Traumatic Stress: Finding Post-Traumatic Growth

Without question, post-traumatic stress disorder is not a mental illness. It is a psychological injury. Just like a physical injury, the sooner we address it, the better the prognosis becomes.

-Jody Carrington

This chapter is different. I’m not going to tell you a story from my memory. Instead, I’m only going to share my journaling from 2016, around the time that I was off work with a psychological injury (also referred to as a PTSD diagnosis.) I have 40 pages’ worth of journaling emails that I sent to my friend Sanjay from March to April of 2016. I wasn’t writing them because of a book. I would never have written them if I thought that you would ever read them. I was writing them because I was struggling to save my sanity. I wrote them because I trusted Sanjay and he told me that they might help me.

The first time that I wrote my feelings out, I titled it: “Thoughts from a broken mind.” That was how I felt in the moment. I couldn’t even concentrate during a conversation. I have pulled select portions to show you what it was like for me to be experiencing mental health problems. I have shared many of these stories as a mental health facilitator with small groups of police officers. After every class, numerous people would come up and say, “That story that you told … that was me … or that was my husband.” They would say that my sharing helped them “not feel alone.” It brought them a sense of connection and shared understanding. It helped normalize what they went through. So, that’s why I am sharing them with you, in case it helps you get through a hard time someday, too.

March 24, 2016

I’ve been having some trouble lately, and it’s really scary and frustrating. I tried to go to sleep at midnight on Sunday, and I couldn’t even sleep. I got up a few times and tried going back to bed, but it wasn’t gonna happen. I could feel my neck trap muscle wouldn’t stop twitching, no matter what I did. I took my melatonin, and it didn’t help. At about 4 AM, I started to write down an agenda to take to HR regarding one of my stressors. I finished up around 5:30 AM and sent HR an email telling them that my meeting for Wednesday couldn’t wait and that I had to come in that day, which I did. Usually, if I have trouble sleeping, it’s waking up from nightmares, but this time, I couldn’t even get to sleep. As an example, I had a shitty sleep on Friday night because I woke up from a couple of bad dreams. My bad dreams aren’t as bad as they were a few years ago. For a long time, I kept a log of the nightmares that I’d call night terrors because they’re horrible. For me, it’s always that I’m at work, and I need to kill someone. The details change, which is why I kept a log to try and understand them.

I had a full-blown fucking meltdown about two weeks ago. I don’t know what to call it; it might be an anxiety attack. It scared the fuck out of me. I was sitting at a crowded Denny’s restaurant talking with a friend about nothing in particular, and I just started getting really upset, and I couldn’t control it. I couldn’t talk. I couldn’t even look at her. I was not just crying, but bawling my fucking eyes out uncontrollably. It was so scary. I felt totally out of control. I remember that the only things I was able to say were a couple of things like: “What is happening?” and “Why can’t I stop?” I don’t think I even managed to finish those sentences. I had a smaller version of this the next day.

I also have a huge amount of anger. I go from nothing to furious so fast and over the smallest things. Someone didn’t put on their turn signal when they turned in front of me. I was screaming at them at the top of my lungs for at least thirty seconds. My throat hurt so bad afterward from how loud I was screaming. I feel really bad every time I go through this cycle. I hate it, but I don’t know how to control it. Even if I don’t let the anger burst out, I still feel it. I don’t know how else to explain it, but I still feel these huge bursts of anger inside, even if I don’t let anything out…

I know that I’m not alone. I’ve talked to many work friends and heard some very similar things from people. It helps to normalize things and makes me feel less broken. I feel pretty alone…

I’ve been drinking a lot. I went to the liquor store and bought five 26-ounce rum bottles, basically finished two in a week. I got blackout drunk on a date with Lisa, and she wasn’t even drinking…

March 29, 2016

I couldn’t sleep again last night. It was really frustrating. I went to bed around 11:30 and woke up at 1:15. I couldn’t get back to sleep and finally got up at 2:30 AM for a while. I fell back asleep around 4 AM I can’t remember what I was dreaming about. I used to write down my bad dreams before I’d forget them because I knew that I’d forget so quickly that if it wasn’t right there, I wouldn’t remember. Maybe I should start again? I think there was something about it that helped me get over it. Like just understanding what was on my mind, let me process everything. I was planning to go into work today, but then just said, “Fuck it, I’m a wreck, I’m better off to rest.” Anyways, it’s really frustrating when you can’t sleep, especially when you want to.

April 19, 2016

I was texting Carrie a bit tonight and telling her how I felt. I really wanted to talk to someone tonight, but I also don’t wanna phone someone at 1 in the morning just to say I’m feeling really down. Times like this make me feel sad to be single, even though I’d rather be single than in a shitty relationship. I know there are lots of people that I could call, but I wouldn’t want to do that. I love my life… but I’m not sure that I like it right now. What the fuck is wrong with me???? It’s making me really sad to type all this. I just read a bunch of my messages to Carrie tonight, and it’s sad to read them. Here’s a quote: “I’m trying to be happy but it’s hard. It’s easier to be drunk…” Feels like the story of my life for the last while. That makes me sad too. I really need to change my mindset and frame of reference and find what I need to do to be more positive.

