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For
nearly 20 years, Dr. Beverly Anderson has provided
psychological services to law enforcement agencies
around the nation. She has consulted on traumatic
stress to more than thirty international and
national law enforcement organizations. Dr.
Anderson has been a featured speaker on Posttraumatic
Stress Disorder (PTSD) for Good Morning America,
CNN, and dozens of television news stations.
She is featured in the Channel 4 News video"Cops
Under Fire." She has been invited to present
her research on Police Trauma Syndrome®
to several organizations and
groups including the International Society for
Traumatic Stress Studies. Dr. Anderson is the
Clinical Director and Administrator of the Metropolitan
Police Employee Assistance Program in Washington,
D.C. Moreover, she is President of The American
Academy of Police Psychology, an organization
that is dedicated to addressing the unique concerns
and stressors of the law enforcement community.
Dr. Anderson is a Diplomate of The American
Academy of Experts in Traumatic Stress and the
Academy is privileged to have her serve on the
Board of Scientific & Professional Advisors.
JSV: I know that you have
been very committed to providing psychological
services to law enforcement agencies for almost
20 years. Can you tell me about the positions
that you currently hold?
BJA: I am the founding Clinical
Director and Administrator of the Metropolitan
Police Employee Assistance Program and have
been since 1988. This program is unique in that
it is a joint union-management approach to addressing
the serious stress-related problems that are
a direct result of policing. I do not work for
the Police Department or the City. My contract
is with the Fraternal Order of Police Labor
Committee. The best part about this independence
is that it ensures confidentiality. The records
belong to me as a private clinician which facilitates
trust in those whom we assist. We have 3,500
officers in the Washington Metropolitan Police
Department. We are not an employee assistance
program in the true sense. We are actually a
long-term services program and provide individual
therapy, family therapy, marital therapy, play
therapy, and various group therapies including
Veteran officers groups, alcoholism prevention
and relapse groups, and weekly critical incident
debriefing groups. With regard to this latter
point, we have an average of two police-involved
shootings per week. Subsequently, we have ongoing
debriefings. Our police department must contend
with one of the highest murder rates in the
United States for a city of our size. Moreover,
we have one of the highest rates of ambushes
and unprovoked attacks on police officers in
the nation. There is a lot of gang violence,
drug-related problems and the like. We have
a situation here that demands all of the emotional
resources of the force. We also do a lot of
training. The foundation of our comprehensive
program is based on training. We have a critical
incident program that begins with the recruits
in the police academy and involves family members.
We are on call 24 hours a day. In fact, just
this morning at 1:30am, I was paged to a police-involved
shooting and had to go to the Homicide Division.
I sat with the officer to assist with what is
best referred to as defusing. This involves
debriefing the officer after the shooting and
then for six mandatory meetings within three
months of the shooting. We are also engaged
in research. We have done work with Dr. Frank
Putnam from the National Institute of Mental
Health on Secondary Post-traumatic Stress Disorder
in the children of police officers. We are still
compiling data. In working with police families
over the years, we have noted a preponderance
of symptoms in the children to include hyperactivity
and attentional problems. I believe that this
is a direct result of experiencing the effects
of parental exposure to trauma.
JSV: As you are aware,
The American Academy of Experts in Traumatic
Stress is a multidisciplinary organization comprised
of professionals from over one hundred forty
specialties. Many of these individuals respond
on the "front lines" of risk and,
at times, danger which are significant stressors.
How does law enforcement stress differ from
other occupational groups such as firefighters
and Emergency Medical Technicians (EMTs)?
