Officer distress in Bangkok, Thailand

“Today police morale and emotional health have hit rock bottom, he said, because of a number of factors, including botched policy-making when it comes to their career path that doesn’t take into consideration the officer’s needs and desires.” Bangkok Post December, 2019

And the year 2020 was not any better and very likely triggered added stress and tension among the working wounded in Bangkok and beyond. Shortly after I visited Bangkok, in early 2020 a member of Thai Army service in the Northern Province went off and killed his superior officer and over 20 people in his community. Very rare in the Thai history. My former Chief and I had met another commander from the Northern Province detail and liked him a lot. He smiled and seemed confident before returning to the Northern Province. Gun violence in Asia is rare and mass shootings are more rare still.

Next came the virus. Thailand got out in front of the contagion and closed things down and required both social distancing and masks. The total number of cases per 100,000 souls is much less than here and most other places.

Meanwhile, Thailand is offering a softer, gentler service to those officers who sign on to be law enforcement officers trying to accommodate the needs of the police service.

Cumulative exposure to stress: The stigma of being human

The impact of cumulative emotional reactions and Post traumatic Stress Disorder (PTSD) has significant negative impact on law enforcement heartiness, job satisfaction and career success (Polizoti, 2018). 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. “Arguably, everything from unattended death, domestic violence, child abuse, and a fatal motor vehicle crash may show up on the call board of any dispatcher on any day or night.” Sefton, 2014. There is no doubt that police officers and first responders are exposed to experiences that are well outside of normal human experience. On top of this requirement many officers do not feel supported by the people they serve and worse, the leadership hierarchy within the agency.

Law enforcement agencies are looking for ways to reduce the human cost of the stress and trauma LEO’s experience on the job but eliminating this all together is likely impossible. This “roller coaster” ride is often why we sign up for the police service where one can have hours of boredom sprinkled with seconds of shear terror and exposure to viral human suffering.

It has been said that LEO’s keep their internal conflict and emotions to themselves always in check and under control. Some fear being perceived as weak and feel intimidated by seeking support for the behavioral health needs resulting from the job. Strength in silence is the archaic mantra lurking behind the blue line and may be the underpinning stigma at work. This stereotype has a significant impact on family relationships, work performance, and career longevity. It has changed in the past decade but very slowly and too many officers are suffering.

Just as we have seen in a subset of the returning member’s of the armed forces, LEO’s are taking their own lives as a result of the accumulation of stressful calls year after year coupled with an erosion of coping skills rendering them vulnerable to becoming hopeless, embittered, and angry. On top of that and perhaps most dangerous is a growing mistrust and perceived lack of respect and support from community leaders, citizens, and sometimes department leaders.

Bias refers to having expectations about a class or subset of people based on unrecognized and unsubstantiated prejudice. Among law enforcement there is a perceived threat of reverse bias associated with having an emotional reaction to the law enforcement experience – at least as far as the front line troops are concerned. There is sometimes an negative attribution associated with being on stress-related leave so many officers who need support do not seek help. Over time this takes a toll on officer well-being. The health risks from years of maladaptive coping to on-the-job calls for service can be insurmountable for some leading to substance abuse, depression, heart disease, and PTSD.

The upwelling of professional disdain toward the police and outright lack of support from the public arising from use of force and incidence of fatal officer involved shootings adds to the LEO “disidentification” with the police service. Once an officer has disidentified with the job he or she is vulnerable to a host of professional challenges associated with becoming at risk for career burn out and embittered.

“Pain is lessened by ceasing to identify with the part of life in which the pain occurs. This withdrawal of psychic investment may be supported by other members of the stereotype-threatened group—even to the point of its becoming a group norm. But not caring can mean not being motivated. And this can have real costs.” according to Steele (1999) who studied achievement in African American college students.

Whether one is speaking about academic achievement or career satisfaction and job performance in the police service “disidentification is a high price to pay for psychic comfort” according to Steele (1999).

