How to survive PTSD

 
                          CopShock: Second Edition
      Surviving Posttraumatic Stress Disorder (PTSD)

                                     by Allen R. Kates, MFAW, BCECR

   Police officers see dead bodies so often, it’s just routine. When LAPD Detective William H. Martin (Ret.) was in death investigations, he saw thousands of dead bodies: naturals, suicides, homicides, floaters, and those in various states of decomposition—and he could not get the images out of his mind. The horror in his nightmares and flashbacks was so intense that he attempted suicide. Fortunately, he got help before he actually killed himself.1

    Most officers would not see as many dead bodies as Bill Martin, but the scenes accumulate in their minds. Ask cops anywhere in the country, small towns or big cities, and they will tell you about the bodies they’ve seen. They remember. They can’t forget. They can’t unsee them.

    When it comes to natural deaths, cops arrive and often walk into a scene of crying and loved ones in shock. Suddenly, police officers are thrown into a psychologist’s nightmare of distraught spouses, children, relatives and friends of the deceased.

    Cops are not psychologists. They are not social workers. They are not crisis intervention people. Yet they have to take on all those roles.

    After cops leave the scene of a natural death, they move on to the next job and then the one after that. They have little time to process what they have experienced, but too often they feel unappreciated. Often the people they tried to help don’t even remember their names.

    What cops may not know is that what they said and what they did at that scene will be remembered forever. If you were kind, they remember. If you were cold and hardhearted, they remember.

Is a routine death ever routine?

    This is my personal story about the night cops came to my door, a story that represents hundreds of encounters police officers have during a career. Journalism is not about the writer telling his story, but, unfortunately, my story is a good example of the impact that police officers can have on your life during a crisis without even realizing it.

    Around 10 PM on the evening of December 13th, 2015, Sherry Bryant, my wife of 21 years, collapsed. Pima County Sheriff’s deputies arrived seconds ahead of the paramedics, and we stood in the living room while the EMTs tried for over an hour to aggressively resuscitate her. But all efforts failed.

    Sherry was a well-known painter in Tucson, Arizona, a superb watercolor artist. A couple of years before, she’d been diagnosed with Stage 4 breast cancer. There was little hope of survival. She’d tried radiation and different chemotherapies, and they seemed to have arrested the advance of her cancer. As Sherry’s creativity came from joy, from the moment of diagnosis, she stopped painting.

    Three weeks before she died, the oncologist put her on a new targeted drug specifically for Stage 4, and it had had thrilling success. Women who expected to die suddenly went into remission. Immediately on taking it, her energy came back, and she felt good. She started painting again. “Now that I’m going to live, I better get to work,” she said cheerfully.

    Although we knew she could still die of the cancer, we hoped she would go into remission like the other women. So when she died suddenly, it was a shock.

    An hour before, we were watching television, and now a paramedic was telling me how sorry he was that he couldn’t save the love of my life, the woman for whom I was grateful every day of her existence.

Cops arrived on the worst day of my life

    Now what?

    Four Sheriff’s deputies were in my living room, and they had arrived on the worst day of my life.

 “The death of a husband or wife is well recognized as an emotionally devastating event, being ranked on life event scales as the most stressful of all possible losses.”2

    For the deputies, this was a typical day, watching someone who did nothing wrong fall apart in front of them. They had nobody to arrest, no one to interrogate, nothing to do but observe someone else’s pain and misery… and try not to feel or get involved, less it affect them, almost an impossible task for a human being, even one trained to be objective.

    Every day police officers walk into scenes like mine. They have no knowledge of the relationship or circumstances. Everything is unknown to them, a scene of violence because death, even a “natural,” is violent and painful and terrifying. They are expected to make sense of this, control the situation, but can they?

    I’ve met hundreds of police officers across the country when speaking at conferences about stress, trauma and Posttraumatic Stress Disorder (PTSD). Cops were always friendly, interested and responsive. I talked about what they did every day, how it sometimes affected them emotionally and what to do about it.

    Here I was faced with what they did every day, not as an observer, not as a speaker, but as a victim, a participant in a drama they knew too well.