April 25, 2016

Nothing too major to write today but I’ll put a few thoughts down. It will be mostly just rambling. Sleep is a big focus for me right now. I’m not sleeping terribly, but I’m not sleeping well. I wake up about 3 times per night, and that’s assuming that I sleep well. I don’t recall any dreams lately. I talked to the therapist about it, and he said that I could easily still be having nightmares, but I’m just not remembering them. It’s not ideal, but it’s a lot better than where I was a few years ago. I go to bed hoping that I just get an actual good solid sleep, but it never happens. Even the timings are usually consistent, which makes me think it’s because I’m hitting the same stages of my sleep cycles. I watched a couple of my Sealfit videos today, including a doctor, who’s a sleep expert today, explaining some of it. Hearing the science was important because I often try to get by without enough sleep. I think most people do, and I’m going to try to make it more of a priority in my life, even when I get through all this stuff lately.

I think alcohol is bad for sleep. I’ve been drinking too much lately. I didn’t used to drink much at all. I would have lots of weeks where I wouldn’t have anything. I’d say it was almost the reverse here for a while. So, I’ve been a bit better lately. I set a goal to not have anything to drink this week. Then, this is really sad to say, but I felt like it was too big of a goal and that I was really likely to fail. So instead, I changed it to: I’m not going to have anything to drink today. I can do that goal. I have no doubt that I can do that. Then tomorrow, I’m going to set the same goal again. Maybe I’ll be able to string 7 of them together. It would be nice. But if I only do 5 or 6, that’s a hell of a lot better than I’ve been lately. And I think it will help me with what I want to accomplish, which is to get a decent sleep. It feels a bit sad to say all of this, but it also makes me hopeful, because I know I can accomplish today’s goal. I’ve given up alcohol before. I didn’t even miss it. It doesn’t make my life better to drink. It generally only makes things worse, but you end up in situations where there are social pressures to drink, and that’s exactly what happened.

April 26, 2016

I didn’t have anything to drink again today. That’s only two days in a row, but I feel good about it. I had a better sleep last night than I’ve had in the past month or two at least. I’m really hoping to have another one that’s similar or better, but I’m not gonna get down if it’s not.

April 30, 2016

I haven’t had any alcohol all week, and I’ve been sleeping well. Coincidence? I think not. The fact that I’m starting to sleep makes me excited to come back to work. I don’t want to get too excited in case it takes a turn for the worse, but I think I’ll be back soon. And I wanna be back. I know some people think it sounds nice to have a bunch of time off, but that’s not me, and I think they’re wrong. I like to be busy. I enjoy joking around with the guys. And I enjoy feeling like I get to contribute. I enjoy being part of a team.

LESSONS LEARNED

Origins of PTSD Diagnosis

Dr. Bessel van der Kolk, professor of psychiatry and president of the Trauma Research Foundation, is one of the leading researchers in post-traumatic stress disorder (PTSD) and has been studying trauma since before the term PTSD even existed. In his book, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma, he writes that: “In 1980, the American Psychiatric Association created a new diagnostic disorder, Post Traumatic Stress Disorder.” Even though the diagnosis only became official in 1980, the symptoms of PTSD had existed among many people, including police officers, for many years.

He provides examples of military veterans who developed similar symptoms from their war experiences, but their symptoms were given a different name back then. War neurosis. Shell shock. Combat fatigue. The earlier generations of cops certainly had symptoms of traumatic experiences, but there was no support, so they taught each other how to numb their feelings in the moment through alcohol. They also learned how to depersonalize some of the trauma through dark humor.

Alcohol as Coping Mechanism

This history of traumatic events that police officers had to face, prior to PTSD being recognized, explains why police culture taught officers to mask their feelings with alcohol. There was no explanation for how they were feeling 50 years ago. So, cops learned to cope with the trauma, based on what seemed to work well enough from the previous generation of cops, which was alcohol. Their alcoholic consumption helped the cops feel better in the moment but, in many cases, would have made their problems worse in the long term. Alcohol is bad for sleep and for your brain. Long-term alcohol abuse is associated with suicidal ideation. Both sleep and suicidal ideation are essential topics within the policing community.

Disorder or Injury?

PTSD still appears to be the most recognized term for these types of psychological injuries, but other terms have been emerging. Another term gaining more use in Canada is the term operational stress injury (OSI). The Canadian Institute for Public Safety Research and Treatment (CIPSRT) is part of a national research consortium and has a mission to help current and former public safety personnel maintain and improve their mental health and well-being. CIPSRT notes that OSI is not a diagnosis in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (5^th edition), often referred to as DSM-5.

OSI is defined as any mental disorder or other mental health condition resulting from operational duties performed while serving in the Canadian Armed Forces. The term was introduced by retired Canadian Lieutenant Colonel Stéphane Grenier to decrease the stigma around mental health conditions by reclassifying them as injuries.

That’s how I now see my experience: not as a PTSD diagnosis, but as a psychological injury. OSI injuries are often associated with psychologically traumatic events. Lieutenant Colonel Grenier was right to decrease stigma by reclassifying people as injured, instead of having a disorder. When I was first given a PTSD diagnosis, it was devastating for me. If the same symptoms had been described to me as a psychological injury, with a potential to heal, I would have had a much better reaction.