BJA: The first thing that comes
to my mind is the public response to firefighters
and EMTs. For the most part, it is a very positive
response when compared to the police. Think
of being stopped by a police officer for speeding,
for example, and you think that you are going
to get a ticket. One of the first things that
you may do is try to get out of it, be nice,
or lie. The public mind set toward the police
officer seems to be more negative. Although
there is a clear danger potential in all of
these groups, the danger is different for police
officers. As the level of violence in this country
escalates, the echos of that violence reverberate
throughout the police community. Unprovoked
attacks on police officers are at an all-time
high. Just a year ago, D.C. Master Patrol Officer
Brian Gibson sat in his patrol car at a stop
light and was shot execution style by a young
man who was put out of a local night club by
a police officer. Another example is Officer
Wendall Smith who was exiting his vehicle after
returning home from his evening shift. When
the attackers saw that he was a police officer,
they shot and killed him. In 1995, Scot Lewis
was shot in the head and killed by a passerby
while Officer Lewis and his partner were assisting
a hearing-impaired person. The assailant then
turned the gun on Scot's partner, Officer Keith
Deauville who returned fire, fatally wounding
the attacker. In these situations, the danger
is not obvious and you don't know who is going
to attack you. The police officer always has
to be ready. That is why officers have what
I call "cop-face" (the need to be
hypervigilant). They have "cop-face"
because they never know (when they have to move
into action). The unpredictability of the job
of policing is an added stressor. This means
that the stress hormones need to remain elevated
at some level (recall the General Adaptation
Syndrome). The police officer is always looking
for what is "wrong" in the picture.
Shift work and midnight duties are common to
other professions but the unpredictability and
the violence make police work unique. You can
add to this, a revolving-door justice system,
with the person you locked up today, back on
the street tomorrow. A police officer also has
to contend with mixed messages from police administration.
On one hand they are told to lock-up and arrest
those involved with crime and, on the other
hand, always remain professional while doing
it. There is public scrutiny of police work,
and at times, media misrepresentation of events.
There is always a threat of civil law suits.
There is significant stress associated with
the use of deadly force - having to kill another
human being. I have yet to meet an officer who
is emotionally ready to kill another human being.
Many officers say that the first thing that
came to mind after they fired the fatal bullet
was "Thou shall not kill." All of
these stressors make police work different from
other professions. Of course, the on-going,
day-to-day exposure to murders, assaults, rapes,
child abuse, domestic violence and "man's
inhumanity to man" intensifies this stress-related
burden.
JSV: What is the most significant
stressor for police officers?
BJA: If you ask a police officer
about the most significant stressor of policing,
they often report "police administration."
However, the nightmares they experience are
not about administration. These nightmares are
about the use of deadly force, shooting their
guns, and being shot. It becomes apparent that
the most considerable stressor is the constant
exposure to trauma, especially over prolonged
periods of time. However, problems regarding
"police administration" are very real
for officers and sometimes constitute the "second
wound." Officers expect that the public
and the media will mistreat them; they don't
expect betrayal from the very organizations
they risk their lives for every day.
JSV: This is quite consistent
with combat veterans who serve multiple tours
of duty.
BJA: This is absolutely correct
and I think that you bring something out that
is so much a part of the police experience.
Without minimizing the trauma of combat, consider
the following. During wartime, soldiers go to
a foreign land, and are likely to remain there
for six months to a year. Police officers are
likely to see twenty years of peacetime combat,
in their own country where they do not always
know who the enemy is. The enemy could be anybody.
JSV: What is "Police
Trauma Syndrome®"
and why do you think that it has taken so long
for its wrath to be examined in the trauma literature?
What are the stages leading to this syndrome?
BJA: Police Trauma Syndrome®
is a diagnostic term that I authored several
years ago to depict the cluster of symptoms
many police officers suffer as a direct result
of the job of policing. It is now a registered
trademark. In diagnosing trauma-related disorders
with police officers, we have found great difficulty
with the criteria set forth in both the DSM-III
and DSM-IV (Diagnostic and Statistical Manual
of Mental Disorders). It has been problematic
for us to use the DSM-III or DSM-IV criteria
for police officers because they typically do
not fit into the Posttraumatic Stress Disorder
(PTSD) criteria per se. A police officer can
witness, inside of one week, more trauma than
most people see in a lifetime. Not only is it
qualitatively different but also, quantitatively
different. They see so much trauma. If you examine
the first of the DSM-IV criterion (for PTSD),
it states that the person's response to the
event must involve intense fear, helplessness,
or horror. Police officers are more often than
not, the first responders to a scene. They have
been tuned to dissociate from their emotions
or suppress their emotions in order to be able
to endure the scene. Theoretically, in most
cases, police officers would not fulfill this
first criterion. They are trained to respond
behaviorally (not emotionally). Also, we tend
to see a biphasic response which oscillates
between anger or intrusive thoughts and numbing.