The reason for this falls back to deeply held bias toward mental illness that cuts across all segments of society. But it hits particularly hard among law enforcement and first responders. This is especially true when a brother officer is silently suffering.

Elevated mental health distress includes suicidal ideation, anxiety, and depressive symptoms. Some LEO’s preferred to seek help from a chiropractor or physiotherapist rather than a clinician or mental health provider” which reveals the true extent of underlying stigma and bias (Berg et al., 2006).

Polizoti, L. (2018) Career resilience and hardiness. LEO presentation. Worcester, MA.
Steele, Claude (1999) Thin ice: Stereotype threat and black college students. The Atlantic Magazine.

Berg et al. (2006). Fighting Police Trauma: Practical Approaches to Addressing Psychological Needs of Officers

Police Training: Revisiting Resilience

What is resilience in police work?  Emotional resilience is defined as the the capacity to integrate the breadth of police training and experience with healthy, adaptive coping, optimism, mental flexibility and healthy resolution of the traumatic events. In general, resilient people are self-reliant and have positive role models from whom they have learned to handle the stressful events all police officers encounter.  In the best of circumstances officers are encouraged to share stressful events and debrief with peer supports that are a regular component of the police service.  Unfortunately, in spite of the availability of peer support many officers are hesitant to utilize and call upon their peers to help with difficult even traumatic calls like suicide and severe child or elder abuse.  One reason for this is a culture of internalizing stress until it whittles away career satisfaction and job performance.  The underpinning of police officer burn-out is the collapse of resilience and onset of maladaptive coping.
How many mid-career officers have reduced productivity and elevated stress that leads to increased use of alcohol, drugs, gambling, abuse of sick leave, and job-related injuries?  According to Leo Polizoti, Ph.D. resilience refers to professional hardiness that is protective against such career burnout and raises both professionalism and job satisfaction. Many believe that hardiness and resilience can be built and polished as the officer grows into his career.
Police training tends to be repetitive and often boring.  Officers train to attain a level of automaticity so that when field encounters become threatening they are quick to utilize tactical behavior in the use of force continuum.  Sadly, police departments everywhere have trained in the active shooter protocol so that when the call goes out every officer knows exactly what is expected of him or her.  By doing so the motor programs and cognitive maps coalesce into a tactical advantage for law enforcement.  Training also helps to reduce autonomic arousal and helps regulate internal levels of stress so that officers can function at optimal levels when needed most.
Just as it is difficult to identify mental illness in a civilian population until the person is off the rails, so too is it difficult to pinpoint a law enforcement officer who is struggling with the long-term effects of the high stress calls police answer on a daily basis. “Stress and grief are problems that are not easily detected or easily resolved. Severe depression, heart attacks, and the high rates of divorce, addiction, and suicide in the fire and EMS services proves this” according to Peggy Rainone who provides seminars in grief and surviving in EMS (Sefton, 2013).
High levels of stress are known to slowly erode emotional coping skill leaving a psychologically vulnerable person at higher risk of acting out in many ways including with violence.  The 2013 case of domestic violence homicide in Arlington, Massachusetts raises the specter of domestic violence homicide in police and first responders. In this case, a decorated paramedic allegedly killed his twin children, his wife and then himself. Outwardly, he and his family seemed happy. What might trigger such an emotional breakdown and deadly maelstrom?
“Although resilience — the ability to cope during and recover from stressful situations — is a common term, used in many contexts, we found that no research had been done to scientifically understand what resilience is among police. Police officers have a unique role among first responders. They face repeated stress, work in unpredictable and time-sensitive situations, and must act according to the specific departmental policies. ” Andersen et al. 2017
The career success they have may be directly related to the application of resiliency training to build and maintain physical and emotional hardiness that lasts a lifetime according to Leo Polizoti, 2018. Before this can happen the stigma associated with reaching out must be reduced.
Reduced stigma will afford officers the chance to express themselves, lower stress and tension, and seek peer or professional help when situations evoke or release the ghosts of cases past – often the underpinning of PTSD. This openness has not yet found its way into the law enforcement culture and while physical fitness has taken hold for career satisfaction – mindfulness has not become fully embraced.
REFERENCES
Andersen et al. (2017) Performing under stress: Evidence-based training for police resilience
Royal Canadian Mounted Police, Gazette Magazine Vol. 79 No 1.
Polizoti, L. (2017) Psychological Resilience: From Surviving to Thriving in a Law Enforcement Career. Presentation. Direct Decision Institute, Worcester, MA
Polizotti, LF (2018) Psychological Resilience : From surviving to thriving in a law enforcement career. Personal Correspondence. Taken 4-21-2018

