retirement

Stress awareness remains a key denominator for law enforcement for managing its malignant power to impair

Michael Sefton, Ph.D. Health Psychology, Human Behavior, PTSD, retirement, Stress , , , , , ,

WESTBOROUGH, MA September 23, 2023 – Police agencies across the country are looking for ways to mitigate the impact of accumulated stress associated with exposure to the worst of the worst of all human experience. These events happen everywhere and are unpredictable. “Arguably, everything from unattended death, domestic violence, child abuse, and a fatal motor vehicle crash can show up on the call board of any dispatcher on any day or night” according to Sefton, 2015. Career longevity and hardiness is essential for good law enforcement. There is a lot of training going on across the country emphasizing the importance of lowering stigma and bias against people with mental illness. Police officers and social workers are now found together in cars where mental illness is a suspected underpinning. The idea in not new and is known as jail diversion. For those with active mental illness diverting the citizen to behavioral healthcare is a better alternative than delivering them to the county holding facility. Programs for jail diversion are gradually making their way into small and medium sized departments across the country thanks to grants and political best practices. Gradually, the law enforcement field has had to look at itself and accept that when an officer is exposed to traumatic events over and over during his or her career, then we can expect that there will be an emotional response of some kind. That is a fact and impacts career longevity including physical and mental wellness.

Police officers are often hard charging men and women – especially right out of the academy and field training. They quickly go all in and no one wants to be seen as weak or unreliable. The field training is also being modified to allow officers to experience normal reactions to these early exposures. Things that can lead to stress and decreased efficiency as life circumstances change. Situations like marriage, children, buying a house, childcare, financial angst, you name it. Add to that mid-career professional jealousy and cynicism, career embitterment, resentment, staying current with court cases, mandatory overtime, holidays, and life becomes pretty hectic pretty quick. High stress situations require considerable time for all people to process. In law enforcement, time is something that is often a luxury. “Downtime is important for our health and our body, but also for our minds,” says Elissa Epel, M.D., a professor in the psychiatry department at the School of Medicine at the University of California at San Francisco. Some say that humans need 24 hours to process a high stress experience and return to normal balance.

“I have several posts that have brought up the human stress response going back to 2015 but there is plentiful research dating back 50 years or more on the human stress response and autonomic dysregulation. I believe strongly that unregulated sympathetic arousal can lead to a decline in physical well-being as the literature guides. The human cost of stress has been well studied and the effects of stress are a well-known cause of cardiovascular illness including heart attack and stroke and others.  It is now known that the brain plays a big role in all of this.”

Stress is a cumulative response to exposure to threatening, fearful, or chaotic scenes. It is especially important that cops are able to quickly assess violent scenes to provide best and most timely action. Active shooter protocols require that teams of officers are not distracted in their search for the shooter sometimes stepping over victims along the way. It can become very difficult unless they are disciplined. “Officers are trained to be vigilant and alert. The job demands it. But these expectations, mixed with chronic exposure to stress can make officers hypervigilant and hyperalert even during moments of calm. The stress of police officers doesn’t suddenly disappear when a shift ends” as reported in Powerline on Law Enforcement, published in August 2023. Whenever I have participated in an after-incident review or formal defusing/debriefing, I rarely have an officer raise his or her hand when asked “did any of you experience significant stress during this call?” That is to be expected to some degree. But honest reporting on call-related stressors like an officer involved shooting, fatal car crash, sudden cardiac event in another officer, or domestic violence homicide should leave any one of us in an elevated state of stress. This comes from the brains response to fear producing events that all human beings experience and takes as long as 24 hours to return to normal. Some say police officers can be taught to reduce the effects of high stress call to 60 minutes. The problem with that is that many agencies with high call volume do not have the manpower to allow one of more officers to sit on the sideline as their stress response slowly trends down to normal. Men and women in law enforcement are vulnerable to chronic stress and many do nothing to mitigate this vulnerability.

