Friday, August 30th, 2013 by

PTSD – WHAT IS IT?

EDITORS NOTE: the following is a guest post from Robert Rabe a Vietnam Veteran who also has 39 Years of Law Enforcement Experience.

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 of 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, and lack of support after the event.

One of the first known cases of PTSD is recorded in the Bible in Genesis; chapter 4. 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 than 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, a feeling of emotional numbness, depression, unwarranted anger, substance abuse, guilt, or stress. Frequently denial or the inability to admit having any of the above symptoms, and an unwilling to seek help may indicate PTSD.

THESE ARE ALL SYMPTOMS OF P.T.S.D.
(by Oscar D. Ramirez, Ph.D. of Crossfire the National Veterans Assistance Corporation.)

Is it possible you may be experiencing PTSD? How many areas can you check below?
SLEEP DISTURBANCES
[ ] 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?

MISTRUST-SUSPICION
[ ] 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?

FINANCES
[ ] 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?

ANXIETY REACTIONS
[ ] 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”?

RAGE
[ ] 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?

IDENTITY ISSUES
[ ] 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”?

REDUCTIONIST THINKING
[ ] 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?

GUILT
[ ] 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?

INTRUSIVE THOUGHTS
[ ] 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?

DEPRESSION
[ ] Ever feel worthless?
[ ] Substance abuse?
[ ] Self-medication?
[ ] Difficulty concentrating? Easily distracted?
[ ] Feel a sense of helplessness or futility about your condition?

DEVELOPMENTAL DISCONTINUITIES
[ ] 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?

DENIAL
[ ] 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. Peer support is provided by those who share similar backgrounds. Officers in times of crisis

Providing peer support groups for police officers and other first responders, helps to recognize 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, which 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.

Bob Rabe is a Vietnam Veteran, with 39 years of law enforcement experience.

CLICK HERE to contact Oscar D. Ramirez, Ph.D. of Crossfire the National Veterans Assistance Corporation.

ABOUT THE AUTHOR: Bob Rabe, is a Vietnam Veteran (military police), with 38 years of Law enforcement experience. He has been involved in Critical Incident Stress Management for over 20 years. He developed stress Seminars – 14 years. He has volunteered his time to over 50 debriefings Involving law enforcement.

We at CopsAlive.com like and support the Peer Support Team Training provided by Jack Digliani, Ph.D., Ed.D. You can find his free materials available for download here on CopsAlive.com or you can visit his website to learn more about his training at: www.JackDigliani.com.

Jack A. Digliani is the police psychologist for the Loveland Police Department and Larimer County Sheriff’s Office (Colorado). He provides psychological services to department members and their families, and is the clinical supervisor of the agencies’ Peer Support Teams. He has worked with numerous municipal, county, state, and federal law enforcement agencies. He specializes in police and trauma psychology, group interventions, and the development of police, fire, and other emergency service peer support teams.

Dr. Digliani is a licensed psychologist and a former deputy sheriff, police officer, and detective. He served as a law enforcement officer for the Laramie County, Wyoming Sheriff’s Office, the Cheyenne, Wyoming Police Department, and the Fort Collins, Colorado Police Services (FCPS). He was the FCPS Director of Human Services and police psychologist for the last 11 years of his FCPS career. While in this position he provided psychological services for employees and their families, and clinically supervised the FCPS Peer Support Team. He received the FCPS Medal of Merit for his work in police psychology.

You can download a free copy of Jack Digliani’s Police and Sheriff’s Peer Support Team Training Manual by CLICKING HERE

You can download a free copy of Jack Digliani’s Critical Incident Handbook by CLICKING HERE

If you feel like you or someone you know is suffering from PTSD and are in need of immediate help please contact your family physician or call the Safe Call Now crisis hotline for first responders at 1-206-459-3020

Safe Call Now is a resource for public safety employees to speak confidentially with officers, former law enforcement officers, public safety professionals and/or mental healthcare providers who are familiar with your line of work.

You can learn more about Safe Call Now at their website at: www.SafeCallNow.org

CopsAlive is written to prompt discussions within our profession about the issues of law enforcement career survival. We invite you to share your opinions, ask questions and suggest topics for us in the Comment Box that is at the bottom of this article.

At The Law Enforcement Survival Institute (LESI) we train law enforcement officers to cope with stress and manage all the toxic effects and hidden dangers of a career in law enforcement.

