by Brian Willis
Law enforcement officers are not strangers to trauma. They respond to thousands of calls involving injuries resulting from traffic accidents, shootings and stabbings. A significant number of these incidents result in someone being seriously injured. All too often, the injured parties are fellow law enforcement officers.
According to the FBI uniform crime reporting statistics in the 10-year period from 1995 to 2004, there were 594 officers killed in the line of duty in the United States and another 717 officers died in what were classified as accidents. In that same 10-year period, 566,523 officers were assaulted, with approximately 30% of those officers being injured in the assaults. Naturally, law-enforcement officers are the first responders in the majority of these cases. Although agencies normally provide basic first aid training, many officers wish there was more they could do to help.
Communicating to Trauma Victims
Verbal Trauma Control is a method of communicating to trauma victims in a way that taps into the tremendous power of the human mind. Positive suggestion can be a powerful tool for healing and can have a tremendous effect on the psychology as well as physiology of the human body. This is especially true in trauma situations. Verbal Trauma Control is a skill that first responders can use to take command of the situation. Examples of incidents include, an officer that has been shot or stabbed, a victim of an automobile accident, a heart attack victim, an injured climber or skier where access to advanced medical care is likely to be delayed, a burn victim or other injured person. Trauma victims are in an altered state of consciousness and highly receptive to suggestion. People trained in the art of Verbal Trauma Control can use this altered state of consciousness to enhance the likelihood of a positive outcome. Verbal Trauma Control is meant to augment first aide procedures and can help stimulate the healing process prior to the arrival of medical personnel.
It is common for a person who has been injured to feel scared, alone and confused. Because people in the immediate environment may be panicked, their communication can be negative, actually compounding the victim’s fear. Instead, by using the most desirable positive verbal skills, first responders may bring a sense of calm, control and focus to the injured person. In fact, Verbal Trauma Control can be used to reduce or stop bleeding, prevent shock and eliminate pain or discomfort. Law enforcement officers, paramedics, firefighters and search and rescue personnel are typically the authority in emergency situations. Regardless of whether the victim is conscious or not, their subconscious mind processes information and is receptive to direction given by trained personnel.
We often talk about the roles of the parasympathetic nervous system (PNS) and the sympathetic nervous system (SNS) in officer safety training. We understand that officers experience an SNS activation during times of stress such as a lethal force encounter. After the threat has diminished the PNS seeks to take back control to create a state of homeostasis (balance) in the body. However, when the officer is injured, he stays in the state of SNS activation longer because new fears are created by the injury. Positive suggestion is a tool which can be used to help with PNS activation and stimulate healing.
W.I.N. - What’s Important Now
In trauma situations, officers must focus on W.I.N. This powerful acronym stands for What’s Important Now? Focusing on What’s Important Now allows the officer to prioritize tasks and deal with the situation effectively and efficiently. On approach, it is vitally important for the officer to calm himself by taking a deep breath and determining a plan of action. Regardless of the relationship with the injured person, or the nature of the injuries, you must remain calm and focus on projecting confidence and authority with your words and your body language. Officers must understand that the human mind may accept or reject suggestions. Therefore, they can only help those who allow them to. You must also realize that while Verbal Trauma Control is a powerful tool, it is not magic! The injured person may still die! Officers must know that although they may do everything correctly and to the best of their ability, the injured person still may not survive due to factors beyond the officer’s control. One critical part of scene management is for the first responding officer to delegate responsibility to those who are assisting and keep all negative people away from the injured party.
As previously stated, the injured person is in a highly suggestible state. The object of Verbal Trauma Control is to maximize the suggestible state to enhance healing. This is why it’s important to give other people jobs to do and to keep negative people away from the injured party. Because of this high level of suggestibility communication, both verbal and nonverbal, are very important elements. When communicating with the injured person, it is imperative that the officer be positive at all times. In order to enhance communication, the officer must get close to the injured person and speak slowly and clearly. He must use clear, suggestions which create expectations for success—he must paint an optimistic future. The officer should make eye contact with the injured person and project a sense of calm and confidence.
Positive suggestions must be made clear, simple and specific. They must be made with a sense of complete confidence and authority. The suggestions must be positive, affirming, believable and focused on healing. Officers should try and get positive feedback from the injured person and personally celebrate all successes with the individual. Some suggestions may be offered in the form of a question. For example, asking the injured person if he would be more comfortable lying down will be perceived less critically and more empowering than telling them to lie down.
Role of Imagination
Imagination is a key element of the subconscious mind and an important part of Verbal Trauma Control. Everyone’s mind processes and codifies information in images unique to that individual. Scientific research has shown that human physiology including blood pressure, heart rate, pain response, muscular tension, respiratory rate, the contraction and expansion of blood vessels and blood coagulation can be affected by those images. This occurs regardless of whether the images are from something the person is actually seeing, or from something they are imagining or dreaming about.
With a basic understanding of the power of imagery, officers can incorporate these mental pictures into their suggestions. An example would be telling the injured person “I bet you can imagine somewhere else you would rather be right now,” “If you could be doing your favorite activity right now what would it be?” or, “If you could imagine being at your favorite place in the world right now, where would you be?” This allows the injured person to tap into the power of their imagination and diverts their attention away from the injury.
