CJ 720 Trauma & Crisis Intervention Blog

Prolonged Exposure Therapy: An Integrated Approach that Incorporates Coping Techniques and Trauma Confrontation

Trauma is an overwhelming emotional response experienced by an individual who has experienced a threatening event. The emotional response of trauma could have a long lasting effect and presence within an individual long after the threat is gone, leaving the individual to experience those high emotional responses in the absence of such threat where they originated from. This persistence of trauma symptoms is identified as Post Traumatic Stress Disorder in which “an individual gets stuck chronically in a stress and trauma response – either because of chronic stress and trauma or because the mind and body lose the capacity to accurately assess a true threat of danger” (Rousseau 2019).

Although there are many approaches to trauma therapy I believe that The Prolonged Exposure Therapy Approach truly targets the issue in individuals who are suffering from PTSD as it helps individuals gradually revisit traumatic memories to help process and manage the emotional response associated with that experience. Other therapy approaches focus on the development of coping methods and emotion recognition/ self awareness to essentially suppress the emotional response when presented with a traumatic trigger. However through prolonged exposure therapy the root of the problem is addressed and that is the threat of the specific event.

When an individual is presented with a situation it is the brain's job to detect it and organize it. Sensory information comes in through the senses (eyes, ears, nose, and skin) these sensations then reach the thalamus in the brain which essentially “ stirs all the input from our perceptions into a fully blended autobiographical soup, an integrated, coherent experience of  “this is what's happening to me””(Van der Kolk p.60 2015) These sensations are then passed to the amygdala and the frontal lobes. The amygdala is located in the unconscious brain and upon receiving the input its function is to determine whether that input is relevant for survival, if so it initiates a fight or flight response for preservation even before the input reaches consciousness. The frontal lobes receive the input and interpret its context based on past experiences and knowledge in order to further carry out a response (Van der Kolk 2015) .

Peter Tuerks elaborates on the organizing function of the brain as it provides evolutionary predictability in disorganized situations. He states that it is the purpose of the human mind to process their surroundings in order to make sense of it and develop a response. Tuerks uses the example of a routine activity such as grocery shopping, when an individual is familiar with a routine or schema it becomes a mindless unmemorable task. However if that schema is interrupted by an unusual  event such as an elephant in the back aisle , the brain actively searches for a similar schema which would make the information at hand make sense. If the brain is unable to organize and make sense of this information it remains readily accessible in the mind. This applies to trauma in which an individual experiences a new and heightened emotional response, that of which is not familiar to the brain. As a result of this situation that has not been categorized an put away in the mind, when an individual is presented with a similar triggering situation, that hyper aroused emotional response becomes cued and reactivated. The heightened emotions experienced by the individual in the triggering situation interrupt the peace of the individual. Therefore it is natural for individuals to avoid such similar and triggering situations that may elicit the same emotional response. This avoidance prevents the individual from being able to process and revisit the situation in order to make sense of it and put it away.

Prolonged Exposure Therapy is typically provided over a period of three months with weekly individual sessions. In the primary sessions the therapist goes over past experiences with the patient to form a relationship, and then also teaches coping techniques such as breathing those of which are to be practiced while revisiting the traumatic experience. These techniques are taught to manage anxiety and to avoid further traumatization as they help patients maintain control of their emotions that may be overwhelming. Once these calming techniques are practiced and understood the therapist them proceeds to initiate exposure of the traumatic experience with the client. This exposure can be done on two ways, imaginal exposure in which the patient describes in detail the events of the experience in present tense with the guidance of the therapist. This present tense guided description is recorded and allowed for the client to take home to further listen and revisit the experience while using calming techniques at home.  The second method is usually approached later in the sessions, in vivo exposure, in which the client and therapist agree on which stimuli to confront outside of therapy as homework. The client works with the therapist to devise a plan on how this exposure is approached (Prolonged Exposure 2019).

I believe that Prolonged Exposure Therapy theoretically checks out as it incorporates hyper arousal suppression techniques and education which is used while confronting and processing traumatic memories and new seemingly similar situations or triggers. Through Prolonged Exposure Therapy the client not only learns new techniques to help them in potentially threatening and stressful situations in the future but it also gives them the tools to gradually confront their traumatic memories giving them the time to process the actuality of the situation little by little resulting in their ability to become more familiar with the situation allowing for processing and putting away of the event.

Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder: Prolonged Exposure (PE) Retrived April 27, 2019 https://www.apa.org/ptsd-guideline/treatments/prolonged-exposure

Rousseau, D. 2019 Trauma and Crisis Intervention Module 1 : Introduction to Trauma / Module 4: Pathways to Recovery

Van der Kolk, B.  A. (2015). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. New York, NY: Penguin.

Self-Care Strategies

Before we begin on strategies for Self-Care, it is important to define Self-Care.
Self-Care - the practice of taking action to preserve or improve one's own health. (Oxford English Dictionary).

Sounds simple enough right? Wrong. Many of us do not take the proper steps and time to take care of ourselves. We are often too busy with every day life, work, children, taking care of others, we don’t leave enough time to take care of the most important person in our lives – which is our own health and well-being.

There are many things we can do to take care of ourselves and self-care can mean different things to different people; however, there are some basic rules that can be applied to everyone. Self-care does not need to be complicated or too time consuming; however it needs to be actively planned rather than something that just happens every now and then.
Here are some basics to stick to when planning for self-care:

1. Get enough sleep
2. Develop healthy and nutritious eating habits
3. Exercise regularly (not obsessively)
4. Learn how to say NO
5. Do something that makes YOU happy
6. Pamper yourself without feeling guilty
7. Surround yourself with people that uplift you

It is important to note that you don’t have to do all of these activities all the time or at once, however picking a few that are important to you is a good way to make it a part of your daily routine.

For myself, the top three from the above-list are: sleep, exercise and doing something every day that makes ME happy. Although I think that some of these can be combined, but for the sake of simplicity, I will keep them separate.

I have battled with sleeping issues for a long time due to stress and injury and I must say not getting proper sleep is a slippery slope to many unhealthy choices that follow. If you don’t get enough sleep, it can truly mess up your immune system, make you irritable and the rest of your day is easily ruined. Some people need 8 hours of sleep, some people need 5, but it is important to get restful sleep. Meditation before bed or reading can help tremendously when having trouble sleeping.

Exercise for me is key to getting my day started on a positive note – it does not have to involve hours at the gym. It can be as simple as taking a 20 min walk followed by some yoga with light weights at home or just using your own body weight to get your blood flowing. Personally, I love to run and do Pilates – both combined is one of the biggest stress relievers for me. I love working out first thing in the morning as it sets the tone for the rest of my day. I have noticed if for whatever reason I am unable to exercise in the morning, my mood is not quite as good and I am more irritable and on edge. Not only does it make my body feel great and strong, but most importantly helps to keep my mind sharp. Furthermore, it increases serotonin levels and leads to good energy and good mood.

Last but not least, doing something every day that makes ME happy is very important. At times this may sound selfish to others, but to make others happy and be a good friend/partner/employee etc. you must take care of yourself first and be content before you can do that for others. This strategy sounds vague, but it can create a lot of positives for one’s well-being. It can be something so simple as walking to your favorite coffee shop to get coffee in the morning; to getting a massage or hanging out with a particular friend that day. The most important aspect of this is you are doing something that makes YOU happy. For me, each day it varies, but sometimes I just want to stay home and listen to music while other times I want to be surrounded by friends at a nice dinner and cocktail or going to a comedy show or spending time with my nephews – it all depends on what small or big thing I want to do that day. It is also important not to feel guilty when doing so. We often do things we don’t necessarily want to do or if we take time for ourselves, we feel guilty about it – that has to stop!

These are some simple steps we can take towards taking better care of ourselves.
Life is not perfect, and we are all busy, but we must take time for ourselves; it does not have to be complicated, time consuming or costly, even 20 minutes a day can have a great impact. When we don’t take time for self-care, our energy and motivation can decrease, making it even more challenging to stick with healthy lifestyle choices.

