Stigma: Talking About the Elephant in the Room 

“Removing stigma from mental health in general society is an important goal for everyone. In policing, it is a goal that must be recognized and acted upon as an urgent priority.”

–   Ontario Coroner’s Expert Panel on Police Officer Deaths by Suicide, 2019

“If you ever say that to me again, I’m walking out of here and never coming back!” I said. I meant every word of it. I was not ready to hear that. I was not willing to hear that. Who did I say that to? My psychologist. Why? Because he had just told me that I had PTSD. In an instant, I went from feeling like I could do anything, to feeling like I wasn’t capable of doing anything. I felt broken and dejected. I felt afraid. So, he went through a list of symptoms from the Diagnostics and Statistical Manual of Mental Disorders, 5^thedition (DSM 5), which is what mental health professionals use to diagnose mental health conditions such as PTSD.

He repeated many of the symptoms I had been talking with him about and explained that they were “consistent with a PTSD diagnosis.” He asked, “So, how long have these symptoms lasted?” It wasn’t days, weeks, or months. It was years. He told me that if those kinds of symptoms persist beyond a few months, then they would meet the criteria for a PTSD diagnosis. Logically, I understood what he was saying. I knew that I would be saying the same thing if I was in his shoes, but I still wasn’t ready to hear it. I wasn’t thinking logically about it. I was having an emotional reaction to what he was saying. I desperately wanted him to be wrong.

I resisted him even when it was in my best interest to take his advice. I wasn’t willing to try the treatment he was recommending. He said EMDR (eye movement desensitization and reprocessing) had proven a highly effective treatment for people in my position. But I wouldn’t even listen to him about it. I wasn’t thinking rationally. I was having a deeply emotional reaction.

Institutional Stigma

I met with a representative from my union. He told me that if anyone ever knew about my PTSD diagnosis, I would be immediately removed from ERT, and I would never be allowed back. My ERT career, and possibly my policing career, would be done forever. I was terrified that this would happen to me. I was very proud to be a police officer. I was also proud to have earned a position on the ERT team. They were both an important part of my identity. I was worried that it would be taken away from me because of something that I felt helpless to control.

Self-Stigma

I carried a lot of internalized shame regarding my PTSD diagnosis, in the form of self-stigma. I had heard of another Emergency Response Team (ERT, also referred to as SWAT) officer, in a different jurisdiction, who was removed from the ERT team after being diagnosed with PTSD. I was worried that the same thing would happen to me. I also thought that some of my friends on the team would no longer trust me to be capable of having their back in a dangerous situation. Their trust meant the world to me. I knew that trust was hard to earn and easy to lose.

I was still working full-time but I knew that I wasn’t in a good mental state. I had recently had my first panic attack. I had another one the following day. I was still working for several weeks after, as I refused to accept that I wasn’t mentally ready to do my job. I was dealing with an accumulation of nearly a decade of traumatic calls at work that I had never properly dealt with. I was also affected by the recent suicide of my godfather Bill. I was stuck with the memory of hearing his wife, Janet, tell me that she had called out for me to help when she had found Bill after his suicide, but I wasn’t there to help her. Logically, I knew that I hadn’t done anything wrong when I wasn’t there for Janet but that didn’t matter, as I still felt tremendous guilt about it.

I was going through a break-up in a relationship. I had work stress that had been accumulating from working way too much overtime. I was getting burnt out. I remember one month where I workedabout 90 hours per week, every week. I didn’t have a day off for a month. Like many police teams, we struggled to find enough officers for calls, so I would answer callouts on my days off. That’s great for the paycheck but terrible for your life.

I had recently experienced my second suicide-by-cop attempt when a young man, barely out of high school, had pulled an imitation firearm in front of me. I felt like a failure because I should have shot him, but I didn’t. I felt ashamed because people could have been killed due to my inaction. Even as the people around me were starting to see that I was not in a healthy place, I continued to work. I wasn’t willing to be perceived as needing help. I wasn’t willing to be perceived as weak.

I talked with my boss, and I suggested that I take two weeks off using my vacation time. I planned to use that time to get control of myself, without being on stress leave. At the end of the two weeks of vacation leave, I could tell that my symptoms were still not under control. I still couldn’t sleep. I couldn’t control the symptoms of traumatic stress that were showing up. I talked with my supervisor, Steve, and I decided that I was going to need more time to deal with my challenges. That decision was very hard for me to make, as I was deeply concerned about the perception others would have of me.