For career hardiness it is essential that law enforcement officers manage their stress. This means regular exercise, a healthy diet, and stress awareness and mindful lowering the body’s elevated fight-flight response. Especially after exposure to the gut-wrenching calls that regularly come across the police scanner. Well-established research has shown that low-level daily stress can create such intense wear and tear on our body’s physiological systems that we see accelerated aging in our cells, says Elissa Epel, M.D. who co-wrote the book “The Telomere Effect.” Epel added: “Mindfulness-based interventions can slow biological aging by interrupting chronic stress, giving us freedom to deal with demanding situations without the wear and tear — and giving our bodies a break” as described in the Washington Post article authored by Jamie Serrano on June 29, 2024. In my experience, the techniques of mindfulness have an appreciable impact on lowering self-regulation described in most literature. The drawback is a lack of carryover and minimal positive practice. It is not for everybody but it can be one part of a comprehensive goal of self-care and emotional resilience needed for long-term career success. The importance of this practice cannot be overstated when cops frequently jump from one call to the next. I offer individual biofeedback sesssions to lower the body’s sympathetic activation that often ramp up at times of threat. For many in law enforcement, the experience of being under threat never goes away. This can hurt.

In the Spring of 2024, I was involved in a Zoom presentation on the important ways to unpack stress and its cumulative impact on physical and mental health offered by Whittier Rehabilitation Hospital in Westborough, MA. Like everything in the new year, innovative ideas and habits are hard to stick with. But building discipline is easier when one becomes committed to educated on what stress can do to our bodies and committed to using our skills to limit the daily accumulation of adrenaline and cortisol and recognizing the signs of an abnormal stress response. Things like poor sleep, irritability, excessive use of alcohol or drugs, forgetfulness, overeating, lack of exercise, isolation, etc. We all do these things at times, we are human. But when you find yourself going off the rails, and are not taking proper care of yourself, it may be a sign of a growing stress response that may lead to depression, anxiety, and a host of physical conditions like hypertension, heart disease, stroke, autoimmune disorders, obesity, and diabetes. A balance of work and personal life should be part of any stress lowering plan. It becomes especially important to pull yourself back into your routine. Things like exercise, nutrition, mindfulness lowering alcohol intake, regular sleep, and maintaining family and social connections become key tasks to help you feel better and lower shame and guilt.

“If we perceive our available resources to be insufficient, along comes the ‘threat’ mindset. When threatened, stress has a catastrophic effect on our ability to perform. We receive an enormous sympathetic surge (adrenaline/noradrenaline dump), and our HPA axis pumps out cortisol. High cortisol levels have a very detrimental effect on higher cognitive processes – decision-making and prioritization” as described in a blog written by Robert Lloyd, MD.

I conduct pre-employment psychological screening here in Massachusetts. Men and women entering the field today are smart and well-educated. Academy curricula integrate behavioral health and officer well-being more than ever teaching students to utilize stress response strategies to lower the threat response sometimes aberrant in acute stress reactions. Agencies like the RCMP and the Finnish Elite Police service are using paced breathing techniques to quickly reduce the effects of high adrenaline that is a hindrance to physical and cognitive functioning. These techniques are easily taught and when learned, need little to no technology or equipment to implement.

According to Leo Polizoti, Ph.D., the primary author of the Police Chief’s Guide to Mental Illness and Mental Health Emergencies, and colleague, stress can lead to a breakdown in adaptive coping. “Learned resilience can be taught and leads to reduced stress and psychological hardiness rather than psychological weariness and burnout. Psychological weariness is a drain on coping skill and regular adaptation to job-related stress needed for efficiency for handling the everyday calls for service. Resilience and career satisfaction are important components of law enforcement and individual officer training, on-duty behavior, and career longevity. Positive resilience will reduce officer burnout, misconduct, and reduce civilian complaints against officers.

Some law enforcement officer deaths may be reduced by using a stress intervention continuum as a way to get out ahead of the buildup of stress. This program ties the range of calls into a stress reduction protocol that empowers resilience and recognizes the importance of stress mentoring and the soft hand-off for defusing the growing impact of high stress and high lethality exposure. If 10 cars are sent to a fatal automobile accident with entrapment, then these officers would be expected to participate in an after-action defusing of the incident. Those 10 units would also be coded with a level 1 call – highest level of acuity. This is easy technology and cars are often dispatched to level 1, 2, or 3 depending upon the severity of the call. It becomes an end-of-the-year task to see which officers have accumulated the highest number of Level 1 high acuity calls. Level 1 is highest priority and puts the officer at highest risk for exposure to traumatic stress and its debilitating impact.