Michael R. 2018 – What self-care is and What it isn’t?
https://psychcentral.com/blog/what-self-care-is-and-what-it-isnt-2/

Post-Traumatic Stress in Animals

According to Rousseau (2019), trauma represents exposure to experiences or situations that are emotionally painful and distressing, that overwhelm a person’s ability to adapt or cope, and over which they feel powerless. One common anxiety disorder that results from trauma is Post-Traumatic Stress Syndrome. Symptoms of PTSD include: flashbacks, nightmares, hostility, difficulty sleeping, etc. Some people who get PTSD usually experienced trauma from child abuse, physical abuse, sexual abuse, an accident, a death of a loved one, or war. Since countless people experience PTSD, an interesting topic to examine would be the chance of animals also suffering PTSD. For many individuals, their pets are a member of their family. Many people adopt their pets from shelters, sometimes rescuing them from abusive owners. The trauma animals experience from physical abuse is similar to that of humans. So, can they develop Post-Traumatic Stress symptoms like humans as well?

Kumar (2017) discusses PTSD in her cat Lola. In May of 2017 in Afghanistan, a tanker truck was bombed. The attack claimed more than 150 lives and injured at least 700 others. The impact of the explosion was felt several miles away, breaking windows and cracking ceilings. 20 minutes after the explosion, Lola was hiding. For the next week, Lola was edgy. She was startled by small sounds and she would follow the author everywhere. Lola would wail when Kumar left the house and be clingy when she returned. She started eating less and losing weight. According to Kumar (2017), the U.S. military has seen this reaction to stress in its working dogs. About 5 percent of the dogs that have served in Afghanistan and Iraq suffer from “canine PTSD,” making some dogs aggressive, timid, or unable to do their jobs.

Romm (2016) discusses Elsom, a chimpanzee who experienced PTSD. Elsom’s mother died with he was 13. At age 15, he suffered a serious injury to his arm. He disappeared for a few months afterward and isolated himself from his community. Upon his return, he was different. He was easily agitated and angry. He was more fearful and had difficulty sleeping. Romm (2016) states that animal mental illness can be triggered by many of the same factors that unleash mental illness in humans, including the loss of family or companions, loss of freedom, stress, trauma, and abuse.

Post-Traumatic Stress Disorder is an awful illness that some people deal with. They are forced to relive whatever trauma they experienced through different psychological symptoms. It is evident, through many articles like the ones mentioned above, that animals can indeed suffer from Post-Traumatic Stress just like humans. Imagine a mental illness so powerful that it has the power to affect both humans and animals. That is the impact of Post-Traumatic Stress Syndrome.

References

Kumar, R. (2017, July 08). Can animals suffer from PTSD? Retrieved from https://www.washingtonpost.com/news/animalia/wp/2017/07/08/can-animals-suffer-from-ptsd/?noredirect=on&utm_term=.b4f2fadef2ef

Romm, C. (2016, May 05). Animals Can Get PTSD, Too. Retrieved from https://www.thecut.com/2016/05/animals-can-get-ptsd-too.html

Rousseau, Danielle, PhD (2019, April 28). [Module 4 Lecture]. Boston University

Self-Care through Resilience

Self-care is critical for all individuals in some form, but it is especially important for those in the criminal justice field.  Self-care strategies are those things an individual does to reduce stress and ultimately rejuvenate ones self.  This could be done through a combination of physical, mental, or even spiritual activities. Self-care could be as simple as drinking coffee while watching the sun rise; soaking in the quiet peace of the morning.  It can also be as vigorous as playing recreational sports every week, or even a more spiritual approach of reflecting on the weeks sermon in church. 

Self-care can be conducted in different ways but also includes making sure ones basic needs are met, such as maintaining a nutritional diet and ensuring one receives ample rest.  These are all factors that can be done prior to the induction of stress to better prepare the body, physically, for the challenges to come.  An individual can also prepare the mind for mentally challenging situations.  Just as one exercises to build their physical stamina, one can also prepare the mind as a form of self-care.  Building ones resilience is an effective approach to pre-conditioning the mind for difficult or stressful situations, which in the criminal justice field, is highly likely.

Resilience is the ability of an individual to bounce back in the face of adversity.  Resilience skills and personal exposure and experiences all add to the response one might experience when faced with a stressful or traumatic event and can contribute to the level or existence of PTSD as a result of the event.  Not every one experiences trauma the same way and not every event triggers a traumatic response from every individual.  What we do know is that trauma can prompt a neurological effect in an individual, causing one’s emotional mind to react and essentially blocking the cognitive mind (Van Der Kolk, 2014).  Yet, learning effective skills can boost an individual’s ability to cope with overwhelming amounts stress or lessen the physiological impacts. 

