Year: 2020

Harlem domestic violence homicide calls for transparent psychological autopsy

Michael Sefton, Ph.D. crisis intervention, Dangerousness assessment, domestic violence, domestic violence homicide, DVH, Human Behavior, Police officer behavior, psychological relevence, terminal rage ,
The psychological autopsy is an individually designed case study that elicits a broad range of factual data regarding the behaviors of a decedent in the immediate day or days leading up to domestic violence homicide. The study is especially important when first responders and essential workers are involved all the while a pandemic ravages the city in which they live. Michael Sefton, Ph.D. Direct Decision Institute, Inc.

The recent domestic violence homicide in Harlem raises the specter of an essential city worker who killed his sister-in-law while his wife called for help. The police stopped the attack resulting in the death of Ubaldo Gomez but not before he shot and stabbed a women in the head with a kitchen knife. The fact is that domestic violence has increased during the pandemic as it does at other of life’s stress points. Did the fact that the alleged murderer was an MTA employee considered to be “essential personnel” have an impact on his mental health that may have been foreseen? What role, if any, did his role as an auxiliary police officer for the NYPD have in the terminal event? A psychological autopsy would answers these questions and establish a worst case scenario of frontline exposure to trauma and possibly offer insight into underlying history that may have been anticipated and stopped. Certainly the hierarchy at 1 Police Plaza will have an interest in this case. The Corona virus has added to risk of DV and DHV.

For too many women who are abused repeatedly during times of crisis there is no place to run and no one to keep them safe. Orders of protection are ineffective and without GPS monitoring and they are nearly impossible to enforce. In a 2011 domestic violence homicide in Maine, the protective order was violated 4 times by Steven Lake who killed his wife and children in Dexter before killing himself in June 2011. That alone was grounds to hold Lake without bail. No police agency removed access to his collection of over twenty firearms. The scene diagrams illustrate how Lake was armed with two firearms and a hunting knife. He murdered his children while forcing his estranged intimate partner to watch. It was thought that he planned a murder spree and he left 9 suicide notes. The final despicable act, as police arrived, was to attempt to light the bodies on fire.

In general, there is little interest in such a comprehensive post hoc psychological examination because there is no pending prosecution. Nevertheless, a psychological autopsy conducted on Lake in the Fall of 2011 revealed a clear timeline littered with red flag warnings that were missed or ignored. The research conducted in 2011 was done pro bono. It undertook over 200 hours of interviews and presented the Domestic Violence Review Board with over 50 recommendations for reducing high rates of domestic violence homicide in Maine (Allanach et al. 2011). The medical autopsy editorialized the case in its final report:

“Despite receiving some mental health counseling it is apparent, in retrospect that the degree of violence and anger possessed by the abuser was not realized.”                                                            Chief, Maine State Medical Examiner

This latest case in point involved an estranged wife, her sister, and the building manager in Harlem. The three were having dinner when someone armed with a firearm broke into the apartment. It was the estranged husband of one of the women. He was wearing his Metropolitan Transportation Authority uniform, and he had a gun according to the NY Post reports. In the meantime we have been told that the perpetrator was an auxiliary police officer and was licensed to carry a firearm. What triggered this paroxysmal violence? If it was foreseeable, then Mr Gomez should not have had access to his firearm.The psychological autopsy will address prior history of intimate partner violence, protection orders in place, work-related stress, recent health concerns related to the corona virus and Mr Gomez trauma exposure history, and his mental health in the days before the murder. 

Police officials said the transit worker, Ubaldo Gomez, shot his sister-in-law and stabbed her in the head with a knife, while his wife reached out for help. When Gomez refused to drop a 12-inch kitchen knife and tried again to stab the man, a police sergeant opened fire, killing him. In the end, there is always at least a single person who knows what is about to happen and often does nothing to stop it. A family member of Gomez suggested “he had some mental issue, something happened. He was always working day and night. He barely slept. He worked.” as quoted in the NY Post. Whether this duplicity and denial stems from cultural beliefs about the supposed “privacy” of DV, society must change the way in which law enforcement manages these cases. The buy-in from police, legislators, judges, probation, and the public-at large needs to be fully endorsed for real change to happen and for safety plans to work. Many states across America are planning to enact “red flag” rules that will remove weapons from individuals with a known history of domestic violence e.g. choking spouse during fight (Sefton, 2019).

Family members who may be in the crosshairs of these insidious events often see but lack the knowledge to stop the emotional and behavioral kinetics once they start. The fear of being murdered by an intimate partner creates emotional paralysis. In a large percentage of DV occurrences, financial and self-image influences as well as outright fear of the abuser by the victim limit moves toward safety. Therefore, a continuum of interagency cooperation is needed to effectively measure risk and understand the pre-incident red flags that are common manifestations of abuse and often forecast terminal violence, all of which occurred in this case. As the totality of these red flags comes into focus it becomes incumbent upon each of us to take action to prevent domestic violence threats from becoming reality (Allanach, et al. 2011).