Sheriff’s deputy took the lead

    One Sheriff’s deputy took the lead, a veteran cop in his 50s, with years of policing on his jacket. He was soft-spoken, kind, comforting and supportive and encouraged me to call loved ones or friends. My neighbors across the street came over immediately, but there was nothing they could do or say except be there for me.

    I called my sister-in-law in Utah to tell her about her sister. It was a heartbreaking call. I felt detached, disconnected, watching myself on the phone as if it wasn’t me. Although I spoke the words, reality had not set in.

   The deputy, whose name I cannot remember, which is typical of traumatized people, asked me about Sherry’s medical treatment, medicine and prognosis. I told him she was Stage 4, a death sentence, but we were hopeful.

Is there such a thing as “anticipatory grief?”

    Is knowing that a spouse is going to die of a terminal illness less stressful on the other spouse? Her death was expected. Doesn’t that give the surviving spouse time to prepare and come to grips with the inevitable?

   The new drug gave us hope that perhaps she would live longer, but it was no guarantee. Knowing that she was going to die soon or could die soon did not make it easier. Quite the contrary.

 “Even when the death is long foreshadowed by a slow terminal illness… observers generally doubt the occurrence of ‘anticipatory grief’ in the sense of an initiation of grieving and withdrawal from the dying partner.

 “Clinical observations of grieving couples reveal… that feelings of attachment may actually intensify… and the marital tie may be further reaffirmed by demonstrations of loyalty and commitment.”3

    It doesn’t matter if the deputy were schooled in the finer points of grieving, as anything could happen when people are in shock and emotions are running high. “Demonstrations of loyalty and commitment” could turn violent. From the deputy’s standpoint, he was in a scene that could turn bad at any moment.

Call to Victim Services

    He carefully broached the subject of selecting a funeral home. I could not comprehend what he was talking about. Why would I want to do that? I had not grasped that Sherry was gone.

    He asked if I would like him to call Victim Services so they would send volunteers who would help me make decisions. Having worked for them as an advocate for a year a while back through the Pima County Attorney’s Office, I said Yes. He did not ask me to call, as my ability to reason was failing.

    Victim Services goes by different names in different jurisdictions. It’s an organization of volunteers who, with police assistance, make death notifications, comfort victims of crime, and step in to help people make decisions when they can’t think straight.

    The deputy called, and they said they would be at my home by 3 in the morning. It was 11 PM. We had some time to wait.

Concealed weapon on the table

    The paramedics left, and Sherry was left lying on the floor in the bedroom, covered by a sheet. I could see her, but I couldn’t go into the bedroom. I felt paralyzed.

    The deputy talked to me for hours, I think as a distraction. He asked me about what I did, what it was like living here, where I came from. He engaged me in a continuous dialogue. In retrospect, it helped me try to adjust to the enormous turn my life had just taken without addressing it directly.

    I noticed that the deputy scanned the room, and his eyes landed on a black bag on the dining room table, and he recognized it right away as a Blackhawk pouch, tactical gear for a concealed weapon. He didn’t ask what was in it. Instead he asked what kind of concealed I had. I described the Taurus .357, and the weapons course I’d taken from police instructors in order to earn my permit. Arizona no longer requires such qualifying measures.

    He was low key, calm, non-excitable, but I understood what he was doing and why he wanted to talk about it. In such tense, traumatic situations, a distraught person could be unpredictable, and try to shoot himself or others. The deputy didn’t confiscate the weapon, but he stayed within proximity. He asked if I had other guns. I did, and described them and told him where they were.

    It was clear he was taking my measure and assessing what I may or may not do. Later, it occurred to me that he was also testing my ability to think, comprehend, and make decisions. Under other circumstances, we would have bonded, but I was distracted. I felt numb, dazed. Why were these people in my living room? Who was that on the floor in my bedroom?

    In an article about Death Notification by Laurence Miller, Ph.D., the author describes how a police officer should behave at the scene of a death, natural, or otherwise.