In 2009, the Army took this concept and teamed up with the Positive Psychology Center at the University of Pennsylvania to develop a program specifically designed to teach resilience skills to Soldiers.  The thought was that if Soldier’s learned specific skills designed to increase their resilience, they could better cope with the challenges of combat.  These skills include methods that focus on the elimination of irrational thinking (i.e. giving in to the worst case scenario in a life threatening situation) to allow an individual to more clearly assess a situation (i.e. strategizing an escape or counter attack).  Resilience skills can also improve personal connections, as connections are linked to an individual’s ability to overcome an event.  This could also include skills designed to bring the body to the most optimal state for performance – mental, social, physical, and emotional skills.  The idea is that a resilient individual is better equipped to cope with difficult situations and can further use these abilities for post-traumatic growth. Post-traumatic growth is the ability of an individual to experience positive change as a result of a difficult event.  “Resilient people tend to take responsibility for their emotional well- being and use the traumatic experience as a basis for personal growth (Southwick & Charney, 2012, p. 13).

Although the concept of resilience and trauma is a fairly new area of study, research has already suggested that resilience does have neurological affects (Friedberg, 2018). Therefore, developing resilience-based skills can contribute to an individual’s wellbeing, their ability to overcome stress and trauma, and their ability to regain control of their mental state.  Because these skills focus on improving an individual’s ability to coop with stress, mastering these skills can serve as a form of preventative self-care.  In the moment, exercising these abilities can help an individual return to a more positive and constructive mental state, ultimately rejuvenating ones self when it is needed the most. 

References: 

Friedberg, Ahron & Malefakis, D.  (2018). Resilience, Trauma, and Coping.  Psychodynamic Psychiatry: Vol. 46, No. 1, pp. 81-113.

Positive Psychology Center. (2019).  The University of Pennsylvania School of Arts & Sciences. Accessed online 22 March 2019.  https://ppc.sas.upenn.edu/resilience-programs/resilience-research

Southwick, S. M., & Charney, D. S. (2012). Resilience: The science of mastering life’s greatest challenges. New York: Cambridge University Press. Accessed online 29 April 2019.  https://doi.org/10.1017/CBO9781139013857

Van der Kolk, Bessel A. (2014).  The Body Keeps the Score. New York, NY.  Penguin Books. 

Strategies for Self-Care

One would think after attending a Dr. Kevin M. Gilmartin presentation hosted by a local police department, I would have a better understanding of the importance of self-care. One would think after attending the previously mentioned presentation and later being assigned to read Dr. Kevin M. Gilmartin’sEmotional Survival for Law Enforcementin a work course, I would have an even better one two punch system for self-care. Guess what? Nope. Not at all. I listened to Dr. Gilmartin talk about being multi-dimensional and having more than just the title of “Krystal the Cop”; heck, I even read the book cover to cover! Here I sit, writing this blog post, after six weeks of discussions on trauma and crisis intervention realizing I am heading down a road of broken relationships, self loss, and walking right into being the victim of Post-Traumatic Stress Disorder caused by my job and those in it.

The emotional changes take place first: Anger can become a prevailing and ever present state in a police home. Then, as the years pass, physical changes can appear. The constant anger and the physical upheaval it causes, combined with years of shift-work-induced sleep deprivation, poor diet, and a sedentary lifestyle, can lead the now veteran officer to face physical changes in addition to emotional issues. (Gilmartin, PhD., 2002, pp. 4-5)

Yep, this is where my life is at. A ten-year veteran of a small town agency where the last five years were spent working a swing shift (1300 hours – 0100 hours), raising a now 7 year old boy, one failed marriage, working on trying to save a five year relationship with another man and his soon to be 7 year old son, looking around to realize I don’t have friends to call at any given moment in time. Clearly I am rocking this self-care! So what do I do? How do I change it? What steps do I need to take?

I have to get rid of the “I usta” responses. According to Dr. Gilmartin (2002), “It describes what they "used to” do before becoming police officers…the things that have been lost from the officer’s life, the things that are not work related…” (p. 69). Recognizing that I need to do things for myself outside of work, to include my family, and to not let the bitterness of my job continue to ruin my life.