It would seem to be vitally important that a transparent psychological autopsy be initiated to gain an understanding of the factual behavior that was observable and measurable in the days leading up to the murder especially given the likely unintended victim. Preliminary reports described Gomez as having a pattern of pathological jealousy and victim stalking. For her part, Gomez’ wife Glorys Dominguez called for help in the weeks prior to the terminal event seeking help.

active shooter addiction Bail conditions in domestic violence CIT Community Policing crisis intervention Dexter domestic violence domestic violence homicide DV DVH DV Homicide extended family fitness health psychology intimate partner violence jail diversion Law Enforcement Leo Polizoti Maine Mass shooting mental health mental illness Michael Sefton parenting Personality Police police behavior police mental health liaison police officer police suicide pre-incident red flags psychological autopsy PTSD red flags Resilience Ron Allanach Sefton Sefton Blog Social skills Suicide terminal rage toxic relationships violence workplace violence

Allanach, RA, Gagan, BF, Loughlin, J, Sefton, MS, (2011). The Psychological Autopsy of the Dexter, Maine Domestic Violence Homicide and Suicide. Presented to the Domestic Violence Review Board, November 11, 2011

Sefton, M (2019) Violence prediction: Keeping the radar sites on those who would do us harm. Blog post https://wordpress.com/block-editor/post/msefton.wordpress.com/5012 taken May 23, 2020.

Sheehan, K, Moore, T. Woods, A. NY Post May 21, 2020 https://nypost.com/2020/05/21/man-killed-in-nyc-police-involved-shooting-was-auxiliary-cop/?

Chaos, Fear and Death from Covid-19: The loss of trust in leadership

Michael Sefton, Ph.D. Corona virus, Human Behavior, psychological relevence , , ,

The Coronavirus has brought to bear chaos and fear among Americans from coast to coast. I am unsure whether any of us expected the virus would grow and infect over 1 million Americans alone in 6 short weeks. The death toll at the time of this post is just under 80 thousand lives. Personally, my aunt and my mother were both infected with the virus at their living facility. Sadly, my aunt has died from the coronavirus but my mother, has been without symptoms, in spite of testing positive 2 weeks ago. Over 30 percent of Americans know someone who has died or been infected by the virus. The fallout to mental health is real. I see it in my own family as nerves become frayed 8 weeks on.

The virus’s threat to basic needs and personal security has eroded the trust in federal leadership. This is due to the lack of an integrated plan to develop a vaccination, provide testing and contact tracing, support unemployed workers, and reconcile still-rising numbers of Covid positive cases while at the same time as some states begin opening businesses. In doing so, potentially asymptomatic individuals may unknowingly carry the invisible killer into a restaurant, laundromat, or tattoo parlor – all deemed essential services as states like Georgia begin coming back on line. This is a fact, whether or not they meet federal government mandates for “opening up” including 2 weeks worth of reduced rates of infection, decreased death rates, and lowering hospital admissions due to Covid-19.  Many epidemiologists believe that opening businesses too quickly will result in a rise in cases of the virus and an increased rate of death.

Now, the White House Task Force is finding itself in the crosshairs of the invisible and lethal disease as members of the White House staff are being diagnosed with Covid-19 and self-quarantined because of exposure to the virulent disease. Members of the inner circle have been tested and some have been diagnosed with the virus including members of the White House service staff and the Vice President’s personal secretary. In the west wing, there is chaos among the staff as to what precautions should be taken while potentially being exposed to the coronavirus. Dr. Anthony Fauci, who has been the face of the response to the virus is now in a voluntary quarantine as a result of the spread of the virus in the west wing among staff members of the White House. Three physicians have gone into voluntary quarantine as a result of coming into contact with the virus as protocols recommend.

Former President Barack Obama harshly criticized President Donald Trump’s handling of the coronavirus pandemic as an “absolute chaotic disaster” during a conversation with ex-members of his administration. Yahoo News May 9, 2020

Medical personnel across the country are on the front line and they are being recognized for their tireless bravery in the hot zones in American cities like New York, Boston, and New Orleans. The law enforcement and fire service have all shown their appreciation with 7 PM shows of support. This also includes members of newly graduated physicians who have been sent to the front lines of the virus in ICU’s and Covid-19 floors in America’s best hospitals. The stress of this is often overlooked. “Since the pandemic began, newly minted residents who normally wouldn’t take care of patients with severe respiratory illnesses, such as those training to be psychiatrists, podiatrists, or orthopedic surgeons, have been asked to volunteer to work in COVID-19 wards” across the country according to a report by Deanna Pan in the Boston Globe on May 9, 2020. These are teaching moments that have brought out the best in young physicians and the old seasoned veterans who supervise. But the cost has been great with increased rates of suicide since the shutdown began in March including those on the frontlines.

On April 27, Lorna Breen, a physician specialist in emergency medicine took her own life after being witness to dozens of patient deaths during the peak of the coronavirus and contracting the virus herself and surviving it. Dr. Breen was a professional and emergency service medical director of NewYork-Presbyterian Allen Hospital and had no history of depression or mental health diagnoses. In the hours before her death her father, himself a physician could tell something was wrong.

Lorna Breen, M.D.

