What Is PTSD?  Why Should We Be Aware of PTSD in Policing?

What is PTSD?

This textbook describes communication within policing. It was decided to add to the book a component of mental health awareness, specifically Post Traumatic Stress Disorder (PTSD). The reason for this is that the long-term effects of policing are being examined in both academic/medical papers and the media, with reports of suicides and mental health issues among emergency responders. This chapter hopes to bring an awareness to the dangers officers face that may subject them to a mental illness. Before this chapter begins this is an opportunity to question what you already understand PTSD to be. Try to answer these questions before you read on.

Who suffers from PTSD?

Do you know anyone with PTSD?

What are the symptoms of PTSD?

How does this affect Police Officers in their work?

How does this affect others?

What can we do to help?

Hopefully you were able to give some answers to the questions posed. As we move forward, we can see if your answers accurately reflect the realities of PTSD.

The author of this section was a police officer in the early 1990s in the United Kingdom. Based on first-hand experience, if an officer at that time saw a person commit suicide or perhaps attended a particularly gruesome murder, their supervisor would most likely acknowledge this fact with a nod and the phrase ”stiff upper lip,” meaning,  “carry on, as before”. There was no expectation of counselling or even a check-up to see how the officer was coping emotionally. PTSD can occur after a concurrent set of events as well as one singular serious event. This chapter will describe the nature of PTSD and highlight some strategies and identifiers from academia already written regarding this subject.

The first question is, what exactly is Post Traumatic Stress Disorder (PTSD)? It is beneficial to understand exactly what it is and, perhaps as importantly, understand how it can affect people. There are many medical descriptions. The Canadian Mental Health Association describes PTSD as a mental illness disorder. It involves exposure to trauma involving death or the threat of death, serious injury, or sexual violence. (The Canadian Mental Health Association: Post-Traumatic Stress Disorder (PTSD) accessed 21 March 2020).

The Lifeline Canada Foundation describes PTSD as an anxiety disorder that can occur after a person has been through a traumatic event. They list events such as disasters, physical assaults, accidents and violent acts such as terrorism or those seen during wartime.

So, we see similarities in the descriptions. The commonality is that there may be a perceived fear for one’s safety or the safety of another, or by looking at the incidents it may be possible to discern a loss of control, or confusion that may inflict fear or bring about intense emotion in the sufferer. PTSD has long been considered, by some, an illness that is akin to the nightmares suffered by those who have served in a conflict, dismissed as something only suffered by those unfortunate enough to have been to war. There have been many terms used over the years such as “shell shock”, “Combat Fatigue” and “Soldier’s Heart”. Seemingly this is not the actual description of how it is caused and certainly it goes beyond wartime situations. (The LifeLine Canada Foundation accessed 9 April 2020).

The sheer nature of the labels given to this condition make it difficult to diagnose and cause it to be accepted as a mainstream public illness. The stereotypical image of the sufferer of PTSD was historically a military man, one who does not want to display weakness, viewing his position in society as the household provider who is expected to keep going regardless of his suffering. PTSD is a more broadly considered illness and is spoken about more freely now, albeit not freely enough, without considerations of stigma from its label as a mental illness. We also understand that this is not an exclusively male illness and does not just relate to conflicts or veterans. So, having labelled PTSD, what are the signs of it? If we can recognize the signs, we may have some insight into how it relates to policing and communications.

It is important for police officers, and in fact everyone, to be able to recognize the signs and symptoms of PTSD. The illness can be a constant, with the person suffering extensively, or may be somewhat dormant. There may be triggering incidents that cause the sufferer to relive all or part of an event or cause increased anxiety. Some of the suffering may be in private, some may be seen in public. Lack of sleep, nightmares, depression, increases in heart rate, sweating, panic attacks, a lack of sexual desire or performance, anger or mood swings, irritability, negativity or an inability to show happiness or affection are included on a growing list of signs of PTSD. It is also true that not everyone that experiences a traumatic event or who is traumatized develops PTSD.

