After a Critical Incident
A critical incident stress debriefing by a qualified police mental health professional, should always be sought within 72 hours of the incident. This procedure may well help a person enough so that further help is not needed. Not all people experiencing a critical incident will require further professional help. As noted, about 1/3 of the people will experience no symptoms,1/3 moderate symptoms, and 1/3 severe symptoms. The following, however, are signs that an officer needs further professional help after a debriefing.
TWENTY SIGNALS THAT AN OFFICER IS STUCK AND NEEDS FURTHER HELP
**The following is adapted from Roger Soloman, Ph.D.:
"I'm Stuck And Better Do Something About It!"
Intrusive Images. Distressing memories, thoughts, nightmares and flashbacks. Flashbacks can be both auditory, as well as visual.
Distress at exposure to events that resemble or symbolize the event. Officer avoids thoughts and emotions connected with the incident, or activities or situations that arouse memories of the trauma. This may sound like a good thing to do. After all, why talk about a highly distressing situation. While this attitude is understandable, if a person cannot talk about the situation without undue and uncomfortable emotions, then they have not properly processed the incident. Typically this pattern of avoidance intensifies and spreads, as other symptoms appear and worsen.
Numbing or restricted range of emotional responsiveness. To defend against the painful emotions surrounding the incident, a person may shut off all emotions. This of course is not a practical solution! We need to experience emotions, feelings and relationships. Life in general sours if we disconnect ourselves from our feelings.
Excessive stress reactions. The physical symptoms of stress are powerful. They result from the "fight-flight response" which is designed to prepare our bodies for danger. However, if we get our bodies stuck in this overdrive mode, we can wear ourselves down physically and emotionally. At a certain point, by reliving the critical incident and not getting over the trauma, we can reset our body's stress trigger. In fact, we can develop a "hair trigger" to stress thus putting a tremendous burden on our physical health.
Hypervigilance. It is common and normal for police officers to be more alert to danger than the average citizen. However, after a critical incident, the officer may find himself in high gear and unable to downshift. This constant state of hypervigilance can become intrusive, uncomfortable, and physically exhausting.
Overreaction/under-reaction/risk taking. Surviving a Critical Incident can put a dent in your spirit. This can result in some behavioral changes on the job as one tries to adjust to the situation. Officers may find themselves under-reacting with a "who gives a shit" attitude. The opposite may occur with the officer "not letting anyone get something over on me"! Finally we see some officers start to take excessive risks. This behavior may serve the purpose of distracting them from painful thoughts of the incident. In addition it may afford them with an adrenaline high that can become addictive.
- Increased irritability, anger, or rage. This symptom can be very disruptive to an officer's life. It can push away his friends, destroy his family life, and gain him a reputation that hurts him on the job.
Oobsession with the Incident. It is both normal and healthy to talk about the incident for a time after it has occurred. However thoughts and images of the incident can take over! Images become easily triggered and one seems to be stuck in the past with difficulty looking toward the future.
The incident triggers feelings associated with past events. An incident may cause thoughts/feelings/images of past negative events to resurface. This can be true even though it was thought that the past incident was dealt with and gone. What can really be problematic is that images of past incidents with apparently little relationship to the current incident can be triggered. For example, seeing a dead child in an auto accident can cause a childhood memory of a friend moving away to resurface.
Self-doubt, guilt, second guessing oneself. An officer may become obsessed with his/her mistakes be they real or imagined. The "what ifs" start to take over. Feelings of inadequacy will then follow. Life no longer goes forward, but stays stuck in the past.
A growing sense of isolation develops. The officer may have been involved in a uniquely bad situation. Even with support, however, he/she starts to think "No one understands what I'm experiencing". To some extent, this may be true. However, there is a trap in this way of thinking. You may push your friends and family away and fulfill your own prophecy that you are alone. At that point the officer may feel lost, abandoned, and different than others.
Intense or sustained feelings of depression, grief, loss of control. A critical incident by it's very nature can make us feel out of control of our lives. It puts us real close with the reality that the world is a dangerous place to live. Officers need to feel that they have control. It is fundamental to their ability to cope. A critical incident can take this coping device away from us. Depression and grief follow. This creates a cycle of intense emotion geared to allow us to feel in control but serving only to take us farther from it.
Mental confusion. Increased distractibility, difficulty concentrating or making decisions, poor judgment.
Development of suspiciousness in dealing with others. Since the critical incident was probably unexpected and painful, we try to gear ourselves to not being hurt in the future. We start to distrust all that is around us. We hope that by assuming the worst, we will not be surprised and hurt. Unfortunately, when this defense runs amok it prevents us from seeing the good in people. It keeps us from making friends. It puts us on the path to cynicism.
Relationship problems. An officer may withdraw from his friends and family. He may in fact actively push them away. He may experience problems dealing with supervisors and peers were previously he had none.
Decline in work performance. Increased absenteeism, burn out, decline in productivity and quality of work.
One may have little or no noticeable initial reaction to the incident, but reactions occur months later. This can be a problem if the officer does not see the connection between the incident and his/her current emotional troubles. The emotions may be triggered by some similar event, the relaxing of defenses such as denial, or occur for no known reason as if "out of the blue".
- Self-destructive behavior.
Substance abuse, poor judgment, and inappropriate decision making may result. These decisions may or may not have to do with the job. For example an officer may decide at this point to have an affair or divorce. Decisions that will complicate his/her life and often result in regrets later on.
IN SOME CASES, SUICIDAL THINKING MAY RESULT. FEELINGS OF DEPRESSION, DESPAIR, GUILT AND ANGER MAY PULL AN OFFICER DOWN TO THE POINT OF TAKING HIS/HER OWN LIFE.