PTSD Then and Now

“PTSD Then and Now”

By: Stephen Blais

Module 3 contained some of the most interesting topic of our studies throughout this course, in my opinion. While reading the material which included symptoms and effects that trauma has on our brain, it immediately brought to mind the biographical war movie "American Sniper," which depicts the life and death of war hero Chris Kyle. There is a scene in the film where Kyle is sitting in a chair in his living room. Kyle is watching a blank screen while the film the depicts scenes from the war during one of his previous tours of duty. There seems to be some type of cookout or birthday party taking place at Kyle‘s house however his mind is clearly elsewhere and he is unable to focus on  -  or enjoy the celebration going on around him.  The horrors of the war were preventing him from enjoying what should have been a joyous occasion.  It seems to me that Kyle was experiencing dissociation and reliving.

According to our text, "If elements of the trauma are replayed again and again, the accompanying stress hormones engrave those memories ever more deeply in the mind.  Ordinary day to day events becomes less compelling, not being able to deeply take in what is going on around them makes it impossible to feel fully alive.  It becomes harder to feel the joys and aggravations of ordinary life...Not being fully alive in the present keeps them more firmly imprisoned in the past" (Van Der Kolk, p. 67, 2015).  For some reason this particular calm scene always stood out to me in an otherwise action-packed movie.

Growing up, I had a close relationship with both of my biological grandfathers who served in World War II. One served as an anti-aircraft gunner and interpreter under the direct command of General Douglas MacArthur. The other served as a turret gunner, who ended up getting shot down in the Pacific, but thankfully survived. The lessons of this class as it relates to trauma kept bringing me back to the countless discussions and stories which both of them told me of their service. Soldiers who are deployed to Iraq and Afghanistan are gone for anywhere from about six months to one year per tour. Soldiers such as my grandparents were deployed for over three straight years! I can only imagine the troubles with PTSD that they must have faced when they returned home from the war. It also makes you wonder which is worse, the constant redeployment of troops that our military faces today, where soldiers serve multiple tours or being deployed for years at a time.

An interesting concept in to the difference between PTSD in World War II soldiers and that of current day soldiers in the finality associated with World War II. According to Andrew Pomerantz, the chief psychiatrist of the VA in Virginia in his discussion about the aftermath of World War II, “Society didn’t want to hear it. You don’t want to hear that your hero who has just come back from winning the war is troubled by what he did over there and the people he bombed, the people he shot. People didn’t want to hear that kind of thing. All anybody wanted to hear at the time was: Isn’t this wonderful? We won. We’ve saved the world. Thank you.” Soldiers during WWII surely suffered from PTSD, but some may have been more able to rationalize their acts of war, because we were attacked and we won the war. Today’s soldiers are fighting a war that has no end in sight, and often times they cannot differentiate from friend or foe in the battlefield.

References:

Pomerantz, A. (n.d.). Soldier's Heart. Retrieved August 13, 2018, from https://www.pbs.org/wgbh/pages/frontline/shows/heart/themes/shellshock.html

Van Der Kolk, B.,2015.The Body Keeps The Score: Brain, Mind, and Body in the Healing of Trauma. Penguin Books New York.

Reentry Awareness Month in Philadelphia

As I’m sure I’ve made pretty obvious, the topic of returning citizens has been and continues to be a passion of mine. It’s a group of traumatized individuals that are just now beginning to receive nationwide attention, but continues to be a controversial topic. I plan on writing my final paper on the topic on this very subject. They are a group that is complex in not only its needs from the community, but are not complete victims in their struggle, as other trauma survivors are such as survivors of sexual assault. I believe that because of their history of offenses, it creates a difficulty from our community to humanize them and their traumatic experiences in places that some would argue “they deserved to be in.”

This, along with the amount of trauma experienced in prison is astounding. The moment one enters prison, several assessments of both mental health and criminal history are made along with strip and cavity searches. While in prison, violent assault, including sexual assault committed by both inmates and officers, dehumanization of inmates and utter loss of free choice is the reality of inmates. Institutionalization is the more specialized term used for inmates becoming accustomed to prison and in many ways becoming accustomed to the trauma that prison entails.