Yoga for First Responders shows how implementing yoga for police and/or firefighters is important for emotional wellness and mental-resiliency (Yoga For First Responders, 2016). The benefits of yoga – stretching, meditation, breathing techniques – can be beneficial for me. Here is a “I usta” for me, I used to practice yoga long before I was a cop and I enjoyed it so very much but now with my schedule it is so hard to find the time. Physical fitness is another “I usta” for me, I used to go to the gym regularly but again my work schedule and having a child that cannot be home alone made it so difficult to maintain my gym schedule. A simple thing as going for drives, listening to music, putting my feet in the ocean and feeling the sand between my toes, all things that can help re-center my well-being and promote self-care.

But what it really comes down to is action. All the strategies in the world won’t mean a thing if I or another is not ready to make the move, to recognize the self-destruction that is occurring by not taking care of one’s self in this line of work. Going out to dinner with NON first responders, having friends that are not all first responders, doing activities that bring joy, being present in the moments with family and making the time to do things other than the job. I truly hope that everyone recognizes the importance of taking care of themselves, regardless of the job they do or regardless of their history.

Works Cited

Gilmartin, PhD., K. M. (2002). Emotional Survival for Law Enforcement.Tucson: E-S Press.

Yoga For First Responders. (2016). Yoga For First Responders. Retrieved from Yoga For First Responders: http://yogaforfirstresponders.org

Self Care and Trauma

Stacy-Anne Parke ~  CJ720 ~ Trauma and Crisis ~  Blog Post

You deserve to enjoy life just as much as anyone else!

You may not know what good self-care looks like, but it forms the backbone of your physical and emotional well being. It encourages progress and healing. It is essential in the maintenance of a healthy relationship with yourself. Sometimes it’s as simple as getting enough sleep, waking up and getting out of bed, brushing your teeth, and providing your body with the right nutrients it needs. Other times self-care can manifest itself in taking walks, yoga (movement), hanging out with friends or not hanging out with friends, relaxing, expression, and listening to yourself.

How do you know you need to practice better self-care? Well, you may:

1. Sleep too much!
2. Or not sleep at all.

   

3. Over-schedule.
4. Have a poor relationship with food.
5. Abuse alcohol and substances
6. Feel constant stress.
7. Feel Helpless

Trauma is overwhelming and often the relationships between your mind and surroundings are heightened- and maybe even painted a shade of grey. Trauma survivors often feel detached, ”the essence of trauma is feeling godforsaken, cut off from the human race” (Van der Kolk, 2014). However, your life deserves to be in color, full of turquoise, light lilac and ignited red. Taking care of yourself is life-saving, it isn’t a luxury but it sure does feel luxurious . Especially for trauma survivors, it is important to engage in “activities that lower the physiological adrenal surge from trauma” ( De Lorenzo, 2018). Engaging in the present reduces those surges. 

The neuroplasticity of your brain continues to develop past childhood; at any age, you can re-heal, grow, and learn. How incredible and hopeful is that?  This can be accomplished through safe relationships, improved adaptive thinking, self-regulation, learning, and social skills, all of which are facets of many self-care plans (Masten, 2014; Matto, Strolin-Goltzman, & Ballan, 2014). Emotions help us to engage in actions and behaviors. Love encourages us to love, fear encourages detachment, while anger can culminate into aggression, violence, and emotional harm. Trauma suspends those emotions and instead leaves the mind and body feeling paralyzed, absolutely stuck in time. With the incredible tool of plasticity it is still hard for our rational brains to take care of ourselves, "the rational mind, while able to organize feelings and impulses, is not well equipped to abolish emotions, thoughts, and impulses" (Van der Kolk, 2009). For example, individuals with PTSD are usually out of touch with their physical sensations; mindfulness can help mend that relationship by allowing the individual to become more aware.