The stress intervention continuum does not single out one officer but identifies all officers – including call takers, dispatchers, and supervisors for defusing particularly abhorrent events like mass shootings, domestic violence homicide, or fatal car crashes. This way, personnel who played a roll in a “bad call” will not be overlooked nor stigmatized for stress reduction defusing and/or debriefing. Chief Paul Saucier who is the interim chief of police in Worcester MA requires that officers attend a post incident defusing after major events with high lethality or particularly lurid stressors. Worcester PD is an agency with over 400 officers and may participate in this program. More agencies are beginning to utilize some form of online screening that officers may complete on an annual basis that measures perceived stress over the previous month. Chief Saucier and I have discussed options for on-line assessment and annual reviews. I have looked at the Perceived Stress Scale – PSS-10 for implementation.

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.

Analysis of Facts helps Reduce Harm to victims of DV

Michael Sefton, Ph.D. Bullying, Dangerousness assessment, domestic violence, Human Behavior, psychological relevence, retirement, terminal rage , , , , , ,
DOMESTIC VIOLENCE REVIEW BOARDS
WESTBOROUGH, MA  January 5, 2018 As we begin to make program recommendations for reducing intimate partner violence it is worth noting that change comes very slowly in protecting those who are most at risk. There is still a paucity of protective measures in place to assess and contain those who are most violent in our society. Retired New Braintree Police Sergeant Michael Sefton was in Augusta, Maine in October 2011 providing testimony about the results of the psychological autopsy conducted by Michael Sefton, Ph.D. Brian Gagan of Scottsdale, AZ, and Ron Allanach, Ed.D. of Conquitlam, BC, Canada and former Chief of Police Joseph Laughlin of Portland, ME.  Dr. Sefton, who holds a doctorate in psychology and is a licensed psychologist provider in Massachusetts provides neuropsychological and forensic consultation on domestic violence including domestic violence homicide and assessment of risk.  The report that was filed came up with over 50 recommendations directly related to reduced intimate partner violence. The report was cited over 12 times in a recent Maine Law Review publication on proposed Conditions of Bail. Little has changed in Maine since our first report in 2011 and there is no leadership to bring forth legislative dialogue.
PUBLIC INFORMATION
The testimony provided to the domestic violence review board offered details about a hideous case of family violence that ended with the homicide of 4 members of the same family and was culminated by an attempt to burn the bodies after the murders and the killer shooting at police officers responding to the missing victim. But they were too late. Their research was conducted over a 3 month period following the homicide deaths of Amy Lake and her children.  The team conducted interviews with over 60 persons with direct knowledge of Amy Lake, the victim, her two children, Monica and Cody, and the murderer Steven Lake.

