Reactions Common to Surviving Victims of Traumatic Events

Post-Traumatic Stress Disorder PTSD is kind of anxiety that is triggered by a traumatic event. The person suffering from it may have seen or experienced an event that predisposed them to extreme fear, feeling of helplessness, or shock just like the officer was involved in the shootout event. Law enforcement agencies have increased the level of risk and stress due to nature of their work. An estimated 90% of law enforcement officers are affected by one or more stressful situations during their career (Brown, 2002)

It is important for law enforcers’ partners to behave appropriately in the field, be hard-working and dedicated people striving to serve the public and do the right thing every time (Roufa, 2016). The officer in the patrol has the highest marks ever in the academy with great civilian education in criminology. He is a well behaved officer with a staunch family, and is faithful to his wife and does not abuse drugs. He also knows the law and regulations by heart. Although the good work of law enforcement is rarely recognized, they should always be ethical. These officers are not expected to indulge into theft, misuse of public office, excessive use of force, speeding, and abuse of authority. Avoiding these unethical behaviors helps to win public trust. Law enforcers should practice the values of kindness, compassion, sympathy, empathy, honesty, integrity, bravery, and justice to guide them towards ethical behavior and ethical decision making. When officers commit crime, they erode public trust and degrade law enforcement’s ability to work within the community and carry out its mission.

According to research, most officers involved in shootings suffer post shooting trauma which is a stress disorder that may include guilt, depression and suicidal thoughts (Stratton, Parker, & Snibbe, 1984). They experience a range of psychological, emotional and physiological reactions that distort time, distance, sight, and sound that is why the officer was trying to scoot under the vehicle. Officers may suffer adverse reactions like sleep interruption, anxiety, depression, phobic avoidance, numbed responsiveness, impaired memory alternating with intrusive, disturbing images of the incident, irritability, impaired concentration, social withdrawal, hypervigilance, and substance abuse. In this case, the new officer started crouching behind the unit shaking, developed a flu, and he was screaming as a sign of stress and anxiety.

Two therapies can be used to treat the officer suffering from PTSD. Prolonged

Exposure Therapy involves forcing the patient to vividly remember every detail of the traumatic experience and verbalize the memories, for example, forcing the officer remember the shootout events. The idea is to relive the story at least five times in one session and then listen to his or her voice on tape-telling the story. It has been discovered that hearing the traumatic memory repeatedly neutralizes its power from bubbling up from the subconscious memory and catching one off guard (PTSD, 2013). Prolonged exposure therapy prefers starting with less distressing details and moving towards those that are more distressing. There are three main components of prolonged exposure therapy – breathing, sharing and listening, and “IN Vivo” Exposure. Breathing is a skill that helps one to relax. Controlling breathing can help to manage immediate distress in the short-term. Talking through the trauma and replaying the tape is also called imaginal exposure where one talks about the trauma over and over with the therapist. It helps one to get more control of thoughts and feelings associated with the trauma. Real World, “In Vivo” Exposure involves approaching situations that are safe, but also avoided because they are related to the trauma. It help trauma-related distress to lessen over time.

Cognitive Processing Therapy, is the second type of PTSD therapy. It begins with writing an impact statement and sharing it with the group. Participants work through the scenario to examine their guilt on other negative emotions. Cognitive processing therapy has four components; learning about your PTSD Symptoms, becoming aware of thoughts and feelings, learning skills, and understanding changes in beliefs.

Other Personality Disorders

Avoidant Personality Disorder

Individuals struggling with this disorder  lack self-confidence, feels inadequate in the social situations and avoid getting close to people and any type of interaction they believe will be uncomfortable or risky (American Psychiatric Association, 2013). Victims describe themselves as anxious, lonely, unwanted, and uneasy. They commonly present with signs and symptoms of Self-imposed social isolation, shyness and anxiety, feeling of inadequacy, hypersensitivity to criticism and rejection, mistrust, feeling inferior, low self-esteem, social isolation, feeling of inadequacy, and fantasy.

This type of disorder commonly occurs to people with a combination of social and psychological factors. People who suffered from Childhood emotional neglect and peer group rejection are also major culprits of avoidant personality disorder. This type of disorder can be treated using various techniques like social skill training, cognitive therapy, group therapy for practicing social skills, and, sometimes, drug therapy in the presence of symptoms like depression and anxiety where drugs like antidepressants may be used. Short-term and long-term hospitalization of these type of patient may not be necessary unless in the presence of chronic side effects which may warrant close monitoring by a profession.

Borderline Personality Disorder (BPD)

This type of disorder is also called emotionally unstable personality disorder. It is an abnormal behavior characterized by unstable relationships, emotions and self-image. Some people with BPD have high co-occurrence rates of mental disorders like anxiety disorder, eating disorder, mood disorder, substance abuse, suicidal thinking and behaviors, and suicide.

Signs and symptoms of borderline personality disorder include severe impulsivity, self-damaging behavior, dissociation, disturbed sense of identity, imagined abandonment and extreme reactions to such, chronic feeling of emptiness, stress-related paranoid thoughts, recurring suicidal behavior. Some of these symptoms may be experienced by people with mental health problems (Borderline Personality Disorder, 2011). Thorough assessment by a qualified mental health professional should be conducted to make a diagnosis of borderline personality disorder. Childhood trauma and congenital brain abnormalities are contributing factors to borderline personality disorder. Other cause are genetics like bipolar disorder, depression, and eating disorder. This occurs as a result of complicating factors of a shared family environment.

            Environmental and Social factors are also a major cause where most people with this disorder report to have experienced traumatic life events such as abandonment during childhood. The third cause of BPD is brain factor where patients have structural and functional changes in the brain. Many are the times this disorder is misdiagnosed but with good clinical assessment by a profession a diagnosis is made and a good management plan is made.

 Psychotherapy is the main treatment for borderline personality disorder where it is based on individual needs of the patient. Medication is also important in managing comorbid disorders like depression and anxiety, chronic feeling of emptiness, identity disturbance, and abandonment. Some medications includes haloperidol, Flupenthixol, and olanzapine.

Post-traumatic stress disorder is a common mental disorder experienced during different traumatic events like in shootings associated with law enforcement. Victims commonly present with irritability, anxiety, loneliness, unwanted and bad images among others. Proper assessment, diagnosis, and management of this disorder, psychotherapy being the main treatment, greatly helps in the recovery of victims.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.

Bisson, J. I., Roberts, N. P., Andrew, M., Cooper, R., & Lewis, C. (2013). Psychological therapies for chronic post‐traumatic stress disorder (PTSD) in adults. The Cochrane Library.

Gunderson, John G. (26 May 2011). “Borderline Personality Disorder”. The New England Journal of Medicine. 364 (21): 2037–2042.

Leichsenring, F., Leibing, E., Kruse, J., New, A. S., & Leweke, F. (2011). Borderline personality disorder. The Lancet, 377(9759), 74-84.

Roufa, T. (2016). Ethics in Law Enforcement and Policing. Criminology carrer.

Stewart, S. H., Ouimette, P., & Brown, P. J. (2002). Gender and the comorbidity of PTSD with substance use disorders.

Stratton, J. G., Parker, D. A., & Snibbe, J. R. (1984). Post-traumatic stress: Study of police officers involved in shootings. Psychological Reports, 55(1), 127-131.