So, as an illness how can it be treated? If we are aware of it, can we prevent it, or at least mitigate some of the symptoms? Indeed, now that there is a movement to concede that PTSD is a widespread problem, especially among first responders, treatment is developing for it and is available. This treatment includes prescription medication and psychological help, varied to the need of the individual patient. In addition, there are support groups, counselling, and a heartening trend that officers are being encouraged by their departments to eat healthily, take breaks at work and to remain fit and active in order to assist in taking care of their overall well-being. Training and awareness is growing and first response supervisors and peers alike are becoming more aware of the signs and symptoms of PTSD. Individual officers are being schooled in their initial training to recognize PTSD and are being given coping strategies. Veteran groups and other organizations and social supports are offering similar services and importantly, the impact is such that officers themselves are breaking the stigma and talking about PTSD. (The Canadian Mental Health Association: Post-Traumatic Stress Disorder (PTSD)  accessed 21 March 2020).

PTSD and Policing

Having discussed what PTSD is and how it may translate into people‘s lives, we can consider the impact on policing. There are likely more impacts, but two that are most evident are to the Police Departments directly, hiring, retirements, and generally ensuring that officers are able to maintain and fulfil the expectations of duty during their employment. The other is the demands and increased risks in almost every encounter with the public. Not knowing a person’s history or what may trigger a person’s PTSD, or what their behaviour may escalate to, will be an officer’s concern. Understanding and exploring the signs and symptoms and becoming familiar with them is a positive start. To the first point, that officers are impacted, it is a positive and increasing trend that Departmental Leaders within policing recognize PTSD as a priority and are leading the way in breaking the stigma of mental illness. Living with PTSD seems to have been a process. Reports and academic papers suggest that historically a stigma was attached to officers who declared they were suffering from PTSD; ridicule, career limitations and pride have all been reasons for non-disclosure of suffering from PTSD. In 2016, the Vancouver Police Union revealed to Global News that as many as one third of its police officers were dealing with post-traumatic stress disorder. This information was obtained from a survey completed by 700 of its 1200+ police officers. This is a huge number and a testament to the fact that officers are under a lot of scrutiny from the public with the increases of public expectation standards and the constant watch provided by cameras and phones. Working under a constant camera lens with such high-stake duties, it seems logical that officers would feel their mental health is somehow affected. With a workforce admitting their health issues, what are the consequences?   In this article is a quote from a psychologist, Dr. Gregory Passey. When commenting on the impact of people with PTSD he states, “It can have a huge impact”, “It disrupts their sleep, and they often have nightmares, difficulty concentrating, multitasking.” (Duran, 2016, p.1). This is a concern in itself;  now expect that person to carry a firearm, drive to high risk calls, make decisions in less than a few seconds and carry high jeopardy work load. Add to that unsociable, long work hours, and attending traumatic events repeatedly, it can be seen that this is a real problem for Police Chiefs. PTSD has been linked to increasing numbers of officers taking months to years off work with illness or even tragically committing suicide.

This is an issue not limited to North America. The West Midlands Police is the second largest police service in the United Kingdom (UK). They do not have a union but have representation through an organization called the West Midlands Police Federation. According to a report published 14 May 2019, one in five police officers is suffering from PTSD. A survey of

• 17,000 police officers was conducted with 47 departments in the UK, carried out by Cambridge with funding from Police Care UK. The results show:
• 21% of police officers who responded reported symptoms consistent with PTSD or the more severe, Complex PTSD (CPTSD)
• 73% per cent of those with PTSD or CPTSD will be unaware they have it
• 66% of those reported a psychological or mental health issue which they felt was a direct result of police work
• 69% of officers feel that trauma is not well managed in their force
• 93% still go to work even when suffering from a work-related psychological issue.

The survey’s findings echo the Police Federation’s latest “Demand, Capacity and Welfare Survey”, which also found evidence of widespread, repeated exposure to trauma within the police workforce. (West Midlands Police Federation, 2019, p.1).

There is no shortage of news stories and research into PTSD in policing, not only around the world but here in Canada. One only has to type Police and PTSD into a search engine to find such information. In particular, there are a lot of officers who are retrospectively taking their department to task for failing to look after their welfare. Unfortunately, there are numerous accounts of officers leaving the force and, sadly, others taking their own life. If we consider the journey of an officer from their excitement and thrill in joining a department to the ultimate sacrifice in taking their own life through not being able to cope, it is not a pleasant read.