Rainone, P. (2013) Emergency workers at risk. (website) http://www.emsvilliage.com/articles/article.cfm?ID=176. Taken 12-1-2013

On Police Identification of the mentally abnormal

How to recognizeWestborough, The police-mental health interaction continues to be one that neither party exhibit great confidence nor take great pride in.  Myths abound about how to treat those so afflicted – especially among law enforcement personnel. I have provided classes for LEO’s and generally they are not well attended and tend to bore the average officer. In Maine, LEO’s are required to have regular training in working with the mentally ill in order to maintain their LEO credentials. Other states in New England have similar requirements and now focus on psychological first aid and deescalation protocols.  I have presented on topics of assessment of risk and dangerousness with some success.  In- service training must be short and to the point or students will quickly lose interest.
The photograph above shows the cover of a guide book first written in 1954 that was instructional for police officers.  It was written to teach the law enforcement officers of the day to recognize signs of mental illness then defined as “abnormal people”.  It was written by 2 Louisiana State University psychologists and first used by a police agencies in the late 1950’s.  I have been trying to find a copy of this early version that was re-published in 1979 and now costs over $100.  It was written because police officers needed training and experience identifying features of psychiatric emergency. This was thought to reduce the uncertainty, fear and confusion around handling these cases by providing education including signs and symptoms.
After nearly 60 years, law enforcement is not significantly closer to understanding the mentally ill than they were in 1954. A colleague, police psychologist Leo Polizoti, Ph.D. has an original copy of this booklet although I have not seen it as yet.  Dr. Polizoti provides consultation to law enforcement, officer selection interviews, and teaches a proactive approach psychological resilience to police officers that can afford them greater career satisfaction, professionalism, and longevity. Dr. Polizoti is tasked with supporting officers who are exposed to the daily grind of violence, suicide, homelessness, and its cumulative impact on a cop’s personal narrative.  His model suggests a fundamental change in how police officers interpret their experiences over time and acceptance of what cannot change and healthy adaptation.  He is a great asset to the Central Massachusetts community and across New England and espouses a model of stress resistance through adaptation.
“In 1954, the National Association for Mental Health first issued the book “How To Recognize and Handle Abnormal People: A Manual for the Police Officer.” Included were techniques on dealing with all kinds of “abnormal persons,” from psychopaths, drug addicts, and the “mentally retarded” to civil protestors and those involved in family disturbances.”  Posted by David Pescovitz, 2015
Text from 1954 How To Recognize and Handle Abnormal People: A Manual for the Police Officer is provided below.  It points out many of the outward signs of disturbed thinking often an underlying feature of those with mental illness – in this case something called ideas of reference. These signs are common among persons with early paranoia and are sometimes missed – even by members of the immediate family. This is still a common symptom of mental illness today and is considered to be the prodrome to a more serious loss of contact with reality. Ultimately, it comes down to who is at more risk for violence?  And how can we be sure?