 Starting with children it’s important to equip them with the right tools for self-management. For traumatized and neglected children this can be established in schools. In fact, schools can be a gateway to creating resilience. Thus, it is imperative

“to receive a good education in schools where they are seen and known, where they learn to regulate themselves, and where they can develop a sense of agency. At their best, schools can function as islands of safety in a chaotic world. They can teach children how their bodies and brains work and how they can understand and deal with their emotions. Schools can play a significant role in instilling the resilience necessary to deal with the traumas of neighborhoods or families … to be the places where children are taught self-leadership and an internal locus of control" (Van der Kolk, 2014)

For traumatized adults, it is imperative that there are established dependable and healthy relationships and if not eliminating toxic ones are ideal.  Addressing the dimensions of self-care through those relationships can then do wonders.

Self-care shouldn't fall solely on the individual either. Friends and family can encourage better stress-management practices; Clinicians have a responsibility of encouraging healthy practices with their clients and themselves (vicarious trauma). Small assignments that turn into habits throughout a course of therapy can lead to momentous changes in behavior and self-worth. Improvements are made in energy levels, productivity, fulfillment/satisfaction, along with overall well-being.

Balancing psychological needs and maintaining a sense of well-being requires effort, consistency, and patience. Not only is there an ethical need for self-care for therapists, but there is a paramount necessity for it in order to live wholly. We essentially have all of the parts to be effectively be present and manage stress; however, self-care keeps those parts in shape and running.

25 ways to practice self-care

1. hydrate
2. walk
3. dance
4. listen to music
5. shower/bath
6. sleep
7. change your clothes
8. yoga
9. clean
10. wash your face
11. read a book
12. write a poem
13. journal
14. light a candle
15. talk to a friend
16. talk to many friends
17. feel- cry, smile, laugh
18. color
19. practice forgiveness
20. practice acceptance
21. set priorities
22. therapy
23. cook
24. surround yourself with your favorite smells
25. try something new

References

Van der Kolk, B. (2009). Yoga and Post-traumatic stress disorder [Interview]. Integral Yoga Magazine, 12-13.

Van der Kolk, B. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. New York: Viking.

My Experiences with Self-Care

Many jobs are stressful.  That being said, I think that criminal justice jobs are especially stressful given how many hours of work are involved (quite often significantly more than 40) and given the types of things that cops have to witness and encounter in the course of their duties.  The police are rarely called in when everything is going perfectly, usually people only call the cops when something is going terribly wrong.  These types of incidents include serious car accidents, suicides, murders, rapes, and many more highly traumatic incidents.  Not only do police officers frequently have to function effectively in very stressful and adrenaline-inducing incidents, but they also have to deal with the emotions of the general public who are less-accustomed to dealing with traumatic incidents.  Most people know that there is a risk of PTSD when one experiences severe trauma first-hand. What many people do not realize is that it is also possible to get PTSD second-hand, from dealing with people who have experienced trauma first-hand.  “‘Vicarious trauma is the transformation that occurs within the therapist (or other trauma worker) as a result of empathic engagement with the clients’ trauma experiences’ (Perlman and Mac Ian, 1995)” (Rousseau D., 2019. Module 1.)  While this quote is referring primarily to therapists, police officers also experience vicarious trauma because of their interactions with severely traumatized individuals or through looking at media, such as photos or videos, of traumatic incidents including rape, murder, suicide, and other violent deaths.  All of this means that law enforcement personnel are usually under a tremendous amount of stress, and not surprisingly the rates of PTSD in Law Enforcement are between 7% and 15% (U.S. Department of Veterans Affairs, 2018), which is significantly higher than the national average, and suicides rates among law enforcement are roughly four times the national average (National Alliance on Mental Illness, 2019).   In order for law enforcement to stay sane and continue to do their jobs they need to have effective methods for coping with stress. Self-care techniques are almost never sufficient to address issues such as PTSD, but these techniques can help alleviate daily stress, and can help prevent a buildup of stress that could cause more serious health issues.  These techniques can also help those who are suffering from PTSD, as long as they are combined with visits to a specialist who can help with the aspects of PTSD that cannot be effectively self-treated.

