Law Review, 82(61), 61-110.

Rousseau, D. (2021). Module 1 Study Guide [Notes]. Boston University Metropolitan College.

Traumatic Experiences in Correctional Facilities:   Who Has it Worse?  Correctional Staff or Those who are Incarcerated

Traumatic Experiences in Correctional Facilities:   Who Has it Worse?  Correctional Staff or Those who are Incarcerated

When thinking of what it would be like to be incarcerated, the lay person can base their perception on any number of popular televisions shows or movies; abusive staff, gangs, stabbings, rapes and a pervasive culture of violence.  While these things do occur, in some facilities much more than others, many short term, low custody sentences may not experience these things firsthand.  However, the constant fear of the above referenced items coupled with poor (if not disgusting) food quality, strip searches, group showers, unsanitary conditions, lack of access to family/friends, lack of sleep due to keys, doors, and cell checks, and reduced/delayed access to medical and mental health may in fact lead to greater negative emotions and trauma.  Any piece or combination thereof can lead to PTSD upon release back into society.  In addition, “Other factors are interwoven into the pathogenesis of this condition, including the many risk factors that underlie the behavioral and thought patterns of many criminals. These include childhood traumas such as extreme poverty, child abuse by their parents or caregivers, experiences of neglect, physical and sexual abuse, as well as other forms of mistreatment” (Thomas, 2019).

According to various research projects:

• Even before entering a prison or jail, incarcerated people are more likely than those on the outside to have experiencedabuse and trauma (Thomas, L, 2019).
• An extensive 2014 studyfound that 30% to 60% of men in state prisons had post-traumatic stress disorder (PTSD), compared to 3% to 6% of the general male population (Wolff, N, et al, 2014).
• 7% of womenin state prisons experienced childhood abuse, compared to 12 to 17% of all adult women in the U.S.. (BJA, 1999).

The below chart is from the Prison Policy Initiative article titled No escape: The trauma of witnessing violence in Prison:

The above charts and studies, however, only examined the effects of correctional environments on those who were incarcerated inside by judicial order and did not consider those who work inside the facilities, often for long and mandated shifts.  Not as many studies could be found on correctional staff related trauma.  But trauma and stress amongst staff can easily be imagined: reviewing horrific case files; witnessing traumatic events; mandatory overtime; role ambiguity; and constant disrespect by the inmate population.  “According to a 2015 article by the National Commission on Correctional Health Care, correctional employees experience higher rates of stress-related illnesses that contribute to low levels of job satisfaction, which has been linked to burnout and is thought to lead to compassion fatigue” (Pittaro, M., 2020). 

In addition, a study conducted and published this year found that correctional officers self-reported significantly higher exposure to potentially psychologically traumatic events than other medical and wellness workers. Moreover, correctional staff also self-reported greater rates of symptoms of mental disorders, including PTSD, social anxiety, panic disorder, and depression, among others (Fusco, N., et al, 2021). 

Based on the above referenced data and numerous additional uncited studies, it is evident from the research and probably obvious to the average law abiding civilian, that both correctional staff and inmates are exposed to the unimaginable and unfathomable behind the walls.  Typically, opposing sides prevent the evolution and availability of growth for each of these populations:  those who may believe that inmates deserve this and should not be afforded anything when being punished and those that may feel that correctional staff are tough and know what they sign up for.  Acknowledging the equality in the two groups and making available trauma informed approaches to care for the inmate populations and programming for self-care for staff is critical to reduce these numbers and ensure smooth transitions for each in society.  The truth is, that nearly all inmates will one day be released into society and, in addition, will be existing with us.  Moreover, staff as well are living amongst us, on their often-limited time off, and should as well be able to ‘leave it at the gate’ in terms of their work stressors.  To that note, similarly, one a sentence and work shift is complete, any individual should be, and we should want them to be, functioning, healthy and productive members of the society in which we all live. 

References:

Bureau of Justice Assistance (BJA).  1999.  Prior Abuse Reported by Inmates and Probationers. https://bjs.ojp.gov/content/pub/pdf/parip.pdf. 