Officers should avoid less desirable suggestions such as “Don’t die!” Instead, use more positive terminology such as “Focus your energy on healing.” Another example of less desirable terminology or suggestions would be “Don’t be afraid!” It would be more desirable to tell him, “Feel safe knowing I am here.” You should also avoid words such as pain. It’s more desirable to use the term “discomfort” not only to the injured, but also when reporting to paramedics or hospital personnel who are taking over caring for the injured. The key here is use positive words and phrases.
The level of first aid and medical skills the officer knows will dictate the specific level of healing suggestions. If the biological, psychological or physiological needs of the injured person are unknown, suggestions may be more general. Examples include: suggestions to encourage stopping bleeding, reducing discomfort and other aspects of healing. Some examples of general healing oriented statements are:
- As soon as your wound is cleansed you can stop that bleeding and save your blood. Paramedics are on the way. Just focus on your breathing and notice how much better you begin to feel.
- Paramedics are on the way. What’s important now is that you allow your body to do what needs to be done to protect your life and begin healing. I can see that your (injured area of the body) needs assistance. Allow your mind to scan the rest of your body and make sure that everything else is ok.
- As I apply pressure to your wound you can allow the bleeding to stop and save your blood. Your body knows how to heal itself. The pressure of my touch just allows you to begin to relax and let your body to do what needs to be done to protect your life and begin healing.
Verbal Trauma Control is a team effort. In order to be most successful it’s important to establish rapport and create an alliance with the injured person. The first simple tactic for accomplishing this is for the officer to introduce himself.
“Hello. My name is ________________. I am a (police officer, state trooper, sheriff’s deputy, park ranger, etc.). The worst is over. I am here to help you. Will you do as I say?” The two simple statements “The worst is over.” “I am here to help you.” will help establish authority, alliance and project empathy. By using this simple introduction the officer has identified himself as someone that can help. This introduction also serves to establish a verbal contract with the injured person, reinforcing that this is a team effort, and lets the injured person know that they play an important role in their own healing. It also serves to give them a sense of power and control, which may bring with it a calming effect. Even if the injured person is unconscious, it’s important to use the same introduction. Tell them who you are and what you are doing.
The next step is to find out the injured person’s name. If he is conscious, simply ask. If he is unconscious, find out from someone on scene. Addressing the injured with his name establishes recognition and familiarity. Ask him to describe the problem. This gives him a sense of control and demonstrates respect for this ability to communicate. Questions may also be asked to help increase his comfort level. Example: Ask him to allow his mind to scan his body for any other areas that may need attention. This takes his mind off of his primary injury and allows distraction for a few moments, possibly increasing his comfort level.
Maintain a balance of power by assuring that control is shared between the officer and the injured person. This is another important element of forging a strong alliance between the two. Officers must be aware that the balance of power may change during the situation. The officer can empower the injured person with a sense of control by having him hold an ice bag or apply pressure to a wound. If he is not willing to do this, you can calmly shift control and do it yourself or have someone else do it.
Prior to or while beginning extrication or treatment, rescuers should tell the injured person who they are, and what they are doing. This is necessary even if the injured is unconscious. By imparting this information, they provide the injured with a certain measure of control and power. He is not helplessly being tossed from one person to another without benefit of knowing what is going on. Officers can anticipate things that may create stress or a good site for the injured and be proactive in their communication. For example, other emergency vehicles responding to the scene may create anxiety for the injured. This anxiety can be reduced by communicating something along these lines, “Some people find the sound of the sirens frightening, but you can know that the sound of the sirens is calming—it means additional help is on the way. They are coming to help you!”
Once familiar with Verbal Trauma Control, you will be able to shield the injured from paramedics and emergency room staff who make negative comments regarding the nature of the injury or level of pain the injured should be in. If the injured is not prepared for these negative comments, it can reverse much of the positive work that has already been done.
Therefore it can be important to anticipate these negative comments and take proactive strategies to safeguard against them. This can be as simple as telling the injured person “You may hear other people make negative comments about how much pain you must be in, or about how bad the injury looks. Know that these people are well-trained, and there to help you. It is just that sometimes they get caught up in the moment and say things that are not good for you to hear. You know how well you are doing and that you can remain calm and in control, regardless of what the medical people say. In fact any negative statements you hear will just make you feel more calm and in control.”
The object of this article is to give officers a brief insight into the potentially life saving power of Verbal Trauma Control and to encourage them to seek more training and knowledge in this critical area.
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2. NLP and Health, McDermott and O’Connor 1996
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6. Guided Imagery for Self-Healing. Rossman, 2000.
7. Patient Communication for First Responders and EMS Personnel. Jacobs, 1991.
8. The Worst is Over. Acosta and Prager, 2002.
9. Emergency Hypnosis. Hastings, 1998.
10. Pain Control. Mottin and Johnson.
11. Emergency Hypnosis. Kein, 1997.