by Bob Rabe
PTSD – Post Traumatic Stress Disorder is a new name for an old story and there are many complexities to its definition. The name, recognizing a medical condition, was coined several years after the onset of the Vietnam War. Similar symptoms demonstrated by soldiers following the Civil War were called nostalgia. GIs during WWI were said to have shell shock. Military personnel from WWII and the Korean Conflict were suffering combat fatigue. No matter what term is used, the symptoms are the same.
There are many descriptions for PTSD:
PTSD – a severe anxiety disorder that can develop after exposure to any event that results in psychological trauma.
PTSD – is a set of symptoms that surface following a dangerous, frightening and uncontrollable event including: sleep disturbance, flashbacks, anxiety, tiredness and depression.
PTSD – is a condition recognized by the prevalence of one or more symptoms affecting people who have
experienced severe emotional trauma such as combat, crime or natural disaster.
PTSD – a person may demonstrate symptomatic behavior after seeing or experiencing a traumatizing event where grave injury or death is involved.
You can find the most recent clinical definition… and other changes from the new DSM-5 by clicking here
Some factors can increase the likelihood a traumatic event may trigger a PTSD response:
- the intensity of the trauma
- being physically injured
- losing a loved one,
- physical proximity to an event
- lack of support after the event
One of the first known cases of PTSD is recorded in the Bible in Genesis Chapter 4, Verse 1-16. Cain killed his brother Abel and tried to discount the severity of his crime. He explained the denial of his guilt by saying, “Am I my brother’s keeper”. As a result, he became restless and overwhelmed with fear. He wandered about aimlessly. The symptoms described were no different from those experienced today.
The observation that “we are the sum total of our experiences” is especially relevant. For some law enforcement personnel, the sum total of their experiences can become too great an unsupported burden and result in symptoms of PTSD. The mental and emotional symptoms frequently lead to unwanted behaviors if left unresolved. To prevent this from happening three areas of PTSD should be addressed: triggers, traits and denial.
Typical triggers include sensual elements like the smells, sounds, sights and resulting feelings experienced at the time. The smell of diesel fuel or ethnic foods may bring back memories of the traumatic event. Hearing a siren or a noise like squealing tires of a crash may be triggers to revive the event. Identifying such triggers is a vital first step in gaining control and “peace with your past”.
The most common traits indicative of PTSD are:
- intrusive thoughts and flashbacks
- imposed self-isolation
- feelings of emotional numbness, depression, unwarranted anger, guilt, or stress
- substance abuse
Frequently denial or the inability to admit having any of the above symptoms, and an unwillingness to seek help may indicate PTSD.
Symptoms of P.T.S.D. by Oscar D. Ramirez, PhD with Crossfire: the National Veterans Assistance Corporation. Is it possible you may be experiencing PTSD? How many areas can you check below?
[ ] Unable to remember dreams?
[ ] Watch TV until late into the morning?
[ ] Do you stay awake as long as possible?
[ ] Wake up often during the night for no reason?
[ ] Wake in the morning still feeling very tired?
[ ] Have nightmares: dream of being shot at or pursued?
AVOIDANCE OF FEELINGS
[ ] Feel “hollow inside”?
[ ] Feel “emotionally numb”?
[ ] Feel detached, aloof, “emotionally dead”?
[ ] Seem to be cold, uncaring, even ruthless at times?
[ ] Unable to feel love or compassion for others?
[ ] Unable to experience either the sorrows or the joys of life?
RESTLESSNESS / LISTLESSNESS
[ ] Numerous changes of address?
[ ] Don’t know why you even exist?
[ ] Ever drive about aimlessly when angry?
[ ] Chronic job-hopping/unstable work history?
[ ] Desire to seek refuge by moving away from the problem?
[ ] No feelings of direction, meaning, purpose, or significance in life?
[ ] Have you lost interest in work or other activities that you used to enjoy?
[ ] Ever feel like nothing’s been going right, and “it’s been like that for a very long time”?
ISOLATION / ALIENATION
[ ] Had many broken relationships – divorces?
[ ] Desire to live a life as a hermit?
[ ] Experience lack of social contact?
[ ] Have few acquaintances, even fewer friends?
[ ] Desire to seek refuge by moving away from the problem?
[ ] Feel isolated, or distanced from spouse, parents, children, brothers, peers or others?
[ ] Unable to feel secure in intimate relationships?
[ ] Do you frequently find yourself questioning the loyalty of friends or relatives?
[ ] Are you suspicious of managers, supervisors, and work peers?
[ ] Have you had numerous broken relationships, divorces?
[ ] Distrust yourself and your ability to “keep it together much longer”?
[ ] Always feel suspicious of being “exploited, used, or abused”?
[ ] Intensely concerned with issues of justice, “right or wrong”?
[ ] Can’t deal with “gray” areas?
[ ] Have feelings of mistrust towards the government, government officials, and mistrust of “The System” in general?
[ ] Is your wife usually the source of financial stability?
[ ] Do you resent promotions and breaks that others got who did not go to war?
[ ] Do you feel frustrated because of inability to provide for the family?
[ ] Do you possess numerous weapons?
[ ] Sleep with weapons within easy reach?
[ ] Ever feel uncomfortable standing out “in the open”?
[ ] Feel uncomfortable when people walk or sit behind you?
[ ] Hyper-vigilance: repeatedly check doors, locks and other security devices?