We see extremes in their responses. This does
not imply that police officers get used to being
exposed to trauma, because we know that this
is not the case. Chronic, long-term and cumulative
stress takes its toll on police officers. When
we talk about the issue of police brutality,
it becomes clearer that the effects of such
stress will come out one way or another. Police
Trauma Syndrome® can result after
a single, catastrophic event such as when an
officer witnesses his partner being killed,
and then having to defend his own life perhaps
by killing the assailant. This could precipitate
full-blown PTSD or Police Trauma Syndrome®
in an officer. On the other hand, after years
of traumatic exposure, Police Trauma Syndrome®
can be triggered by an incident that is not
immediately life-threatening, like the following
incident.
A veteran officer with young
children at home got a call to respond to an
unconscious person. Well, what do you think
of when you hear "unconscious person"
- a street person, a person who is intoxicated,
a stroke or heart attack victim? There is not
too much warning in these situations. The officer
goes into an apartment and there he finds an
eight-month-old baby with a core body temperature
of 106 degrees. He immediately begins mouth-to-mouth
resuscitation because the baby is not breathing.
The baby vomits sour milk into the officer's
mouth. The ambulance finally gets there and
the baby is taken to the hospital and dies.
No one tells the officer what the baby has died
of. He doesn't know if the baby is HIV positive,
has meningitis, or is contagious! No one will
talk with him because there has not yet been
an autopsy. He goes home. Can he touch his children?
He cannot look at his young baby without having
intrusive thoughts and overwhelming feelings
about the baby who had just died. In this case,
the officer had an acute reaction and this triggered
memories of other experiences and he was in
a full-blown crisis. Another example is the
veteran officer who had been on the scene of
many suicides over the years. On one particular
occasion, he began to tremble and hallucinate,
and he experienced panic symptoms, etc. This
was a person with 22 years on the force! There
are so many factors involved. The important
thing to convey about Police Trauma Syndrome®
is that when a clinician sees this term, consider
that the individual is suffering from events
experienced primarily on the job. It is a direct
result of the occupation of policing. Our veteran
officers group has identified several stages
leading to full-blown Police Trauma Syndrome®.
(This group has been meeting for four years
and is comprised of officers with 17 years or
more on the Department. They have all been high
achievers on the job but have paid a price emotionally).
They have defined a five-stage model.
In the first stage, the "Rookie"
Stage, an officer is "shocked" by
the world he sees - the violence, the neglect
and cruelty toward children. He sees a world
that he didn't know existed. The second stage
is the "John Wayne" Stage and is marked
by an uncertainty as to the "balance"
of the badge. The officer is filling a role
as he/she understands it. The "tough"
image portrayed by the media cops is all that
officers may know. The officer may take pride
in owning all of the police gadgets. Their communicative
style is primarily one of "commanding,
ordering and directing." During the third
stage, the "Professional" Stage, the
officer has a good sense of his/her own identity.
No matter how much verbal abuse they encounter,
they remain courteous and in control (e.g.,
responding to an angry motorist he has just
ticketed, you might hear, "Well, sir, I
am sorry that you are making reference to my
mother right now; however, you did go through
that stop sign and I am required by law to cite
you"). While for appearance's sake, this
may seem problem-free, in actuality what's happening
is that the officer may be "numbing"
his natural emotions. "Dehumanizing"
citizens as a coping mechanism will cost the
officer in his personal life. Defense mechanisms
that help an officer adapt to the job are maladaptive
in his/her personal life.
These stages do not necessarily
follow a consecutive pattern. Our experience
has been that officers can jump from one stage
back to an earlier stage. For example, a veteran
officer who is in the "Professional"
Stage may revert to the "Rookie" Stage
upon witnessing a gruesome, traumatic event.