Maine Law Review

“Although Maine’s statute lists these prohibitions, it lacks the enforcement tools to protect victims against violence associated with guns and other weapons, which is a major factor in Maine’s domestic violence deaths.” Nicole Bissonnette, 2012
HIGHEST RISK
Most researchers agree it is nearly impossible to predict when DVH will occur.  However, the psychological autopsy provides many obvious red flags that offer clues to an impending emotional conflagration or explosion of anger and blame.  The problem in the 2011 case was two-fold.  First, the requirement for bail was not seriously considered because Lake had no criminal history – and yet Mr. Lake had demonstrated an unwillingness to adhere to the legal mandates of the order of protection and violated the court order at least 4 times over the year before he killed his family. Given this unfettered lack of personal control, he should have been held for a hearing of potential dangerousness.  And secondly, the cache of firearms that Lake was known to have kept was not surrendered to police nor was an effort made to obtain the 22 weapons Lake owned by members of law enforcement. No one thought the guns would be an issue.
Many believe that when the victim indicates a strong fear belief that her spouse intends to kill her that risk of DVH is elevated exponentially and must be taken as fact. These often unspoken fears illustrate the need for supervision, assessment of potential for dangerousness and containment of PFA violators. Substantive red flag factors suggest a true risk of violence exists. The study also found that individuals with heart disease who are depressed will often have higher inflammation levels in their body. Many studies show that a combination of exercise and fatty acids, such as Omega-3 found in salmon, can reduce inflammation and consequently reduce bouts of depression and mood swings.In the sworn statement in 2010 for an order of protection, Amy Lake specifically reported that she feared that her husband might kill her. These fears of death would come to fruition one year later. And they did come true in despicable, horrific fashion.
It is not uncommon that red flags are often present early in the relationship as people reported during our research interviews during the psychological autopsy.  Many people we spoke to were aware something agregious was going to happen.  These include obsessional jealousy, threats of death, sexual aggression, unwillingness to integrate into extended family, any use of a weapon, and others.  In the course of their research Sefton and Gagan interviewed Dale Preston who was convicted of DVH in 1982 and served 18 years in Maine State Prison for the murder.  When asked what may have stopped him from killing his wife, Mr. Preston indicate “there was nothing that could have stopped me…”  In these cases, a greater awareness of risk or dangerousness is essential and in some cases a person must be contained for the safety of others.  Such containment requires NO direct contact with an abusive spouse, GPS monitoring, house arrest, or no bail imprisonment.
The case in Maine occurred in June 2011 – exactly 1 year to the day after the victim obtained a protection from abuse order from her husband.  The murders occurred 2 weeks before the divorce was to be finalized and were likely triggered by the abuser’s anger over not being permitted to attend his son’s 8th grade graduation ceremony.  The Bangor Daily News presented details of the recent psychological autopsy presented recently in Augusta, Maine.  Over 30 states across America have formal homicide review boards.  “To make this general deterrence aim successful, abusers must not have access to their victims nor to potential weapons, and the risk of punishment associated with breaking the law must outweigh the abuser’s urge to commit the conduct.” said Denaes, 2012. Bail is a judicial condition that allows a person to be released from jail with the promise to appear in court to answer to charges. Bail also provides for public safety by keeping violent offenders in jail when necessary.
I make an effort to review those published from New England states.  Vermont has an excellent annual report of domestic violence homicide and publishes all recommendations and changes in statutory requirements following individual cases of DVH.
Ronald Allanach et al., Psychological Autopsy of June 13, 2011, Dexter, Maine Domestic
Violence Homicides and Suicide: Final Report 39 (Nov. 28, 2011),
http://pinetreewatchdog.org/files/2011/12/Dexter-DVH-Psychological-Autopsy-Final-Report-112811-
111.pdf.
Nicole R. Bissonnette, Domestic Violence and Enforcement of Protection from Abuse Orders: Simple Fixes to Help Prevent Intra-Family Homicide, 65 Me. L. Rev. 287 (2012).
Available at: https://digitalcommons.mainelaw.maine.edu/mlr/vol65/iss1/12
Johannes N. Denaes, PUNISHMENT AND DETERRENCE 7 (1974) (“General prevention may
depend on the mere frightening or deterrent effect of punishment—the risk of discovery and punishment
outweighing the temptation to commit crime.”).
See id. at 34-35

“Under the Hitler Cross: The story of one woman’s life-long conscription”

Michael Sefton, Ph.D. aging and memory, Childhood violence, Human Behavior, retirement , , , ,

President Paul von Hindenburg
President Paul von Hindenburg

Lena told me she grew up in East Germany – behind the iron curtain from which she escaped when she was 33.  Her best memories were from a time when Hindenburg was the country’s president.  She lived in East Prussia near the Polish-Lithuanian border where most East Germans were Lutheran.  As children, they were made to stand under the “Hitler cross” each day before school and recite the Socialist pledge for nationalism that she cannot forget. She recites the narrative for me in her native German – translating the final few words into English – “the flag is more important than the dead” she mocked shaking her head. Lena had an unexpected and compelling history about which her doctors seemed unaware.