During my research for my final paper, however, I found an interesting article of a reentry month that is celebrated in Philadelphia. This Reentry Awareness Month is celebrated in June and is a new resolution for the city. The article that showcases Philadelphia’s resolution also attaches an article for trauma-informed events around the city. These events are geared not only towards the 25,000 returning citizens in the city, but to loved ones and community members that would benefit in learning about returning citizens and their plight in returning to the community and dealing with their trauma. If you wish you read more about this, here’s the link: https://generocity.org/philly/2018/05/29/reentry-awareness-month-18-events-coalition/

The manifestation of childhood trauma

In module two we explored the different types of childhood trauma’s and how these trauma’s can follow a person into adulthood causing adverse health effects. A child’s brain development can be affected by traumatic events, whether these events happen directly to the child or if the child is just a witness to a traumatic situation These effects to the brain development may have lifelong costs. For example, studies have shown that the more adverse childhood experiences a child has, the higher the chance of health problems in adulthood. Children who’ve experienced trauma may be at risk for health problems such as, asthma, depression, heart disease, strokes, etc. Further, these people may have a higher risk of suicide than those who didn’t experience any abuse as a child.

Studies have found a link between childhood abuse and mental health issues in adulthood. How the child becomes psychologically affected can depend on a variety of factors. These factors can range from, the severity of the trauma, if it is long term or short term, the type of trauma, the relationship to the abuser, etc. Each of these factors may either decrease or increase the psychological impact that the trauma has on the child. Children who’ve experience trauma, such as child abuse, may have an increased likelihood of developing several psychological conditions (e.g. bi polar disorder, PTSD, depression etc.).  (Morin, 2018)

Instead of seeking help, children and adults may suppress their emotions and bottle up how they are feeling or try to forget the trauma completely. A child with a history of trauma, may be the kid in school who has “behavioral issues”, who displays anger, and aggression for unknown reasons. As kids become adults, the trauma doesn’t just disappear, it is often buried subconsciously. We’ve also learned in our readings that adults may have only fragmented memories of trauma that may appear when they are triggered. Even if an adult did suffer traumatic events in their childhood and had gone years without receiving help, it is never too late to start healing old wounds. However, the sooner the therapy begins, the sooner the healing starts. There is no easy cure, and trauma can’t be healed with a dose of medication. Although medication can help people control their symptoms, trauma is complex to treat, and several interventions together are often more helpful and successful, such as active therapy/counseling, cognitive-behavioral therapy, and/or medications or other alternatives (e.g. service dog) at once. (Dube,2018) Studies have taught us that adverse childhood experiences are more common in people than we would like to imagine. The effects of trauma may not subside on their own, and may pose a significant threat to a person’s life without them even knowing. When this trauma remains unhealed it may then affect the next generation, creating a cycle that is hard to stop. (Dube, 2018)

Dube, S. Rn (2018). The steps that can help adults heal from childhood trauma. Retrieved from http://theconversation.com/the-steps-that-can-help-adults-heal-from-childhood-trauma-77152

Morin, A., Forman, J., & LCSW. (n.d.). The Effects of Childhood Trauma. Retrieved from https://www.verywellmind.com/what-are-the-effects-of-childhood-trauma-4147640

School Shootings

As we look at school shootings it has become so popular now that it’s sad. When parents send their children to school it’s suppose to be a safe space. No parent should ever have to know that their child was murdered at school. No teacher or student supposed to feel that dread and terror that takes over a person in an incident such as this. They are suppose to feel safe when they come to school.

After such an event happens how are those affected are supposed to deal with the trauma.  Although people are resilient and often bounce back after difficult times, these events nearly always interrupt our sense of order and safety. The impact often extends to individuals who live far outside of the affected area with no personal connections to the event. This is especially true when the event is human-caused with the intent of harming others. Even counsellors with advanced training can become overwhelmed by the intensity of these tragic events. The ACA provides some tips and resources for counsellors and their clients.