We found this in many officers who responded
to the Air Florida crash in 1982. The carnage
and death they were exposed to that night and
during the body recovery days after changed
their lives. Many of the officers experienced
the "Burnout" Stage which is number
four in our model. Anger and contempt for the
criminal justice system, the Department, politicians,
and the citizens highlight this stage. The officer
begins to isolate from family and friends -
believing that they do not "have a clue"
as to what the world is really like. The fifth
and final stage is full-blown "Police Trauma
Syndrome®." The individual
is no longer able to function effectively as
a police officer. This state is characterized
by sleep problems, anxiety and/or depression,
flashbacks, intrusive thoughts, mood swings,
rage attacks, social isolation, and a deterioration
in relationships. The officer may consume alcohol
or other drugs or experience an escalation in
usage. Suicidal thoughts may arise. This condition
is far more pervasive than one might think.
Sadly, what usually happens, without intervention,
is that the officer retires (if he/she can)
and disappears into obscurity. We are working
very hard to prevent Police Trauma Syndrome®.
JSV: What about the use
of deadly force? For example, what do police
officers go through after they are involved
in a deadly shooting? Does the use of deadly
force affect police officers more than other
stressors?
BJA: Involvement in a police
shooting may be the cataclysm of a police career.
When I began working with officers, it was almost
unheard of for an officer to be involved in
a shooting. It was rare. Now in this city (Washington,
D.C.), we average two police-involved shootings
a week. There are many factors involved in the
event that have to be examined. For example,
was the officer injured? How lasting was the
injury? Was the officer's partner injured or
killed? Was the suspect killed? Who was the
suspect - an adolescent, elderly person, a mentally
ill person? How grotesque was the shooting?
What was the physical proximity of the officer
to the suspect? For instance, I remember one
officer who told me how the suspect looked at
him before he died and asked "why did you
kill me?" That is what the officer will
remember. Was the officer taken by surprise?
For example, one minute the officer was giving
directions to a citizen and the next, he has
a gun pointed at him. Also, were other people
in danger of being killed or injured? Was the
use of deadly force appropriate or can the officer
be potentially convicted of homicide? There
is also the potential for civil liability. What
is the officer's coping style? Is there substance
abuse? Police officers oftentimes use self-destructive
coping mechanisms such as drinking, gambling,
workaholism, etc. What was the department's
response to the shooting? Were they supportive
or punitive? Some departments take an officer,
remove his weapons, and place him in the back
of the car. Who else goes in the back of the
car? Suspects! What is the emotional impact
on an officer when this happens? He feels that
he must have done something wrong. Another factor
that affects officers in the aftermath of a
shooting is how the media handles the reporting
of the shooting. So often, in their haste to
report a story, the media will distort the facts
and not usually to favor the police. Officers
have a favorite phrase they use to describe
the media, "Don't let the truth get in
the way of a good story."
Immediately after a police
shooting, a quick response by management and
mental health personnel is crucial. Counselor
support within hours of the shooting as well
as follow-up services send a critical message:
"You are important to this Department and
this community." Follow-up services should
also include the family. We have prepared a
booklet for officers, officials and family members
that discusses how to best manage police critical
incidents.
JSV: Recently, in New York,
there was a very unfortunate encounter for some
police officers involving "Suicide-by-Cop"
in which an individual, who apparently wanted
to kill himself, pointed a plastic gun at officers
and was, subsequently, fatally shot. In your
experience, how often does this occur and how
do you assist officers who confront such an
event?
BJA: This is yet another very
sad fact of life for law enforcement officers
- one that happens all too often. The kind of
individual who uses police officers for his/her
own suicide will influence the officer's reaction.
Individuals who commit heinous crimes and then
precipitate an officer's use of deadly force
will evoke a different response from an officer
than a depressed adolescent who just wants to
die and doesn't have the nerve to do it himself.
The natural response for the officer is often
one of anger. When a person makes a decision
to point a gun at a police officer, that officer
must react to protect his life. The public doesn't
seem to understand this. Citizens will ask "couldn't
you have shot him in the arm?" or "couldn't
you shoot the gun out of his hand?" Our
job is to help the officer place the responsibility
on the person who caused this event. At the
same time, we validate the normal feelings that
accompany such a tragedy.