They were driven from their homes by the advancing Red Army during WW II in the 1940’s as millions were.  Yet, these East Germans were subjected to despicable atrocities most people are not aware of during the evacuation. “They took our homes. The banks were all closed. We had nothing” becoming tearful.  I bear witness to Lena’s personal memories – the narrative of her life living under the Hitler cross and the journey to America.

Now 91, she lives alone since her husband died over a decade ago. She lives 70 miles from her daughter.  I was asked to interview Lena and determine if she was capable of returning to her home alone after she sustained a fall and broke her humerus – the long bone in her arm. It was the second time she had fallen in the past year. I reviewed the chart and her nurse commented that she is noncompliant and suspicious somewhat randomly.  It was my role to provide an understanding of Lena’s cognitive status for the treatment team with some pithy explanation as to why she keeps falling and whether she can go home again.

Lena is frail in appearance and has a small frame.  Her eyes are hard and I cannot tell what color they are.  Her white hair is wispy, thinning.  She is sporting a blue sling that keeps her shoulder from moving. It is her dominant arm I note with some reluctance. Sadly, I wonder if the traumatic recitation I am now hearing may be a sign of the psychic unraveling that some elderly trauma survivors experience shortly before death.

As a consultant I try to remain dispassionate.  I need to determine her orientation, awareness of illness, capacity to concentrate, and review her gait training, balance, and daily carry over.  I find Lena hard to redirect but I need to respect the urgency of her thoughts while she painfully unburdened herself.  I am not optimistic about her returning home.

Moments of pleasure

Lena wants to go home so she can maintain her small garden in which she plants tomatoes and colorful flowers each year.  “People admire my yard and sometimes stop to take pictures of the flowers” she reports with a slight and hopeful smile.  She even boasted a one-handed technique used to plant her garden last year after suffering a shoulder injury in her first fall.  With her left arm she dredged an orifice just large enough for the seedling.  Then with the heel of her foot she covered and packed the plant with great acumen and apparently admirable results.  Resourceful and independent, I thought bringing new meaning to the green thumb adage.

Unfortunately for Lena, there is more than just making her garden she worries about. She is afraid about what might happen to her home when she isn’t there. There has been vandalism – “they painted the Hitler cross on my mailbox and house and broke my windows” she reported indignantly. “What can you do” her voice trailing off.  Once, she paid some boys to shovel the driveway.  They convinced her to pay them before the job was done and ran off taking her twenty dollars leaving only the snow behind.  The same thing happened with the landscapers who she had hired to rake the leaves this fall.  Can she go home again?  I could derive little experience of joy in her history – often an outward sign of depression.

Lena was raised on a farm, I learned. But she had a brief childhood marred by atrocity and abject savagery.  She was one of 9 children.  “We had horses and cows and an orchard” she reminisced. Lena was brought up Lutheran but had Jewish ancestry. “Her mother was very religious” she described.  Because they had property, landowners were expected to attend regular community meetings during which her father often spoke out against the government – against Hitler.  “They had an eye on him when he came home from the war” she reflected. “They came and beat him up once, she remembered – somebody told on him” referring to the time he spoke out against the war at the community meeting.  His battered and bruised body “looked like a rainbow” when describing his wounds. “Hitler did not grow up a German – he moved from Austria and promised to spread the ‘German way of life around the world'” she mused.  “All he did was invent the autobahn”, now her bitterness and mistrust began to show.

Traumatic Losses

Lena saw 15 members of her immediate family murdered.  Her father was shot to death in the orchard behind the family home when she was 9 years old by the German secret police because he spoke out against Hitler at a local meeting of property owners.  Her 7-year old brother was made to watch.  Her 4 older brothers were conscripts and died in the war. Lena said that her grandmother married a Jew.  He was very nice, she pleaded. Later, the family home was taken from them and the animals were killed during the evacuation of East Prussia late in the war.  By then she had already lost her parents.  Neither the Germans nor the Russians were humane to the native population of Lutherans and Catholics, and Jews.