• Attend to self care. While it may seem counterintuitive to think about taking care of yourself first, you cannot be of service to others if you are unstable. Monitor all of your physical health needs - being sure to eat, sleep, exercise, and (if possible) maintain a normal daily routine.
• Pay attention to your emotional health. Remember that a wide range of feelings during these difficult times are common. Know that others are also experiencing emotional reactions and may need your time and patience to put their feelings and thoughts in order.
• Try to recognise when you or those around you may need extra support. It is not uncommon for individuals of all ages to experience stress reactions when exposed (even through media) to shootings or mass violence. Changes in eating and sleeping habits, energy level, and mood are important signs of distress. Watch for regressed behaviours, such as clinging in children and intense emotional reactions, such as anxiety or a strong need for retribution in adults. When necessary, point individuals to licensed professional counsellors who can provide needed support.
• Avoid overexposure to media. While it is important to stay informed, media portrayals of shootings and mass deaths have been shown to cause acute stress and post traumatic stress symptoms. Limit your exposure and take a break from news sources.
• Maintain contact with friends and family. These individuals can provide you with emotional support to help deal with difficult times.
• Focus on your strength base. Maintain practices that you have found to provide emotional relief. Remind yourself of people and events which are meaningful and comforting.
• Talk to others as needed. It is important to ask for help if you are having trouble recovering and everyday tasks seem difficult to manage.

Program Trains Teachers, Students to Deal with School Shootings

Bibliography

Dailey, S. (n.d.). Coping in the Aftermath of a Shooting. Retrieved from https://www.counseling.org/knowledge-center/coping-in-the-aftermath-of-a-shooting

VOA. (2018, January 06). Program Trains Teachers, Students to Deal with School Shootings. Retrieved from https://learningenglish.voanews.com/a/school-shooting-simulation/4192418.html

Do “safe spaces” help or harm?

            I recently read a couple of articles about the superhero production company Marvel offering grief counseling for fans, who watched their recent film Avengers: Infinity War. My first reaction when seeing the title of the article, “Marvel Offers Greif Counseling at Comic-Con for Fans Traumatized by the End of Infinity War” (Lussier, 2018) was “annoyed.” Come to find out, it was more of a joke and Marvel used it as a way to promote the movie being released on DVD and digital formats. Fans can line up at a booth next to Petco Park in San Diego, put on a name tag, and enter an air-conditioned room where an actor who is there to talk with the group about their best memories from the Marvel Cinematic Universe. You get a donut, you watch a deleted scene from the Infinity War Blu-ray and then you get a t-shirt on the way out (Lussier, 2018). The article also mentioned that fans can visit a “group hug” prop of The Hulk. I did think this was a funny way and smart advertisement idea to pair with an ending of a very popular movie that ended a certain way fans may have not anticipated. To me, it was also an attempt at mocking this new age of “safe spaces.” All of this made me think of where do we draw the line when dealing with trauma and stress?

            Presently, we see schools and colleges offering “safe spaces” to their students and staff. This gives them a way to feel safe while expressing their views. I completely agree these areas should be held for people dealing with serious trauma such as school shootings, sexual assault, drugs, and alcohol abuse. Though, I believe it’s getting ridiculous. Schools are offering safe spaces for people, who didn’t like the way the election turned out, and an unfavorable social media post, etc. I feel we’re causing more harm than good. Blocking students from exposure to things they dislike and don’t agree with can hinder them from growing. According to political advisor Van Jones (2017) “One is a very good idea, and one is a terrible idea.” The good idea, he said, is “being physically safe on campus, not being subjected to sexual harassment and physical abuse.” “But there is another view that is now ascendant … It’s a horrible view, which is that ‘I need to be safe ideologically, I need to be safe emotionally, I just need to feel good all the time. And if someone else says something that I don’t like, that is a problem for everyone else; including the administration…You can’t live on a campus where people say stuff that you don’t like? You are creating a kind if liberalism that the minute it crosses the street into the real world is not just useless but obnoxious and dangerous. I want you to be offended every single day on this campus. I want you to be deeply aggrieved and offended and upset and then to learn how to speak back (Rose, Huffpost). Students are soon going to be entering the workforce and have co-workers and/or bosses they may dislike. The student may not be prepared with the certain life skills needed to deal with negativity and disappointment. The greatest sources of our suffering are the lies we tell ourselves… people can never get better without knowing what they know and feeling what they feel (Van Der Kolk, 2014). To me, letting people deal with things they don’t like can help them grow and become stronger. It's time to become an adult and stop complaining about every little thing! Be grateful for what you have and the opportunities the world gives you.    Thanks- Kyle

Lussier, G. (2018). Io9. Marvel Offers Grief Counseling at Comic-Con for Fans Traumatized by the End of Infinity War. Retrieved August 11, 2018 from  https://io9.gizmodo.com/marvel-offers-grief-counseling-at-comic-con-for-fans-tr-1827781404

Rose, F. (2017). Huffington Post, Safe Spaces on College Campuses Are Creating Intolerant Students. Retrieved August 10, 2018 from https://www.huffingtonpost.com/entry/safe-spaces-college-intolerant_us_58d957a6e4b02a2eaab66ccf

Van Der Kolk, B. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Penguin Books. New York, NY.