Journaling Experience

A close friend named Sanjay, who was on my ERT team, told me about an experience that had helped him. He said he had been told by someone to put his thoughts down in writing and to send the thoughts to them in an email. He said that it acts as a form of journaling. My first reaction was, “Not interested.”This sounded too weird to me. However, I had a huge amount of respect for Sanjay. I looked up to him as a mentor because he had earned my trust. So, I gave it a try. Sometimes, we need to trust the people we are close with, even when we can’t trust ourselves.

As sad as these events that I experienced were, I can talk about them now, without being overwhelmed by emotions. The events will always be sad because they are sad, but the emotions no longer control me in a way they used to. I have stripped the emotional pain away from the memories so that I no longer feel overwhelmed by them.

These emails were my “truth in the moment.” I never expected anyone other than Sanjay would read them. I wasn’t even sure that I would hit “send” to deliver them to him, but they were all my truth. I felt like I was going crazy. I titled my first piece of writing “Thoughts from a Broken Mind” because that was how I felt. Broken and hopeless. I was lucky I had people who cared about me and who could see that I was struggling. I was lucky that I already had enough trust with them, that I was willing to get help. Many people aren’t so lucky.

So, here is some of my truth that I share with you. My hope is that you will remember some of these lessons, so that when something similar happens to you, you can have hope that you can get through it. Someone else has got through this, and you can come out the other side better and stronger too. 

March 24, 2016 (Sent from Mark):

Hey Bro

First off, if me telling you about some of what’s going on in my life is a burden for you, feel free to either leave it for a while or just not read it.

Second, and I know this goes without saying, but this all stays between us for now. I’m not at all suicidal, so there’s no reason to bring other people into it. Please don’t forward to anyone else or share with anyone. I also worry about what it would mean if other people knew everything going on in my head and my life.

I went to see a psychologist on Monday. I’ve tried going before, but I didn’t find that it helped. I’ve lowered my expectations so that they’re a lot more realistic this time. Hopefully, that helps. I was referred to this guy by someone who told me that he’s been diagnosed with PTSD and that this guy helped him. I know we talk about not diagnosing anything from R2MR, but he told me that I have PTSD. I told him that I’m 100% not ready to accept that or handle that. If my options are to see him and acknowledge it and deal with it or pretend I never went to see him, I will 100% never go back. I am absolutely worried about what that will mean for my career, but more so my life, how I’m treated, and my own outlook on myself. I did my own research and thinking about things when my symptoms were really bad a few years ago. I absolutely believed that I had PTSD back then but just wanted to deal with it myself, and I think that I did.”

On March 27th, Sanjay responded and his message included: “The big SWAT guy isn’t supposed to break down… or is he…”

On March 29th, I responded, and it included:

“As to your point about whether our mental picture of a SWAT guy can cry… We’re people first, SWAT guy doesn’t and should come until later. I don’t even want to say it comes second because I think that we actually have other roles that should come ahead of it. It’s one aspect of my life, and it is something that I feel very passionate about, but it doesn’t consume me.” 

Lessons Learned

Stigma Reduction

As the reaction from the union representative showed, institutional stigma around mental health in policing is real and has been a feature of the policing culture. I felt that stigma when I experienced some mental health challenges. I believed that my policing career would be hurt if I acknowledged and sought treatment for PTSD.

Mental health challenges exist, but officers have worked within a culture that historically discouraged them from seeking treatment. I recently completed a research project interviewing police officers while completing my master’s degree and the presence of mental health stigma was the most important finding of the research. It is perpetuated from a hurtful cultural stereotype that cops shouldn’t have emotions and that they shouldn’t show emotions. We cannot expect ourselves to stop being human. It is a harmful stereotype we need to leave in the past.

In a 2019 journal article, Velazques and Hernandez write, “It is crucial for law enforcement officers to feel they are supported and encouraged to seek psychological help without having to endure any additional shame. The idea is a work in progress because cultures do not transition immediately which is why early intervention and education is imperative.” I am trying to accelerate that cultural change, both to reduce mental health stigma and to increase education by writing this book about my experiences.

Personally, I was fortunate that I received great support from friends and coworkers. However, I continued to carry much of the stigma in my own head. It was the messages I was telling myself. I had a self-limiting belief that I couldn’t do anything because I was diagnosed with PTSD.