On the night when the nation’s top virus spokesperson physician Anthony Fauci, M.D. went into voluntary quarantine, the president of the United States had a meeting of his senior staff and none of the members at the meeting were wearing personal protection, like masks. Physicians and epidemiologists are calling for social distancing and personal protection yet the White House resists and engages in ongoing updates and meetings without the use of masks or social distancing. With two White House staffers testing positive for the virus, including Mike Pence’s secretary Katie Miller, the president is making light of the protocols set forth by the CDC and the WHO. This inconsistency and disingenuous message is not lost on anyone.

NBC News profile of Dr Breen

Delayed actions at the top have resulted in confusion about what steps the U.S. Government and the individual states must take to reduce the impact of the viral outbreak. The U.S. has the highest number of Covid-19 cases and the highest number of deaths in the world. The streets of America are empty and businesses are shut down and many will never reopen. The unemployment rate is nearly 15 percent. This is the highest rate of unemployment since the great depression. People are worried and in conflict over medical information they are hearing and what they see in the White House increases that conflict.

“It’s a terrifying, solitary, dehumanizing death that these people go through, and it’s going to leave wounds in our society for a long time,” Tara Bylsma, 30, a second-year internal medicine resident at Boston University Medical Center in Boston Globe May 9, 2020

Working on the front lines with patients who are dying is horrific. This is especially painful when there is seemingly nothing that can be done to help them. First responders and frontline hospital workers are trained to provide emergency care. When their training is not effective than feelings of helplessness will grow. These feelings can be overwhelming. At the same time, the rule of law comes into question and there is growing suspicion that the virus is man-made or an overblown scam. People are pushing for release from social distancing and using the argument that their constitutional rights are being infringed upon by forcing them to remain in their homes. Some are becoming angry and out of control.

In late January, 2020, the World Health Organization declared a pubic health emergency because of the exponential growth of the virus in China and later in Italy and Spain. Trump has since denuded the WHO as being overpriced and undervalued as only he is capable of doing. Sadly, Americans were unprepared when it’s first case arrived in February and we were told not to worry the virus would soon disappear. But it has not gone away and the United States is in lock down as a result.

Human to human transmission of the disease was thought ‘not possible’. The pandemic was first publicized and forewarned by a physician in Wuhan, China who ultimately died from the virus. He had been arrested and warned by police against speaking publicly about the risk of the virus and threatened with sanctions.

Meanwhile, President Trump was publicly yammering about his trust in Chinese President Xi Jinping and the deals he was making to benefit the American economy. His focus was not on the growing fear of American workers but the vulnerable economy that President Trump needs to get himself reelected in 6 months. In the meantime, the virus has not vanished nor faded away with warmer weather but continues to claim over 1000 lives each day across the country. Now, with the coronavirus in the White House, the presidential spin over wearing masks and maintaining social distancing takes on new meaning.

How will the political narrative shift now that Trump and his team has been directly exposed to the virus and members of the Coronavirus Infectious Disease team have become quarantined leaving the president alone in the garden for his bite of the apple?

Domestic violence during the Pandemic – The private response to stress

Michael Sefton, Ph.D. Human Behavior
We don’t need anything or anyone, If I lay here, if I just lay here; Would you lie with me and just forget the world? Snow Patrol
The coronavirus has changed almost everything in America. Especially the rate of employment. Unemployment claims across the country are through the roof and it will be weeks before money is available to those most in need. The stress of this has increased calls for domestic violence in Massachusetts and across the country. Domestic violence stems from one intimate partner using coercion and control to dominate his spouse usually was a result of deep-felt anxiety and fear of abandonment. Music sometimes resonate with social issues. The lyrics from “Chasing Cars” written by Snow Patrol reflect the expectation seen in dysfunctional systems that demand loyalty often at the expense of extended family relationships. These lyrics may sound romantic but they illustrate the desire to isolate a partner to the extent that nothing in the world matters projecting an air of being marginalized and seeking comfort in a partner who shares a common detachment. Truthfully, most people need their families, friends, and work relationships making the mournful request in the song somewhat irresponsible yet compelling for many who may be so inclined. Lyrics by Petula Clark written by Tony Clark in 1964. Music often takes on the poetic plight of the emotionally imprisoned. It reflects social mores and falsely depicts life without hope. Helplessness and wishful thinking as the message of hope. “Don’t hang around and let your problems show, Forget all your troubles and forget all your cares and go downtown; linger on the sidewalk where the neon signs are pretty, How can you lose”? The Fresno sheriff’s department filed 77 percent more domestic violence reports two weeks ago than three weeks ago. The Seattle Police Department received 614 calls in the last two weeks — 22 percent more than average rate. Domestic violence prevention organizations in Boston warn of an increase in cases according to the Boston Globe on April 3. Domestic violence is a private matter that many people do not want the police to know about. But that is the outdated myth. In keeping DV a private matter domestic partners are victimized on average over 7 times before police are summoned. DV gets worse and more pervasive when times get tough. Now as the country is shut down because of mandatory social distancing, intimate partners are frightened that one wrong comment, or a late dinner, of the wrong glance at a cashier may result in the countdown to terminal violence. Helpless again.As cops, we must see it and call it out. Arrest is mandatory whenever there is evidence of physical violence. Among the highest red flag risks is the victims belief that she will one day be killed by her spouse. It is usually an ominous premonition. Law enforcement can plant the seed to recovery by encouraging a viable “safety plan” and leaving the victim a dead cell phone that can allow a 911 call when needed. This may be done in the aftermath of the crisis. If you know of someone in a dangerous interpersonal marriage or relationship talk to them about making a safety plan. They may need a friend or family member one night as a matter of life and death. They should not count on orders of protection because these are often inadequate and ignored.
At times of stress, families struggle to maintain the emotional homeostasis that keeps them safe. The normal roles and hierarchy within a family system may erode. Michael Sefton 2020