 “Tolerate silence and be prepared for the calm to be broken by sudden explosions of grief and rage. Intense reactions should be physically restrained only if there is some danger to self or others.”4

    Although I did not explode in grief or rage and there was no reason to restrain me, I did break down in sobs intermittently.

    Dr. Miller comments on whether or not an officer should leave the grieving person alone, even for a moment.

 “Respect the family’s privacy, but don’t leave a family member alone unless you’re sure they’re safe.”5

    In my situation, the deputy never left my side. He was my rock, my focus, and if he had left, I think I would have felt abandoned.

    The author of the article has more advice for police officers at death scenes.

 “Be as gentle as possible…”

 “Try to be as calm and supportive, as comforting and empathic, as possible. Let the tone and cadence of your voice register the appropriate amount of respect and dignity, but don’t become overly maudlin or lose control yourself… be prepared to spend as much time as necessary…”6

    The Sheriff’s deputy did all the right things.

Just me and the deputies

    The deputy kept me engaged and talking for four hours before two people from Victim Services appeared around 3 A.M. They sat down and told me about my choices for a funeral home. I could not decide. How did I know what a good funeral home was? So I chose one that was closest.

    They asked if I wanted to call the home and I said I couldn’t and asked them to. They phoned and set up transport for my wife’s body.

    They saw that the lead Sheriff’s deputy had control of the situation, they were no longer needed, and they left. I asked my neighbors to go home, as they had to go to work in a few hours. I’ll never forget their love and kindness.

    Then I was alone with the Sheriff’s deputies. Three stood by the front door while the lead officer continued to talk to me. His words were soothing and compassionate. He did not comment on the fact that Sherry had died. There was no point.

    Around 4 AM, the transport arrived. Two men rolled in a gurney, and shut the door to the bedroom.

    I didn’t know what to do. Should I be in there? The officer reassured me that it was okay for us to wait in the living room while they lifted her body onto the stretcher.

    The door opened and one of the men came out and asked me if I’d like to see her face before they covered her up. I said, No, I wanted to remember her the way she was before. Then they closed the door again.

    A few minutes later, they wheeled her out and again gave me the option of seeing her face. I asked if I could hold her hand for a moment. They undid the covers, and I took her hand in mine. It seemed so small. I told her that I was sorry, that I thought she had more time, and I wept.

    The officer stood by my side. I suppose if anything was going to happen, if I was going to do something uncharacteristic, it would be now. I was too crushed to even move.

    Before long, the officers left, but before they did, the lead deputy gave me his phone number if I needed him.

 What did the deputy experience?

    What did that deputy experience? He stayed with me for hours. He witnessed my hurt, pain and grief. There was nothing he could do. He was helpless, just like me. How did he deal with it? Most police officers cope with routine death just fine.

 “Most police officers eventually develop tolerance for ‘routine’ death on the street, and most death events would barely rate on their ‘Richter scale’ of emotion. During years on the street, they develop mature coping strategies and responses that allow them to shrug off all but the most vivid of death scene and dead body experiences.”7

    I don’t know how this deputy dealt with Sherry’s death and my grief. I assume this was yet another event in his career that had little emotional impact. However, for some officers with a long history of witnessing death, this could have been the last straw.

 “Each police officer, like any human being, can be pushed beyond the limit of his psychological experience and endurance, to a point at which he becomes overwhelmed. Even officers of the highest caliber training, and greatest spiritual, physical, cognitive, and emotional strength and experience can become over saturated at some point…”8

 The last straw

    In my book, CopShock, I describe the experiences of K9 officer Jonathan Figueroa of the New York Police Department on the day the World Trade Center was destroyed. He was on bucket brigade for 14 months recovering remains on the pile when another unspeakable event occurred: a jetliner with 260 people on board crashed into the Queens neighborhoods of Belle Harbor and Rockaway Beach on Long Island. He was among the first responders to the crash, “recovering the bodies… mothers holding their babies…. You can’t block that out.”9

   As well as coping with what he saw and did at the scene of the gruesome plane crash, he spent 98 hellish days on the pile looking for body parts.