The Lifelong Impacts of Child Sexual Abuse

Over 300,000 children are sexually abused each year in the United States, but that number is thought to be much larger as it is estimated that 90% of all child sexual abuse is never reported (“CSA Statistics, n.d.”). Child sexual abuse is defined as any sexual activity between an adult and a child; and it can also occur between children (Rousseau, 2018). The trauma that the child suffers mentally and physically has an impact on them for the rest of their lives. Right after the abuse occurs, they may feel powerless, ashamed and distrustful of others ("Effects of Child Sexual Abuse,” n.d.). Other short-term effects many include exhibiting regressive behaviors, such as thumb-sucking, and bed-wetting; sleep disturbances; eating problems; behavior or performance problems at school; and an unwillingness to participate in activities ("Effects of Child Sexual Abuse,” 2018). Long-term effects include depression, anxiety-related behaviors, eating disorders, obesity, anxiety, repression, sexual and relationship problems (Hall, 2011).

In Dr. Van der Kolk’s The Body Keeps the Score, he revealed that child sexual abuse victims, specifically those of incest, can even be impacted by autoimmune diseases (Van der Kolk, 2014). He did a study at Mass General that recruited twelve women who had histories of incest and twelve women who had never been sexually abused. Their results confirmed his findings - that the incest victims had abnormalities in their CD45 RA-to-RO ratio (Van der Kolk, 2014). Unfortunately, incest has been found to be the most common form of sexual abuse; with impacts even more detrimental (Hall, 2011). A study compared women who had histories of incest and women who experienced non-familial abuse. It found that “women who experienced incest reported higher current levels of depression and anxiety when thinking about the abuse (Hall, 2011).”

Other aspects of the abuse that increased feelings of distress were cases where the sexual abuse was extensive, a higher number of cases and a younger age during the first abuse experience (Hall, 2011). Child sexual abuse has detrimental impacts that can last throughout adulthood. It’s of the utmost importance for further research to be conducted on preventative measures. No child should have to experience anything like this.

References

“Child Sex Abuse Statistics.” (n.d.). Retrieved from          http://riseaboveabuse.org/child-sex-abuse-statistics/

“Effects of Child Sexual Abuse.” (n.d.). Retrieved from    http://victimsofcrime.org/media/reporting-on-child-sexual-abuse/effects-of-csa-on-the-victim

Hall, M., & Hall, J. (2011). The Long-Term Effects of Childhood Sexual Abuse:           Counseling Implications. Retrieved from             http://counselingoutfitters.com/vistas/vistas11/Article_19.pdf

Rousseau, D. Dr. (2018). Trauma and Crisis Intervention: Module 1. Boston   University.

Van Der Kolk, B. M.D. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. New York, NY: Penguin Books.

The Effectiveness of EMDR

Eye Movement Desensitization and Reprocessing (EMDR) has been shown to be an effective method in treating those exposed to traumatic events.  Discovered unintentionally by Psychologist Francine Shapiro in 1987, she observed that as her eyes moved rapidly, it "produced a dramatic relief from her distress" (Van Der Kolk, p. 253).  Through the use of EMDR, patients are able to revisit past traumatic experiences without painful re-creations which could otherwise result in re-traumatization.  EMDR consists of eight phases:  history taking, preparation, assessment, desensitization, body scan, closure, and reevaluation (Rousseau, 2018).  EDMR treatment is minimally invasive to the patient as it does not require them to talk about their traumatic experience.  Instead, EMDR focuses on stimulating and opening up the associative process as "therapists ask their clients to hold the memories of anxiety-provoking stimuli—for example, the painful memories of a frightening accident—in their minds. While doing so, clients track the therapist's back-and-forth finger movements with their eyes" (Arkowitz, 2012).  This process helps take loosely associated memories and images from a patient's past and piece them together to a more comprehensive perspective of the traumatic experience.  Through studies, it has been shown that rapid eye movement (REM) sleep "reshapes memory by increasing the imprint of emotionally relevant information while helping irrelevant material fade away" and "make(s) sense out of information whose relevance is unclear while we are awake and integrate it into the larger memory system" (Van Der Kolk, p. 262).  By large, those affected by PTSD have difficulty getting to and remaining in REM sleep.  Because EMDR mimics REM sleep through the moving of the eyes back and forth in a rapid manner, "EMDR should be able to take advantage of sleep-dependent processes, which may be blocked or ineffective in PTSD sufferers, to allow effective memory processing and trauma resolution" (Van Der Kolk, p. 263).  By becoming in-tune with the context of the emotions and sensations related to traumatic events, patients can learn to overcome physical reactions that were previously dictated by the imprint of the past.