Benchmark behaviors for healthy police service

Michael Sefton, Ph.D. Human Behavior, Leadership, Police officer behavior, Stress , , , ,

Law Enforcement flag

What are the bench-mark behaviors that are reflective of healthy police officer career development? How does a young man or woman go from a squared away academy graduate to an over burdened, irascible and embittered mid-career cop? There is a growing literature that suggests officer behavior and law enforcement culture become instilled in the field training process that takes place immediately following successful formal classroom training. The answer to the question about officer embitterment is a mystery but after spending time with members of law enforcement in Chicago in late March 2019 it begins to become apparent that police officers grow and remain productive in an environment of support: both within the organization and within the community in which they serve.

There are factors intrinsic to law enforcement that detract from career satisfaction like the risk of personal harm or death, career ending injury, time away from family, shift work, and forced overtime. This is a well known set of stressors that officers learn shortly after signing on. But things that may be unexpected include the quasi-military chain of command that often stifles education and innovative thinking, professional jealousy, arbitrary executive orders, the lack of opportunity to participate in policy making, nepotism among non-civil service personnel, and the lack of support for the sacrifice made by the field qualified troops for physical and behavioral health injuries. The period of field training differs from job to job. Field training picks up where the academy classroom education leaves off. Newly minted LEO’s all must undergo field training and are assigned to a single field training officer (FTO) who provides on-the-job training about the realities of frontline police work and closely monitors officer behavior and responses in the field.

Field training usually lasts between 12-18 weeks and was first initiated in San Jose, CA in 1972 according to research published in 1987 by McCampbell of the National Institute of Justice at DOJ (1987). “The primary objective of the Field Training and Evaluation Program (FTEP) is to ensure that all probationary police officers receive optimal field training, predicated upon staffing the Field Training Officer position with qualified officers, and to ensure through proper training and evaluation that only competent, motivated, and ethical individuals become Chicago police officers” as published in the Chicago PD Field Training Program and Evaluation Standards (2018). Field training officers have specific training in mentoring with an understanding of the demands of “street work” and the transition from classroom recruit to patrol officer. The FOR training process lasts several weeks as seasoned veterans learn how to be mentors and evaluation the training needs of individual probationary officers. 

The selection of FTO’s differs from department to department and has implication on long-term officer success. Attrition rates exceed 25 % under the FTO’s leadership and tutelage in many agencies. FTO’s can be expected to experience training fatigue and should be permitted time between assignments. “Dworak cautioned about agencies falling into situations in which they over-work their FTOs, resulting in diminished quality of work, and subsequently, decreased value delivered to the recruit being instructed” Wyllie, 2017

“The FTO is a powerful figure in the learning process of behavior among newly minted police officers and it is likely that this process has consequences not only for the trainee but for future generations of police officers that follow.” Getty et al. (2014) There is little standardization of training protocols aside from FTO catechizing war stories day after day with tales from the street followed by endless inquiry over possible decisions based on department protocol as the sometimes defiant FTO sees fit.

“New officers can be taught when to legally arrest and use force, but the academy cannot instill in each trainee the breadth of intangible, community, value-based decision-making skills that are necessary to manage unpredictable incidents in varying situations.” Getty et al. (2014)

FTO’s are closely monitored by the department training hierarchy and are required to provide daily observation report as to the demonstrated progress of probationary police officers toward developing competence in over 10 areas of police-related duties including decision making, judgment, court testimony, use of force, etc. At the end of each 28-day cycle FTO’s submit a detailed review of progress and potential deficiencies that arise. In Chicago, IL a probationary police officer (PPO) must complete a minimum of 3 28-day cycles with an FTO. It is known that FTO’s help to instill the police culture in PPO’s including policing by the book and prevailing beliefs and attitudes as they exist within individual agencies. I strongly believe that FTOs play a role in reinventing the police service and lowering the stigma associated with behavioral health and response to exposure to trauma.

Job satisfaction is greatest soon after the law enforcement officer is taken off field training and designated “field qualified”. Following the 12-18 week field training officers remain on probationary status for up to 2 years from date of hire. There is some thinking that FTO behavior rubs off on PPO’s and can impact career identity including misconduct later on long after field training has ended. Officer resilience depends upon solid field training with adequate preparation for tactical encounters, legal and moral dilemmas, and mentoring for career development, job satisfaction, and long-term physical and mental health.

Chicago Police Department (2018) FIELD TRAINING AND EVALUATION PROGRAM http://directives.chicagopolice.org/directives/data/a7a57be2-1294231a-bf312-942c-e1f46fde5fd8c4e8.html taken March 29, 2019.