It takes a healthy and educated police officer to observe, understand, and control unpredictable situations. Officers are required to adapt to the demands of individual calls for service.  A colleague Dr. Leo Polizoti has identified a model for coping with the strain of police service.  He cites the importance of avoiding apathy, withdrawal and bitterness on the job.  “Understanding the 3 C’s of hardiness, Challenge / Commitment and Control will assist officers to manage stress more effectively, resulting in fewer emotional and medical problems. By viewing each new situation as a challenge, instead of a threat, you become committed to that challenge. You can readily see yourself in control and better able to deal with the situation. You will enhance your “hardiness” or resistance to stress” Polizoti, 2018.   
“He may think, for example, that announcements made over the radio have something to do with him personally. He may even hear his name mentioned. These are called ideas of reference which, of course, means that the patient thinks people are referring to him in one way or another. In the beginning, ideas of reference may occur only occasionally, but they gradually become the rule rather than the exception, and finally they may develop into definite delusions of persecution or grandeur.”
The list below are the signs of “abnormal persons” that are printed in the booklet published in 1954:
  • He shows big changes in his behavior.
  • He has strange /losses of memory, such as where he is or what day it is.
  • He thinks people are plotting against him, or has grand ideas about himself.
  • He talks to himself or hears voices.
  • He thinks people are watching him or talking about him.
  • He sees visions or smells strange odors or has peculiar tastes.
  • He has complaints of bodily ailments that are not possible.
  • He behaves in a way which is dangerous to himself or others.
Interestingly, the bullet points above remain accurate today with the understanding that too many individuals suffering with a major mental illness also have substance abuse/dependence.  It is this fact that confounds most LEO – mentally ill encounters.  “Beyond the rigors of police work, lie the demands of a personal life, specifically a wife or husband and children. Maintaining a healthy and happy family life is on its own a demanding responsibility. Add these powerful life stressors and demands to the burdens of police work and  an officer may begin to feel the weight upon his or her shoulders.” Polizotti, 2018.  Emotional and physical strength and endurance requires hardiness that comes from personal responsibility and comittment to excellence and peak performance.  Greater focus on sobriety – including opioid and alcohol dependence is essential. If this can be maintained mental illness may remit to the extent that subjects can remain in the community. Programs like A.A., N.A., and other 12-step groups are free and often afford subjects great support.  In most cities there are 12-step meetings every day morning, noon and night.  The problem is getting people to realize they have a problem.  Even airports hold A.A. meetings for travelers in need of the 12-steps. We are working on a replacement manual like the one cited in this post.