Many who experience traumatic events attempt to suppress their memories by shutting down "the brain areas that transmit the visceral feelings  and emotions that accompany and define terror" (Van Der Kolk, p. 94).  In an attempt to protect themselves from the hurtful past,  trauma victims can unintentionally prevent themselves from feeling fully alive in the present.  As a result, the traumatic memory remains stuck in the patient's mind, "undigested and raw" (Van Der Kolk, p. 258).  To be able to recover from trauma, its crucial that patients are able to feel present and be aware of what is going on within them.  "The core of our self-awareness rests on the physical sensations that convey the inner states of the body" (Van Der Kolk, p. 95).  EMDR helps to restore a trauma victim's broken "self-sensing system" and reactive it by integrating the traumatic material into a "coherent event in the past, instead of experiencing sensations and images divorced from any context" (Van Der Kolk, p. 257).  EMDR allows the brain to activate new images, feelings, and thoughts from seemingly unrelated events while simultaneously restoring the patients sense of agency, engagement, and ownership of mind and body.

EMDR therapy can also be used to help those who are grieving over the loss of a loved one and those suffering from debilitating medical conditions.  Family members are "often unable to retrieve positive memories of the deceased, which further exacerbates and complicates the grieving process" (Shapiro, 2014). Similarly, those who experience a tragic medical condition such as a burn victims or amputees may benefit from EMDR.  In both examples, EMDR treatment helps the individual to focus on pleasant past experiences rather than the emotional present.  The individual can then mark their grief as a specific point in time and begin to understand that their tragic event is not what defines them as a person and start to heal emotionally.

Patients showed dramatic improvements with very few EMDR treatments.  In a study of twelve individuals, Dr. Van Der Kolk found that after only three EMDR sessions, "eight of the twelve had shown a significant decrease in their PTSD scores" (Van Der Kolk, p. 256).  It was also found that patient's PTSD scores improved substantially better than those who used pharmaceuticals (Prozac) for treatment.  After several EMDR treatments, patients were able to integrate their traumatic memories and continue to improve to the point where many were cured of their ailments and remained cured months after treatment, unlike those who relapsed once off the medication.  Further, Dr. Francine Shapiro found, "Twenty-four randomized controlled trials support the positive effects of EMDR therapy in the treatment of emotional trauma and other adverse life experiences relevant to clinical practice. Seven of 10 studies reported EMDR therapy to be more rapid and/or more effective than trauma-focused cognitive behavioral therapy. Twelve randomized studies of the eye movement component noted rapid decreases in negative emotions and/or vividness of disturbing images, with an additional 8 reporting a variety of other memory effects. Numerous other evaluations document that EMDR therapy provides relief from a variety of somatic complaints" (Shaprio, 2014). EMDR has proven to be an effective, minimally invasive, and long lasting treatment option for victims of trauma.  This holistic approach may prove to be more beneficial to trauma victims than other more invasive or pharmaceutical dependent treatments that may not have as long lasting results.

Although much EMDR  treatment research has shown "that processing memories of such (adverse life) experiences results in the rapid amelioration of negative emotions, beliefs, and physical sensations (Shapiro, 2014), there is one glaring limitation to EMDR.  It has been found to be not as effective in patients who have experience childhood trauma.  Dr. Van Der Kolk suggests EMDR doesn't work as well in children because of the mental and biological changes that occur in children who experience chronic child abuse.  Because an abused child's life can have a variety of "triggers", they may not be able to distinguish their trauma as being a past isolated event that they can move on from, as EMDR attempts to do.  Abused children often lack a secure base and secure attachment with loving caregivers. "A secure attachment combined with the cultivation of competency builds an internal locus of control" (Van Der Kolk, p. 115). Without these primitive skills, the physiological changes in children after experiencing a traumatic event can make it harder from them to break free from the past as it could be harder from them to look within and realize they're not the cause of their own trauma.  Nevertheless, EMDR is an extremely useful tool that can be used in the medical field for both patients and family members alike.  This treatment can help mental health professionals pinpoint what adverse experiences are effecting an individual so psychological and physical resolution can occur.