Wyllie, D. (2017) Why the FTO is one of the most important police employees. Police One https://www.policeone.com/police-products/continuing-education/articles/338249006-Why-the-FTO-is-one-of-the-most-important-police-employees/ Taken March 30, 2019 Sun, I. Y. (2003a). A comparison of police field training officers’ and nontraining officers’ conflict resolution styles: Controlling versus supportive strategies. Police Quarterly, 6, 22-50. Getty, R, Worrall, J, Morris, R (2014) How Far From the Tree Does the Apple Fall? Field Training Officers, Their Trainees, and Allegations of Misconduct Crime and Delinquency, 1-19. McCampbell, M. S. (1987). Field training for police officers: The state of the art. Washington, DC: National Institute of Justice.

Domestic Violence amid worries of pandemic

Link Michael Sefton, Ph.D. Human Behavior , , ,

Brian Gagan of People Results, a Scottsdale, Arizona consulting firm on the left with Dr. Michael Sefton, a psychologist provider in Massachusetts are interviewed by media outlets in Maine following publication of the Psychological Autopsy of Steven Lake, a northern Maine man who murdered his wife and children after being denied permission to attend his son’s 8th grade commencement celebration. The Psychological Autopsy is a detailed case study designed to uncover cues to precipitating factors in DVH. The research conducted in 2011 undertook over 200 hours of interviews and presented the Domestic Violence Review Board with over 50 recommendations for reducing high rates of domestic violence homicide in Maine. 

At times of stress, families struggle to maintain the emotional homeostasis that keeps them safe. The normal roles and hierarchy within a family system may erode. The social distancing required during the coronavirus outbreak has frayed many people into irrational and sometimes dangerous behaviors. Domestic violence thrives at times when the strain of social order violates family routine. Fear and uncertainty over physical health coupled with 7/24 news reporting of death and suffering can be overwhelming for some. 

As with many out of the ordinary times, the incidence of domestic violence increased amid fears of contracting Covid-19. In a Chicago suburb a man killed his wife and then himself as the couple waited for word on the virus swab they had taken together. Neither person tested positive for the virus. Their bodies were discovered after family member grew concerned after not hearing from them over several days. 

According to a Washington Post, Patrick Jesernik killed his girlfriend because he feared they had both contracted Covid -19. His girlfriend, Cheryl Schriefer was murdered after she developed symptoms including shortness of breath. The couple were discovered to be dead by Will County Sheriff’s deputies whose preliminary report suggests murder suicide. 

Star of Will County, Illinois Sheriff’s Department

Domestic violence homicide when Covid-19 strikes fear – coercion and control take over

There is no telling what triggered this tragic event. The Will County Sheriff’s Department had no prior contacts with the couple so no pattern of DV could be established. However, with fear of becoming infected with the virus it is plausible that Mr.Jasernik believed he was ending what he wrongly assumed would be a horrific end of life for them both amid the growing pandemic. 

Some hotlines for people suffering from anxiety and depression have reportedly received more calls, particularly in areas where the coronavirus is spreading rapidly like Maryland and Portland, Oregon, but the National Suicide Prevention Lifeline did not report an increase last week. (The phone number is 1-800-273-8255.)

At these times: Still words to live by… from 2015

Michael Sefton, Ph.D. aging and memory, Human Behavior, Relationships, Stress

Chief Bert DuVernay on right photo by Susie Mullican
“Take care of yourselves, rest as much as you can, read good books, sing loud songs (when you’re alone…would be best) and read a poem now and then”  Ann Sefton, 2015
These were the words of Ann Sefton in a Holiday card sent to my wife and I and are among the best advice I have ever received from my mother or anyone else.  I think they are worthy and spoken from the heart and I intend to share them with anyone who will listen.  The kindness and wisdom in the words struck me as a reminder of the joy and simplicity I seek in my life. Those words along with the espoused words of David Trimble, Ph.D. are beliefs that foster greater self-awareness, self-compassion, firm authority, integrity, and coherence to my life. Here’s to a great New Year! Let’s pray for the end of the Coronavirus and return of our society as we know it. April- 2020 Just an update: my mother Ann is now in memory care at the Bethany Healthcare in Framingham, MA. She introduces me proudly as her husband. My mother continues to experience joy on a daily basis and is receiving excellent care at Bethany. She is resilient and happy and will rest and sing loud songs. She has made friends. She still enjoys election coverage but must wait for now. I have not been able to visit for 3-4 weeks because of the risk of transmitting the virus. Meanwhile, Chief DuVernay recovers from several medical procedures and is on the mend. We wish him Godspeed as he and his wife Teresa plan a long-awaited westward move into shared retirement and grand-parenting. Because of the social distancing mandate due to Covid-19, I regret that I may not have the chance to say goodbye properly to Bert and Theresa. That would make me very sad and put an end our regular ‘Lunch with the Chief’ meetings where many former officers come together and shoot the “you know what” and share time together over lunch and remember our times together. The photograph shown is to recognize Chief Bert DuVernay on the anniversary of his retirement from the New Braintree Police Rep in 2015.  Read The shared words and share them with someone you care about.

