Latest findings and recommendations about traumatic stress
|The largest study of its kind has confirmed that LEOs commonly experience a wide and potentially "devastating" range of mental and emotional reactions to life-threatening encounters.
But they show such remarkable resilience in bouncing back that, contrary to popular belief, very few actually leave law enforcement or suffer permanent damage from their traumatic encounters.
The study, which assesses nearly 1,000 officers with the Los Angeles County Sheriff's Department, was conducted by two of the nation's most prominent police psychologists, Drs. Audrey Honig and Steven Sultan, Director and Assistant Director respectively of LASD's Employee Support Services Bureau.
They surveyed deputies directly engaged in all the agency's officer-involved shootings over a 9-year period (not just shooters but others present at these episodes as well), plus survivors of other kinds of high-stress, high-intensity critical incidents, including major fights, attempted disarmings, a jail riot and traffic accidents in which cops were injured or killed. About 450 separate critical incidents were involved. Each officer voluntarily completed an anonymous 5-page questionnaire 3-5 days after his or her crisis event, just before participating in the department's standard mandatory post-episode interview with a staff psychologist.
Their findings, Honig told Force Science News, offer valuable lessons and recommendations for administrators, trainers and street officers. A full report of the study will appear in the December issue of The Police Chief magazine, scheduled for release early next month.
Here are pre-publication highlights, with exclusive insights offered to Force Science News readers by Honig:
Separately examining the records of 540 deputies who were involved in shootings between 1998 and 2002, Honig and Sultan discovered that only 2 officers "subsequently filed worker's compensation claims for psychological conditions attributed to the life-threatening event." These officers eventually returned to work, and "none retired as a result of a stress-related disability." Honig notes: "It is highly unlikely anyone would leave because of trauma without taking a disability retirement. You get 50 percent of your income--tax free--for the rest of your life. Not many would pass that up."
What all this tells Honig is that cops "are very resilient people. Everyone is going to experience at least some stress reactions" during and/or after a life-threatening event. "But most officers automatically utilize many of the techniques that we would want them to" (such as talking about their feelings with peers and family members) in order to put their incident in perspective and move on with their lives.
Among officers, "trainees and rookies may have an unusually difficult time dealing with a critical incident, regardless of their level of involvement," Honig says. "A seasoned officer has had some balance in his or her career--some good and bad experiences and a sense of confidence. But a new officer already is at a heightened level of anxiety" because of the newness of everything, even without critical stress.
Interestingly, legal worries seem to be easing somewhat after critical incidents. The percentage of officers citing legal concerns as a response dropped from an earlier survey, despite the fact that it is still a given, in Honig's view, that "if you fire your gun there's likely to be a lawsuit." In her opinion the decrease in anxiety is "a sign that as an organization we are doing a good job of making officers feel we are supporting them and are not their adversaries in the legal arena." It's when officers feel "they are being hung out" by their agency that escalated legal concerns are most likely.
In terms of recommendations that Dr. Honig feels are supported by the study, she cites these as most important:
1. Use these findings in training to provide a critical incident inoculation before sending officers out on the street. If officers understand what stress reactions may occur and that they are normal, they are less likely to be "knocked off their feet" by them. "If you can help officers beforehand to build a picture frame in which to put this experience, you can defuse a lot of the reactions and prevent them from misinterpreting what happens," Honig explains. "It's much harder to 'train' someone about what to expect after the fact."
2. Make sure your department requires a mandatory, one-on-one, post-event debriefing of involved officers with a mental health professional. Making it mandatory erases the stigma of "seeing a shrink" and overcomes the near-universal reluctance by cops to seek professional help. A one-on-one meeting, Honig believes, is far superior to a group debriefing.
All officers engaged in the event should go, not just the central player or the ones who seem most emotionally affected. "Sometimes the stoic officer needs help more than the one who is visibly upset," Honig explains. Be certain that the professional understands the police culture, will respect confidentiality and is versed in the nature and consequences of traumatic stress.
3. Have your intervention program set up before you need it. "In the middle of a crisis is not the time to set it up," Honig advises.