After being forced from their farm, Lena was committed to a warehouse to live.  It was one big room.  She was made to sleep between similarly damaged souls – many who succumbed – leaving their postmortem remains for others to see.  She and her sisters were raped.  Elderly women were raped and murdered.  “People don’t know” she grieved now bearing witness to spectacles no person should ever see.  She described the dreams she has to this day – of being trapped in a room with no escape but would go no further.

I return the next day to see what carryover she has of our first emotional conversation.  I notice Lena sitting next to others in the community room – intrepid – yielding no outward sign of her inner torment.  She spoke to no one with a glower on her face that could dissuade even the most confident salesman.  She nodded and smiled slightly – faint recognition, I predicted. Uncertain. We agreed to meet again later in the day after bingo.  I had been strongly impacted by her disclosure and felt I needed to hear more.  What had happened to Lena since coming to America? Was she a member of her community? What kind of life had she built here in New England?

The promise of a better life brought Lena and her husband to America in 1952. She had one daughter.  Her Lutheran beliefs taught her the importance of helping others in her community – even neighbors on Cape Cod, MA where she still lives. But the efforts made by she and her husband were often not returned in kind.  People were not friendly and welcoming so soon after the war.

“My husband was a teacher in a technical school (in East Germany) and used to help the man who lived behind us when his car would not start” boasted the frail woman with a strong German accent.  Here she expressed her bitterness at being persecuted by those who were ignorant and prejudice against people who are different – perhaps more so toward immigrants from Germany when they first arrived after WW II. “Kids don’t know about it today” she complained.  She worried that the abject trauma she experienced during the second World War would one day become irrelevant – forgotten.

Secondary Trauma

The pain she felt in Germany was not eased by the democratic change of scenery. In fact, Lena herself was accused of killing Jews by a neighbor simply because of her country of origin.  Her daughter was bullied and abused between school and home.  The child’s principal refused to allow her to come and speak to the students to help them understand that she too had Jewish blood and had suffered unspeakably at the hands of the Nazi’s and those who drove them out.  She wanted to protect her only daughter from the hatred and vitriol and suffering she had endured.

“I am responsible for what happens here in school,” said the child’s principal, “not for what happens when she leaves the school grounds” in a despicable collusion of denial and lack of courage. More than anything Lena wanted to shelter her only child from the same truculence she endured and make a better life than the one she knew. She didn’t even know Hitler” she cried, now rocking slightly.

Lena described a time when her husband was burned by acid that had been mixed into the water he used to wash his hands while working a stint in a local automotive garage.  Afterward, he was sent to a physician who indicated the condition of his hands was a disease brought with him from their country in an outrageous distortion of the truth.

“You can complain to nobody” she bristled.  “The police don’t do anything” she bemoaned.  After her home was vandalized, one officer asked “What do you expect us to do sit in the driveway?”

Can Lena go home again?  I am sure Lena would love to return to the idyllic family farm with the orchard and horses the way she remembers it before the Hitler cross flew above her school yard. To visit with her large family before the time when her father was murdered and her windows were broken and her mailbox was disgraced with the Hitler cross. Who can you tell, nobody knows what happened anymore?

I cannot envisage a life-like the one Lena has had with its childhood trauma, loss, and recurring prejudice and persecution. Yes, I would expect that Lena is suspicious and mistrustful but she is not paranoid.  What would anyone do if they experienced the life events and atrocities experienced by this woman?  The emotional resilience Lena has shown raising her daughter and making a home for her family has inspired me to look at her differently than others might have done in my position.

Lena should go home and yet she is at risk of falls when alone. She has fallen and broken both the left and right shoulders – unsteady on her feet.  Her fear and anxiety stem from an underlying sense of vulnerability based entirely on her history of personal trauma and abuse while living under the Hitler cross. The reason for her noncompliance and emotional detachment are the predictable product of her early beginning in East Prussia near the border with Poland. It represents her fiercely stout-hearted spirit and enduring strength – features of the emotional veneer that are the underpinning of her being.  It would be wrong to remove her from her place of safety and take her from the garden she loves that brings her a few moments of joy each summer.  She feels pride in the tomatoes and colorful flowers she has grown for others to stop and see and sometimes even take pictures.