Increased Demands and Risks

As discussed, there are demands placed upon police departments to look after their officers but there are also the personal and individual demands placed on the officer themselves, just by the sheer nature of their role. Some are clear and obvious potential triggers, such as gruesome crime scenes, accidents or personal physical attack; others are more subdued. When considering the broad depth and variety of criminal acts and incidents that occur daily, not a day goes by when law enforcement officers are not dealing with something that others do not want to even think about having to attend to. It is easy to see how these incidents add up, but let us now consider one of the less obvious builders of stress.  We have discussed many forms of interviewing techniques; each brings the victim, suspect or witness back to a place in time. Often that place is described in graphic detail. If we add visual injuries, video evidence, sound recordings or even eye witness observations, it is not surprising to learn that a real concern is the well-being of the interviewer. It is important to recognize that the interview process is potentially traumatizing and to offer victim support or peer support where possible to the victim and witness. The interviewer themselves is often the forgotten subject and, as discussed, over time this may lead to problems associated with PTSD. Officers also have to collect evidence for court cases; sometimes this involves examining digital or recorded evidence and listing the offences committed in these recordings. These job requirements can eventually lead to difficulties in carrying out daily activities in the officer’s life, job, and relationships with their families and colleagues. Tragic incidents such as the reported US army reservist who reported that PTSD had left him suffering from anxiety, depression and hallucinations. The web link to this news headline is: CTV NEWS: Gunman who killed 5 Dallas police officers showed PTSD symptoms

In Canada cases such as the RCMP officer Sgt Chris Bewsher have been reported in the news. Sgt Bewsher sued the Canadian government because he perceived he received a lack of support or counselling while he suffered from PTSD. The link to this news report is listed here: Former Mountie with PTSD sues Ottawa after multiple northern postings

In B.C., Canada, the Wounded Warrior Run “raises awareness of occupational stress injuries suffered by military and first responders”. This is designed to support Canadian first responders, armed forces and veterans.

Police officers may not know that a member of the public they are dealing with is suffering from PTSD, however there are some recognizable symptoms and signs. Not all are apparent at once, or indeed at all, but hopefully knowledge of such will assist them in their duties. Some people that suffer from PTSD have trouble with interpersonal and social skills that at one time were not an issue to them:

• The person may have a powerful sense of disconnect and may not grasp another person’s point of view, read their reactions or be able to correctly gauge the thread of a conversation. As a result, they may seem distant or fearful, confused or frustrated.
•  The disconnect for the conversation makes them unable to create emotional rapport. This may occur straight away and will add to the anxiety and frustration.
• Self-esteem may be low and, as a result, the person may appear to lack assertiveness. This may lead to feeling that they are not listened to, and compound the need to withdraw from others.

PTSD also can trigger the nervous system activation or a high stress condition in the brain and body including signs and symptoms:

• Being highly sensitive to others can lead to hypersensitivity. Such things as the other’s tone of voice, volume of voice or surroundings, and issues of trust being lost are major hurdles to overcome.
•  Not having two-way open communication may cause someone to adopt a rigid portrait of stubbornness, not always a good thing in dealing with officers making demands.

Of course, there is always the profession where quirks and behaviours are clearly entering into the lifestyle of Mental Instability and illness:

•  There may be times when a PTSD sufferer loses track of a conversation, and may need clarification of what was being said. An apparent difficulty in keeping up with the message and lack of decisiveness in decision making or answering questions may lead to anger issues. Often this processing confusion will be aided if the person writes information down to help to process it. Overwhelmed people need time and if not given it will feel further frustration.
•  With the difficulty in listening and processing, a problem may develop in organizing information. Imagine having a conversation with someone that is logical to you but the other person is not following it. People with PTSD can formulate or process information in a way they feel is right but to the other person it is not logical and sometimes even scrambled in nature.
•  At the increased level the person may have a more serious lack of concentration and focus, with things on their mind and so many thoughts and feelings rushing through their mind that it makes it very hard to focus.
• Another frustration is the lack of process and focus that is not supported well by memory. Losing one’s train of thought or forgetting simple tasks leads to a massive frustration that can add to the mental illness of the person. (Retrieved from The Art of Healing Trauma Blog: PTSD Challenges – Communication).

