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With the 10th
anniversary of 9/11 upon us, consider this:
Critical incidents and traumatic events, large
and small, have been occurring forever. Their
singular and cumulative impact has challenged
many a first-responder (police, fire and emergency
medical.
Thirty years
ago, this was critical incident stress management:
Lots of talk, a written report and some slaps
on the back. The next stop was a tavern for
a few cold ones. And then, “just one more,”
which turned into a few more, and who knows
how many brain cells vanished in a wash of alcohol.
Later we would help him stumble up his back
stairs.
That’s
how we consoled a fellow officer who had been
working a walking post, responded to a nearby
bank-robbery call and got involved in an exchange
of gunfire. It was the same years later, when
a fellow squad member of our FBI office in New
York was shot and killed. Taking in the scene
of his murder — he was still sitting behind
the wheel with a couple of holes in his head
and his blood turned to Jell-O on the car’s
upholstery — sickened us. And day after
day, the news kept showing the scene.
Once, on a
cold December evening, while driving to a police
department party, I encountered a crazed, pistol-firing
doper shooting at some apparent associates.
A shot was fired in my direction; there was
a subsequent chase with more shots, some tense
moments and a successful ending. Upon arrival
at the scene, a supervisor, observing blood
on the ground nearby, asked: “Are you
all right?” My reply was: “Yeah,
I think so.” To which he responded: “OK,
see you at the Christmas party.”
None of that
is considered appropriate critical-incident
stress management today. We have learned an
awful lot in the last few years in responding
to and supporting those involved in critical
incidents — like the terrorist attacks
of Sept. 11, 2001.
This is particularly
true when it comes to the potential “second
injury.” For many, the more devastating,
insidious and longer lasting injury is the emotional/psychological
reaction. Sort of like insult to injury. Often,
the “second injury” is exacerbated
by the employee’s fear of sharing his
or her experience — fears that the department
or other agency may pursue adverse action in
a use-of-force incident, fear of civil action,
of blame, of appearing weak, of second-guessing
by peers, superiors and the public, etc.
The hypothalamic-pituitary-adrenal
axis and the release of stress hormones, more
commonly referred to as the “fight or
flight response,” is a natural process
that helps us react and make the quick association
between a threat and negative consequences.
But it may be so repeatedly, drastically and/or
indelibly seared into the memory as to drive
us to dysfunction.
The stress
hormones entrench the memories of the emotionally
significant event via the amygdala (part of
our brain that regulates fear and other emotions)
and the factual content in the hippocampus.
An officer operating with a predominantly competent
cognitive process before a critical incident
may end up with an emotionally dominant process
during and after the incident. The horrifying
memories may have been stored with such intensity
that the mechanism that normally regulates this
may be overridden, and emotion can dominate.
This is not
good for most people and extremely precarious
for a law-enforcement officer or other first
responder. Post traumatic stress may sometimes
become a career- and life-disabling emotional
hangover. And trying to stoically stop the process
is tantamount to telling someone with dysentery
to just use will power.
In fact, the
“image armor” that some first responders
wear may even impede healthy recovery, sort
of like some of the less-than-healthy, age-old
law enforcement remedies like alcohol, promiscuity
and isolation. Climbing into a bottle or the
wrong bed doesn’t help anyone.
Think of the
hundreds of smaller traumatic events occurring
in communities daily. Who is always there? That’s
right, our first responders. There are, of course,
the big ones: 9/11, TWA Flight 800, Hurricane
Katrina or Virginia Tech. But each additional
trauma, small or large, adds another brick to
your psyche’s baggage and can literally
wear new pathways in our brains. Some begin
to react as if everything were a tragedy, others
as if nothing is. Either way, it all adds to
anxiety.
So the next
time you see a first responder who may appear
to be at less than their absolute professional
best, think that it may not have been 9/11,
Katrina, or even the last smart-mouthed teenager
encountered, but rather an accumulation of hurts.
Think again, too, that notwithstanding the stress,
chaos or pain, we always respond.
Mark C. Johnston,
Ph.D., recently retired from 30 years
of law enforcement and as the FBI’s Northeastern
U.S. employee-assistance program manager. He
is now the police in-service training program
manager for Atlantic County’s Anthony
Canale Law Enforcement Training Center.
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