Polizoti, L. (2018) Personal Life Demands. Presentation – Direct Decision Institute.
How To Recognize and Handle Abnormal People: A Manual for the Police Officer (1954) Matthews, R. M.D. and Rowland, L. Ph.D. NATIONAL ASSOCIATION FOR MENTAL HEALTH, INC. 10 COLUMBUS CIRCLE, NEW YORK 19, N. Y.

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From anonymity and stigma grows resilience

Today there is still a great deal of stigma associated with reaching out for peer support within police departments. Officers’ fear being misunderstood and seen as weak if they acknowledge their vulnerability years into the job. The blue line bleeds each time an officer takes his or her own life yet the silence within the ranks is stunning. An officer may act heroically in their efforts to save a child who isn’t breathing and fail.  An officer may be first-in to a call for domestic violence homicide and fail.  An officer may be dispatched to a horrific motor vehicle crash and come upon an overturned minivan with a shamble of entrapped human misery and death and still feel a failing.  These events create a chink in the armor and sometimes reveal gaping personal anguish that accumulates over time. The cumulative impact of trauma adds to the layers that belie the outward calm.  As a former police officer there are calls I covered that are painful to this day. Abject failure. Exposure to subclinical, traumatic events takes a toll of both physical health and emotional wellness and can lead to PTSD, secondary traumatic stress disorder, and burn out.
Prevention of law enforcement suicide is paramount.  As recently as early November, 2018 a former police chief died by police assisted suicide killed by his former officers after charging them with a kitchen knife.  And in Baltimore County, MD, School Resource Officer Joseph Comegna, a 21-year veteran of the force, took his own life at his desk in the public school.  “And unlike line-of-duty incidents, which tend to receive a great deal of media coverage, law enforcement suicides rarely get much press, says Al Hernandez, a 35-year veteran of the Fresno Police Department (FPD) in California. Hernandez helps connect officers to mental health care.” according to Jack Crosbie writing in Men’s Health about a suicide death of an NYPD officer who died in early 2018.
The impact of stress on the lives of LEO’s is well known and can have pervasive impact on officer well-being both in and out of uniform.  Hypertension, cardiovascular disease, substance abuse, and depression are just a few of the behavioral health consequences that may result from repeated exposure. Ongoing vulnerability to traumatic events can result in anger, resentment, strong negative emotions, and reactive embitterment that can erode job satisfaction and job performance (Sadulski, 2017). Critical Incidence Stress Debriefing plays an important role for police by helping LEO’s manage their trauma and post-traumatic stress. It should be provided as part of an integrated system of peer support. Most departments have officers trained in CISD whom provide peer support to brother and sister LEO’s who are in crisis. Key among these relationships is the hand-off to mental health professionals when indicated. Peer support is not treatment and the relationship between the peer support and psychological treatment should be clearly defined.
Each of us in law enforcement has a duty to reduce suicide among the men and women in blue whenever possible. This requires a substantive understanding of the risk factors associated with LEO self-destruction. Chief among law enforcement is the camaraderie that bonds officers together during times of stress. Peer support is a key factor in reduced emotional suffering among law enforcement officers. 
Risk factors for suicide increase when the conventional need for belongingness among law enforcement officers which is thwarted by the estrangement or isolation.  This comes with individual officer discipline, e.g. suspension, or some other factor pushing him/her out that can be isolating and evoke feelings of thwarted belongingness according to Thomas Joiner (2009). Social alienation is a powerful emotional dynamic that results from the experience of being estranged from a core group of supportive friends, colleagues, and immediate family. This occurs in many ways including change in social reciprocity and reduced exposure to primary interpersonal ties resulting in powerful feelings of loss and growing belief of being a burden. This may be the result of disciplinary actions toward the officer, on-the-job injury, or departmental requisite following officer-involved use of force. 
Embitterment has large implication on LEO productivity, career satisfaction, job performance, citizen complaints, and officer health. It grows slowly as a function of career experience perceived support, and critical incident debriefing and peer support are vital to officer longevity.  Mentoring in the field and supervisory support reduce officer isolation and sometimes powerful feelings of negativity that can fester over time according to Polizoti, 2018.  Ostensibly, resilience is the opposite of embitterment. Have you ever worked with someone who rolled with the punches – literally and figuratively?  They can have felony cases dismissed in court and remain nonplussed maintaining a positive attitude and a “better luck next time” belief system.  
Lethal Self-Injury – Acquired Ability
The final risk factor involves a gradual desensitization to pain and human suffering according to Joiner (2009). Over time, exposure to repeated violence, homicide, intimate partner violence, and other “salient fearsome experiences”, the self-preservation instinct gradually disintegrates into a residual fearlessness in the face of life threatening danger and an acquired capacity to ignore the horror and humility of violence with a higher tolerance of pain and substantive capacity for suicide (Joiner, 2007).
Joiner believes that the capacity for suicide is acquired over time from the repeated exposure to trauma such that the reaction to horrific traumatic events, e.g. domestic homicide, loses the ability to evoke a normal emotional response and habituates to a decreased emotional reactivity, a higher tolerance for pain, and a fearlessness in the face of death. Given this proclivity toward feeling “numb” in the face of high levels of violence, over time researchers look for protective factors such as reducing isolation and more frequent debriefing after every critical incident rather than wait until LEO coping goes the way of attachment and perceived support. 