When you hide your pain, you are likely to amplify it by judging yourself for even feeling that pain. When you talk with people you trust, you can gain strength from the love, support, and acceptance you receive from others. I’m specifically saying, “Share your world with people who have earned your trust.” That’s where you can be vulnerable. They are the ones who can help you let go of your pain, just like you would for them. Many psychologists, academics and researchers agree that having a good support network is one of the best protective factors for PTSD.

Purpose: Add Meaning to Suffering

I have resolved a lot of the trauma I experienced. There are things I couldn’t even think about. Now, I’m able to talk about them openly, even while public speaking, without becoming consumed by emotion. Honestly, I don’t even feel like crying at all. This has given me the chance to use the suffering I experienced to help other people, which has helped me to find a purpose and a meaning in that suffering. I get a lot of happiness from helping and serving other people, which is probably a part of what attracted me to a career in policing. Being able to take pain that I experienced and use it to help others gives that pain a purpose, and pain with a purpose is much easier to bear.

We all want to feel a sense of meaning and purpose in our lives. Writing this book gave me a great sense of purpose because I believe that we can and will save many lives by helping people to manage their own mental health. I expect that improved police officer mental health will decrease the number of police officers who die by suicide. I have spoken with many police officers who have found ways to use their painful experiences to help others and, therefore, to give their pain meaning. It can be as a peer, supervisor, trainer, with your family, or out in the community. It can be something as simple as having more empathy for people you interact with. 

I Don’t Feel Ashamed

The best way for me to reduce the stigma around mental health is to give a voice to my experiences, so that I can share them with others. Even when I was off work on stress leave, I used to say to myself, “I don’t have anything to be ashamed of because I haven’t done anything wrong.” I still believe that to this day. It’s an important message to tell yourself and, more importantly, to truly believe. But there’s a reason that I had to keep repeating it to myself. There was a long time when I didn’t believe it. I could understand it on a logical level, but I didn’t truly believe it at a gut level. I was judging myself more harshly than anyone else. I had worse things to say to myself than anyone else. That is self-stigma.

Later in this book, I’ll refer to numerous police officers who were involved in shootings that are described in Chuck Rylant’s book Shots Fired: The Psychology Behind Officer-Involved Shootings. These officers mentioned all kinds of trauma they have experienced throughout their careers, and how their experiences affected them. Several of them described moments of holding their gun and contemplating dying by suicide. Many described relationship problems, night terrors, and conflict in their personal lives.

These officers are courageous. They are heroes for using their vulnerability to help others. Their individual experiences represent patterns of similar experiences that countless other police officers have experienced for decades. They are willing to speak up about their experiences. They are willing to break the stigma around mental health. Breaking this stigma becomes easier for future cops to do, as more cops before them have been vulnerable enough to share their experiences. As Brené Brown says, vulnerability is not a weakness, it is a strength, and it is often closely aligned with courage. And courage is not the absence of fear, it is the ability to overcome fear.

Insecurities Expressed as Stigma

A part of what we see and describe as stigma comes from deep insecurities within the officers who are perpetuating the stigma. They feel some emotions that are like what I describe, but they are insecure someone will find out about it. So, they need to put other people down for having emotions. They are trying to comply with the notions of police culture passed on to them: “Feelings are weakness. Suck it up, princess.” They can also feel a sense of superiority over people who don’t conform with their belief that we must deny our emotions. It’s bullshit. It needs to stop. Don’t let someone else push their issues onto you. If you see someone perpetuating that stigma, then speak up about it, so that we can continue to reduce the stigma together.

Journaling Science

On April 20^th I sent an email to Sanjay that said:

Thanks for the call yesterday. It was nice to hear from you. I’m still trying to work on my stuff. One of the things that I really enjoy doing is reading books that can teach me things. Right now I’m focusing on a book called the happiness advantage. I really like this book and I’d recommend it. However, I just hit a section that really caught my eye because it relates to this and what we’ve been talking about. I’ll quote something from the book and I think it will make some more sense:

“Experiments show that when people are primed to feel high levels of distress, the quickest to recover are those who can identify how they are feeling and put those feelings into words. Brain scans show verbal information almost immediately diminishes the power of these negative emotions, improving well-being and enhancing decision-making skills. So whether you do it by writing down feelings in a journal or talking to a trusted coworker or confidant, verbalizing the stress and helplessness you are feeling is the first step toward regaining control.”