References:

Protecting the Sheepdog: Resource Allocation during Budget Restrictions

Nationally, law enforcement agencies are recruiting and screening citizens to ensure qualified applicant have the moral and psychological aptitude to protect their communities. While the agencies are striving to provide transparency in policing practices and allowing only the most qualified candidates a chance at serving, there is little discussion outside scholarly channels about the challenges law enforcement officers face. Many departments are being forced to do more with less and often times officers are the ones who are shortchanged.

Memphis police officers make on average 43 percent less base salary than Austin police officers after their first year and also face cuts to their medical benefits, time off, and other benefits (Thompson, 2014). It is reasonable to suggests police officers and other emergency service providers experience higher rates of psychological trauma and stress leading to earlier morbidity and mortality than premature death by gunshots or other physical trauma. The daily experience of increased stressors on law enforcement officers place the sympathetic nervous system into a constant rollercoaster ride of fight or flight responses that place excessive where on the cardiovascular and central nervous systems. In an effort to resolve the conflict of maintaining homeostasis and to cope with the stress and trauma of work, officers may experience adverse health conditions such as insomnia, alcohol use disorder, depression, chronic fatigue, and hypertension (Stevens, 2008). Van Der Kolk (2014) identifies the unbearable and intolerable nature of trauma, which has the potential to have primary and secondary effects on those who experience the trauma and others indirectly exposed to it such as spouses and children. In order to care for the community, law enforcement officers need to have assistance afforded and guaranteed to them.

Elvin Semrad discouraged scholarly textbook readings for his residents during their first year in an effort to prevent perceptions of reality from becoming obscured by psychiatric diagnosis (Van Der Kolk, 2014, p. 26). Law enforcement agencies can benefit from putting scholarly literature down for a brief time and look around without trying to assign labels and categories of their officers and see that many face stressors daily and should be afforded the upmost care. Psychology has expanded greatly in modern times and new pharmacological treatments are available that many often may seek out for help instead of talking through stressors. Encouraging support groups for traumatic events and stress debriefings with avenues to gain time off work to recover psychologically without stigmatization is necessary with the events officers face on a routine and daily basis. Health insurance should provide adequate coverage for mental health care and physical conditioning. Cardiovascular exercise has great potential to lower stress levels in officers and to burn off hormones from heightened calls. With departments being requested to do more with less it is imperative that officers do not face the brunt of budget restrictions and instead be afforded every opportunity to succeed without worrying about overtime to pay bills or second jobs to gain better medical coverage.

References

Stevens, D. (2008). Police Officer Stress Sources and Solutions. Upper Saddle River, NJ: Pearson,

Prentice Hall.

Thompson, A. (2014). You won’t believe what Austin Texas is offering Memphis officers. WREG

Memphis. Retrieved from http://www.wreg.com

Van Der Kolk, B. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of

Trauma. New York, NY: Penguin Random House Publishing.

Stress and Law Enforcement

As people, we all have the chance to experience some type of stress or traumatic event in our lives.  How our minds and bodies react to the stress and trauma determines if we will live as we always have with positive or negative responses.  This is extremely evident in the field of law enforcement.  Those like myself, who choose to be part of law enforcement, recognize that stress is a part of the job and assume it will not affect us.  Prior to this class, when I would hear the terms trauma, stress, and PTSD my thoughts would always turn to our military, feeling as if they were the ones who were susceptible to these terms because it’s a wartime exposure and response. Little did I know, we are all susceptible to the effects of trauma and stress, which can lead to PTSD and all of the responses that may come along with it. 

         As Law Enforcement Officers, we respond to calls where most people are at their worst and in need of help.  The chronic exposure to such traumatic events can affect individuals differently and can come in many different forms either mentally or physically or both.  This is on top of the current social climate where not everyone sees the Police as allies and protectors.  As we might not even be aware of the effect the stressors of the job are having on us, we are still tasked, every day, with making life or death decisions, in split seconds, all while maintaining the ability to think like a counselor, social worker and lawyer.  To perform the job day to day, the men and women need to make sure they remain in healthy mind and body to combat the negative effects of stress and trauma such as PTSD, anxiety, depression and even health problems (Hinkman, Fricas, Strom, & Pope, 2011).  If these conditions are not treated they can lead to numerous underlying responses such as cynicism, emotional detachment, reduced efficiency, absenteeism, aggressiveness, substance abuse, personal relationship problems, PTSD, health problems and even suicide (Beshears, 2017). 