    Five years after 9/11, he visited a friend in the hospital, another K9 officer who had been hit by a car during his midnight. Jonathan had seen many cops “bandaged, bruised, beat up, in the hospital.” It was no big deal. But that was the last straw.

   That minor incident triggered night sweats and terrors, anxiety, panic attacks, nightmares and flashbacks, not as a result of seeing his friend, but from not having addressed his other experiences. Unable to deal with his out-of-control emotions, he eventually tried to kill himself. He found help from a police officer peer support group and is now doing well.10

    Now you put cops in a scene where there is a natural death, for example. For them, no big deal. They see it every day. Yet that could be the last straw that triggers unresolved emotions.

   So there is really no such thing as a routine death.

 “Contrary to public opinion that police work is ‘routine,’ their job is very often filled with traumatic, dangerous and stressful occurrences.”11

    At some point, a police officer could become over-saturated.

 “Police have to cope with not just violence, but the pain of seeing… grief-stricken families, which can lead to long-term symptoms (of PTSD).”

 “Anytime you can identify with a victim you are called to, that narrows the emotional and social distance and it makes you more vulnerable to become symptomatic.”12

Consequences when investigating a routine death

    The consequences of investigating a routine death may not be apparent. For the Sheriff’s deputy, my situation was routine. For me, it was a life-altering event, nothing routine about it. It caused my life to stop. All my hopes and dreams for the future were gone in an instant. I was shattered glass on the floor. The deputy understood that and took it home with him. How many more grieving spouses did he see during his career? How did the deaths affect him? What did he do about it?

The deputy’s kindness, compassion and presence

    It’s now 28 months after Sherry’s death, and I often think of the Sheriff’s deputy’s kindness and compassion. He made a profound difference in my life.

    Sometimes I wonder how things may have turned out if he had been distracted or just wanted to get out of there and couldn’t face another grieving person. What if he didn’t stay with me? What if he didn’t engage me in conversation for hours? What if he didn’t stand by my side when Sherry’s body was brought out?

    I was glad that he never said worn-out and meaningless phrases like: “Everything’s going to be okay,” or “She’s in a better place,” or “I know how you feel,” or “Things will get better,” or, as one person told me about a month later, “At least she didn’t suffer.” Of course, she did.

    What the deputy gave me the most was his presence. His being there gave me the most comfort. Certainly, he didn’t talk about the obvious, and spoke about other things on a superficial level. And that’s what I needed. I was in no condition to face reality or talk about what had just occurred.

    I may have thanked him when he was going to leave, I don’t remember. That terrible night is a blur. To this day, I haven’t reached out to him, although I said I would many times. It’s just too real.

    That sounds like a poor excuse. However, I suspect I’m like everybody else who has suffered an extreme shock and loss. It’s not that I’m not grateful. It’s that I’m still devastated. One day he will receive a note from me, seemingly out of the blue, thanking him, and he’ll wonder why it took so long. He may not even remember me, as he has been to hundreds of scenes since that night.

    Many officers feel that the public is ungrateful, that they don’t care about the good that officers do. We do. I do. But the event that the Sheriff’s deputy witnessed affected me so deeply, injured me so profoundly, broke me in ways I could not imagine, that it is hard for me to speak words of thanks or write a note, even after so many months.

The path to burnout

    I’m sorry that I may have contributed to a negative event in this deputy’s work life. An accumulation of discouraging incidents can sometimes lead to burnout in police officers.

    Burnout doesn’t happen all at once. It’s described as “a slow-creeping form of exhaustion accumulated over years of perfectionism, stress and overwhelm (sic)…”13

 “Burnout is a state of chronic stress that leads to: physical and emotional exhaustion, cynicism and detachment, feelings of ineffectiveness and lack of accomplishment.”14

    There are a number of causes of burnout, but among them are feeling unappreciated, nothing you do seems to make a difference, and you feel increasingly helpless, hopeless, cynical and resentful. Contributing causes are lack of recognition or reward for good work.15

    People who develop burnout the most seem to be perfectionists. Nothing is ever good enough. Police work appears to attract perfectionists.