I return yet again to visit Lena and clarify some of her story and see how she is progressing. In what city did she live?How had she coped with the trauma of her life?  When I enter her room I notice an aide rounding up the sheets and blankets from her bed.  “She has been transferred to a nursing home,” he remarked without emotion. She had been discharged only a few minutes before I arrived.  Her doctor believed it was the safest thing to do. Her daughter agreed I suppose.

For whatever reason Lena felt safe enough in my presence to share the narrative of her life over the course of a couple of weeks.  I made an effort to deconstruct the mistrust she projected and summarily to lessen her emotional burden.  Arguably, I was unable to extract a pithy aphorism that would send her homeward based on my impression.  Yet I wanted to explain the rationale for her transfer.  I am sure she was dispirited about not going back to the Cape.  Again conscripted into battle over personal control and humility forced to sleep once more among the damaged souls. “Nobody knows what happened” Lena might say – but I do now.

IMG_4112
Michael Sefton, Ph.D.

Things of importance

Michael Sefton, Ph.D. aging and memory, Human Behavior, psychological relevence, retirement , , ,

WESTBOROUGH, MA November 30, 2014 A patient once said Dr. Sefton “don’t ever grow old”.  At the time I wondered what he meant.  The man was alert, physically fit and had a great support system. We have heard for years that today’s baby boomers are growing older. No kidding, I am one of them.  “People believe human touch and the relationships we forge along the way sustain us into our old age with a sense of well-being”  according to Michael Sefton, Ph.D., who provides neuropsychological testing for older patients.  Along the way the connections we make open our experience and our hearts. As people age, time begins to have greater significance – especially at the end of life. Some people say time moves quicker with age – especially when memory fades. Greater attention to things of importance must include keeping memory and history alive. Ask yourself “what do I value most?”  If the answer in your head is money, job promotion, or things like material objects then priorities may be outright misguided. Next, ask yourself how much dignity you might feel if you suddenly were made to feel irrelevant?  That is how may older Americans feel as they age and enter the “golden years”. Depression and loneliness are highest among people who are older and have become marginalized. This contributes to the inability to participate in their communities adding to feelings of loneliness and increased risk of functional decline and even early death (Singh, A. and Misra, N., 2009).

Cultures everywhere include senior citizens among the things that are valued and respected although this is not universal. Some believe that with age comes wisdom. Here in America, the population of older citizens will grow by a factor of 2 in the next decade or two. No society should discredit those who are older and may be stepping aside to a younger generation.  “Senior citizens, especially those who may be blind, deaf, immobile or senile, contribute less and require more care, which is likely unavailable” according to Discovery Health. The growth of older Americans has far exceed the growth of programs geared to help those in need. Why?

Retirement and aging

For those who are entering the last years of employment a sense of trepidation may confound their decision to retire. The age of retirement has edged upward largely due to financial need. People are constantly speaking out about the need to plan ahead for the retirement years. In a blog I wrote about police officer retirement the success a person feels in retirement depends upon how valued they feel in society (2014).  Many believe that older workers are more reliable and bring a higher level of maturity that benefits employers everywhere.  Others see the older worker as the greeter at the local box store – someone now irrelevant. The impact of this prejudice adds to a high incidence of depression among people over 65. The rate of poverty among older Americans is greater than 15-20 percent, according to Intergenerational Learning Service based in Illinois.  And the rate of grandparent’s who take care of their grandchildren has never been higher.  How is this scenario apt to impact human development for years to come?

A fundamental change in attitude must take place toward people who are aging here in America.  At the same time, a belief in lifelong learning and personal responsibility for health and well-being will give an older person an equal advantage for those who are aged and wish to continue being relevant.

Michael Sefton

REFERENCES

Singh, A. and Misra, N., (2009). Loneliness, depression and sociability in old age. Industrial Psychiatry Journal, Jan-Jun; 18(1): 51–55.

Sefton, M. (2014) https://msefton.wordpress.com/police-service/the-working-chief-a-job-greater-than-the-sum-of-its-parts/. Blog post, taken November 30, 2014.