Communicating with People with PTSD

The first and perhaps most important thing to understand in communicating with someone with PTSD is that they may not need help at all. They are coping, they are able, and they would rather get on with their day in the way they normally did before they discovered they had the illness. There are some simple ideas for helping if it is necessary.

• If someone is under stress, try to reduce it, be tolerant of work performance issues, and don’t add more pressure.
• No two people will have the same illness symptoms. Make sure you do not pigeon-hole anyone. If you become aware of the circumstances, have a conversation to see how the person wants you to communicate and determine if there is anything you can do to assist. Do not push your ideas or perceptions on them.
• Expect that there may be repetition and some personal stories in conversation with them. Let them talk; there may be a reason they are doing so.
• If the person has or displays crises, or has a confrontation, you should remain supportive and calm. Maybe there is a support person, family member or someone that can be called around whom the subject is comfortable. If it is appropriate and comes up in conversation, see if the person needs logistics such as meals, fluids or medication that will make it easier for the person. As a rule, liquor should not be presented, since it may be part of the problem.

In short, remain calm, keep your professionalism, but show dignity and respect, be a great listener and try not to be judgmental or overbearing with your assistance. Be honest, however  bad news can be devastating, so be mindful of timing and where you are; always keep in mind the best interests of the person and be positive in your choice of words.

Tips for Communicating with People with TBI and PTSD

The Canadian Mental Health Association: Post-Traumatic Stress Disorder (PTSD)

PTSD CONCLUSION

PTSD is a mental illness that is being highlighted as a real concern to law enforcement personnel. There doesn’t have to be a trigger incident; it can be caused by one incident, a multitude of incidents or simply a prolonged exposure to incidents over time. The causes of PTSD are very individual to the person suffering from them.

For many years people attributed PTSD to those suffering a serious, often macabre or devastating, event, such as witnessing a murder, military actions, or being a victim of a violent offence. We have established that, while this can be true, it doesn’t have to be the trigger. Living with PTSD can be extremely problematic for the individual as well as their friends, family and work colleagues. Behaviours in an individual can change. They can develop nervousness, aggression, tiredness, irrational behaviour, overreaction, or under-reaction. There is no normal behaviour pattern, but usually there is a change in emotions from what was previously considered normal for the person. Some people with PTSD use alcohol and drugs to help control or forget the feelings; generally this will only intensify the emotions and perpetuate the illness.

Historically, a stigma has been attached to talking about PTSD. Law enforcement officers in years gone by would attend scene after scene, get through their days without proper debriefing or counselling, and basically carry out their own coping strategy, which may have included an alcoholic drink. Nowadays, with the significant increase in social media platforms, there is a massive shift towards PTSD awareness, with a particular focus on first responders and military personnel who take their own lives because of PTSD. This attention has raised awareness. Most police departments are putting training in place, and officers are talking about PTSD and supporting each other. Cognitive-behavioral therapy and support groups are common. No longer is the individual expected to come forward, but supervisors and peer support is now available to allow individuals to talk about their experiences.

It is evident that there is a long way to go to really understand how to assist officers with PTSD. It is clear that academy training and peer support on their new teams is not enough. Increasing awareness and commitment to assistance will help officers to open up and talk about their feelings without fear of rejection or being judged. ‘Suck it up” is no longer the appropriate or expected action of an officer returning from a call. Dark humour once buried the problem and masked the emotion; now it is everyone’s responsibility to ensure that proper debrief and follow up takes place. Before officers assist each other with their mental wellness, they should also be helping themselves. Included is a chart examining the physical signs, behavioral changes, and emotional signs exhibited with PTSD.

(American Military University: Police Officers Face Cumulative PTSD retrieved 2020-02-10)

To close the chapter, we include descriptions of PTSD as seen through the eyes of a police officer from the United Kingdom. A friend and former colleague of the author, this officer was typical in nature and her career path followed that of anyone progressing from patrol into the detective position. She dealt with violent and often traumatic street incidents, and spent time in an office dealing with traumatic files and interviewing children and their offenders, which is one of the most common causes of stress for police officers. Officers find offences against children particularly difficult to process. They often take on the role of temporary guardian, on-scene social worker, medical examiner and support to the child, while maintaining ethical integrity and professionalism dealing with the suspect. Child protection police departments can be known to have a short officer tenure to prevent too much exposure and burn out for officers. As PTSD can be so different from one sufferer to another, I have also included an account written through the eyes of a Canadian paramedic working in BC. I hope this information in the form of personal accounts will assist in your awareness and understanding of PTSD as an illness.