Our “Armor Your Self™: How to Survive a Career in Law Enforcement” on-site training program is an eight hour, hands-on, “How to” seminar that helps police officers and other law enforcement professionals armor themselves physically, mentally, emotionally and spiritually to survive their careers in police work. To learn more CLICK HERE

The concept of “True Blue Valor™” is where one law enforcement officer has to muster the courage to confront a peer who is slipping both professionally and personally and endangering themselves, their peers and the public. It takes a system of organizational support and professional leadership to support and foster the concept of courage and intervention. We will train your trainers to deliver this program to your agency.
To learn more CLICK HERE

Our “Armor Your Agency™: How to Create a Healthy and Supportive Law Enforcement Agency” Program includes critical strategies that you will need to build a system of support and encouragement for a healthy and productive agency. To learn more CLICK HERE

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CLICK HERE if you would like to contact us to learn more about training for your organization.

I’m John Marx, Founder of The Law Enforcement Survival Institute and the Editor of CopsAlive.com. Connect with me on Facebook, LinkedIn and Twitter.

CopsAlive.com was founded to provide information and strategies to help police officers successfully survive their careers. We help law enforcement officers and their agencies prepare for the risks that threaten their existence. Thank you for reading!

9 Comments

  • I am a former police officer and Scotland Yard Detective and until a couple of years ago the Editor of Constabuary Magazine which was the largest police magazine in Europe for over 25 years until 2011. I am also a trained trauma psychotherapist, addiction counsellor and medical hypnotherapist and have been for over 15 years. I think this article is very good indeed but would like to add one thing.

    Having treated hundreds of police officers, soldiers and others suffering from PTSD I have found EMDR Therapy singularly the most effective and quickest treatment along with peer support. This treatment came from the USA in the late 80’s developed by Dr Francine Shapiro and now is available in the UK usually by psychiatrists, clinical psychologists or psychotherapists.

    I have seen patients lift out of the PTSD state in as little as two or three sessions so if you have not heard of it or are not offered it I would make enquiries with your therapist. There is some more information about it on my website and an also an article I wrote about it.

  • Hi Chris,
    Thank you for you service and thank you for your comments here. I think we have a mutual friend in Nicola Zichella from Italy. I would love to have you write something for CopsAlive about police stress from your perspectives in the U.K.

  • I am glad this subject is being openly discussed, for to long this subject has been in the shadows. Yeah, I suffer from PTSD and it has sent my life on a one way ticket to hell. I am not the man I once was, but I wish to find my way back.

    I dont remember much about last week, an non-eventfully week. However I recall my Police days with laser-like focus, the date, time, my partner, the victims.

    When it got to much for me, I had to tell the Dept., about 4,000 sworn Officers, that something was wrong with me. I never felt more abandoned in my life. Which is saying something considering my upbringing.

  • Hi Rich,
    Thank you for your service and I’m sorry to hear that you are having trouble. Have you been able to get help or find some relief?

  • My computer crashed in midway to to my post. Nonetheless, a Dept. of 4000+, I would have thought they had dealt with someone with PTSD prior to me. Not the case and the older ones , all Vietman vets as the 10 vet points made the difference on getting on the job at the time. They for some reason didnt make it to the position of power.

    They were thankfully to have a steady job for their family. BTW, I enlisted in 1982, so I had it easy

    However cracks begin to show in Cops/police officers. What effect one will have ZERO effect on another, been there many times. I think it is about the human makeup/DNA We can blame our parents…Lol

    Personally, I want a place a Cop can retreat to, get your mind straight and determine if that is ones path in life. I DONT NEED Cops killing themselves, their wives, …etc.

    Just one man’s thought. Lift the veil, we are all humans and if there is help one shouldnt feel the shame. GET the help prior to suicide, the hostage thingy, shooting at neighbors, drinking to death…all that I have seen my fellow cops do.

  • With any thoughtful article, the key is making the message stick. This one hits the mark. I particularly can cling to Triggers, Traits, and Denial, or how I will begin to use this term as TTD.

    More than two decades in the military spread across a couple of years in Afghanistan and Iraq proved many things, but near the top of my list of truths is that traumatic experiences leave a mark…even if those traumatic events don’t leave visible evidence. Education of PTSD is key, empathy among our present and past service minded professionals is essential, but above all, it is the commitment and passion by guys like Robert Rabe who advance this noble cause to keep this injury on the forefront of our citizenry will save lives and families.

  • Hi John,
    Thank you for your kind comments!

  • […] is PART TWO in series of PTSD – What Is it? by Robert Rabe) CLICK HERE to read Part […]

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