I have heard several other people react the same way to the term PTSD. Some military veterans, such as former Navy SEAL Mark Divine, have advocated for the term PTSD to be replaced with PTS by dropping the word “disorder” altogether. Another prominent advocate for the perception of PTSD as a brain injury is retired General Romeo Dallaire, who wrote the book Waiting for First Light: My Ongoing Battle with PTSD. General Dallaire courageously describes his long battle with PTSD, including his extensive struggle with alcohol abuse and suicide attempts.

General Dallaire also writes that PTSD is an injury to the brain and that he wishes he had sought treatment for his brain injury years earlier. As he describes in his book, “The brain is as vital to life as any organ in the human body. To treat an injury to the brain as less urgent, less in need of care and compassion than other, more obvious types of injury is misguided and ignorant.” General Dallaire learned this wisdom the hard way, as he says he wishes he had sought help sooner for his psychological injury.

Although I am not a clinician, I strongly agree with the concept of removing the “disorder” part of the PTSD term. The shame and stigma I felt from my PTSD diagnosis was hard on me. However, a few months later during a psychological assessment, another psychologist told me that he wasn’t so sure that I had PTSD. He said that I might just have had some symptoms. Now that I am several years later along my journey of healing, I have learned how to manage my mental health in a way that I am largely symptom free.

I now describe my personal experience as being that I had a psychological injury and that my brain has largely healed. I don’t even care if my situation warranted a PTSD diagnosis or not. My experience is consistent with what some high-profile people in this field are saying, such as General Dallaire. I expect that the movement toward describing a psychological injury instead of a disorder will gain strength in the coming years, and there may even be future changes to reclassify the diagnosis for things that are currently grouped into a PTSD diagnosis. I will still use the term “PTSD” at times in this book because it is the most common term in the general public.

Leg Injuries Compared to Brain Injuries

If I showed up to work and kept working with a broken leg, I would be doing a disservice to my team. I would not be able to keep them safe as a cover officer. I wouldn’t even be able to keep myself safe. That would be terrible for officer safety, and it would put me, my coworkers, and the public in danger. My leg would get worse over time. The broken leg would not heal properly, and I might never be able to get the full use of it. A long delay in seeking help to treat my leg would also make it harder for it to fully heal.

This would affect my ability to be an effective cop, but more importantly, it would affect the rest of my life. It would impact my time away from work with my family too. We can all see the dysfunction in that example. We need to look at psychological injuries the same way. If I broke my leg arresting someone, nobody would think twice about needing to recuperate, unless I stubbornly refused to get help for my broken leg. There would be nothing to be ashamed about.

Would it be any different if I broke my leg outside of work, while skiing or playing hockey? We can see logically that it shouldn’t be. When I returned to work after my broken leg had healed, I would be welcomed back as a valued member of the team. That’s how we need to react to psychological injuries. Your brain can heal, but sometimes nobody knows that you’re “walking around on that broken leg” because nobody sees it. That is why it is so important to provide people with more education about their mental health–and reduce the stigma around mental health.

Timeframe of Recovery

How long would it take an officer to return to work from a leg injury? A sprained ankle, an ACL tear, or a fracture would all take different amounts of time to recover. Some may require officers to be off work or on light duties for long periods of time, whereas other injuries may result in officers being able to continue working. We need to recognize the similarity with psychological injuries. We cannot see the injury, but we can respect that each injury is different. We should provide those officers with the same respect that we would want, which includes giving the injured person the benefit of the doubt. One good way that I have heard this described is to treat them like they have cancer. How long will someone be off work if they are diagnosed with cancer? Clearly the answers will vary dramatically, and we should hold ourselves to the same standard for psychological injuries.

Post-Traumatic Growth

I was asked to talk about my experience as an example of post-traumatic growth in February 2020 during a mental health training event for cops. After the event, I was approached by a police psychologist who told me that I needed to share my experiences with more people, which motivated me to start writing this book. Post-traumatic growth is a crucial concept in this chapter and this book. In a 2019 scientific review of research published in Policing: An International Journal, Velazquez and Hernandez defined post-traumatic growth as “A positive change that occurs in one’s life following a traumatic event.” Many cops will experience traumatic events during their careers. Some will experience mental health symptoms associated with PTSD or psychological injuries. I want to teach others what helped me to grow stronger after my traumatic events.

Think of this in terms of stress and your body. If I asked you to bench press 400 pounds right now, it would crush almost every one of us, including me. Even the people who can bench press 400 pounds today had to work up to that ability. It required exposure to physical stress and time for their body to heal from that stress. Your body can adapt to the stress and will come out stronger if you help it to recover. Your body becomes more ready for the next challenge. Your mind can be the same way. You can build your resilience from traumatic events and mental health challenges. You can become more ready to deal with future events. This concept of growth through adversity is also a central theme in the book, What Happened to You? Conversations on Trauma, Resilience and Healing, where Dr. Bruce Perry and Oprah Winfrey define the same concept as post-traumatic wisdom.

