Things that are difficult to speak
On Friday another police officer died from suicide. This is possibly the second such loss this week. Like many of us, my life has been touched by suicide. Two important men in my life both died that way: my Uncle Bill and my PhD Supervisor, Richard Ericson. At neither time, did I talk about it. I still don’t. But when I teach students, many of whom will go into policing, I do talk about someone else I once knew, someone who died in similarly tragic circumstances.
Back in the early 2000s, I taught a course on criminal profiling. Most of my students were either people with zero criminal justice experience but a love of cop shows or frontline police officers taking courses so they could transfer units or departments. There was one notable exception: a highly experienced detective, who said very little. He said very little and freaked the hell out of me with his intensity. If I’d had any criminal bent, I would’ve started confessing to him immediately. Instead I made a very different type of confession one day after class: I’d started having nightmares. Cold sweat, hyperventilating, panicked nightmares. And I had an intuitive sense he would understand. So, I told him about what I had been doing, which was pouring over Correctional Services of Canada files to create profiles of their released sex offenders. The work was mostly interesting, until I started having nightmares.
He got it immediately: I’d made the fatal mistake of identifying with one of the victims. I could easily see how what had happened to her, could have happened to almost any of us, and in my sleep, that reality was causing me to come unglued. We talked about the mental distance you need to keep functioning. Then I asked him, someone who has seen and experienced some pretty horrendous things, “how do you deal with it?” He laughed. “I drink.” He disappeared from my class and sent me an email apology months later, saying he’d had to leave because of a big break in an important case. I wished him well and hoped we would meet again. We didn’t. A few years later, I discovered, he had died by suicide.
Why tell this story to my students or to you? Because it’s incredibly important to realize that we remain in our infancy when it comes to understanding and dealing with PTSD, other operational stress injuries and/or mental health in policing in general. Yes, I’m aware there are any number of “solutions” out there – people hawking programs based on mindfulness training, R2MR and so on. The overwhelming majority of these are evidence based only in so much as they’ve been derived from or tested on other occupational groups. We assume they work because they work in reducing stress among some people, right? As if the horrific experiences many officers deal with is comparable to the workplaces of corporate types or teachers. And R2MR, as I’ve documented previously, has received, as of this writing, only one independent evaluation (not brilliant results). Peer support programs remain largely untested, and the one study I’ve seen since the 1990s – a master’s study by one of my own students, who is herself now in policing – shows the uptake for these programs can be long, slow and painful, as they entail garnering trust in spaces where trust is often at a premium.
Yes, there are some types of treatment that have wider support – cognitive behavioural therapy (CBT, which mindfulness is a part of), dialectical behavioural therapy (DBT) and the new Eye Movement Desensitization and Reprocessing (EMDR). I want to urge caution, though, in promoting these as ‘cure-alls’ or ‘sure fire fixes’. They can work well for some people, in some circumstances, and there’s a mountain of research, especially with CBT, that shows it can be effective in dealing with PTSD, OCD, anxieties and so on for many people. However, the reality is that not all treatments will work for everyone all of the time and we risk further stigmatizing people when we suggest otherwise and then individuals subsequently ‘fail’ out of treatment. A more realistic appraisal is necessary, particularly given the very low evidence base when these treatments are applied to the often unique experiences found within policing, or they are delivered in the form of unevaluated programs or, worse yet, in the form of a completely untested two hour online training video.
I know of what I speak: I had un-diagnosed PTSD for decades and failed out of every single form of therapy they had going in the 80s and 90s, at which point I gave up on therapy and opted instead for emotional lockdown (one reason among many, the nightmares were so disturbing to me, my walls were letting me down). By the way, emotional lockdown is a common coping strategy among heavily victimized women without access to high quality treatment. I’ve spent many years conducting field research on trauma from criminal victimization and can tell you that while this strategy is often treated as dysfunctional, it is not: it allows people without emotional or other supports to function over the short to medium term in spite of their mental, emotional and physical scars. I suspect (and the work coming out of Nick Carleton’s lab in Regina on high rates of un-diagnosed operational stress injuries would seem to back me up) that many police officers operate the same.
Why it’s not a good long-term strategy – and I, an admitted lockdown artist, acknowledge this – is that we cannot control what might possibly trigger a response and break down or grind down our psychic walls. And that was the reason I broke down a couple of years ago – after being affected by two more deaths from suicide, my own students. I found myself chewing out a therapist that a kindly Associate Dean at my University was keen for me to see. It's amazing what a little insight and empathy can do. After I ran out of steam, he said a few things that floored me. I’m not ‘fixed’, but I did gain a huge insight into emotional burnout, warning signs, and was given, and gave myself, permission to stop feeling guilty when I’m unable to care for, or take care of other people, because I can barely take care of myself. I also learned that I don't hate people, it's just that the cost of caring some times is too high for me. Oh, and I also learned that you don’t ‘fail’ out of therapy; some styles, some therapists, some things, just doesn’t work for you. And that's okay. Something will eventually click*.
One day I hope the research will catch up and we will have better understanding of the complex nature of trauma, individual pathways to resiliency, individual and group traumatic responses, different treatment options (and what works and what doesn't). But in the policing world, we’re not there yet and we desperately need to keep going.
* After a particularly bad spell where my PTSD loomed up, my own GP said to me: "I don't want to put you on anti-anxiety meds because of the possibility of addiction. And there's no point in sending you to a psychologist because you'll just argue with them. What about a dog?**" Not all therapy has to look alike and there's growing research on the benefits of different modes of 'pet therapy.'
** I actually wanted a 'therapy doberman', because I have issues with people being too close to me physically or of being in crowded spaces. My GP would only give me a prescription (yes, you can get one) if I agreed to get a lapdog. Hence, I have Chewbacca, a six pound Morkie, known around the office as "the little psycho." This is the same dog that famously rolled around on the floor in a Deputy Chief's office, ecstatically huffing the carpet like something had died there. He then followed up that trick by trying to poop in the crime analysis unit.