         The first step in managing and treating the effects of stress and trauma, before it is too late, is identifying the causes of stress which are not only the job-related functions but can also be internal and individual causes.  Internal factors can include poor management, long and constant hours and even poor equipment, while individual factors can include family, financial and personal relationships (Beshears, 2017).  By identifying these causes officers can find a method to address and discover a personalized approach to self-care before it goes too far.  For this to be effective, Law Enforcement Organizations first need to remove the overall belief that seeking help for chronic exposure is a sign of being weak or vulnerable.  I feel that, if this was accomplished, those who are in the high-risk field of law enforcement would be able to access therapy or help without fear of professional or coworker ridicule from embarrassment.  There are many methods an officer can care for themselves physically and mentally, but the methods need to be made known, all the while removing the negativizes stress and trauma has on everyone especially those in the Law Enforcement field. 

         Police One, put together a great article on how police can reduce and manage stress, outlining ways to reduce and manage stressors among police officers.  The highlighted ways in managing and reducing stress are healthy eating, taking scheduled time off, a realistic exercise program, getting away from the job and having conversations about something other than work and plan to achieve balance in one’s life (Beshears, 2017).  By the use of these methods officers are less susceptible to the effects of chronic exposure but, not immune.  To increase these chances, I feel that organization could implement an annual psych evaluation with an employed professional.  By integrating this evaluation as part of the annual performance review, and not only when a tragic even occurs, this will provide individuals with the opportunity to speak with a professional and it will be applicable to all, making it required for everyone, and not just singling one person out.  Also, by performing these annually, there will be a base line and progressive observations for officers that can be monitored and hopefully alleviate complications in the future. As a result of these reviews officers can talk to a knowledgeable person regarding ways to effectively self-care to reduce and manage the effects of stress and trauma creating a long and healthy career.  By doing this, the officer, co-workers, society and the organization will benefit from the healthy well-being of those who are serving.    

Works Cited

Beshears, M. (2017, March 30). How Police Can Reduce and Manage Stress. Retrieved August 5, 2018, from PoliceOne.

Hinkman, M. J., Fricas, J., Strom, K. J., & Pope, M. W. (2011). Mapping Police Stress.Police Quaterly, 14(3), 227-250.

Therapeutic Approaches, What is the Baseline?

Humans are made to communicate and be in community. Using words is how we make connections, learn, express our feelings and needs, how we reveal our fears, and how any form of healing from trauma can begin.

While there are multitudes of approaches to choose from and each trauma victims will have individual needs (and therefore individual plans to adjust their healing process) talking, specially talk therapy, is pivotal and foundational to any healing.

That said, it can be argued that talk therapy could be used as the baseline or a supplemental to other therapeutic approaches. At times talk therapy may need to be used alone, but it can also be used in conjunction with other therapeutic approaches in order to bring the fullest healing to a victim. (Fritscher, 2018). It may be best to take a deeper look into talk therapy to grasp how it can integrated or supplemental to other forms of therapy and yet completely necessary for healing.

To begin, author Van Deer Kolk (2014) offers this quote: “nobody can ‘treat’ a war, or abuse, rape, molestation, or any other horrendous event, for that matter; what has happened cannot be undone. But what can be dealt with are the imprints of trauma on body, mind, and soul” (p. 205). However, “the challenge of recovery is to reestablish ownership of your body and your mind - of yourself” (p. 205).

Due to the challenge of recovery those in the mental health field have developed numerous ways of attempting to assist victims in establishing ownership of themselves. One to the foundational remedy developments, and what I believe to be the most effective, is analytical talk therapy.

Van Der Kolk (2014) insists that therapists have an undying faith in the capacity of talk to resolve trauma (p. 233). While not easy, talking and communicating about an event is one of the most healing things a person can do. This can be said because no one can heal from anything until they name it. Meaning, no one can heal from trauma until the know what they need healing from. Analytic talk therapy can accomplish this.

It accomplishes the above goals by helping clients “break the silence” (Van Der Kolk, 2014, p. 235). Trauma and traumatic events present a difficult task when it comes to communication, though, they are almost impossible to put into words. Therapist can and will attempt to help clients break their silence through a few avenues.