Professional M.H. Intervention: Making the hand-off

Michael Sefton, Ph.D. Human Behavior ,
Whenever there is a serious call of any kind, we review the incident..  We will attempt to weigh the seriousness and potential impact on law enforcement officers.  We will contact our CISM  Team members who may work in the district involved (they’d be more familiar with the officers) and obtain an assessment from them.  We will also contact supervisors that responded to get their impression of how the incident may have impacted their officers.  After a careful review, we will decide on whether or not we conduct a debriefing.  Sometimes (on rare occasion, we will contact the officers directly (the officers that were involved in the incident).  However, we try not to do that, because we don’t want them to try to debrief the incident over the phone (officers will naturally start talking about the incident over the phone and we don’t want that), but sometimes you need to go directly to the source.   Cumulative trauma extends beyond shootings and other “critical incidents,” however. Among cumulative trauma are the days and nights of being cursed and shouted at, listening to the screams, viewing dead bodies, and the momentary scares and fears that go along with law enforcement. These are the “bumblebee stings” that add up; one or two may be tolerable but, as they add up, the pain increases to the breaking point—and posttraumatic stress disorder (PTSD).
  • Line of Duty Deaths
  • Suicide of a colleague
  • Serious work-related bodily injury
  • Multi-casualty/disaster/terrorism incident
  • Incident with high degree of threat to personnel
  • Significant events involving children
  • Events in which the victim(s) are known to personnel
  • Events with excessive media interest or scrutiny
  • Events that are prolonged that end with a negative outcome (failed CPR)
Any significantly powerful, overwhelming or distressing event when any incident such as the above occurs, we will be notified by our Operations Division and or CISM Team members and or rank and file officers, soon after the incident.  These incidents will always elicit a response of some sort (these are all “Mitchell Model”events).  After investigating, we make a determination on how to proceed;whether it calls for a Debriefing, a 1 on 1 with a trained peer counselor, a critial incident diffusing, a recommendation for clinical services, OnSite Academy, McLean Hospital, sometimes no action will be taken at all, but there will definitely be a response (as in an investigation and careful thought), etc.  We take many criteria into consideration when we make our determination.  What other officers have informed us about the involved officer, how long the involved officer has been on the job, what other incidents the officer has been involved in, the officers personality, who was with him/her during the incident, how gory the incident may have been, any external issues etc.   We almost never make a final determination until we have consulted with one of our clinicians.

The “will to live” and the sad case of Mary Ward

Michael Sefton, Ph.D. Human Behavior

In the mid 1990’s, I was a young psychologist and I provided on-call coverage at three Southern California hospitals for issues relating to mental health problems. Little did I know, that one case would become such an international phenomena that I would be brought back to Los Angeles to testify as to what I thought had caused the death of a small, but feisty, apartment manager named Mary Ward. I was in internship in Boston when I got the call that I was needed in a case involving the death of Mary Ward. 

Mary Ward was a 77-year old elderly woman living in Santa Ana, CA approximately 20 miles south of Los Angeles. Her name should bring to life the spirit of healthy aging. She was an active, independent widow who worked as an apartment complex manager. She was very active in her church. She had no children but plenty of friends and grew up in the South migrating to Los Angeles as many of us did. Mary was a small woman with wispy gray hair and a slight southern twang that was remnant to her distant past. Regrettably, I never really had a long conversation with Mary before she died as she was generally emotionally distant and anxious, but cooperative with her care. She stood just over 5 feet and weighed 140 pounds. My first meeting with Mary was in May 1992. I was the psychologist on-call at Martin Luther Medical Center in Santa Ana. Mary was brought to the emergency department after being sexually assaulted in her home by a 20-year old man who was swimming in the pool at the complex she managed. The man was caught in the act and sent to jail.

“The question of what makes the human heart break, or what makes the human spirit either resilient enough to bounce back even stronger or break, is not something the criminal law was designed to answer,” said Santa Ana defense attorney William J. Kopeny. Renee Lynch Los Angeles Times January 24, 1994

The call came in at 4 AM it was near Memorial Day, I remember because we were planning our son’s late-May birthday party. The nurse at the ICU told me that an elderly woman had been sexually attacked and raped at knife point. She was alert and was cleared for me to interview. She had undergone the demoralizing evidentiary examination in the hours that I selfishly lay sleeping – on-call. This is the process to which rape victims must consent in order to salvage DNA evidence that the police need to track down potential suspects in the aftermath of cases of sexual assault. In the times I have been present in the aftermath of these evidentiary exams, I have come to bear witness to the impact they have on victims. When some women realize what is involved in the hospital examination, many will forgo prosecution to avoid the stigma, demoralizing, and re-victimization of the evidentiary examination.  

In this case, Mary Ward was attacked in her kitchen while on the telephone with 911 operators. The perpetrator was intoxicated, three times the legal limit. He could be heard on 911 recordings threatening Mary. So too, could operators hear the distraught, sobbing of Mary Ward. He was taken into custody at gun point while committing his sexual attack on Mary.

