HEALTH & WELLNESS
So how do you sit with a shattered soul?
Gently, with gracious and deep respect.
Patiently, for time stands still for the shattered,
and the momentum of healing will be slow at first.
- Kathleen Steele
Secrets and Silence
The aftereffects of trauma
Not all injuries are visible.
The consequences of repeated exposure to trau-
ma incidents can cause law enforcement officers to
develop aftereffects called post-traumatic stress dis-
order (PTSD), or the term now often used by trauma
specialists: post-traumatic stress injuries (PTSI). This
is a serious and destabilizing condition that often ev-
idences a strong relationship between mental health
IRIS
symptoms and substance abuse issues.
PERLSTEIN
As a therapist with First Responder Services, part
LCADC, LPC,
of
the inpatient program at Penn Medicine Prince-
ATR-BC
ton House Behavioral Health, I have seen how hard
it is for law enforcement officers to revisit an especially gruesome
crime scene.
The list of traumatic events to which law enforcement officers
are exposed is long, including child abuse, sexual trauma, murder
and suicide. The serious wounding or death of a partner or an es-
pecially heinous crime against a child can be the breaking point or
the moment of greatest strain at which the officer may experience
physical, cognitive and behavioral symptoms. The memories of
near death from bullets or other attempts to inflict physical injury,
viewing and handling a mangled body, and dealing with abused
or molested children remain at a cellular level in the body of the
officer. In some sense, the officer’s body and mind contain and
hold the images of the scene of the crime. These horrific images are
fixed, despite all efforts to erase them.
Impacts of traumatic stress after the call
It has been reported that there are approximately 800,000 offi-
cers in the United States. According to some studies, 19 percent of
them have PTSD. Other studies point out that approximately 34
percent suffer symptoms associated with PTSD.
I have heard first responders relate work experiences that were
so intense, it took them hours, days or weeks to emotionally de-
compress from the situation. This makes it difficult to function
normally. It also takes a significant toll on the family. The chal-
lenge to spouses, partners and children can be immense. Family
members should be prepared for the law enforcement officer to be
in denial. The officer frequently will not reveal feelings, believing
that he or she should be strong enough to deal with the traumatic
events and stress. Often, there is the perception that seeking help is
an indication of weakness.
Additional consequences
It is important to help the first responder realize that asking for
help merely allows them to be human. The image of the first re-
sponder as the superhero/heroine can lead officers to hide their
hidden pain and symptoms under a false mask. The untreated
trauma is a primary cause of major depression, panic disorders,
generalized anxiety disorders, substance abuse, suicidal acts and
marital troubles. Self-medicating with substances such as drugs,
alcohol and other destructive behaviors masquerade as a remedy
to pain but carry additional deep consequences.
Help for the first responder
The families of first responders who are involved in a critical in-
cident are also at risk for vicarious trauma or compassion fatigue.
Often the family members may have symptoms similar to PTSD. It
is important to come forward for treatment.
In treatment, the clinician should:
• Listen and bear witness to the traumatic events.
• Teach the concepts of safety and grief work.
• Help the officer use pain management and self-soothing
skills.
• Educate about typical trauma-bonded reactions.
• Let the officer know that he or she can heal, despite horrific
events.
• Honor and respect the officer’s ability to share his or her need
for help.
Iris Perlstein is the director of Allied Clinical Therapies and a clinical
specialist for First Responder Treatment Services at Penn Medicine
Princeton House Behavioral Health. First Responder Treatment Ser-
vices at Penn Medicine Princeton House Behavioral Health provides
enhanced/customized care for law enforcement officers, firefighters,
active military, EMTs and other first responders while they are in
treatment at Princeton House, an inpatient hospital for those with
mental health and substance use disorders. Princeton House inten-
sive outpatient and partial hospital programs also feature trauma
tracks for men and women. For information, see princetonhouse.
org/firstresponder or contact Ken Burkert, peer support specialist, at
908-346-1691.
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NEW JERSEY COPS
■ JANUARY 2019