Psychologist Larissa Sherwood and colleagues conducted a review of 20 studies over a ten-year period with over 6000 participants. In a 2019 article in the Journal of Traumatic Stress, they write, “Previous research has also supported the resilience perspective, whereby positive coping strategies for previous traumas can build resilience and act as a protector of PTSD in future traumas.” This means that as you overcome your traumatic stress through positive coping strategies, you can insulate yourself with protection against PTSD from future traumatic events. Former police officer turned academic, Professor John Violanti, concurs that post-traumatic growth can become a protective asset against future traumas. We need to understand trauma and how to best heal from injuries caused by traumatic experiences.

As the author of I Love a Cop: What Police Families Need to Know, clinical psychologist Dr. Ellen Kirschman explains, if we have unresolved traumas, then we are more susceptible to the damaging effects of future traumatic experiences. If we can heal and learn from them, they will help build our resilience for any future traumas. It’s like continuing to work with your unfixed broken leg. Your leg would then be more susceptible to future injury.

Neuroplasticity—Trauma Changes Your Brain

Dr. van der Kolk explains, “The reason people become overwhelmed by telling their stories, and the reason they have cognitive flashbacks, is that their brains have changed.” He uses the analogy of a splinter in your brain that causes an infection: “It is the body’s response to the foreign object that becomes the problem more than the object itself.” He has studied the brains of patients who suffer from traumatic stress and found that nearly all of them show abnormal activation of the insula, which “integrates and interprets the input from the internal organs.” The insula is also responsible for sending signals to the amygdala, which activates the fight-and-flight response. This takes place without any conscious thought or awareness and can leave the patient feeling “on edge and unable to focus.”

Psychologist and science journalist Dr. Daniel Goleman, who has won a lifetime achievement award from the American Psychological Association, agrees. Richard Davidson is a professor of psychology and psychiatry. Dr. Goleman and Professor Richard Davidson wrote the book Altered Traits: Science Reveals How Meditation Changes Your Mind, Brain, and Body, where they describe “how stressful events produce lingering neural scars.” They write that neuroplasticity “shows that repeated experience can change the brain, shaping it.”

Dr. Goleman and Professor Richard Davidson cite several examples of how a brain changes based on a person’s experiences. They provide a guide for intentionally changing your brain in the way that you choose. You can take action to create intentional neuroplasticity. They describe the strong benefits that mindfulness can have and the science that proves it can reshape our brains after trauma, in a way that helps to quiet an overactive amygdala. As I describe in Chapter 1, this intentional ability to change your brain is also supposed by Professor Andrew Huberman, who is one of the top academics studying neuroplasticity.

I’ll come back to this later in the chapter as I discuss ways to manage the trauma.

Reliving Traumatic Experiences

Dr. van der Kolk describes a study where patients were scanned in an MRI machine while listening to a script describing their previous personal traumas. Their brains and body indicators showed that they were reliving their trauma, even more than a decade after the original experience. This is a crucial distinction: their bodies and minds were reliving, not simply remembering the experience. He observed that within the limbic system, the amygdala was highly activated.

When patients were shown images, sounds, or thoughts that reminded them of their traumatic experience, their amygdala was triggered. The result was that “activation of this fear center triggers the cascade of stress hormones and nerve impulses that drive up blood pressure, heart rate, and oxygen intake—preparing the body for fight or flight. The monitors attached to [the patient’s] arm recorded this physiological state of frantic arousal, even though she never lost track of the fact that she was resting quietly in the scanner.”

One area of the brain lit up with activity while he was testing PTSD patients regarding their traumatic memories. This area is called Brodmann’s area 19, and it is a visual area responsible for processing images as they enter the brain for the first time. This was unusual because normally Brodmann’s is activated only in the first instance of seeing something, and then the images are transferred to other parts of the brain that interpret the images. He explains, “We were witnessing a brain region rekindled as if the trauma were actually occurring.” This relates to the fact that your brain can continue to relive the same feelings for years that you experienced during the original trauma.

Dr. van der Kolk’s description of what was happening in a victim’s body, so many years after the trauma, showed the physiological responses of a traumatized person. Their body was literally reliving the same reactions to their initial traumatic experience. When I was re-experiencing traumatic events, my mind and body were literally reliving those traumatic experiences. Your body reacts as if you are still in the traumatic experience.

Describing the Unspeakable

The scans showed a decrease in a region of the brain called Broca’s area, which is one of the areas needed for speech. Dr. Van der Kolk writes, “Without a functioning Broca’s area, you cannot put your thoughts and feelings into words. Our scans showed that Broca’s area went offline whenever a flashback was triggered.” These images demonstrate that trauma can have similar effects to physical lesions in the brain and strokes.

The left and right sides of the brain process information in different ways. The left side of the brain is more analytical and is responsible for remembering facts, statistics, and words, whereas the right side is more sense-driven and is responsible for storing memories of our senses, such as smell, sound, and touch, along with the emotions that accompany them. “When something traumatic reminds traumatized people of the past, their right brain reacts as if the traumatic event were happening in the present,” he explains. In the study, PTSD patients experienced a spike in adrenaline, which led to a dramatic increase in the heart rate and blood pressure of patients while listening to things that triggered their memories of their traumas.