At LASD, a trained peer who has survived and successfully coped with a shooting establishes contact quickly after the event to offer support and guidance to the involved officer(s) and continues to follow up during the next week. The personal debriefing with a psychologist occurs within 24 hours to 5 days after the event. Then follow-up phone contact is made by the psychologist two weeks afterwards. On-going confidential counseling is available if post-event symptoms are not abating. Six months after the event, the psychologist again checks in with the involved officers.
"Having these opportunities to process the experience in a constructive way speeds up the trauma recovery and reduces the symptoms," Honig says. Usually "there is a sharp drop off" in problems after 2 weeks, and if symptoms persist at 6 months "then you are stuck on something in an unhealthy way" and need more intensive professional intervention. Relatively few officers end up in that situation.
4. Understand that your reaction to a critical incident may be intensified if you already are experiencing stressful events in your life -- a divorce, a family death, job or money problems, rebellious kids -- when the incident strikes. "You're likely to be less resilient then and find it harder to bounce back," Honig says. "Hardiness is a function not only of your own personality and style but of what else is going on in your life as well."
5. Be aware that a significant percentage of officers experience memory loss for important parts of the incident. This will affect their statements and the interviews they are subjected to, as well as testimony they may be expected to give later. If they say they can't remember that doesn't necessarily mean they are lying or deliberately withholding information. "Sometimes they may never recall 'missing' facts," Honig says. "But sometimes proper questioning may improve their recall."
Interviewers who are specially trained in cognitive interviewing techniques [see Force Science News, transmission #2, sent 9/29/04] may be able to "find" an officer's "hidden" memories by incorporating visual, auditory and emotional stimuli in their questioning.
Failure to deal knowledgeably with an officer's memory status "can result in increased litigation and liability," Honig warns.
6. Also take note of the high percentage of officers who experience a narrowing of vision (what Honig calls funnel vision) during a crisis. "That's an adaptive reaction under stress to help an officer focus in on what's important," she explains. "But the down side is that you lose peripheral vision, which can have a negative impact on your safety."
Officers need to be trained to keep scanning their environment during an incident, she maintains, "otherwise they won't scan under stress. With enough training, you can make scanning a reaction. You can overcome funnel vision just as you can overcome the majority of the body's automatic reactions. But you may have to over train to reach a level of confidence and proficiency."
An additional recommendation is advanced by Dr. Alexis Artwohl, a law enforcement psychologist and trainer with more than 20 years' experience and a member of the national advisory board for the Force Science Research Center at Minnesota State University-Mankato. Herself a leading researcher of critical incident phenomena, she believes this latest study underscores "the critical importance of stress-inducing, reality-based training." She explains:
"The more vulnerable, helpless and overwhelmed an officer feels in a crisis, the more likely he or she is to feel higher levels of physical and emotional distress" during and after the incident.
"When you provide officers with high-quality, stress-inducing, realistic training, not only are they likely to feel less vulnerable and helpless in a life-threatening event, but the better they will perform and the less likely they are to feel negative reactions afterward. When they experience stress inoculation in training, the fewer use of force problems they have on the street. That is the message that agencies need to hear."
In her Police Chief article, Honig emphasizes that "stress survival strategies, including visualization or mental rehearsal, positive self-talk and controlled breathing, trained to a level of confidence and proficiency, are critical to both improved performance under stress and increased resilience following a traumatic incident."
Honig says that her latest report covers only "a small fraction of the database" she and Sultan amassed from their survey. With the help of the Force Science Research Center, she hopes now to further analyze the information to "draw more correlations and see what else is connected to what."
For instance, she points out that statistically it is still "very rare to be involved in a shooting in law enforcement. It is not unusual to draw your gun on duty but to fire it--that's a pretty small club."
Yet as a group, she says, the officers who "cross that line" are more likely to be involved in subsequent shootings. "As we analyze our data more, we may be able to explain why this is true. Perhaps we can establish correlations that will help us identify officers" who seem most at risk for repeated critical incidents.
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