My PTSD

By Sharon Spriggs.

“Close your eyes, just for a minute and imagine. Think about what someone with Post Traumatic Stress looks like. Try and think also about the cause of their PTSD. Do they have battle scars, missing limbs? Are they badly burned, blind? In all likelihood the person you are imagining will be in uniform. The army, navy, RAF (Royal Air Force), and the causes of their post-traumatic stress are clearly visible and easy to imagine. Perhaps a firefighter, paramedic or, of course, a police officer, all of whom are involved in accidents, sustain injuries and witness horrendous sights on a daily basis. “Is the person you are imagining crying constantly, looking tired and haggard, jumping at the sound of any loud noise or bang, drinking more than usual, being violent and having unexplained outbursts of anger?” This is what my psychologist asked me to do when he told me he thought I might be suffering with PTSD.

Of course, I said it was impossible. Surely, I would know if I’d been involved in something that bad it would give me PTSD. “What if I was to tell you your next-door neighbour was suffering with PTSD, or your mum, your brother, sister, best friend? What about the person sitting next to you in the office? PTSD isn’t one size fits all. One of the worst cases of PTSD I have ever had to deal with is from a woman who saw her dog get run over.” And there it was. I was diagnosed with PTSD

I am not an authority on PTSD but I do know it can affect anyone. I know you don’t have to have suffered a life changing injury, been involved in an horrendous incident. You don’t have to have been to war or been scared for your life. Basically, you just need to have been getting on with your life. It won’t necessarily be because of one single incident, or one particular day. It can be something that has built up over weeks, months, years and suddenly BOOM! You will be taking the trash out one day and you trip over a stone, or someone will say something mildly offensive, you might drop a plate. It can be anything but that incident, on that particular day will be the catalyst. The most mundane of things and that’s exactly what happened to me.

The first instance was while I was at a shop in the local shopping centre looking for some swimming shorts for my husband. I recall having difficulty finding the size on the pair of shorts I was holding. I could see the US size, the EU size, all the different countries but not the UK size. I remember getting frustrated and then angry and I felt as if the lights were getting dimmer. I began pacing up and down the shop, going towards the entrance where it seemed lighter. I recall feeling really short of breath, suddenly claustrophobic and wanting to scream.  By this time tears were rolling down my cheeks. I walked out of the shop with the shorts in my hand, just half a dozen steps then came back again, continuing to pace. People were watching me but to be honest I think they were too frightened to approach me. Finally, I threw the shorts to one side and stormed out of the shop. I don’t recall what happened after that, I’m assuming I found my car and drove home, I just remember getting into my bed exhausted and falling asleep and not waking up ’til the next morning. Did I realise or even suspect I was suffering with PTSD at that stage? No. Did I tell anyone, even my husband? Of course not, perhaps if I had he would have told me he’d noticed my erratic moods, restless sleep, irritability. Then again, he might just have thought, and this is no disrespect to him at all, that I was due on my period. After all I hadn’t had any recent injuries or accidents…. well not in the last 3-4 months.

Then one day, whilst at work, I received a phone call from my husband, his father had been rushed into hospital with a suspected heart attack, he was on his way to pick me up. Several hours later, tired, emotionally exhausted and worried about what the future held for my father-in-law, we set off home. Ten minutes into the journey I received a phone call from my sergeant. Was I coming back into work? Had I submitted the file I was working on? Had I contacted CPS for an update? When would I be coming back in? With my head a blur I instructed my husband to drive me to the station. Again, I don’t really remember what happened after that but my husband told me I walked into the office and went up to my desk and I just started packing. I found a box and started putting scissors, staplers, crime reports, files, pens, random pieces of paper into it. I never spoke, not one word and nobody spoke to me. Just watched. My husband asked me what I was doing but I never answered and when I cleared my desk completely, I just walked out, box in arms and went back to the car. When we got home, I got undressed and again, slept for several hours.