Jose Alonso Garcia and Mary Ward did not know each other. Garcia was 20-years old. He had no criminal record. Mary heard him swimming in the darkened pool of the small apartment complex. At 2:00 AM, she left the apartment where she had been sleeping and asked Garcia to leave the pool. He did not live in any of the 18 apartments in the small urban enclave. Immediately he came at Mary, forcing her to retreat to her kitchen where she could call police. She believed she was safe. But while talking to 911 operators, Garcia broke through the kitchen door of her small, one bedroom apartment. Police were dispatched with urgency because there was a crime in progress and the victim could be heard begging her assailant to stop his attack. “You’re choking me” according to 911 transcripts. Were it not for the police response, Mary may have been murdered that night in May. 

The psychological trauma associated with gross sexual assault while being held at knifepoint is insurmountable for many. Mary would never recover from the attack that left her in an acute psychogenic crisis.  Following my initial assessment, Mary voiced the wish that she had died with her husband years earlier. Mary was consumed by a fear that her attacker would come back. The fear she experienced far exceeded anything that had ever happened to her in her life. She was perplexed as to why a man would want sex with a woman her age? She never realized that rape was not about sex but more about punishment and rage. Garcia was angry that Mrs. Ward had banished him from the pool and reacted in kind.

Mary saw herself as a kind person who liked helping people. She did many good things. But the emotional recovery from sexual violence such as this would take years. Unfortunately, even if this has not occurred Mrs. Ward was sick and would not live long. She had cancer in her body but the thought of the cancer spreading in her body frightened her less than the fear brought about by her assailant or his words or the smell of his breath that night. Instead, Mary Ward died alone. A victim whose ordeal she could never comprehend. “Why would anyone want to take advantage of an old lady?”

Police arrived to find Garcia in midst of the sexual assault of Mary Ward. At gunpoint, Garcia was ordered to stop the attack and submit to arrest. He was taken into custody that night and within 30 days he would be charged with the murder of Mary Ward. The assault on Mary would result in an acute stress reaction from which Mary Ward would not recover. The consummate result of her attack resulted in her will to live being traumatically exsiccated. In doing so, it “hastened her death” just 30 days after the attack. Physician and concentration camp survivor Victor Frankl believed that once gone, the purpose of life and the will to live cannot be restored.

It was my responsibility on this night to conduct a mental status examination on Mary Ward. On many levels it felt wrong to ask the frail Mrs. Ward to chronicle the events she had experienced and measure, to the extent that it was possible, if she could go home again. Given that her home was the location at which the rape had taken place, she had powerful feelings that it was unsafe to return there. She had no family. After 2 nights in the ICU, I asked that she be transferred to a psychiatric unit for crisis support due to the powerful, on-going reaction she was experiencing. Her capacity to cope was eroded and she bemoaned her wish to have died before this had happened. “I wish I would have died” barely audible. She was apathetic and exhibited a powerful blunting of her emotions. She was helpless to do most anything.

Mary Ward was found to be emotionally overwrought. She could not focus and was re-experiencing the events of the attack on a primitive level. There was no psychotherapy that would mitigate her trauma – only time. She described the smell of his breath and him panting in her ear over and over. The image of the knife he was holding caught the corner of her eye making her too frightened to move or fight. Her thoughts were confuse but suggested no anger in her suffering.

“I will never be able to live after this.” “Why would he want sex with an old lady?” she repeated. “There are plenty of women his age who live around here.” Pleading. Mary Ward in quotes

Mary could not go home. The psychiatric support she received at the hospital did very little to lessen her personal trauma. She remained in bed most of the time and was uninterested in group therapy. She stayed in the psychiatric unit for 3 days before moving in with a member of the church. During these days she was visited by her pastor and friends from her church. Individually, with me, she described deep feelings of shame and humiliation. Her sleep was fragile and she could derive no purpose in going on in life. She blamed herself for the attack and could demonstrate no particular anger toward her attacker. There were strong feelings of panic linked to men she saw in the neighborhood. In southern California there were were triggers everywhere. “There’s not much more you can do to an elderly woman than rape her in her own home. Attacking her and doing what he did, the defendant killed her” said the O.C. District Attorney, who brought the unusual charges of murder against Garcia.

For his part, Garcia was remorseful, but lied to police saying that Mary had invited him in to her kitchen. His hubris was smug and disarming. He received 23 years in prison for ostensibly raping Mary Ward resulting in death.

Mary was denuded of a sense of purpose and meaning from which there was no return. Even having cancer brought purpose and hope. Members of her church took her to cancer treatments and doctor visits. Mary derived pleasure In the service of others – her extended family. In the aftermath of the rape, she cried daily and seemed to have no will to live as if the light went out and Mary Ward had given up that which illuminates our path. Months after her death the trial was televised locally and nationally. The defense team described the draconian charges with pity for the defendant. The death, they spun, was the result of her cancer. The district attorney would go on to bring to life the zeal Mary brought each day to all she did and had expert witnesses who painted the picture of a victim who suffered from the time of her attack until the day of her death one month later. There was nothing we could have done to help Mary.