He writes that the “stress hormones of traumatized people, in contrast, take much longer to return to baseline and spike quickly and disproportionately in response to mildly stressful stimuli.” People with PTSD literally feel and perceive their traumas, even years later, as though they are feeling and perceiving them for the first time. Therefore, ongoing traumatic stress symptoms are devastating for patients. They are not only remembering the events, but they are also reliving them through bodily sensations. This also shows why people who have been affected by trauma will have more hypervigilance and a higher startle response.

Dr. van der Kolk notes that numerous studies of PTSD patients have found that their stress hormones become elevated and do not return to baseline levels after the danger has passed. Their brains have changed. However, there are tools to counteract these effects, such as breath control and mindfulness. These tools have the potential to baseline levels of hormonal function in the brain, which is relevant to people suffering from PTSD. These are areas of research to pay close attention to in the future.

Emotional Support is Crucial

Dr. van der Kolk states, “Study after study shows that having a good support network constitutes the single most powerful protection against becoming traumatized. Safety and terror are incompatible.” Therefore, we can help each other by supporting each other. He continues, “Much of the wiring of our brain circuits is devoted to being in tune with others. Recovery from trauma involves (re)connecting with our fellow human beings.” He is explaining on a biological level what Lt. Col. Grossman said in Chapter 4: “Pain shared is pain divided.” That is, connecting with others on an emotional level promotes healing.

Larissa Sherwood and her colleagues write that, “Support appeared across the literature as a crucial protective factor against the development of PTSD and other adverse mental health outcomes.” Numerous studies have also shown that the inverse in true, as Velazquez and Hernandez write, “The lack of perceived support is one of the greatest risk factors for PTSD.”

Although I didn’t understand it at the time, I credit the amazing emotional support that I received as a key factor in my recovery from my psychological injury. We need to change the culture so that we are more supportive of each other, and we will have better and faster recoveries from our traumatic experiences.

Connecting with others by opening up and sharing my experiences of nightmares, alcohol abuse and panic attacks helped me because it allowed me to feel a sense of emotional connection. I was shocked at how many people said, “That was me too.” Even though the exact details of our experiences were different, we found great similarity in the big picture of our experiences. These traumatic experiences are worse when you are suffering in isolation, while thinking “what the hell is wrong with me?” Therefore, I am sharing my experiences, so that when other people experience symptoms of traumatic stress, they can understand that they are not alone. That someone else has been able get through this before and that they can too.

The Detrimental Feedback Loop

Sleep and alcohol consumption can contribute to a detrimental, self-reinforcing feedback loop. I’ll elaborate more in Chapter 10, but because they both have such a huge impact on mental health, I include them while explaining the science around trauma.

Our sleep is normally a balanced feedback loop. We follow our circadian rhythm, along with a lesser-known secondary process that I’ll describe in Chapter 10, called “the buildup of sleep pressure.” These two processes guide us to balance our sleep in a cyclical pattern, which is also guided to regulate by our external cues through light and temperature. However, as we add in trauma symptoms and alcohol abuse, we can instead spiral downward. We don’t sleep well. We need more caffeine (or other stimulants) the next day. We need more alcohol (or other depressants) to feel better the following night, which makes our sleep worse again.

Long-term alcohol abuse has been the coping method of choice throughout much of the history of police culture, and it has had terrible impacts. As Dr. Amen states, “Alcohol is directly toxic to brain function.” Alcohol may make people feel as though it helps them fall asleep, but it is actually disrupting your sleep patterns in multiple ways, as I’ll explore in Chapter 10.

Sleep Helps to Forget

We might commonly think of sleep for its benefit of helping to consolidate the memories we need. However, it is also responsible for helping us to forget the memories we need to forget. As sleep scientist Professor Matthew Walker writes in Why We Sleep, “The capacity to forget can, in certain contexts, be as important as the need for remembering, both in day-to-day life (e.g., forgetting last week’s parking spot in preference for today’s) and clinically (e.g., in excising painful, disabling memories, or in extinguishing craving in addiction disorders).” Sleep, and more specifically REM sleep, will help you to forget painful memories. REM sleep is also a part of your sleep that is highly disturbed by alcohol.

Mind-Body Connection

Our traumatic experiences may start as psychological trauma, but they can also have physical manifestations. For example, I have a friend who said that after experiencing a terribly traumatic call, he started losing clumps of hair from his head due to the trauma and the stress. Another officer developed a facial tick after a severely distressing call, which they did not even recognize for years. Dr. Gabor Maté is the author of When the Body Says No: The Hidden Cost of Stress, which discusses the connection between mind and body. He explains that our psychological state and level of stress will impact our physical health through the onset of chronic illness. The impacts of the mind-body connection are crucial to understand because when we try to focus only on one aspect, we are likely to miss the other ways that it is impacting us.

Tools to Manage Trauma and Stress

Here are six tools that helped me manage my traumatic experiences.

Tool 1: Take Action

Helplessness is a terrible feeling, especially for a cop. We are used to being in control. We make decisions. We fix problems. But what happens when you feel helpless about fixing your own problems? Feeling like you have no control over what is happening is terrifying. It left me feeling like a powerless victim.

