Fight-flight response

Covid-19 pandemic: No more important time for resilience

Michael Sefton, Ph.D. Corona virus, crisis intervention, Firesetting, Health Psychology, Human Behavior, PTSD, Stress , , , , ,

It has been frequently mentioned that exposure to death and uncivilized brutality has an impact on wellness and personal resilience. Not a surprise. Especially in these pages, I make an effort to point out that the cumulative impact of traumatic exposure slowly whittles away one’s capacity for mental health, empathy and emotional efficacy. “There is a relationship between the severity, frequency and range of adverse experiences, and the subsequent impact on mental health.” (Dillon, Johnstone, & Longden, 2012). The conundrum has always come down to just what constitutes a “traumatic” event in childhood? Sometimes there is no single identifiable event that a child brings forth that may later become a trigger of serious emotional instability later in adulthood.

The Covid-19 virus has the potential for creating traumatic events depending upon the degree of exposure and a child’s understanding of the narrative brought forth by parents and other trusted adults during the pandemic. “Over 30 percent of Americans know someone who has died or been infected by the virus. The fallout to mental health from the coronavirus is real. I see it in my own family as nerves become frayed 8 weeks on.” according to the blog post from May, 2020. Trauma informed therapy supports the model of early traumatic experience being the underpinning of many mental health outcomes we see later in life. The biopsychosocoial model identifies physical abuse, sexual abuse, exposure to violence, chronic substance abuse as the substantive reasons for many mental and physical illnesses years later. When we look in the rear view mirror at this virus we will see the litter of emotional wreckage that may leave its hooks in many people around the globe.

Coronavirus. Ise.ac.uk

There is a relationship between the severity, frequency and range of adverse experiences, and the subsequent impact on mental health.

(Dillon, Johnstone, & Longden, 2012).

“The more adverse events a person is exposed to in childhood, the greater the impact on physical and mental health and well-being, with poor outcomes including early death” (Anda, Butchart, Felitti, & Brown, 2010; Anda et al., 2006; Felitti et al., 1998). There was a time in my training that I collected data on childhood fire setting and the psychodynamics of pyromania. I saw 50 children in my fellowship year who came because of fire setting. Without a doubt, there was marked early instability in the childhood homes in these kids that likely germinated into fascination with fire play and perhaps more directly, physically aggressive behavior. Many of the children I assessed were suffering from early onset trauma.

Depending upon the age of onset using fire as an expression of internalized conflict suggests a serious emotional disorder in need of expert assessment and treatment. The interest in fire may appear normal but slowly interest foments in homes where a prevailing emotional vacuum permits – decreased emotional warmth, access to fire starting materials, an absent parent, and frequent domestic violence.  

The inconsistent and unpredictable exposure to violence contributes to excessive and unpredictable behavior as children become adults. Often without direct knowledge of a specific trigger, trauma activates brain circuits that drive fear and emotional behavior including substance abuse, domestic violence, and assault. What is more, these absorb community resources as psychological needs grow.

The coronavirus has profound impact on the emotional stability of people around the world because of its unpredictability and lethality. It evokes fear, and uncertainty as it spreads unchecked. Later, the virus can serve to trigger long hidden memories in a way that can sabotage healthy human development leading to vague anxiety, physical symptoms, loss, and deep despair.

Scott D. Jones of Arlington, MA was a decorated paramedic who responded to a mass homicide in 2000 in which 7 people were shot in an episode of workplace violence. He would go on to kill his second wife and 2 children 14 years after repeated episodes of severe depression and suicidal behavior and domestic violence toward his first wife.  These behaviors were the first red flags of an impending emotional breakdown and terminal rage. Paramedic Jones certainly had problems but the repeated exposure to trauma – especially the mass shooting, activated his fight-flight response intolerably and may have been one of the demons he faced in the end.

Michael Sefton, Ph.D.

Trauma can be triggered by loss due to Coronavirus in two ways. First, by direct contact with a family member who is hospitalized and may have died. Nearly every person who contracted the virus had someone left behind that was worried about their health and eventual recovery. Many had family members who communicated with patient via text messaging and FaceTime – until the loved one could no longer do so. Families relied on the updating calls of first responder nurses, chaplains, social workers, and physicians.

Next, through secondary exposure to similar cases and media coverage that assails efforts at closure and engrains the narrative of fear, guilt and shame by reporting ever increasing case numbers, hospitalizations and deaths survivors are left feeling numb and unable to mourn. Funerals were deferred or could not be held at all as some jurisdictions required the cremation of the remains of coronavirus victims. This has a negative impact on survivor health and well-being often evoking a religious and moral crisis of faith. Survivors have enormous guilt and sadness not being with a loved one who died from the virus or waiting to go for medical at the onset of symptoms. They mourn to mourn and are left feeling numb at the lack of closure.

So whether it is early trauma associated with domestic violence or trauma from repeated exposure to work-related experiences, there is a resilience that resides within most people that guides the rise from being overwhelmed again and again to move forward with courage and hope and feelings of hardiness. These are learned responses to high stress events like a pandemic, but people who are positive thinkers, optimistic, physically fit and emotionally insightful rise up, controlling the lives they lead.