The next day I reported in sick and I agreed with my husband to make an appointment with the force counsellor. Did I know or suspect I had PTSD at this stage? No, I didn’t, neither did my husband and neither did the counsellor. We all agreed however I might be suffering with stress. No shit, Sherlock!

A week went by, maybe ten days. My husband was at work and I sat huddled under a duvet on the settee. Like so many other days I hadn’t dressed, washed or cleaned the house. I’d gone upstairs briefly to fetch something and I heard a knock on the door. I was a mess and had no intention of answering it but watched covertly from behind the curtain. There was a car outside that I didn’t recognise so I just waited and watched until the caller walked back down the path and then I recognised him, my Superintendent, followed by my Chief Inspector. My heart leapt into my mouth. There was only one reason two senior officers called on you and it was to deliver the worst news possible. I raced downstairs, tears already welling up in my eyes, I opened the door and called to them. As I led them into the living room, I became conscious of how messy the living room was, I quickly raced ahead bundled up the quilt and threw it into the dining room. I directed the Superintendent into a chair and became aware of all the old newspapers tucked down the side and quickly grabbed them. All the time I was asking myself why I was doing this, why I was worried about an untidy house, it didn’t matter. Deep down I knew I was trying to avoid having to deal with the inevitable news.  The Supt began to engage me in small talk. How was I feeling, was I doing OK? ‘I’m fine’ I said. ‘I’m doing OK’ I replied, all the while wondering why they didn’t just get on with it. Why weren’t they asking me if I wanted a cup of tea, or if there was a relative who could be with me. I just kept looking from one to the other and screaming in my head GET ON WITH IT!!!!! ‘You brought some paperwork home with you,’ the Supt said. I looked at him confused before confirming I had. ‘Why?’ he asked. ‘The file needs to be in by the weekend,’  I said. ‘Is it done?’ ‘Nearly,’ I said. He just stared at the newspapers I had clutched to my chest. The silence was deafening and I couldn’t stand it anymore. ‘Is he dead?’ I blurted out. The Superintendent and Chief Inspector looked at each other in confusion. ‘Where is he?’ Tears began streaming down my face as I looked from one to the other. ‘Chris (my husband). Where is he? Where have they taken him? Suddenly a look of realisation dawned on the Chief Inspector’s face. ‘No, no it’s OK, he’s fine. He’s fine. That’s not why we’re here.”  I didn’t believe them and asked them to leave. I tried contacting my husband, but couldn’t get hold of him but managed to reach my counsellor. That’s when I had my first full blown panic attack. My husband was finally traced and he came home. The fall out of emotions was a shock to both of us and it was agreed it was time to get more specialist help and an appointment was made to see a psychologist.

So, here’s why I was suffering from PTSD. In the twelve and a half years I had been a police officer I’d had someone try to stab me in the face as I peered through a letterbox. I’d walked into an invisible glass wall whilst investigating a burglary and knocked myself unconscious. A man had tried to take my head off with a baseball bat…the same man who half hour earlier had tried to murder his ex-wife’s partner.  I’d had someone try to bite my nipple off as I struggled on the floor, he’d also punched me several times on the side of the head, so hard it was later discovered he’d left me with diminished hearing in my left ear. I had been involved in a car accident on my way to a blue light run, which put me in hospital for several days, attended a road traffic accident where a taxi had hit a motorcycle and I had to administer first aid on the roof of the Black Cab where the rider lay. I had spent an hour talking someone off the top floor of a multi-storey car park, holding onto his hand as he was threatening to jump, not sure if he would take me with him. Four years on the Family Protection Unit dealing with the horrors of child abuse, abuse on Vulnerable adults and Domestic Violence where a woman I had spent three years trying to keep safe from her partner had eventually had her throat slit. All every day trials and tribulations that are dealt with by police officers up and down the country on a daily basis. And here is the issue. There is one thing all of the above incidences had in common. Something it took several hours of tears, heart wrenching, soul searching and numerous expensive visits to the psychologist to discover, and that is not a single one of those incidents was dealt with in any constructive or therapeutic way. No counselling. No chats from supervisors. No phone calls from HR, but this wasn’t the exception, this was the norm. You just didn’t address these things in those days, so it was twelve and a half years of worry, stress, injury, panic, adrenaline. Emotional highs, emotional lows. Good days, bad days. All there in my head just waiting for someone or something to light the touch paper. BOOM!