Fusco, N., Ricciardello, Jamshidi, Carleton, Barnim and Hilton.  (February 15, 2021).  When Our Work Hits Home: Trauma and Mental Disorders in Correctional Officers and Other Correctional Workers.  National Institutes of Health.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7917131/. 

Pittaro, Michael.  March 24, 2020).  Correctional Officers and Compassion Fatigue.  Psychology Today.  https://www.psychologytoday.com/au/blog/the-crime-and-justice-doctor/202003/correctional-officers-and-compassion-fatigue. 

Thomas, Dr. Liji.  (February 27, 2019).  Prisoner Post Traumatic Stress.  Medical Life Sciences News.  https://www.news-medical.net/health/Prisoner-Post-Traumatic-Stress.aspx.   

Widra, Emily. (December 2, 2020).  No escape: The trauma of witnessing violence in Prison.  Prison Policy Initiative.  https://www.prisonpolicy.org/blog/2020/12/02/witnessing-prison-violence/#lf-fnref:1. 

Trauma Informed Policing by Frederick Morse

In recent years perhaps no profession has received as much scrutiny as law enforcement. Americans are redefining social norms and expecting more professionalism and accountability from law enforcement. One of the areas in law enforcement that has been beneficial, yet not without growing pains, has been the proliferation of body-worn video cameras. An additional facet of American life that has also received a fair amount of attention is trauma and mental illness. Research has shown that early childhood trauma can result in hindered growth resulting in uncontrolled anger, inappropriate behavior, disregard for rules, and drug or alcohol abuse (Rousseau, 2021). These precursors often result in contacts with law enforcement.

In the United States, a growing number of service requests for law enforcement similarly involve police interaction with vulnerable individuals or those experiencing a psychologically based crisis.   A recent study in Scotland revealed that approximately 80% of all calls for service for law enforcement were non-criminal in nature (Gillespie-Smith, 2020).

With this dynamic in mind, scholars in Scotland conducted research where they exposed police personnel to trauma informed practices. Specifically, the study chose one police division and showed them the documentary “Resilience: The Body of Stress and Science of Hope.” The documentary explained how chronic stress releases hormones within the body of children which then results in dysfunction in the minds and bodies of youth. After viewing the film, the police personnel were given an overview of the 1998 Adverse Childhood Experiences (ACE) study and scores. There was a panel of experts available for questions and to provide further context for the data.

Police personnel learned that in Wales, individuals with an ACE score of four or more were twenty times more likely to be incarcerated at some point in their life than the general public (Bellis, 2015).  Similarly, the officers learned that approximately 89% of the prisoners in Wales reported at least one ACE (Gillespie-Smith, 2020). Police personnel who received the trauma informed training were then questioned as to their attitudes and understanding about suspects, witnesses, and victims. The researchers then compared the answers with answers from officers from another police division that did not receive the trauma informed policing training. The answers were not significantly different (Gillespie-Smith, 2020). Many of the officers who received the training expressed confusion about the ACE score research. The officers indicated that the trauma had occurred before their involvement and they failed to see how the new knowledge could benefit their current role. This was a common theme in the feedback from the participants (Gillespie-Smith, 2020).

On its face, the scholarly work in Scotland appeared to be unremarkable. However, if law enforcement agencies in the United States could build upon this trauma informed approach to policing and combine it with the technology of body worn video, real progress could be made. Law enforcement personnel have countless contacts and calls for service with individuals with mental health needs. A trauma informed approach to these calls for service could curtail any use of force and would result in decreasing further trauma to the individual in crisis or the officer.

Law enforcement administrators need to seek out strategies for improved professionalism and techniques for de-escalation. With the use of body worn video, contacts with individuals in crisis or mental health decompensation can be reviewed by law enforcement trainers and mental health professionals to improve officer responses and protocols. All contacts with citizens with mental health needs would be given a unique computerized clearance code making it easier to identify and retrieve the incidents for later review. The review of body worn video would be for educational purposes only, with the goal of improving trauma informed practices for law enforcement personnel. Police agencies could generate training videos from body worn video footage from actual interactions. The videos would include instructional narratives from mental health professionals and would be disseminated to other stations and personnel.  A secondary objective would be to ensure that law enforcement personnel are getting the necessary and timely assistance from mental health agencies. If both agencies can work in a collaborative manner, individuals in crisis might receive professional intervention and proper care instead of a trip to the county jail.