Over the years both in school and in various jobs I have had to learn to deal with being in stressful and sometimes frustrating situations. Throughout this time, I have found three specific things that help alleviate my stress and help me relax. The first one is dogs, well really any type of animal, but I prefer dogs.  Growing up I had dogs and I found that when I would get stressed out, if I just played with the dogs, I would feel better.  When I went away to college, I was not able to take my dog with me and he had to live 7 hours away with my parents.  While I was away, I met professors who had animals and I would go over to their houses and play with their pets.  Now that I have a house with my wife, we have a two-year-old Siberian husky and I find her very helpful in reducing stress.  Over the years I have found that taking a dog for a walk is particularly effective at reducing stress.  And this brings me to my second strategy – exercise.  I enjoy walking and hiking, but I do not particularly enjoy running. That being said, I have found that any form of outdoor exercise, including running, is effective at reducing stress and frustration.  This is particularly true if I combine it with dogs and go for a walk or hike with my dog.  The third strategy that I use is music.  I have studied classical violin my whole life and for the past ten years I have also played Scottish fiddle music.  I generally do not find that playing music is as effective as outdoor exercise, but it certainly helps.  I am sure that these strategies will not work for everyone, but in my experience, exercise helps most people, and animals help those whom are not allergic to them or afraid of them.

References

Rousseau D. (2019). Module 1. Introduction to Trauma. Lecture, BU Blackboard Learn

Rousseau D. (2019). Module 6. Trauma and the Criminal Justice System. Lecture, BU Blackboard Learn

U.S. Department of Veterans Affairs. (2018, September 25). National Center for PTSD. Retrieved April 29, 2019, from https://www.ptsd.va.gov/professional/treat/care/toolkits/police/managingStrategiesPolice.asp

National Alliance on Mental Illness. (2019). NAMI. Retrieved April 29, 2019, from https://www.nami.org/find-support/law-enforcement-officers

Trauma and Stress in the Field of Law Enforcement

Stress and traumatic events in life are things that can affect anyone at any given point in time. The level of severity may differ, but we all are equally susceptible to such events. With the varying level of severity, individual’s ability to react to such incidents vary as well. People work through stress or traumatic events they have experienced, to retain the normal/positive life they lived before. Sometimes this does not occur. As a member of law enforcement, this topic is very real and important in the law enforcement community. Working as a law enforcement officer, I as well as others, chose to get into the field understanding the stress that comes with the job and assume that we will not fall a victim of traumatic situations from our work experiences. This class has developed my understanding around things such as trauma, stress, and PTSD. I used to believe individuals that suffered from these things were not mentally determined enough to overcome their experiences or simply could not separate incidents from their personal life. I quickly discovered with this course, we can all feel the effects of traumatic and stressful situations. If symptoms go untreated, it can lead to many life changing struggles to include PTSD. Other symptoms include “increased absenteeism, turnover, declines in performance,  slower reaction time, poorer decision-making ability,  increases in complaints, policy violations, and misconduct allegations. (RTI, 2018)”

Law enforcement officers respond to calls when almost every time, people are experiencing their worst days. With responding to negative situations frequently, officers are exposed to traumatic events that can affect an individual differently both physically or mentally.  In addition to stresses brought on by responding to a situation, the negative social views on law enforcement can increase the stress felt from by an individual when handling a situation as many individuals do not support police. When responding to calls, officers are required to make split second decisions that could be life or death endings and are required to possess the cognitive ability to think as a counselor as well as an enforcer of the law. “Managing officer stress facilitates better decision-making, fairer treatment and improved relationships between officers and the community members they serve. (RTI, 2018)”

In order to combat the effects of stress/trauma, individuals must recognize the work-related as well as individual factors that create stress and fatigue in the officer. Examples of work-related factors are excessive overtime, shift rotations, change of job duties, etc. Examples of individual factors are family problems, financial problems, health concerns, etc. (Beshears 2017). An officer’s ability to recognize which factors are relevant to them will assist in developing a customized plan to strategically attack the negative factors affecting their mental state. As we have seen in class, this becomes effective once an agenda is absorbed and supported by a police department as a whole to include superior officers. Breaking the barriers to seek treatment is a big obstacle to overcome as the negative stigma surround mental care is still relevant in today's time. I believe that once this challenge has been overcome, individual’s likelihood to seek treatment or help will exponentially increase with them not having a fear of being targeted negatively. Individuals have many options when it comes to treatment but it requires publicity on its availability as well as it having no negative consequences to participating in it.

