Cumulative PTSD – A Silent Killer

Originally posted August 2014

Author:
Andy O’Hara 
Founder – Badge of Life USA

Cumulative posttraumatic stress disorder is a common enough malady for emergency responders.  Unfortunately, it is subtle in its buildup and complex in its symptomatology, and is usually ignored by the responder and his department until it’s too late.

Before we get started, let’s define cumulative. Cumulative is “increasing or increased in quantity, degree, or force by successive additions, something that is growing by accumulation.”  In some cases, such as a success or the compilation of knowledge, accumulation is a great asset, but when it comes to seeing and dealing with certain scenarios day in and day out, accumulation can become the cause of a disease or injury.

Imagine a normal 20-year career in law enforcement and the number of unthinkable situations officers are put into, either to fix something or render aid.  Responders often clean up after someone has lost their life at their own hand or the hand of someone else or, in the worst case scenario, being involved in a deadly force situation. Most people don’t call upon a police officer when everything is conventional; people call when the situation is beyond their control.  Some of these incidents can be unimaginable, such as gunshot or stab wounds, critically injured people, rapes, death and then dealing with family and friends who are in hysterics.

Cumulative trauma extends beyond shootings and other “critical incidents,” however. Among cumulative trauma are the days and nights of being cursed and shouted at, listening to the screams, viewing dead bodies, and the momentary scares and fears that go along with law enforcement.  These are the “bumblebee stings” that add up; one or two may be tolerable but, as they add up, the pain increases to the breaking point—and posttraumatic stress disorder (PTSD).

All of these daily occurrences get filed away as the officer goes through his career. Subsequently, he continues moving from incident to incident with very little thought, other than wondering what lies ahead. These incidents may be filed away but they are not forgotten.  In fact, one day the slide show of incidents will begin to take its toll on the person, rendering him worse for wear.  Think of it like this: a giant redwood tree stands strong in the forest.  Every single day, for twenty years, someone takes one swing at it with an axe.  After every single blow to the tree’s foundation it becomes weaker, until one day, the final blow occurs and the tree succumbs to the cumulative blows, falling to the ground.

Unlike catastrophic events such as officer involved shootings where the department has people in place for treatment, the effects of cumulative PTSD take a backseat and are rarely recognized and addressed.   Unlike a physical injury that may or may not occur during a career, mental traumatic injury can happen almost daily.  When the demon of PTSD surfaces it goes ignored and officers become a risk to themselves and others who are relying on them.

The answer lies in the “annual mental health check,” in which officers visit a therapist of their own choice at least once year on a voluntary, confidential basis.  Done like an annual physical exam or dental cleaning, the mental health check affords law enforcement personnel the opportunity to examine the past year, review what has worked well and can be reinforced, and determine what has not worked so well.  Only in this way can the officer vent the pressures of the job and find new ways of handling the cumulative trauma as they occur.

It is time that the leaders of America’s police departments acknowledge that violence and stress are at an all-time high, which means the pressures on the men and women of law enforcement are also at a peak.  Officers are suffering because of a lack of support in this area.  Chiefs need to be proactive by leading the way, having measures in place to ensure personnel have a place to debrief their weary minds and get much needed help to deal with cumulative PTSD—before it’s too late.

Founder’s Note:

Thank you Andy for giving the readers your insight into cumulative PTSD. It would be great if the various Workers Compensations Boards of the various organizations in Canada and the United States would not give individual officers a difficult time when making claims of their PTSD in the area of cumulative PTSD, instead of one critical incident.  It would also be great if Human Resource personnel who run sensitivity training programs so that company employees learn to value diversity, listen more effectively, balance co-worker’s need with organizational goals, handle conflict and respond to others with empathy had those skills themselves.