Submitted by: Frederick Morse

Works Cited

Bellis, M. A. (2015). Adverse Childhood Experiences and their Impact on Health-Harming Behaviours in the Welsh Population. Wales: Cardiff: Public Health.

Gillespie-smith, K. B. (2020, August). Moving Towards Trauma-Informed Policing: An Exploration of Police Officer's Attitudes and Perceptions Toward Adverse Childhood Experinces (ACEs). Retrieved from https://www.research.ed.ac.uk/en/publications/moving-towards-trauma-informed-policing-an-exploration-of-police-#:~:text=In%202018%20Ayrshire%20Division%20of%20Police%20Scotland%20announced,perceptions%20and%20attitudes%20towards%20becoming%20a%20trauma-in

Rousseau, D. (2021). Trauma and Crisis Intervention. Module 2 Study Guide. Boston University.

Liquid Trauma Treatment and Law Enforcement

For most professionals, when colleagues ask to grab a few drinks after work, this is seen as a friendly gesture to build relationships at the workplace. For law enforcement this can be seen and used as a way to cope with the stress and trauma from the job or to self medicate for anxiety, depression or post-traumatic stress disorder. While the exact number is hard to calculate, it is estimated that approximately 23% of all police officers in the United States are alcoholics. To put that into perspective, there are an estimated 800,000 sworn officers in the United States which would mean approximately 184,000 officers are considered alcoholics. Some officer’s may have already been or will eventually become alcoholics, prior to being hired, due to genetic predisposition or the environment they were raised in. While this may be true, it is easy to see how the job and the lack of mental health resources available would lead to such troubling statistics. 

The day I was hired and sworn in as a police officer, a family friend, who was an active duty police officer at the time, told me that I now had “a front row seat to the greatest show on earth.” Without knowing what the job entailed and the mental health issues that face police officers, I find it somewhat ironic that my family friend and I were drinking at the time. I saw the occasion as a celebration while he may have seen it as a way to self medicate to ease the pain of  the demons he carried with him as a result of being a cop. The idea that I could sign up for a job where every day, every hour, and every minute was different sounded too good to be true. And at first, this was exactly what it was like for me every time I pulled that bullet proof vest over my head, buttoned up my uniform shirt, and shined my boots. Today, every time I put on that vest, I am quickly overcome with stress and anxiety of the unknown. The adventures of the job and the adrenaline filled incidents that I yearned for quickly became mundane and I felt as if I was becoming complacent which is a killer in this job. “The very nature of police work includes regular and ongoing exposure to confrontation, violence, and potential harm. Exposure to potentially traumatic experiences on a regular basis sets the stage for a series of mental health complications, including posttraumatic stress disorder (PTSD)” (Maguen et al., 2009, p. 754).

Perhaps it was because of the COVID lockdowns without much else to do, or perhaps it was me subconsciously self medicating from the stress of the job, but I soon found myself drinking almost every night. My fiancé recognized this and quickly made me realize that it was becoming a problem. I am extremely fortunate and grateful that my fiancé had the courage to speak up and confront me about my drinking habits. For many this resource is not available and they are left searching for help while fighting to stay anonymous. The search may continue long enough where officers feel they don't have any options and end up take their own lives. “Law enforcement suicide is real and is the number one killer of police officers,” occurring “1.5 times more frequently than suicide in the general population” (Rousseau, 2021, p. 7).

The stigma around mental health and its subsequent treatment is extremely prevalent in law enforcement but the more alarming issue is the lack of resources available to officers. This may be because of the stigma but leaders within the profession have a moral and ethical obligation to do better. I have heard from some classmates that their departments offer mandatory mental health services without questions asked and their colleagues are far better for it. This is an example of forward thinking leadership while combating the stigma that surrounds mental health. The country needs more leaders like this to step up and take care of their own. This will not only lead to healthier officers but it will also lead to better relationships with the public they serve. 