Police One wrote an article highlighting the ways officers can manage and reduce stress they encounter at work and at home. The article focused on healthy eating, leveraging vacation, exercise programs, and focusing on friendship relationships with individuals outside work that will assist in encouraging non-work conversations (Beshears, 2017).  This will help to reduce but not eliminate the threat officers faces of trauma/stress symptoms. One way that our organization has developed a process to check the well-being of its officers is through re-enlistment.   Our organization requires individuals to be medically screened both physically and mentally every three years to ensure that nothing is going unnoticed. This does not only benefit the organization but also prevents officers from hiding their internal struggles as this is a mandatory program.  One thing that I would recommend is for them to increase the frequency of how often the tests are completed rather than only every three years. It would better provide an explanation to whether or not an individual’s mental state is declining or getting better. By our organization participating in this, we have seen officers benefit tremendously as well as folks of the community. Officers are able to maintain the readiness to adequately respond to calls for service and properly serve their people without any threats from internal struggles they may face.

Beshears, M. (2017, March 30). How police can reduce and manage stress. Retrieved April 28, 2019, from https://www.policeone.com/stress/articles/322749006-How-police-can-reduce-and-manage-stress/

Stress Reduction Programs for Police Officers: What Needs to Change. (2019, February 01). Retrieved April 28, 2019, from https://www.rti.org/insights/stress-reduction-programs-police-officers-what-needs-change

Seeking the Appropriate Care for Mental Illness

Medication is a common approach used to treat many forms of mental illnesses, including depression, anxiety and PTSD.  It is estimated that approximately 242 million adults in the United States, roughly one in six Americans, take prescription psychiatric drugs (Fox, 2016).  Many people who experience mental health issues seek care from their primary care physician, rather than a mental health expert, which can lead to several issues. 

Psychiatric medication is not a bad thing, as long as prescribed by a mental health professional and it is not abused.  In fact, medication can be very useful in treating symptoms of mental illness.  However, research conducted by the Center for Disease Control and Prevention, has shown that going directly to a primary care physician without consulting a mental health professional, could result in the patient being prescribed the wrong medications (Smith, 2012).  This research also revealed that many people who go directly to their primary care physician for help with mental illness may not be made aware of other evidence-based therapies that could help them (Smith, 2012).  According to Dr.Rousseau,“most literature regarding pharmacotherapy stresses that it works more effectively in tandem with other treatments rather than individually” (Rousseau, 2019, p.12).  Some forms of therapy have been found to be more effective then medication alone, for example, a study using EMDR to treat PTSD, showed that EMDR was more effective than Prozac (Van der Kolk, 2015).      

Medications alone do not cure mental illness, they reduce symptoms by manipulating neurons and neurotransmitters (Rousseau, 2019).  Without curing the underlying issue, the patient will never recover and will need to stay on the medication(Van der Kolk, 2015). This could result in medications being used long-term, which could make them habit forming (Holmes, 2016).  A study conducted by the Agency for Healthcare Research and Quality, found that 84% of participants in the study who reported taking psychiatric pills, reported they had been taking medication for two years or more (Holmes, 2016).  Another factor is that all medications have side effects, so long term use could cause other health issues. 

Although it may be comforting to go to a primary care physician because a relationship has already been established or because medication seems like a quick fix, the best option is to see a mental health professional for mental health issues.  Mental health professional have been specially trained to give proper diagnoses and are able to offer more treatment options then medication alone.   

Work Cited:

Fox, M. (2016, December 12). One in 6 Americans take antidepressants, other psychiatric drugs. Retrieved April 28, 2019, from https://www.nbcnews.com/health/health-news/one-6-americans-take-antidepressants-other-psychiatric-drugs-n695141 

Holmes, L. (2016, December 15). Study Shows Taking Mental Health Medication Is Incredibly Common. Retrieved April 28, 2019, from https://www.huffpost.com/entry/psychiatric-medication-use_n_58515e35e4b0e411bfd49171

RousseauD. (2019). Module 4. Pathway to Recovery: Understanding Approaches to Trauma Treatment. Lecture, BU Blackboard Learn

Smith, B. (2012, June). Inappropriate prescribing. Retrieved April 28, 2019, from https://www.apa.org/monitor/2012/06/prescribing

Van der Kolk, B. (2015). The body keeps the score: Brain, mind, and body in the healing of trauma. Penguin Books.