JSV: Police officers are
often portrayed in the media as the "cool"
and "calm," Clint Eastwood-type. In
your opinion, what effect does such a stereotype
have on officers, if any?
BJA: We have worked very hard
to dispel that myth and it seems to be working
with our younger officers. With officers on
the job ten years or so, you see that macho-mystique
portrayed in the Lethal Weapon movies. I remember
Mel Gibson taunting the police psychologist
in one particular movie after she had voiced
concern for him. That image is not helpful for
the public or the police. I have yet to meet
a cop who has a "make my day" philosophy
of policing. However, the rigid, macho mentality
that does exist is a barrier to debriefing after
a critical incident. In the long run, it makes
the officer more vulnerable to the cumulative
effects of traumatic exposure.
JSV: From time to time
the media has highlighted cases of police brutality
such as the Rodney King beating in 1991 in Riverside,
California. Do you think that police "brutality"
is a problem in this country?
BJA: Yes, I do think it is
a problem. I also say that we have to look at
this problem in context. This begins with verbal
abuse which, I believe, is a direct result of
chronic exposure to trauma such as death, suicide,
rape, assault, etc. (i.e., precipitants for
Police Trauma Syndrome®). Police
departments need to begin to deal with this
more appropriately and more efficiently. They
need to do more than one debriefing meeting.
They need to train recruits and supervisors
in an ongoing, comprehensive fashion. Standards
need to be set high and kept high. Unless there
is change, I think that we will continue to
see this problem. We need to look at stress
education and training in the same manner as
we look at body armor (i.e., bulletproof vests).
This equipment prevents physical trauma to the
body. Likewise, if a department has a good stress
inoculation training program that is ongoing,
then this is the kind of armor that is needed
to prevent (or mitigate) some of the psychological
trauma.
JSV: On that note, how
is critical incident stress debriefing in the
Metropolitan Police Employee Assistance Program
conducted by you and your colleagues?
BJA: Knowledge about the debriefing
process begins in the Police Academy. The recruits
and their family members are given a booklet
entitled Critical Incident Stress Debriefing
- Important Information for Officers and Family
Members. We begin with that education in
the Academy. The recruits go through stress
training. If and when they have an incident,
they become more responsive. As soon as an incident
occurs, one of the on-call therapists responds.
The protocol of immediate intervention involves
normalizing and validating feelings. We may
also educate the officer (e.g., "these
are some of the reactions that you may have
and the important thing for you to remember
is that this is normal"). After that, debriefing
times are offered to the officers who will attend
a total of six mandatory debriefings on department
time. If they come when they are off of their
shift, they receive compensation time for attending.
Our offices are not located near a police facility.
We are in an office building away from police
facilities. There is ensured confidentiality.
The meetings are held in a group setting. They
are co-led by police officers who have been
through a critical incident. The officer is
not acting as a therapist, but talks about his/her
own reactions. Appropriate boundaries between
the police and therapist roles are essential
for the success of the program. The debriefings
involve stress education and exploration of
each police officers' event. They learn that
they all respond in a relatively consistent
way and there is normalization of their responses.
They are able to hear other officer's "story"
which helps many officers to believe that they
can heal from their experience. To quote one
officer, "You see things through new eyes."
I refer to this process of debriefing as a cognitive-affective-behavioral
intervention. They understand what has happened
to them, learn about their feelings, and have
to go an extra step to learn how this event
is going to change them. The ultimate goal is
to help officers find some meaning in the event
and take their experiences to a new level. This
is what survivors need to do. It is not just
survival but prevailing and overcoming. We have
to help officers respect the enormity of what
has happened to them and understand that it
is powerful. We also have to help officers realize
that, in time, they have to make the event a
part of the past. It does not need to be a constant
torment even if the memory may last forever.
JSV: Although there is
an increasing recognition of the psychological
effects of domestic violence on victims, considerable
research still needs to be conducted. With regard
to the effects of domestic violence on children,
what recommendations could you give to officers
who respond to domestic violence calls where
young children have witnessed a traumatic stressor
(e.g., mother's battering, etc.)?