We are offering a zoom platform event entitled The Psychological Impact of the Cornavirus Pandemic: Common sense answers on November 11, 2020 at 5:30 EDT and again in December 10, 2020 at 7 PM. It is free and to be sent the zoom link contact: jswiderski@whittierhealth.com or call the Whittier Rehabiltation Hospital at 508-870-2222 in the U.S. If you plan on attending the 12/10/2020 session please drop me an email at: msefton@whittierhealth.com

Michael Sefton, Ph.D.

Another look at self-destruction in law enforcement and its septic underpinning

Michael Sefton, Ph.D. Field Training Officer, Health Psychology, Human Behavior, Police officer behavior, PTSD, Stress , , , , , ,

This is a photograph produced by Dave Betz who lost his son (pictured) in 2019 to suicide.

Officer Dave Betz lost his son David to suicide in 2019

The code of silence.  It surrounds the culture of police work and always has.  I was once told there are two kinds of people: police officers and ass holes.  If you were not a police officer then you were an asshole.  It was a brotherhood with a formidable blue line that defined the police service as a singular force against all that is bad.  Some have said that law enforcement offers a front seat to the greatest show on earth.  Until what is viewed in the front row cannot be unseen and slowly chips away the veneer of solidarity by threatening the existing culture.  For police officers to have long term career success the organization must come to grips with its membership and relieve them of the stigma they feel that prevents them from coming forward. Who would go for that?

If the organization devalues its rank and file for experiencing the natural, neurobiological reaction to repeated, high lethality exposure to violence and death, then who would join such an organization?  Fewer and fewer applicants are signing on in 2019. If a police officer is emotionally denuded by the job why would he or she step up and break the code of silence and be labeled a “nut case” only to lose his badge, firearm, and police authority?  No one will sign on for that kind of treatment.

Each time a member of the law enforcement community takes his or her own life the unspoken silence becomes a lancing wound to the festering emotional infection that is from repeated exposure to traumatic events. The reappearing wolf in sheep’s clothing cuts his teeth on the souls of unwavering academy graduates now paired with senior field trainers who promise to teach the tricks of the trade. Academy graduates come forth like professional athletes with all the confidence and enthusiasm of an elite athlete.  They need experience and mentoring so they know what they are up against.  I was asked to speak at the annual Society of Police and Criminal Psychology meeting in Scottsdale, AZ in late September, 2019 on the importance of the field training program on long-term officer wellness and career satisfaction.

Country music blared from the car radio as Dave, dressed in pajama pants and a t-shirt, stood over his son and realized he was dead.

Father of 24-year old police officer David Betz, 2019

The psychological autopsy may provide insight into the manner of death and must include prior exposure to trauma.  How many first-in homicide calls had the decedent handled? How many unattended SIDS deaths?  How many death notifications? How many cases of domestic violence where the victim was too frightened to speak about the nightly horrors in the marital home? How many times did he witness the remnants of a violent motor vehicle crash with ejection?  Each time he bears witness to this inhumanity he risks never coming back. Some spouses will say they remember when they lost a husband or wife. “It was after the 4-alarm fire – sifting through the rooms for possible causes and finding the old woman who rented the place in an upstairs bathtub” or “the time the addict threw his newborn son off the 14th floor balcony because his baby mama did not return from work when she was expected.” Many espouse the use of the psychological autopsy as a way of honoring an officer who died by suicide as a means of linking the suicide to their tour of duty. 

High lethality calls must be tracked allowing for paid psychological defusing time in the aftermath of these calls.  Defusing and psycho- education can be provided for the entire group who handled the high lethality call rather than identify a single officer.  Aftermath check-ins and peer support should follow. An officer who begins to exhibit changes in his normal work routine, e.g. increased tardiness, citizen complaints, or substance abuse should be referred for psychological follow-up that is linked to annual performance reviews and recommendations for corrective action.

In truth, the reader may wish to put himself into the position of the first arriving police officers at Sandy Hook Elementary School in a place called Newtown.  In December, 2012, twenty seven people were violently murdered – most were first grade students. I have read the Connecticut State Police report of the Sandy Hook shooting and was left feeling numb and physically sickened. It is over 1000 pages of grueling detail.  Now, when I see TV images of LEO’s running on campus toward the sound of gunshots, I know they must step over the desperate victims, some of whom take their last breath reaching for a pant leg or a blue stripe or a black boot covered in blood all the while begging to live.

Recruits enter the police service with high hopes of making a difference but quickly learn that their purpose in life is being sucked out of them like embalming fluid moving though the lifeless remains of a brother or sister officer who could endure no more. Coming forth and asking for help is not a sign of weakness but a sign of strength, resilience, and heroism. There should be no penalty or secondary administrative sanction when an officer comes forth.  They must be provided behavioral health treatment and a pathway to return to the job.  

Police officer suicide impacts police agencies everywhere in America and across the globe. Many officers feel abandoned by their agencies and become marginalized because they struggle with depression, substance abuse, and PTSD after years of seeing the worst life has to offer. It is time to lessen the expectation of shame among the troops who serve communities large and small. No father should be first in at the suicide death of his own son and be expected to stand with a photo and share his story at the same time he remains stoic and brave.