Bibliography:

“How Common Is Alcoholism with Police Officers? - The Recovery Village.” The Recovery Village Drug and Alcohol Rehab, The Recovery Village Drug and Alcohol Rehab, 22 Dec. 2020, www.therecoveryvillage.com/alcohol-abuse/related-topics/facts-alcoholism-police-officers/. 

Maguen, S., Metzler, T. J., McCaslin, S. E., Inslicht, S. S., Henn-Haase, C., Neylan, T. C., & Marmar, C. R. (2009). Routine Work Environment Stress and PTSD Symptoms in Police Officers. Journal of Nervous & Mental Disease, 197(10), 754–760. https://doi.org/10.1097/nmd.0b013e3181b975f8

Rousseau, D. (2021). Module 6 Study Guide [Notes]. Boston University Metropolitan College.

Self-Care and Trauma

People who experience trauma deserve to be free from the weight and pain that it bears upon them. Throughout this class, we have discussed multiple treatment methods that can work individually or that can be used together to find the best treatment plan for the individual. Not all treatments are as widely accepted as others and one that seems to walk on that fine line is self-care. Self-care however is an important part of healing from the trauma, but it should be started when the individual is ready for that experience. Trauma affects our entire body, mind, and our whole being. When all of these aspects are affected we have a harder time being present, connecting, and relating to others. By focusing on ourselves through self-care, our mind and body can work together again to create a healthy and happy lifestyle that may have not existed before. 

Highland Springs Clinic mentions that on one’s journey to healing and recovering from a traumatic event, it is important to remember the practice of self-care. They also wrote that “self-care is not commonly the first method survivors think of when they are overcoming a traumatic experience, however, it is a critical part of healing”(Hood,2020). Before starting any kind of trauma therapy, it is important to understand what trauma is and how it may present itself in you. Knowing when to start self-care is dependent on the individual and they have to allow themselves to be ready. Self-care is not the same for everyone, but listening to your body and mind and what it needs is a first step for starting this journey. Our body usually recognizes what we need and will signal to us when the time for recovery is here. Highland Springs Clinic mentions some areas of self-care that are good to start with are get more rest, find someone to talk to, journal about it, use exercise as a tool, and find engaging hobbies (Hood, 2020). While this is only a shortlist of self-care options they are good places to start for people who are ready to treat their trauma by loving themselves. 

Whitney Goodman LMFT, a licensed psychotherapist brings up a good point that self-care is supposed to make us better in the long-term and that it is not a quick fix. In society now, the term “self-care is officially a commodity, and people are buying it off the shelves to prove that they care about themselves”(Goodman, 2019). It is important that people who chose self-care to help them with their trauma understand that learning to love yourself and take time for yourself is not an easy process. Goodman stated “real self-care happens in the decisions you make every day and it requires practice, commitment and putting yourself first and getting in touch with what you really need, not just what you really want”(Goodman, 2019). Her short list of self-care is: get in touch with your feelings and actual needs, practice kindness, and ask yourself “what do I need at this moment”. One big point that Goodman and Highland Springs Clinics mentioned is staying away from drinking or using substances since it is not self-care. There are so many different kinds of self-care out there, that experimenting with them will help us find which ones work for us. It is important that people who have experienced trauma believe that they deserve self-care before starting to practice it. 

Everyone that goes through a traumatic experience reacts differently emotionally, psychologically, and physically. Being able to accept and be ready for the step of self-care is important to accept the responsibility for yourself, your body, and your mind. Finding a positive self-care routine when ready to embark on the journey will help the overall healing process. It is important to remember that there is no right or wrong way to self-care, it is all about what helps that individual after trauma to become whole again. Dr. Bessel Van Der Kolk writes “the full story can be told only after those structures are repaired and after the groundwork has been laid: after no body becomes some body”(Van Der Kolk, 2015, p.249). Trauma is stressful, but acting on self-care can alleviate that stress. As well as realizing that the trauma needs to be dealt with in a positive way and wanting to deal with it will help accomplish the first step with the journey of self-care.

