Trauma Counseling Varies Among Emergency Workers


 
 

Bailey Davis | | Monday, March 17, 2008


CHEYENNE, Wyo. -- Statistically, law enforcement officers are more likely to die by suicide than in the line of duty.

For first responders, the hours or days after a traumatic event used to be filled with paperwork and a few beers with the guys. Today, for some, the days after a traumatic event also can include counseling.

Ask them about their worst day on the job, and most first responders will tell you about the time a baby died while they performed CPR, the time they responded to a car fire where the driver was burned beyond recognition, the night they had to listen to threats on their family or the three-hour-long gun battle with a suspected murderer.

While some first responders are able to shrug off those situations as part of the job, others might want to seek counseling. But many believe they'll never live it down with the guys back at headquarters.

Family pressure

"I talk to my family (about problems at work)," Cheyenne police officer Jon Allen said.

"Probably my wife needs to go to counseling," he joked.

At 8:30 every night that he is able, Allen takes a break from patrolling to go home and say goodnight to his 5-year-old daughter.

The trauma and stress does take a toll on police officers, he said.

"In the grand scheme of things, that's probably why there is so much alcoholism and divorce in law enforcement."

The Cheyenne Police Department doesn't have a specific counseling program for its officers, Allen said.

Counseling is offered through their health insurance, but he doesn't see many people using it.

And even if a more extensive program were available, there is a stigma attached to counseling, he said.

"Most cops will not do it," he said. "They would have to be forced."

Allen's windshield camera caught video of a woman he arrested for a hit-and-run accident in Cheyenne. The woman was drunk and yelled strings of profanity at him.

As he drove her to the jail, Allen calmly turned up the music in his patrol car and turned the camera around to face her.

"I have Hepatitis C," she yelled from the back of the car. She spit on the glass between them. "Now you can give it to your wife."

"I'm going to laugh when you get killed. I hope your kids know how you got killed."

A thick skin

Cheyenne Fire and Rescue firefighters live in a relatively constant state of flux. One minute they might be cooking dinner, cleaning the firehouse or relaxing in a recliner. They might even be fast asleep in the middle of the night when that alarm goes off. Within minutes, they're halfway to the fire that everyone else is running away from.

But that doesn't happen in Cheyenne very often.

They run to calls that turn out to be false alarms: a faulty hydrant, a false fire alarm or someone who looks hurt but turns out to be napping in the park.

They go out on a lot of medical calls, like injuries or escorts from doctor's offices to hospitals. But 90 percent of those patients could probably drive themselves to the hospital, said firefighter Ryan Hammeck.

They end up hoping for a fire, because that's what they train for. They never wish injury or pain on anyone, but they do enjoy their job, which includes using the training they've received.

"It's the best job I ever had," Cheyenne firefighter Will Fiscus said.

But not every day is a good one. Fiscus said he once had to perform CPR on his friend's 18-month-old daughter.

"She didn't make it," he said, staring into the giant pan of ground beef he was making for dinner at the house. And that was hard, especially because she was a child and because he knew her.

But "99 percent of the people you don't know from Adam," he said.

First responders develop a thick skin, Fiscus said, and the stress and bloody scenes don't really bother him.

Responding to a child can be tougher. A call of a choking child will get your blood pressure up, he said.

Fiscus said he doesn't feel a huge need for counseling because of the low call volume they have. "I can't remember the last cardiac arrest I ran," he said.

Besides that, there's a stigma about going; a sort of "macho" thing, he said.

Counseling might be helpful, he added, but, "you can't force somebody. It's got to be up to the individual. Everybody handles stress in their own way."

Getting rid of it

In 1985, Wyoming Highway Patrol Trooper John Jerkins spent three hours in a gun battle with a murder suspect who had committed armed robbery, shot a deputy and shot several other people.

Jerkins was almost shot and killed more than once during the incident, he said.

Seventeen years later, he approached a psychologist to thank her for her work with a friend of his.

She asked him how he was doing, and "all my innards just jumped," he said. "I had a violent physical reaction to that question. She said, 'Maybe you need to come see me.'"

Today, Jerkins said, he is glad he did. He learned that the 17-year-old gun battle had been ruling his life.

"I didn't even know that it had taken over a lot of aspects of my life," he said.

He used to have nightmares and used to be angry, irritable and stressed, he said. Doctors told him he was headed for a stroke or a heart attack.

After counseling, "I'm a lot better man than I was." Even Jerkins' father is glad that his son is a much more laid-back guy now, Jerkins said.

Today, he is very vocal about recommending counseling for first responders.

Until recently, "nobody knew you could get rid of (the pressure). You just learned to live with it," he said.

"Sometimes you have to put your emotions in your pocket. But most people don't bring them back out. You've got to get rid of that stuff," Jerkins said.