Bessel Van Der Kolk is a psychiatrist, author, and expert on PTSD and trauma. He is a professor of psychiatry at the Boston University School of Medicine and a past president of the International Society for Traumatic Stress. In his book The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma, he described writing as one of the most effective methods to access our inner feelings. He explained that if we speak with someone, especially if we don’t have enough trust, we have a “social editor” who changes what we say. However, “writing is different.” He states that experiments around the world have continually found that writing about upsetting events improves mental and physical health.

Dr. Daniel Amen, psychiatrist and author of Change Your Brain, Change Your Life agrees with the benefits of writing down your feelings and has described himself as “a big fan of it.” Psychologist Dr. Jordan Peterson, author of 12 Rules for Life: An Antidote to Chaos, has also explained the similar powerful benefits of journaling to resolve previous emotional pain. We need to normalize journaling, as it brings tremendous benefits. We need to tell the stories of people who have used it and found it to be incredibly successful in resolving traumatic memories.

The benefit of journaling is an important point of agreement for many of the world’s top psychologists.

Trust and Connection

In her book Dare to Lead: Brave work. Tough conversations. Whole hearts, Brené Brown describes trust as a “marble jar.” She said that when we have positive interactions with people, we build trust. We put marbles into the jar, and when our trust gets broken, we can dump a whole bunch of marbles out in a hurry. I tried journaling because I had so much trust in Sanjay. For some police officers, they hit a point where they become suicidal, and they can’t even trust their own thoughts. You need to know who you can trust. You need to know this now, before you are experiencing traumatic symptoms.

Who do you know that you could be sure would have your best interests at heart? These are also the people we need to turn to most when we go through our hardest times. Dr. Van Der Kolk explains that studies showed “that having a good support network constitutes the single most powerful protection against becoming traumatized… Recovery from trauma involves (re)connecting with our fellow human beings.”

You need to know who you can trust, and you need to lean on those connections to help you through your challenging times, especially if you hit a point where you aren’t able to trust your own thoughts.

What Can We Do About Stigma?

The Expert Panel on Police Officer Deaths by Suicide is the report from the Ontario Coroner’s Office after 9 police suicides occurred within the Canadian Province of Ontario in 2018. It provides recommendations after investigating the deaths of 9 police officers. The first recommendation is titled “Normalizing Mental Health Challenges.” This recommendation—given urgent priority—states that mental health stigma needs to be reduced. For this to happen, the report says, “Mental health must come out of the shadows.”

This is why I have written this book. This why I am sharing what I wanted to hide in the shadows. As I re-read the first lines of my journaling it struck me that I was in a hurry to say that nobody else could ever read what I was writing to my brother. However, after hearing from so many other officers with similar experiences, I have learned that normalizing our experiences by talking about them openly would help future officers immensely. It will help to reduce the stigma that they will feel and it will also help them to recognize the patterns that previous officers have experienced, so that they can get help, and get better more quickly.

So, instead of hiding my darkest moments, I’m bringing them out of the shadows for everyone to see. This normalizes the challenges that I went through and that so many of us go through, by decreasing the stigma around mental health. This can normalize helpful strategies to overcome those hardships by sharing the lessons that took me so many years to learn.

Summary

Mental health stigma is a big problem, especially in policing. I felt that stigma when I experienced psychological injuries. I was told that if anyone knew what I was going through, I would be permanently removed from my position on the ERT team, possibly even from all front-line duties. Some of the people reinforcing this mental health stigma are doing it out of their own insecurity. It is perpetuated from a false notion of an “emotionless cop” stereotype that we need to leave in the past.

I also carried a significant self-stigma when a psychologist diagnosed me with PTSD. I wasn’t willing to hear it and I wasn’t willing to try his recommended treatments, but trust helped me get through this. I had enough trust in Sanjay to try the journaling he recommended. There is substantial evidence of the physical and mental benefits of journaling. I am writing this book so that I can use the stories of my experiences and the lessons I learned from them to help break the stigma around mental health. Join me as I set my sights on stigma.

Key Takeaways

• Stigma is carried within the policing organizational culture and is passed on from the more experienced officers to newer officers.This stigma becomes internalized by officers who judge themselves and become worried that others will also judge them as harshly.
• Stigma prevents police officers from seeking professional help, even when they need it. We need to recognize it and continue to shape policing culture to reduce and remove the stigma around mental health.
• Expressing your feelings through writing (i.e., journaling) is highly recommended by expert psychologists because it is an effective method for managing emotional pain.