References

Goodman, W. (2019, July 12). When Self-Care Becomes a Weapon. Psychology Today. https://www.psychologytoday.com/us/blog/healing-together/201907/when-self-care-becomes-weapon. 

Ph.D., D. Julia. Hood. (2020, January 27). The Importance of Self-Care After Trauma. Highland Springs. https://highlandspringsclinic.org/blog/the-importance-of-self-care-after-trauma/. 

Ocrcc. (2020, October 12). self-care Archives. OCRCC. https://ocrcc.org/tag/self-care/.

Van Der Kolk, B. (2015). The Body keeps the score brain, mind, and body in the healing of trauma. Penguin Books.

Acupuncture as Trauma Therapy

Over the relatively short period of time that trauma treatment has been studied, there has been a myriad of different methods proven to help trauma victims in one way or another. Despite this, there is yet to be a cure-all that works completely for every individual and every trauma. To fully accept the reality of a trauma and be free from the weight it bears, multiple treatment methods working in tandem with one another is the best approach for healing.

One treatment method that is less often discussed but proven effective is acupuncture. Acupuncture is an ancient Chinese practice that utilizes small needles placed along pressure points on the body to help with energy flow and pain relief. Chinese documents dating as far back as 100 BCE describe the system of diagnosis and treatment that is now recognized as acupuncture (White & Ernst, 2004). The original idea of flowing meridians in the body has given way to modern neurology’s explanation that the needles stimulate nerve endings and brain function (White & Ernst, 2004). While the practice is centuries old and has been utilized in cultures across the globe, there is surprisingly little research on its effects.

Although there is little research on the subject, other forms of therapies have developed from its principles. Emotional Freedom Techniques is a more common method that, while self-administered, relies on the same bodily energy flows as acupuncture and has also been proven to cure the physical and psychological effects of trauma. In a survey following the September 11^th attacks, the 225 individuals questioned said that acupuncture was the most effective method in helping them overcome the immediate trauma of being in the Towers (Van der Kolk, 2014). Acupuncture has also been found to be a “promising treatment option for anxiety, sleep disturbances, depression and chronic pain” as related to the trauma spectrum responses (Lee et al., 2012). While more research is needed to identify the mechanism of action between the needles and the actual relief, the success stories speak for themselves and make the practice a worthy contender for comorbid treatment.

The way acupuncture can aid in trauma recovery is by alleviating the symptoms either directly or residually caused by the event. For example, after a car accident, an individual might suffer pain in their neck and experience anxiety whenever they are in a car again. Acupuncture can help to relieve the neck pain that both hinders quality of life and acts as a constant reminder of the accident. Chronic pain is also a common side effect of adverse childhood experiences. When an adult comes in for therapy with a long history of repeat traumas, alleviating physical pain is a great starting point to begin recovery. This allows for a greater sense of control in one’s own body and opens doors for further therapeutic practices like yoga and exercise that would not have been possible with chronic pain. Acupuncture may not be the cure-all that therapists and researchers are looking for to help their patients overcome past traumas but its longstanding history and overwhelming success rate for non-trauma related pain demands more research be conducted on the practice’s effects on trauma.

References:

Lee, C., Crawford, C., Wallerstedt, D., York, A., Duncan, A., Smith, J., Sprengel, M., Welton, R., & Jonas, W. (2012). The Effectiveness of Acupuncture Research Across Components of the Trauma Spectrum Response (TSR): A Systematic Review of Reviews. Systematic Reviews, 1(1). https://doi.org/10.1186/2046-4053-1-46

Van der Kolk, B. A. (2014). The Body Keeps the Score. [VitalSource Bookshelf]. Retrieved from https://bookshelf.vitalsource.com/#/books/9781101608302/

White, A., & Ernst, E. (2004). A Brief History of Acupuncture. Rheumatology, 662–663. https://doi.org/10.1093/rheumatology/keg005.