[ ] Do you feel most comfortable with your back to the wall, or in a corner of the room?
[ ] Do you have a tendency to react under stress with “survival tactics”?
[ ] Generally irritable?
[ ] Ever destroy inanimate objects?
[ ] Verbally and or physically abusive?
[ ] Punch holes in walls with your fists?
[ ] Fantasize about retaliation and destruction?
[ ] Strike out at others for no apparent reason?
[ ] Invent several elaborate plans to “get even” and dwell on them for long periods?
[ ] Desire to live a life as a hermit?
[ ] Lack of confidence in your own abilities?
[ ] Do you ever feel like “a reject” from society?
[ ] Feel “hollow” like “an old man in a young man’s body”?
[ ] Do you like motorcycles because they give feelings of independence, speed, light travel, high maneuverability, low profile, solitude, exposure to the elements, instant acceleration, very loud noise, high vibration, feelings of raw power, feelings of courting danger, and an “adrenaline rush”?
[ ] Give away material things easily?
[ ] Able to easily strip away all non-essentials?
[ ] Feel the need to “get to the point” in all conversations?
[ ] Irritated easily by insignificant chatter (small talk) and all non-essential conversation?
[ ] Hoard material and supplies that might be necessary for survival?
[ ] Able to leave the area at the drop of a hat knowing exactly what you need to take with you, and exactly where you would go?
[ ] Ever feel guilt for surviving the war when others (who may have had more to live for) did not?
[ ] Feel guilt that perhaps if you had stayed a little longer you could have “made a difference”?
[ ] Feel guilt for acts committed, or acts observed without making an effort to stop them?
[ ] Feel guilt for returning to the relative safety of home and leaving friends behind that were still engaged in combat?
[ ] Ever have ‘flashback’ episodes?
[ ] Intense thoughts of “what might have been”?
[ ] Ever experience strong reaction to certain sights, sounds, or smells?
[ ] Have feelings of being somewhere other than where you really are?
[ ] Memories of traumatic events ever interrupt your routine thought patterns?
FEAR & CONTROL ISSUES
[ ] Try to control everything that happens around you?
[ ] Fear of people around you trying to control you?
[ ] Fear of dying and afraid to go on living?
[ ] Fear of surprises or situations over which you have no control?
[ ] Fear what might happen if you ever lost control of yourself?
[ ] Ever feel worthless?
[ ] Substance abuse?
[ ] Self-medication?
[ ] Difficulty concentrating? Easily distracted?
[ ] Feel a sense of helplessness or futility about your condition?
[ ] Feel that there are “holes” in your developmental stages?
[ ] Feel like you “lost something” when you were growing up?
[ ] Feel that you will never be able to regain what you have lost?
DEATH IMPRINT & CONTAMINATION
[ ] Think about death a lot?
[ ] Feel that you will never, ever get close to anybody again?
[ ] Feel that everyone that you get close to is somehow “contaminated” by you, and dies?
[ ] Unwilling to seek help, don’t trust anyone?
[ ] Ever feel like “It’s no big deal, I can handle it.”
[ ] Do you ever deny that “your experience” could have anything to do with your attitude?
[ ] Are you unable to admit that you have any of the above symptoms or that you may have post traumatic stress disorder, (PTSD)?
[ ] Do you deny even the possibility that there may be spiritual solutions to the problem of Post Traumatic Stress?
Sudden changes or critical incidents have dynamic effects on your emotional, psychological, physical, and/or spiritual well-being. Some people experience reactions immediately, others at some date in the future. Individuals can take basic preventive strategies to help themselves recover faster and avoid PTSD.
The goal of any treatment or support plan is to help create structure out of chaos, identify and better understand the emotions, and to create a reasonable and positive action plan. A peer support group is most effective in the treatment of PTSD for several reasons. Peer support group means just that, obtaining help from someone at your own level. Those who share similar backgrounds provide peer support.
Officers in times of crisis
Providing peer support groups for police officers, and other first responders, helps everyone recognize that the problem of PTSD exists, and provides the vehicle to talk of solutions. This peer group must be readily available above all else. A peer support program might be thought of as a training program that teaches a more effective way of listening to another person. Peer training is a crucial factor for a peer support program to be effective. Officers should receive 3 to 5 days of training from a skilled practitioner, who focuses on developing listening skills, assessing problems and determining the need for referral to professionals.
Peer support team members are not therapists. They are just officers, who have taken it upon themselves to be better prepared to be of support for other officers. They don’t solve problems for others nor are they expected to take on the responsibilities of or for others. They simply try to be supportive as the individual officer helps him or herself to a successful solution.
No one wants to believe tragedy can occur at any time in their careers, but it can and does. Don’t be pessimistic, but realistic. Your job, income, health and well-being are not guaranteed. Your focus has to be on being as proactive as possible. Resources have to be in place to help all involved. When the unexpected occurs be as prepared as possible. That is why it is crucial to recognize and immediately deal with the situation and the potential related problems that can multiply traumatic stress and create PTSD. Do what is necessary to reduce stress and remain a healthy strong person.
About the Author: Robert “Bob” Rabe, is a Vietnam Veteran (military police), with 38 years of law enforcement experience and 26 years as a firefighter. He has been involved in Critical Incident Stress Management for over 20 years and has developed and taught seminars on stress reduction for over fourteen years. Bob has volunteered his time to over 50 debriefings involving law enforcement officers.