BJA: There are some states
that have passed laws that are much more stringent
with regard to protecting people. However, there
is so little that a police officer can do. He/She
can arrest a perpetrator, which he may have
to do. But, when it comes to removing a child
from the household, it becomes painful for a
police officer. I have spoken to officers who
have described a desire to take the child home
with them which, as you can imagine, can cause
other problems. Officers are so powerless in
many situations. This powerlessness is close
to police officers. They must live with this.
The only thing we can tell them is that they
should talk about it but, they oftentimes, don't
want to talk about it. It hurts to talk about
it. They say, "What good does talking do,
it doesn't change the situation." This
is another stressor for police officers. When
they go home, they say they don't want to talk
about it because they "leave the job at
work." The real reason they don't talk
about it is because they are trained on the
job to suppress their emotion. So, if they begin
talking about it at home, they can't just tell
it like a story that happened to somebody else.
They may become overwhelmed with emotion and
they don't know what to do with those feelings.
We go back to that biphasic response - numbing
and dissociation. Many officers are uncomfortable
with their own emotions.
JSV: As a member of the
Board of Scientific & Professional Advisors
of The American Academy of Experts in Traumatic
Stress, are there any suggestions or concluding
comments that you could offer with regard to
helping survivors of traumatic stress?
BJA: The big word for me is
"depathologize." We need to look at
the public health problem of traumatic stress
in society. We need to look at traumatic stress
not as a mental illness but as a public health
issue. I read an interesting comment recently
in an article. The author said that "PTSD
is to the world of psychology what AIDS is to
the world of medicine." I think that this
is true. There is a preponderance of traumatic
events (e.g., the increase in violence, natural
and man-made disasters, etc.) in society. Those
who are exposed to trauma need to receive assistance
and should not have to feel that they are "crazy"
when they seek help.
JSV: As you are aware,
The American Academy of Experts in Traumatic
Stress recognizes that traumatic events are
an unfortunate part of the human experience
that individuals from many disciplines work
with on a regular basis. What do you see as
the major advantage of an organization such
as the Academy that is dedicated to increasing
awareness and ultimately, improving the treatment
for survivors of such events across such an
eclectic group?
BJA: The American Academy of
Experts in Traumatic Stress serves a unique
and vital purpose. We have to take traumatic
stress out of the exclusive domain of psychology
and psychiatry. We have to do this! Traumatic
stress and its aftermath belong to all of us
- medical doctors, lawyers, police departments,
psychologists, psychiatrists, teachers, insurance
companies, legislators, etc. Education is a
crucial step and the issues must be addressed
in a public forum (as the Academy's mission
statement indicates).
JSV: Tell me about The
American Academy of Police Psychology. I understand
that you are the President of this organization
which is the first organization of its kind
to address the concerns of the law enforcement
community.
BJA: The American Academy of
Police Psychology is an organization dedicated
to addressing the unique concerns and stressors
of the law enforcement community. Some
of the major goals of our organization are to
establish standards for police counseling, debriefing,
and stress programs and to initiate research
in the area of police trauma. Moreover, we are
committed to educating police departments, family
members, police officers, educators, and criminal
justice programs about the nature of law enforcement
and the unique stressors associated with this
profession. With regard to this latter point,
this must be dealt with in order to have a healthy
work force. This can benefit the police officer,
their families and the community. As an organization,
we want to focus exclusively on law enforcement.
We have had other agencies approach us who want
to affiliate with us and work on other issues.
However, we want to remain focused on law enforcement
stress and traumatic exposure of police officers.
We want to advise communities and police departments
on how to put programs together that can be
preventative in nature. Many police officers,
when they retire, suffer in silence. Twice as
many police officers kill themselves each year
than are killed in the line of duty. The high
incidence of divorce is reflected in the fact
that intimate relationships are difficult for
many police officers. There is a high incidence
of trauma-related problems that really demands
that we take care of law enforcement officers
in the way that they take care of us. We have
nearly 700,000 law enforcement officers in this
country. They have spouses and many have children.
All of those people are affected as well. Law
enforcement is an emotionally and physically
dangerous job. The Academy's mission is a singular
one - helping those who protect and serve.
©1998 by
The American Academy of Experts in Traumatic
Stress, Inc. |