References
Sadulski, J. (2017). Promoting Police Resilience through Peer Support. Law Enforcement. Blog post taken November 20, 2018
Joiner, T. (2009). The Interpersonal-Psychological Theory of Suicidal Behavior: Current Empirical Status. Science Briefs, APA, June.
Polizoti, L. (2018) Critical incident resilience training. Personal correspondence, September.

 



The Alpha Male: leadership, mentoring and new age behavior

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Michael Sefton, Ph.D.

Westborough, MA July 2, 2014  By definition the alpha male is the most dominant and powerful in the group.   New age leadership requires flexibility and fluid leadership that must adapt to the needs of  individual officers and meet the needs of a heterogeneous group.  The most successful alpha males may be those that hold back and allow individual officers to define their response based on the tactical scenario encountered rather than a single response template.

A new officer was dispatched to a vehicle on the side of the road with one male sleeping or unconscious behind the wheel. It was after midnight.  His response was aggressive and unidimensional while making contact with the sleeping motorist.  As a precaution the dispatcher had called for the fire department and EMS to roll on the call in case there was a medical emergency.  The officer had been taught to modulate his patrol presence in accordance with situational demands but in this case he did not.  Known as verbal judo, police officers use these verbal strategies during interviewing to maintain control of chaotic scenes.  This scene was neither chaotic nor demanding.

I was told that the bellicose police officer could be heard yelling at the motorist – telling him to “leave his town” and he should be aware of the commotion he had caused by sleeping on the side of the road.  Given that no alcohol or drugs were suspected there was no need for the motorist to be admonished as he was.  Arguably, the motorist should have been praised for his decision to pull over when tired rather than risk a crash by falling asleep behind the wheel.  These kinds of aggressive verbal encounters needlessly put people on the defensive and do nothing to enhance citizen-police relations.  They represent an attempt at controlling a scene when it was clearly not confrontational and therefore unnecessary.  Some believe this kind of verbal banter does more to inflame a scene than to achieve the desired disarming needed to assure the scene is safe.  The patrol presence illustrated in the scenario above reflects an anxious and inexperienced officer who used the color of authority to unfairly intimidate the motorist setting the community policing ideal on its heals.  This kind of response sets a tone for adverse citizen encounters that must be addressed during the field training period – well before he is on his own.

Police officers are taught verbal judo – a technique used to deflect and protect officers who encounter a verbally aggressive complainant, victim, or even fellow officer.  It works with all kinds of interpersonal conflict but is thought to provide tools for police officers to maintain their authority at all times.  Verbal judo is defined as a method of interviewing that takes advantage of the training in verbal discourse and conflict resolution.  Some call it martial arts for the mind that meets verbal aggression with empathy and disarming tactics such as nondefensive recognition of the point of view being thrust upon you.  The case presented was neither hostile nor threatening and should not have been met with the antagonism demonstrated by the officer.  During the field training the inexperienced officer may have been corrected for such a response.  The field training supervisor may have modeled the appropriate handling of the incident using empathic recognition of the plight of the sleepy driver sandwiched into the corrective intervention needed by enforcement of the town by-laws that state “no overnight parking is permitted on town roads”.

The purported competition for “alpha” male status belies most citizen contact as if each encounter calls for one person to win and one person to lose.  It need not be this way.  The animal kingdom bears witness to conflict over alpha male status almost everywhere.  In many instances frank disrespect for the alpha role has led to bloodshed and turf wars in American cities from coast to coast.

There is contemporary leadership emerging among new officers that comes in the form of mentoring and active field training.  The model takes its pages from theories of community policing.  There is no room for conflict over the alpha role and the days of “taking names and kicking ass” are over.  The real battle should be waged over which male is comfortable in a shared alpha role or better still – which male can mentor a young man ultimately handing over the alpha role while at the same time maintaining a cohesive sense of self-respect, firm authority, and an empathic regard for those who might be king.