What happens when you’re able to take some control of your circumstances, no matter how small? You can take back some of the power. It’s your power. Nobody else can do it for you. When you see you get some control and can change the outcome, it gives you hope, which is crucial when you’re at your low point. We can grind through a lot of hard situations, but we need to see the hope of a better future. Even if it feels like we’re in a long tunnel. We need to have a belief that things will get better. What we need is hope.

Dr. van der Kolk says, “Most treatment studies of PTSD find a significant placebo effect.” Placebo effects are real and have been demonstrated in countless studies. However, when you decide to take part in a study relating to PTSD, you are taking an action. You are reclaiming your agency and a sense of control. It is no longer something happening to you, but now something that you have some control over. Instead of feeling powerless about something that is happening to you, you feel empowered when you take some action.

For me, taking control meant reclaiming my self-control with my drinking. I drank because it made me feel better in the moment. It felt like it worked “well enough.” I didn’t understand that it was a vicious cycle: a harmful, self-reinforcing feedback loop. A good analogy for this feedback loop is like when you get trapped in payday loans and credit card debt for your finances. You start to get behind, so you borrow some money at high interest rates. At first, it feels better in that moment but then you just keep owing more and borrowing more. You eventually need to find a way out of the downward financial spiral, or you’ll end up in bankruptcy.

Alcohol is comparable to that payday loan because it feels like a short-term alleviation of your problems, but it just keeps piling on more problems. You eventually need to find a way to break the cycle, but in the moment, it can feel impossible. After I managed to stop drinking, I learned how bad alcohol was for my sleep. I had a moment, alone in my kitchen where I yelled, “Why the fuck didn’t anybody teach us this in training?” That was the first time I ever thought that we need to get this information out to new police officers. Remembering that moment, is a part of why I started writing this book.

Tool 2: Micro-Goal Setting

At the start of this chapter, I provided my journaling email on April 25, 2016, about when I quit drinking. I remember waking up that morning, and my first thought was: “I need to quit drinking,” but my next thought was “I can’t.” I didn’t mention it in the email, but when I decided that I couldn’t stop drinking, I shrank my goal all the way down to the next hour. It was about 9 AM, and I remember thinking, “I don’t usually drink before noon,” and I just kept building from there. Daytime was easy. I would start drinking at night because I dreaded trying to sleep. I was afraid of nighttime. I was afraid of my nightmares. I later learned the term for this type of goal setting. It’s called micro-goal setting.

I read about the Navy SEAL’s BUDS (Basic Underwater Demolition/ SEAL), and most of them use this concept to get through Hell Week, a test of physical endurance, mental tenacity, and teamwork. Start by picking one tiny achievable goal. One that you know that you can achieve soon. Just focus on getting to the next meal. Once you achieve that goal, set the next goal that seems achievable. When you string all these micro-goals together, you can achieve some amazing results. It’s like the quote: “A journey of a thousand miles begins with a single step.” Don’t focus on the thousand miles. That feels too overwhelming and makes you want to quit. Instead, the harder the challenge, the smaller you should make your micro-goals.

Tool 3: Expressing Thoughts and Feelings

Journaling is one tool that helped take my feelings, which were hard to describe in words, and gave them a voice. Describing those emotions helped take some of the power away from them. As you learn to understand and express how you feel, the power those feelings hold over you can be released. As Dr. van der Kolk explains, in journaling some traumatic memories will be reprocessed from fragments of sights and sounds into fully processed memories. He writes, “Language gives us the power to change ourselves and others by communicating our experiences.” However, I think that traditional journaling is just one way to take our thoughts and feelings and express them. Some people may be able to do that in different ways.

One example of non-traditional journaling was when I started a list of nightmares on a notebook next to my bed. I started doing this because I felt like I was going crazy. I didn’t understand what was happening to me at all. I would remember that I had woken up from nightmares the night before, but I would struggle to remember the details. This hadn’t happened to me before experiencing trauma as a police officer. I kept a pen and paper next to my bed so that I could write down the details of my dreams shortly after they ended. This helped me recognize the patterns and I think it also helped me process the traumatic memories. I suspect that it helped move the trauma out of my subconscious mind and into my conscious mind (I’ll discuss brain science in greater detail in Chapter 8.)

I didn’t know that many other cops had similar experiences with nightmares from traumatic calls. I also didn’t know that this log of nightmares would help me, but it did. Professor Jordan Peterson, clinical psychologist, and author of Beyond Order: Another 12 Rules for Life, includes Rule 9, which states: “If old memories still make you cry, write them down carefully and completely.”

Professor Peterson explains that after waking up from your nightmare, you need to think about it, to imagine it with as much detail as you can manage. The more detail and the more upsetting, the faster the person gets better, and the longer the recovery lasts. However, he cautions that if this emotional pain persists beyond 18 months, then you need to take action to free yourself from it. He states, “Part of your soul is stuck in the past and you need to rescue it.” It takes courage to confront that pain from the past when you go back to rescue your soul. We need to learn to redirect the courage that we apply to physical dangers to also confronting psychological dangers and hardships.

I wrote out my nightmares, and it helped them go away. The first time that I journaled, I was basically crying for four hours straight. It let me release that pain. I can talk about all those experiences now, even the most painful ones, and I no longer become emotional anymore. I don’t fight back tears; I don’t even feel like crying. They are events from my past that no longer consume me. I have also learned to continue resolving additional emotional pain as I experience it. As Dr. Carrington explained in Chapter 4, I took the emotional pain out of my backpack and left it on the floor.