One way is that a therapist will help, ask, and enable clients to become aware of their bodies while speaking or listening. The therapist will ask the client to tell them their stories or experiences and tell them to be aware of visceral sensations while talking or being asked questions. Being aware of these sensations is the key emotional awareness (Van Der Kolk, 2014, p. 240). Once emotional awareness is achieved, clients can begin to put words to what they are feeling and discover what made them feel this way. Once this is identified with words, a story can be pieced together that can offer an object to blame and give words to pain, which can effectively reduce the effects of trauma

A second method is asking clients to write to themselves. This is one of the most effective ways to access your inner world of feeling (Van Der Kolk, 2014, p. 240). One of the specific exercises therapists will engage clients with is the practice of free writing. This is where a client will use any object as their own “Rorschach test” and begin writing the first things that come to mind as they look at the object. The client then continues to write without stopping or rereading and soon finds that there is a string of memories, thoughts, and associations that are uniquely theirs (Van Der Kolk, 2014, p. 241). Using this exercise gets the clients into conversation with him or herself and positively reinforces the use of words to discover themselves and find healing from trauma.

To show how effective analytical talk therapy is we can look at the first systematic test of the use of language and talk therapy done by James Pennebaker in 1986. Pennebaker was a professor at the University of Texas and turned one of his classes into a experiment. He asked students to think about a deeply traumatizing event in their lives and divided the class into three groups.

One would write about what was currently going on in their lives, another would write about the details of the traumatic event, and the third would write about the facts of event, their feelings/emotions about it, and what impact they felt it had on their lives. The students wrote continuously for 15 minutes on four consecutive days. As time went on the students would reveal secrets they had never verbalized, were emotional as they wrote and all of the students agreed that it increased their self-awareness and ability to articulate their pain (Van Der Kolk, 2014, p. 242).

One specific thing that is interesting to note is that the group that wrote about both the facts of the experience, their feelings/emotions about it, and how they thought it was affecting their lives were said to benefit the most. Van Der Kolk (2014) explained that those who wrote about their deepest thoughts and feelings about their trauma had improved moods, a more optimistic outlook on life, and even better physical health (p. 242).

The study above reveals that talk therapy is effective because it uses the body as a bridge to overcome the inability to put words to trauma. It provides a passage for understanding ourselves and enables us the ability to express how we feel. When we are able to express this we can then begin to piece together the timeline of our experiences and bring the chaos into focus. Once this can happen, healing can take its full effect.

Hence, talk therapy can be seen as necessary for any healing (Fritscher, 2018) and as such, a need to incorporate this into any therapeutic approach may not only be possible but may be necessary.

For instance, Cognitive Behavioral Therapy or CBT would not be possible without talking and analyzing through why an individual perceives a certain traumatic event and how it may govern how they feel or act (Rousseau, 2018, p. 13). A client must become aware of how they act or feel in certain situations and connect it to why they perceive the traumatizing event as they do. How is this done? Through talking and naming their trauma and their feelings/actions. This could not be done without incorporating analytic talk therapy tactics with CBT.

Even using medications as a therapeutic approach needs talk therapy. Here it may be best to use it after a medical diagnosis for medication is used. Once the correct medication is found and a victim expresses interest in further healing, talk therapy may be the next best step.

The examples of the necessity and baseline of talk therapy could go on and on. The need for basic human interaction and communication is necessary for any therapeutic approach to fully work (Fritscher, 2018).

Hence, the power of words and speaking out fears, alienations, perceptions, feelings, confusion, victories, and praises can make or break a therapeutic approach. Without talk therapy and its foundational practices, most therapeutic approaches run the risk of falling short in the quest to heal trauma victims.

As the post began with a quote, let it end with another relevant insight from Van Der Kolk (2014). Even though trauma can keep us “dumbfounded, the path out of it is paved with words, carefully assembled, piece by piece, until the whole story can be revealed” and thus healing from traumatic events takes place (p. 234).

Reference:

Fritscher, L. (2018). Talk Therapy. New York, NY: Well Mind.

Rousseau, D. PhD. (2018). Trauma and Crisis Intervention. Boston, MA: Boston University.

Van Der Kolk, B. M.D. (2014) The Body Keeps the Score: The Brain, Mind, and Body In the

Healing of Trauma. New York, NY: Penguin Books.