How corrections officers can recognize PTSD
A police psychologist explains the symptoms of post-traumatic stress disorder and how COs can get the help they need
Ellen Kirschman has been a police and public safety psychologist for over 30 years, along with being the best-selling author of I Love a Cop. After agreeing to sit down to an interview, here are Ellen’s thoughts on living a correctional officer’s life, dealing with stress, and much more.
To contact Ellen, visit her website, www.ellenkirschman.com.
Q: What does PTSD look like for someone who has faced trauma on the job? Are there levels to how it can affect someone?
Ellen Kirschman: Post-traumatic stress disorder is a painful emotional condition lasting thirty or more days that develops in some first responders following exposure to:
- A single extremely disturbing event such as combat, crime, an accident, or a natural disaster.
- A series of such events. The psychological disturbance created by this exposure is so great that it significantly disturbs or impairs a person’s social interactions, ability to work, or to function in general.
The diagnostic criteria for PTSD must include a clearly identified trigger such as the threat of death, serious injury, or sexual violation. This is in contrast to other stress-induced conditions like cumulative stress or critical incident stress. Cumulative stress is a buildup of what might be called micro-insults.
Critical incident stress refers to the symptoms that occur in days immediately following a dramatic incident. CIS affects a responder's emotional, physical, behavioral and cognitive functions (see below), but these symptoms are temporary and will fade within a matter of weeks.
Further diagnostic criteria for PTSD require that exposure occurred in one of the following scenarios:
- The individual experienced the traumatic incident directly.
- Witnessed it firsthand.
- Learned that a close family member or friend was the victim of a threatened or actual violent or accidental death.
- Experienced firsthand repeated or aversive images of the traumatic event.
This last criterion about repeated exposure is especially important for corrections officers who will attend dozens of disturbing events in their careers.
Symptoms fall into four categories: emotional, physical, behavioral and cognitive.
- Emotional symptoms might include: numbness, irritability, depression and so on.
- Physical symptoms can range from elevated blood pressure to a variety of medical problems with no diagnosable medical cause.
- Behavioral symptoms involve sleeping problems, nightmares, changes in personal habits, eating patterns, or use of drugs and alcohol.
- Cognitive symptoms include difficulty concentrating, poor memory, problems with mental tasks and details, difficulty making decisions.
If you are experiencing critical incident stress or post-traumatic stress, get help quickly from a clinician who is trained to treat trauma and is culturally competent to work with corrections officers. There are also many effective medications that will stop nightmares.
Q: Suicide rates amongst law enforcement personnel are higher than the general public? Why is that? What can we do to ensure these rates decline?
EK: Statistics are hard to come by and are controversial, depending upon the source.
The most reliable statistic and the most important, in my opinion, is that police officers are two to three times more likely to kill themselves than they are to be killed in the line of duty.
For more information about police suicide, including statistics, readers should go to www.badgeoflife.org, a website founded by law enforcement officers with the mission of preventing police suicide.
Q: Why do corrections officers commit suicide?
EK: There are many reasons officers kill themselves.
The repeated themes are depression, actual or threatened loss of a relationship, actual or threatened loss of one's job, hopelessness, and substance abuse.
Compassion fatigue and repeated exposure to trauma and tragedy surely play a part in some of these deaths.
Q: Does one have to be depressed to commit suicide?
EK: This is a complex question. The easy answer is yes, of course.
But there are other instances of people who may not be clinically depressed choosing suicide over terrible pain or torture, for example.
What they have in common with those who are depressed is no hope for escaping an intolerable situation.
Q: What are warning signs for loved ones or coworkers?
EK: First responders may not show the usual signs because they are so adept at covering up their feelings.
The usual symptoms include loss of interest and joy in life, changes in weight and sleeping habits, obsessive interest in suicide, constant references to suicide, giving away things of value, and reckless behavior (on the job and off).
This is not a complete list. Beware of two things:
- It is not true that people who talk about suicide won't kill themselves. They do.
- People who decide that suicide is their best option often appear happy because they've finally decided that death is their best option.
This makes their deaths even more shocking because friends and family believed they were getting better.
Q: If one recognizes they are feeling hopeless or helpless, what can they do?
EK: Get help right away (see below).
Tell someone you trust, a friend, a peer supporter, a chaplain, how you're feeling and give them your guns. All your guns.
If you are worried about someone else, ask them directly if they're thinking of killing themselves.
Don't mince words. Get their guns away from them. Many people who are stopped from killing themselves are glad they didn't and go on to lead fulfilling lives.
Buying time is what saved them.
Q: What should one look for when looking for a mental health professional who will understand the nature of this job?
EK: Someone who understands the law enforcement culture, what you do and why. These folks may be hard to find. That's why we wrote Counseling Cops: What Clinicians Need to Know.
Most corrections officers prefer a therapist who is direct, transparent and has a sense of humor. A list of culturally competent clinicians can be found at www.frsn.org.
Q: What are some phone numbers or retreat programs people can call if they or someone they know needs help?
EK: The First Responders Support Network (FRSN), of which I'm a member, is a volunteer organization of peers, clinicians and chaplains.
FRSN sponsors monthly or bi-monthly six day retreats for first responders with post traumatic-stress injuries, three retreats for spouses and significant others of first responders (SOS program), and advanced peer support training.
Read more about our retreats at www.frsn.org.
Safe Call Now is a nationwide confidential resource for emergency personnel and their families. I am on their advisory board.
Contact them by email at www.safecallnowusa.org or call them at 1.206.459.3020. They can connect you to clinicians and substance abuse treatment centers with experience working with first responders.
www.badgeoflife.org: Lots of information and resources to prevent police suicide.