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How to train for and heal from psychological 'holes'

You have either been to a call or you are heading to the call in the future that will leave a hole in you, but you have an enormous amount of control in how you are changed by how you prepare


When I was a rookie officer, I was told the goal of every shift was to go home with the same number of holes in your body as you went to work with. This seemed to be simple enough, and statistically I figured had a pretty good chance of accomplishing this every day. 

In spite of close call with a shotgun one evening, I’ve managed to follow that advice for my entire career. In fact, with the number of law enforcement officers or first responders in general having contact with millions of citizens every day, statistically the vast majority of us still go home every day with no additional holes…right? 

The advice I was given was sound — the problem was my senior officer was only talking about the physical holes and he failed to tell me about the mental ones. I would like to pass on the same advice to you as it relates to the psychological holes in your mind. You have either been to a call or you are heading to the call in the future that will leave a hole in you. If you are a senior officer in your career it is likely that there are several holes in you already. While I will focus on law enforcement officers, these same holes are found in our dispatchers, crime scene personnel, firefighters, EMTs and paramedics. 

Preparing for Holes
We train more often and equip ourselves to deal with the threat of holes from gunshot wounds. Hours on the firing range, traumatic medicine courses, and ballistic vests all provide layers of protection. I won’t suggest anyone go out and try this but if you get a physical hole in you from a gun battle you, will be lauded a hero and decorated with medals. 

But it’s far more likely we’ll suffer from psychological holes that can lead to extreme stress, depression, loss of family, loss of identity, and suicide. We don’t train to deal with the mental holes and they are unlikely to come with glory or medals. They are more likely to damage our careers, our family, and even our health. We must be just as vigilant about preventing and treating these holes as we are their physical counterparts. 

Critical incident stress may be caused by a major incident creating a big hole or the accumulation of minor incidents that leave multiple small holes. Either way the damage is just as real as the massive hole from a 12-gauge slug or small ones from multiple .22 caliber rounds. No supervisor or shift partner would allow their officer to go back on patrol or return home with these types of physical injuries without an intervention and evaluation, so why do we allow it with mental injuries? 

While the number and type of traumatic calls an officer takes over a career are too long to list, one of the most universal calls that will likely leave a hole in first responders is the death of a child, especially as the result of violence. These scenes must be controlled and processed like every other crime scene but the aftermath is often long lasting. Reoccurring dreams, flashes, anxiety, anger and other post-traumatic stress symptoms are common among first responders who work these types of scenes. You may go home and hug your children a little tighter at the end of that shift, but do you talk about it with your spouse or colleagues? 

Being Proactive
A study by Vogt, Leonhardt, and Pennig (2004) showed that being proactive in the mental health of employees reduces recovery time, employee turnover rates, and health care costs to agencies. The same studies show increased morale, better work culture, and increased trust within the agency. Not only is it the right thing to do but it accomplishes the goal of administrative supervisors in every agency: better work and reduced cost. 

We can all agree this job will change you, but you have an enormous amount of control in how you are changed by how you prepare. We risk our lives together in the field brave enough to take bullets for each other and yet we are not brave enough to ask for or offer help. 

Check on your partners, check on your subordinates, and train for the psychological holes.


References
Vogt, J., Leonhardt, J. Ã., & Pennig, S. (2004). Economic evaluation of CISM--a pilot 
study. International journal of emergency mental health. Vol 6(4), 2004, 185-196.

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