Describing a situation he had seen, Jerkin said: "You can't be at a crash scene with a dying father telling his daughter goodbye, with two dead sons laying on either side of him, and not be affected by that."

A solution exists

While it seems only natural for a civilian to seek counseling after a traumatic event, often first responders just chalk it up to being part of the job.

But the Wyoming Highway Patrol has found another solution. Major Keith Groeneweg, support services commander at the patrol, advocates the program that the patrol has implemented.

"It has saved a tremendous number of careers in this agency," he said.

It's a three-part program: Family Support Network, peer support and counseling by a professional.

The Family Support Network consists of spouses, children, parents, siblings or other family members of the troopers who support each other.

Groeneweg described an incident when a trooper died of a heart attack. He said the Family Support Network made sure the house was cleaned, took care of the yard work and made sure the refrigerator was full of food.

They even came back to be with the trooper's wife when his uniforms were removed from the house.

"We really do pride ourselves on being a family," Groeneweg said.

The peer support segment is a group of trained troopers who go to the scenes of critical incidents and help fellow troopers think through what happened.

When there's an incident where an officer has to point a gun at someone - even if it's never actually fired - that can shake people up, said Mike Ritter, a state trooper and member of the peer support program.

"We don't just point guns at people willy-nilly," he said.

It's not uncommon for officers to alter the events of traumatic situations in their memories, Groeneweg said. Sometimes after an officer-involved shooting, the officer will say, "I emptied my gun on that guy," when really he or she only fired one or two shots, he said.

They also start to second guess every little thing, said Ritter. Did I do everything I could to avoid the result? Should I have been more polite? More clear? More firm? Am I going to get sued?

The peer support members can help the officer give a more accurate report of what happened and help them "stay grounded" until they are able to go in for counseling, said Ritter.

The last part of the program is professional counseling, which is required by the Highway Patrol no more than 24 hours after a "critical event," like an officer-involved shooting or when first-aid efforts fail.

The psychology

"It's not just a program, it's a philosophy that says 'people first,'" the Highway Patrol's contracted therapist, Kathy Majerus, said.

She uses some special techniques to help officers "air their dirty laundry," so to speak.

She uses a technique called Eye Movement Desensitization and Reprocessing, or EMDR, to help the officers recall memories more clearly and be better able to deal with them rationally.

The process involves using lights that flash on a board or anything that makes the patient's eyes move back and forth; left, right, left, right. While doing so, the patient recalls certain events or memories.

The EMDR International Association Web site, www.emdria.org, says, "EMDR appears to be similar to what occurs naturally during dreaming or REM (rapid eye movement) sleep. Therefore, EMDR can be thought of as a physiologically based therapy that helps a person see disturbing material in a new and less-distressing way."

The goal, said Majerus, is to separate memories of traumatic events and help the officer take the important parts - the experience, the facts, etc. - and let go of the emotional trauma and second guessing.

"You've never going to be able to totally forget about it," Trooper Mike Ritter said, but the treatment helps him feel better and think more clearly.

Ritter said he had to respond to an accident once where he was sure the little girl and her mother, who were T-boned by a truck, would soon be dead.

Miraculously, they both lived, but Ritter still remembers the vivid colors of their bloody injuries.

After EMDR treatment, Ritter said, he is able to clearly remember the event in black and white, without a lot of the emotions he felt at the time or right afterward. That helps him benefit from the experience of it without having to relive the sights, sounds and smells of the accident every time he thinks about it.

Emotional baggage

But it isn't always one big event that can trigger anger, resentment or a range of other emotions that can lead to family problems, depression, anxiety or suicide.

What psychologists sometimes call "stacked trauma" can lead to the same issues.

Each time an officer responds to an injury or fatal wreck, or any other type of incident, it's like weight being added to emotional baggage that the officer must carry. Whether it weighs as much as a baseball or a bowling ball, it adds up.

Even though after a while fatal wrecks can become "just another fatal," it adds up.

"It wears them down, not just physically but mentally," Groeneweg said.

Majerus said she often sees officers who say their wives, partners or family told them it was time to come in because they were acting particularly angry or irritable.

"They call it a tune-up," she said.

From the top down

Not everyone needs counseling, however. Ritter said he knows "really well-adjusted" officers who could deal with the "bad (stuff) that happens" on their own.

But many can't, and the mentality that only weak people need counseling is old, Groeneweg said.

"There is absolutely no stigma attached to it," Ritter said. In fact, it's almost a badge of honor to go, he added.

That attitude comes from the higher-ups, the people who can influence the mindset of the entire department.

"The stigma evaporates from the top down," said Majerus. If there are no repercussions for seeking counseling, tangible or intangible, treatment becomes standard when subjected to trauma.

"It just becomes part of the equipment," she said.

"We're finding that the people who come out of it are stronger for it," Groeneweg said.


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