   One of the ways police officers can reduce the chance of succumbing to burnout is in being helpful. I’m afraid in my situation, I did not acknowledge how helpful the Sheriff’s deputy had been.16

    If the Sheriff’s deputy who helped me so skillfully feels unappreciated as a result of his experience with me, then it is my fault.

    I recognize his empathy, compassion and willingness in trying to get me through a horrific day. Under the circumstances, I don’t know if I was capable of acknowledging his gift or reacting any differently.

    I hope this chapter will, in some small measure, assure the Sheriff’s deputy and police officers who have similar experiences with civilians who are in shock, unresponsive and seemingly unappreciative, that you have made a difference in our lives.

    To that Pima County Sheriff’s deputy: It is simply not enough to say thank you for what you did for me… and continue to do for many others.

    I will thank you for the rest of my life, and I will remember you. That should count for something.

    I hope you feel that on the day I needed you the most you did great.

Allen Kates

                                             

                                                                           Sherry Bryant
                                                                             1946-2015


Footnotes

 1. Kates, Allen R. (2008). CopShock, Second Edition: Surviving Posttraumatic Stress Disorder (PTSD). (pp 191-211). Tucson, AZ: Holbrook Street Press.

2. Osterweis, Marian; Solomon, Fredric; Green, Morris; Editors. Reactions to Particular Types of Bereavement, Institute of Medicine (US) Committee for the Study of Health Consequences of the Stress of Bereavement. (1984). Washington, DC: National Academies Press, US.

 Also: Holmes, T.H., and Rahe, R.H. (1967). The social readjustment rating scale. Journal of Psychosomatic Research 11: 213-218. Pub Med.

3. Ibid.

4. Miller, Laurence, Ph.D. (2007, June 15). The worst possible news: Death notification and body identification for law enforcement officers. www.policeone.com/health-fitness/articles/ 1267704-The-worst-possible-news-Death-notification-and-body-identification-for-law-enforcement-officers/. Retrieved February 18, 2018.

5. Ibid.

6. Ibid.

7. Greene, Claudia L., MD. (2001). Human remains and psychological impact on police officers: Excerpts from psychiatric observations. The Australasian Journal of Disaster and Trauma Studies. ISSN: 1174-4707. Vol: 2001-2. www.massey.ac.nz/~trauma/issues/2001-2/greene.htm. Retrieved February 22, 2018.

8. Ibid.

9. Kates, Allen R. (2008). CopShock, Second Edition: Surviving Posttraumatic Stress Disorder (PTSD). (p90). Tucson, AZ: Holbrook Street Press.

10. Ibid. (pp93-95).

11. Violanti, John. (2016, July 8). A tragic reminder that policing takes a toll on officers, too. Epidemiology and Environmental Health, University at Buffalo, The State University of New York. Theconversation.com/a-tragic-reminder-that-policing-takes-a-toll-on-officers-too-62256. Retrieved February 12, 2018.

12. Sivasankar, Shyam, Ph.D., Mohney, Gillian. (2016, July 18). Abcnews.go.com/Health/psychology-experts-police-cope-fear-stress/story?id=40663991. Quotations from Ellen Kirshman, Ph.D. Author of I Love A Cop: Revised Edition, What police families need to know. Retrieved March 3, 2018.

13. Hohlbaum, Christine Louise. (2012, January 12). Why am I so burned out? Burnout is real. Are you affected? www.psychologytoday.com/us/blog/the-power-slow/201201/why-am-i-so-burned-out. Retrieved March 24, 2018.

14. Carter, Sherrie Bourg, Psy.D. (2013, November 26). The tell tale signs of burnout…do you have them? www.psychologytoday.com/us/blog/high-octane-women/201311/the-tell-tale-signs-burnout-do-you-have-them. Retrieved April 4, 2018.

15. Smith, Melinda, M.A; Segal, Jeanne, Ph.D.; Robinson, Lawrence; Segal, Robert, M.A. (2018, February). Burnout prevention and treatment. Techniques for dealing with overwhelming stress. www.helpguide.org/articles/stress/burnout-prevention-and-recovery.htm. Retrieved March 28, 2018.

16. Ibid.