Others have found outlets for their thoughts and feelings that take different forms than traditional journaling. One example of this comes from Daniel Sundahl, who worked as a firefighter and paramedic in Alberta, Canada. He produces amazing photographs and artwork that capture the emotions and traumatic experiences of being a first responder, military, or healthcare professional. Daniel also helped with the creation of the cover for this book. You can find his work at DanSun Photo Art at www.dansunphotos.com.

Daniel has an incredible talent for expressing through images that which feels unspeakable: the pain, the tragedy and even the hope that we need. We connect with him through his art. He’s also an advocate of breaking stigma, helping others, and that post-traumatic growth is a powerful concept for those who experience trauma.

Tool 4: Emotional Support

I talked with people I could trust about what I was doing. I didn’t talk to everyone about it, but I think that it’s healthy to let the people who’ve earned your trust know what’s happening in your world because they support you. That’s how they earned your trust. After the first week I quit drinking, I set a goal: I wasn’t going to drink for a month. I had proved what I was capable of, and I was ready to gain even more control. I was ready to build even more confidence. I told some close friends and family about it. Two people asked if they could join me in not drinking for the month of May. It meant a lot to me that I wasn’t going to do this alone. It gave them a reason to talk with me about my drinking and to support me. It helped transform the situation into something that we did together, which makes it easier to do when you don’t feel so alone.

Tool 5: Professional Help

We have established the need to remove the stigma around mental health in policing, especially the stigma of seeking professional help. I felt that stigma, and it prevented me from accepting the treatment method of EMDR (eye movement desensitization and reprocessing) that was recommended by my psychologist. There are a variety of scientifically proven treatment options that you can try with a psychological professional. EMDR happened to be the one that was recommended for me, as it has a high track record of success through scientific research. However, I recommend seeking the guidance of psychological professionals, while also being open to considering different treatment options that may suit you.

We need to recognize that it is often hard for officers to take this step. It was incredibly hard for me to take this step. We can create a culture that normalizes professional psychological help. This should be implemented in basic training. You create a proactive relationship with a psychologist, prior to being in a crisis. We think of that as being normal with our general practitioner doctor. Can we change the culture to see having a psychologist in the same manner?

The most shocking insight from the research that I conducted for my master’s degree, was a high percentage of the police officers that I interviewed wanted it to be mandatory for all police officers to see a psychologist on a recurring basis (at least annually.) Most cops don’t want to be told that they have to do anything. What these officers were actually requesting was that the organization normalize mental health. Each of them was already able to see a psychologist as many times as they would like, for free, and in a confidential manner. Yet many reported having never been, despite reporting symptoms of traumatic stress. To bluntly summarize the intent of the officers: They were asking for cultural change to destigmatize psychological appointments. We need to recognize how hard it can be for an officer to get past their own resistance to seeing a psychological professional.

Tool 6: Regaining Control of Your Body

Breathing

Breath control is the one physical thing you can consciously choose to do that will alter your level of arousal. That is a powerful ability. It sounds so simple. It is simple to practice, but it’s also highly effective. I used breath control when I had my anxiety attack in a crowded public restaurant. I was able to calm myself by focusing on my breathing. I didn’t understand the science at that moment, but it did help slow down my heart rate and let me regain control of myself. There is a lot of science behind this simple concept. In The Body Keeps the Score, Dr. van der Kolk explains the science:

All [bodily systems such as breathing and heart rate] are a product of the synchrony between the two branches of the autonomic nervous system (ANS): the sympathetic, which acts as the body’s accelerator, and the parasympathetic, which serves as its brake…. The sympathetic nervous system (SNS) is responsible for arousal, including fight-or-flight response…. The second branch of the ANS is the parasympathetic (“against emotions”) nervous system [PNS]…. It triggers the release of acetylcholine to put a brake on the arousal, slowing the heart down, relaxing muscles, and returning breathing to normal…. There is a simple way to experience these two systems for yourself. When you take a deep breath, you activate the SNS. The resulting burst of adrenaline speeds up your heart, which explains why many athletes take a few short, deep breaths before starting competition. Exhaling, in turn, activates the PNS, which slows down the heart rate. If you take yoga or a meditation class, your instructor will probably urge you to pay particular attention to the exhalation, since deep, long breaths out help calm you down.

I have heard Kevin Hines, a suicide survivor whom I will introduce in Chapter 7, describe the same concept through actions. Kevin now travels the world trying to break the stigma and talk about suicide prevention. When asked what he would tell someone who is considering suicide, Kevin responded, “Stop, breathe in for four seconds. Out for eight. Do this thirty times in a row.”

He didn’t explain the science, but he is outlining the actions that someone can take to lower their level of arousal. This serves to move their mind away from their emotional brain and to regain more control in their prefrontal cortex. He also points at his nose while saying “breathe in” and his mouth when he says “breathe out” to reinforce the message.