My testimony was a tiny part of the prosecution. Sadly, it was just the beginning of a complex prosecutorial overreach that the jury did not buy. I have always felt that I failed Mary by not bringing her suffering to life. There was no doubt in my mind that Mary Ward was a vital, full of life, and integrated into her community. Her cancer was but a speed bump and did not worry her.

Garcia was sent to prison for over 20 at this point. A google search revealed an obituary of a man a few years older in age but little more. He must be back in the community some where. Perhaps he was rehabilitated, I will never know. The State of California made a stand in charging Mr. Garcia with murder just as Mrs Ward made a stand that night in defense of her purpose in life. 

America strong and we stand united in this fight against Covid-19

Michael Sefton, Ph.D. Human Behavior ,

“As clinicians, promoting empathy, mutual respect, inclusion, and equality can be as important as accurate communication, diagnosis, and treatment. COVID-19 presents an opportunity for us to rise to the challenge on all of these fronts and to reaffirm that our best chance to stand against a global threat is together, united in solidarity.”

COVID-19 presents a major medical and public health challenge for the global community, with a looming but unknown mortality risk understandably creating fear, uncertainty, and panic among groups around the world. Unfortunately, its emergence has been accompanied by another “viral epidemic”: anti-Asian racism and discrimination. As Asian American physicians, we are deeply concerned about the consequences of this parallel epidemic.

Choi, E. et al. Annals of Internal Medicine. (2020) http://freshlook.annals.org/p/blog-editors-authors.html taken 3/27/20

Positive Policing and Purpose in Life

Michael Sefton, Ph.D. CIT, crisis intervention, domestic violence, Field Training Officer, Gift of Fear, Health Psychology, Human Behavior, Police officer behavior, PTSD, retirement, Stress, Suicide by cop
Purpose in life has been introduced as benefiting people, including law enforcement officers, to find a positive sense of purpose and personal satisfaction in their work product and in their lives. It was originally espoused by Viktor Frankl in 1946. Frankl, a physician, survived the German concentration camps and the deliberate extermination of 6 million Jews during WW-II. His wife and entire family were killed at Auschwitz and Dachau. How could he possible find purpose and meaning in life after this horrific experience. In the book Man’s Search for Meaning, first published in 1946, Victor Frankl shares the experience of seeing hundreds of people herded off to their extermination. People and members of his immediate family were horrifically gassed and sent to mass graves. Frankl’s theory holds that “there are three primary human capabilities, or, in his words, noological possibilities: self-detachment, self-transcendence, and the ability to “spiritually be in touch” with something or someone independent of spatio-temporal dimensions” according to McGann (2016) who reviewed Frankl’s book Man’s Search for Meaning.
Officer well-being is essential for career longevity. It becomes apparent that police officers grow and remain productive in an environment of support: both within the organization and within the community in which they serve. These attributes build a sense of personal meaning and career purpose. Leo Polizoti, Ph.D.
In Man’s Search for Meaning, Frankl described the daily demoralizing prisoners underwent both physically and psychologically. Survivors of the horrific images at concentration camp Auschwitz began to find meaning in their forced labor – even humor along with camaraderie. Many of us glean a significant sense of well-being from what we do personally and professionally. Most cops derive great personal meaning and purpose from the job of police officer at least for the first 3-5 years. Law enforcement officers’ derive much of their identity from the work they do on a daily basis and can experience wide ranging stress from call to call. As such, it has become well-known that police work requires special understanding of one’s community and a positive sense of personal responsibility, well-being and resilience for career success and hardiness (Polizoti, 2018).
Our tour guide at the West Bank in Israel in 2019 – Rami Nazzali found great purpose in teaching visitors about the plight of Palestinians on the West Bank and Gaza Strip – He strongly believes the plight of Palestinians in the Gaza Strip and West Bank are fighting for purpose and meaning in their lives. Rami Nazzali writes for The NY Times.
Purpose in life refers to an underlying belief that what you do for work has importance and purpose on a larger scale. Moreover, to diminish oneself as a result of career embitterment runs a risk of the erosion of purpose and loss of group membership. That is when one becomes marginalized and loses his purpose and the “why” for living. Viktor Frankl believed that once gone the purpose of life and the will to live cannot be restored. Mark Dibona previously was a patrol sergeant for the Seminole County Sheriff’s office in Florida, where he supervised nine officers, but the memory of the June morning where he was called upon to resuscitate and dying infant still haunts him. “Other stressful situations include, but are not limited to: long hours; handling people’s attitudes; waiting for the next call and not knowing what the situation will be; and even politics within the department. Then, on top of it all, officers are frequently criticized, scrutinized, and investigated for decisions they make” said Michelle Beshears on the faculty at American Military University. Among police officers between seven percent and 19 percent of police officers experience symptoms of Post-Traumatic Stress Disorder, compared to 3.5 percent of the general population. A colleague and friend, Sergeant Mark DiBona retired from law enforcement in 2019 has had some difficult times on the job in Florida that effect him in a profound way. He is an strong advocate for law enforcement mental health and suicide prevention. “Until this day,” said Dibona, who admits to having contemplated suicide several times before he began counseling, “I can feel the warmth of that baby on my arm.” A child Mark believed he could save.