So, when you next think of PTSD remember, it’s not like a broken bone, a rash, a laceration. There won’t necessarily be any visible identifiable signs. it doesn’t come with a big sign saying ‘Warning! PTSD Approaching’. It just silently worms its way into your head, quietly creeping into your senses, distorting your emotions. Creating triggers, responses and overreactions to things that wouldn’t normally affect you. What is the biggest cause of PTSD?  Ego. Bullheadedness. Thinking you are the exception to the rule, the big I am. Embarrassment. Thinking you would be considered weak if you admitted to suddenly feeling scared, worried, apprehensive. Can PTSD be prevented? Definitely. Have a conversation. Share your day. Address your concerns. Don’t push things to the back of your mind. Grab counselling with both hands if offered. Accept you are human.

(Sharon Spriggs. personal communication 2020)

A powerful account as I am sure you will agree. Here is another experience, this time from a paramedic:

The Psychophysiology of PTSD

The following is from a blog written by a paramedic with direct experience of PTSD:

“When I first started developing symptoms of PTSD, it was all very confusing.  The main emotion that came up for me was sadness.  However, it was not a normal sadness, it was a supercharged sadness. It comes up with an intensity that is difficult to describe unless you have experienced it.

What I truly couldn’t understand at the time, were why these emotions kept on coming up. It seemed any small emotion, thought, sound or even the way someone would talk to me would trigger it. I had no control over my emotions and it was extremely unsettling. I would also get intrusive memories and thoughts. I might be having a great day, then all of a sudden memories of the bad calls would surface and suck all the happiness out of me. Sometimes the intrusion is an image, sometimes it is an emotion, other times it involves sounds or smells, sometimes a scene would re-play and I would be re-living what had happened. I would get sucked into the past. Needless to say, staying in the present was extremely challenging.

The lack of control, the lack of understanding of what was happening, and the inability to find a solution was what was most troubling for me with PTSD. Thankfully through counselling, reading books, and some research into trauma and the brain helped me better understand what was happening to my body and mind. In fact, what I learned was completely fascinating (mind you I am a bit of a nerd).

Understanding the psychophysiology of trauma and memory was a major stepping stone for me. When what I was experiencing started to make sense, I felt a sense of autonomy and control again, I knew I wasn’t going crazy.  This knowledge didn’t make having a flashback or getting triggered less painful or prevent them from coming up, but suddenly things were a bit less scary.

One way to look at PTSD is to see PTSD as your body’s way of adapting and protecting you from traumatic experiences. However, your brain’s method of protection can result in memory consolidation problems. Normally memories are experienced and processed into long-term storage by an area of our brain called the hippocampus. This memory consolidation can occur during waking hours but the majority of the work occurs during REM sleep and trauma can cause a disturbance to this memory consolidation process (Marle, 2015).

In summary, when a person is exposed to trauma, our body’s natural instinct is to try and protect ourselves. In the process of doing this, our survival brain (older reptilian and limbic system) takes over our rational brain (neocortex). It is important to remember that this is a natural process, it is only when the trauma is so overwhelming that it causes certain parts of our brain to deactivate, like the hippocampus, that it can interrupt memory processing and potentially lead to PTSD.

The truth is, no one is immune to trauma, simply being human and having a highly structured brain makes you vulnerable to trauma. Those who are in professions that are often exposed to violence and death, like first responders and military personnel, increases their risk of occupational stress injury and getting PTSD.”

End of account.

As you can see, these accounts give a valuable and interesting insight into experiences of non-military first responders and how they describe their understanding of their personal encounter with PTSD. For myself, in general as a police officer, I always liked to talk to a colleague after my shift, especially after a busy night. I found comfort in a listener who understood completely the events of the evening, was not shocked or horrified with the details of what I had seen, and could understand the need to talk or wrap the seriousness up in humour, if I found it necessary. To be able to give a reassuring and understanding ear and quiet nod to my colleague’s accounts was also helpful, to feel useful to someone about whom you cared. This removed some of the emotional burden for me and was a strategy I employed on a regular basis to help me work through the emotions and adrenaline rushes of patrol work, especially as an unarmed officer, which as a UK police officer was the case.