In the book, The Oxygen Advantage: The Simple, Scientifically Proven Breathtaking Techniques for a Healthier, Slimmer, Faster, and Fitter You, author Patrick McKeown has titled Chapter 3 “Noses are for breathing, mouths are for eating.” He says, “Mouth breathing is synonymous with emergency, activating the same fight-or-flight response that our ancestors experienced.” Mouth breathing involves your upper chest, whereas breathing through the nostrils is associated with breathing through the diaphragm and will help calm you down.

Mindfulness and Meditation

Mindfulness and meditation are also strongly associated with connecting to our breath. In Altered Traits, authors Dr. Daniel Goleman and Professor Richard Davidson explain that “the amygdala, a key node in the brain’s stress circuitry, shows dampened activity from a mere thirty or so hours of MBSR (mindfulness-based stress relief) practice.” They also state there are signs that “these changes are trait-like: they appear not simply during explicit instruction to perceive the stressful stimuli mindfully but even in the ‘baseline’ state, with reductions in amygdala activation as great as 50 percent.”

Their term “trait-like” is crucial to this science. It means there is evidence that these activities alter the baseline state well beyond the act of meditation. The symptoms of PTSD have a strong scientific connection to an overactive amygdala, and this science shows the physical connection to help reduce an overactive amygdala.

I like to think of mindfulness and meditation as your ability to conduct a workout for your prefrontal cortex. It is your way of exercising your control over your own mind. I expect the scientific evidence of the power of mindfulness to grow in the coming decade, especially for those dealing with trauma and relieving stress.

Dr. van der Kolk agrees that we can take control over our body’s reactions using our breath. He writes, “We have the ability to regulate our own physiology, including some of the so-called involuntary functions of the body and brain, through such basic activities as breathing, moving, and touching.” Learn how to regulate your body and mind by intentionally using your breath to control yourself.

The Future

“PTSD is real. It can be sneaky. It can be subtle. It can be loud. It can be inconsistent. It can destroy relationships. But it can be managed and controlled with the right supports.” Sheri Lux writes this at the conclusion of her book Finding My Fire, where she describes the battle of her husband Michael Lerat with PTSD and his suicide on October 10, 2017. She wrote her book to destigmatize mental health and to educate other people, to warn them of the dangers that Mike faced. She also wrote that, “My wish is that police training incorporates more education on PTSD at the beginning of careers. Spouses and partners should also be involved with that. Looking back, it was easy to get caught up in the culture and patterns that were the accepted norm. This often meant that dealing with job challenges entailed sharing a bottle of booze with colleagues.”

Tragically, nothing we do can change what happened to Mike but we can listen to what Sheri advocates: more training and education about PTSD at the beginning of a police officer’s career. Her wish aligns with top researchers such as Professor John Violanti, who wrote something similar in his book Police Suicide: Epidemic in Blue. Suicide will be the topic of the following chapter.

My Final Thoughts

Do all cops have PTSD? My answer: No. I have been asked this question many times. From police recruits who have yet to take their first call, from 15-year police veterans, and from many officers in between. Each time, they are trying to understand their own experiences in relation to exposure to trauma in police work. Personally, I was once diagnosed with PTSD. I suffered from symptoms of PTSD for many years, but I now live a life that is relatively free of those symptoms. You may experience symptoms of trauma as a cop, but there is help. The sooner that you start working on these psychological injuries the better. I wish I had known that as a new police officer.

Front line duties as a police officer will continue to involve exposure to traumatic events. There will continue to be fatal vehicle crashes, tragic suffering, and violent attacks on innocent people. I was not prepared for how my traumatic experiences would impact me. I didn’t even understand what was happening to me. Why was I screaming with rage? Why was I reliving my worst experiences in my dreams? Why was I still crying about things that happened years ago?

My brain adapted based on my experiences. It was trying to prepare me for future high-stress events by replaying them in my dreams. I wasn’t just remembering those moments, I was reliving the same feelings, which were terrible. I couldn’t see the changes when I looked in the mirror, but the chemicals and hormones in my body had changed.

I started out as a victim to my PTSD diagnosis, which left me feeling helpless. I felt ashamed for my weakness. It made me feel like a broken failure. Then I realized that I wasn’t broken, I was injured. Which meant that I had some control over my healing process. I took action to control the things that I could control. I stopped drinking alcohol, which was so crucial for me. It helped me to break a vicious cycle that prevented my brain from healing.

My realization that I had some control over the changes to my brain was a paradigm shift for me. Instead of suffering as a victim to my disorder, I started to get better. My brain had changed due to my traumatic experiences but over time my brain was able to heal. Sleep was my best medicine—and removing alcohol allowed my healthy sleep to start to come back. Journaling was also a key part of my recovery. It helped me to process my traumatic experiences so that I could let go of them. If you are suffering from traumatic experiences, rest assured there are healthy coping strategies, backed by science, that can help you.

KEY TAKEAWAYS

• Psychological injuries should be treated with the same importance as physical injuries. Focus your efforts on healing from your injury, instead of being a victim to your circumstances.
• Neuroplasticity means your brain will change due to your experiences, just like your body will change based on your experiences. You control your actions, which can impact the changes to your brain, including how your brain heals.
• Feeling helpless against the effects of trauma is a terrible experience. Take action to regain some control of your situation. You can’t control everything, but you can control a part of your outcome.