Resilence and management of high stress situations

 The likelihood of becoming involved in an on-the-job shooting in one’s career is generally quite low across law enforcement officers in the US and Canada. However, there is a high degree of likelihood of almost daily encounters with high stress calls involving intimate partner violence, substance abuse, children at risk, unbearable human suffering and death.  I recall being involved in a search for a middle age male who did not return home after a night of drinking.  His route typically brought him across an abandoned rail road bridge.  As you might guess he did not make it across the bridge on that cold night instead falling off and drowning. He was found partially submerged and caught on some tree branches visible only by his L.L. Bean jacket which he had bought for those cold walks back from the neighborhood watering hole.  He was known to most of the police officers – two of whom were charged with going out into the river and retrieving his remains.  The body had been in the water about 48 hours.  It was not something I had seen before. I stood by for the retrieval and was involved in the notification.  My first of many.
These kinds of calls stay with you.  Especially early in one’s career.  The response of the family to losing their 50-year old father was especially difficult as he had young children from his second wife.  But I know officers and EMS first responders who have had one
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Boston Police Officers react to Marathon bombing  ABC TV – photo credit
experience after another just like this and worse. A colleague described rolling up a driveway to an open garage and bearing witness to the home owner hanging from a ceiling joist. Suicide. Imagine the psychic imprinting officers experienced responding to recent mass shootings in Las Vegas or to a small church in rural Texas where so many people are killed or maimed and to be unable to stop the bad guy before it all happened. It happens every day it seems.
Here in Boston, 3 people were killed over 300 people were badly injured after two homemade bombs were set off during the Boston Marathon setting the stage for a complete shutdown of the city while area police officers searched for the suspects.  MIT University Police Officer Sean Collier was killed by the bombers while seated in his patrol vehicle on duty 3 days after the bombing.  Within hours a firefight ensued in Watertown, MA as the bombers were found in a hijacked SUV.  The brave officers from Watertown, MA, Boston Police, MBTA Transit Police, and Harvard University PD fought it out for 8 minutes with Dzhokhar Tsarnaev and his brother Tamerlan who was killed in the gun battle and run over by his brother. MBTA officer Richard Donohue was shot during the gunfight nearly losing his life. After a year of rehabilitation he returned to duty and was promoted to sergeant but ultimately could not recover from his wounds and retired in the line of duty. It took extra days and over 1000 police officers to locate the second bomber cowering in the covered boat of a Watertown resident. His image was published in the Boston Herald depicted with the snipers red dot on his forehead.  Citizens applauded law enforcement as they left Watertown on that night.
To survive these incidents one needs to have resilience also known as the psychological resources to process the experience with all of its ugliness and to know that you did what was needed with the training and experience you bring to the job every day.
By using alcohol to cope instead of resilient thinking one often develops other problems and this can lead ultimately to suicide. Alcohol is often related to suicidal behavior.” according to Leo Polizoti, Ph.D at the Direct Decision Institute in Massachusetts.  
After a stressful event, your body and mind must return to its baseline calm and ready state so that the officer may again activate and serve in whatever capacity is required without the baggage of the calls gone by.  As this “baggage” builds unfettered the likelihood of a decline in officer job performance grows sometimes exponentially.  There should be opportunity and on-going training to process the images in order to put them away and restore emotional equilibrium.  In some department realistic training includes use of simuntions where officers actually shoot their weapons at active shooters during training exercises.  The weapons are full sized handguns fitted with special projectiles that do not cause lethal injuries.  All training is conducted with head and face protection.  Many departments are building resilience training into their recruit academies – no only building physical strength but emotional wellness too.  “Current training teaches officers about biological awareness (bio-awareness) since psychological and physical reactions in the body arise from biological responses to the environment. Mental and physical states don’t happen independently and both must be addressed in reality-based training” Anderson, et. al., 2017.
“When a person encounters a threatening situation, they experience a surge of natural chemicals, such as adrenaline and cortisol. These chemicals allow the body to respond quickly. When this biological threat response is moderate, it enhances performance through more accurate vision, hearing, motor control, and response time. However, when the threat response is severe, the response can negatively affect performance by creating distortions in thinking, vision and hearing, and by increasing motor control problems, which can result in slower reaction times.” Anderson, et. al., 2017
Police in Massachusetts and throughout America are faced with the worst of all human experience.  Arguably, everything from unattended death, domestic violence, child abuse, and a fatal motor vehicle crash may show up on the call board of any dispatcher on any day or night as I posted in May, 2015. In the case of traumatic events – officer safety demands CISD and in the long run physical health and well-being are the underpinnings of a resilient professional who will be there over and again –  when called upon for those once in a lifetime calls that most of us will never have to answer (Sefton, 2015). “Psychological benefits include reducing distress, enhancing confidence in abilities and recognizing psychological responses that need the attention of a mental health professional” Anderson, et. al., 2017.  When necessary police officers undergo critical incident debriefing and peer support. Some benefit has been demonstrated using biofeedback to reduce the trending autonomic arousal through a paced breathing protocol to ameliorate the sympathetic-parasympathetic mismatch that has well described negative impact on physical health, emotional embitterment, and job satisfaction (Sefton, 2017).
“The primary goal of all modalities of biofeedback including physiologic modalities and neurofeedback is to restore the body to its “normal” state of homeostasis.  The process promotes mindfulness and paced breathing to gradually lower respiratory drive, reduce heart rate and blood pressure, and enhance other abnormal physiological readings such as skin conductance, abnormal finger temperature, and elevated electromyography.  It takes practice and understanding of its value.” Sefton Blog post 2017
Ultimately law enforcement and all first responders must be afforded support along with training to adapt to situations most human beings would never choose to confront and do so in a manner that instills personal dignity,  integrity, and continued professionalism.

Polizoti, L. (2017) Psychological Resilience: From Surviving to Thriving in a Law
Enforcement Career. Direct Decision Institute presentation.
Judith Andersen, Ph.D., Harri Gustafsberg, M.A., Peter Collins, M.D., Senior Cst. Steve Poplawski, Bsc., Emma King, M.A., Performing under stress: Evidence-based training for police resilience. RCMP Gazette Magazine Vol. 79, No. 1.
Sefton, M. (2015) Critical Incident Debriefing: The cumulative effects of stress. Blog post: https://msefton.wordpress.com/topics/dv-and-trauma/police-service/critical-incident-debriefing-the-cumulative-effects-of-stress/ Taken 12-30-17.
Sefton, M (2017) Biofeedback: Teaching the body to return to a proper homeostasis. Blog post: concussionmanagement.wordpress.com https://wordpress.com/post/concussionassessment.wordpress.com/3682, taken 12-30-2017