Working in the emergency services can be an extremely rewarding career. It can also be fraught with stressful situations that are at times potentially traumatic. There are four characteristics of traumatic events, particularly for those people working in such environments (police, military personnel, other emergency services) which can cause issues with how the brain processes these incidents. Let’s look at them in some detail:
Dislocated expectation is when something different occurs to what you were expecting and the stress response (fight, flight, freeze) is induced.
An experienced police officer who I work with closely in the TRiM (Trauma Risk Management) world often tells her story in a training setting and it is a very good example of ‘dislocated expectation’. During her probation, a few years ago, a call came in from a lady who said she had found someone in her garden “not moving and bleeding”. There was a local gentleman who was regularly drunk and occasionally disorderly in this area and the police were well versed in moving him along.
So off Rachel set on her own to the location, expecting to find this gentleman, well known to the police, and move him on. When she arrived at the address, she was not prepared at all for what she found. The scene was chaotic – members of the public milling around in shock and others in despair. Once the ever-increasing crowd of neighbours and on-lookers parted to let Rachel through, she immediately clapped eyes on the dead body of a woman. Within a second, panic seared through Rachel's body and momentarily she was frozen.
So there you have it, complete dislocated expectation. Rachel thought she was going to be moving along one of the local regular ‘customers’ and was faced with something completely unexpected…but not just unexpected, horrific in nature. Despite doing a very good job at the scene to contain the situation and wait for back up, Rachel’s brain would not have prepared her for what she found. If she'd have known that what she would discover could be distressing in nature and had more information, then Rachel would have been able to prepare (as best as possible) for something potentially traumatic rather than being taken by complete surprise.
Emergency service personnel are often trained to expect the unexpected but the brain does not always work this way, so if anything completely 'left field' comes along, the stress response of fight, flight or freeze can be induced and cause a temporary delay in action.
There are times when you can walk into an
environment and something about it triggers a stress response. There will always be one event, or maybe more
as a police officer that you can instantly recall as being difficult,
upsetting, horrific etc. It doesn’t mean
to say that you will have flashbacks forever more and sleepless nights
remembering the detail, but sights, sounds and smells in particular can remind
us of those events and cause a ‘pattern match’.
This response is unconscious – not in your
How you deal with this memory recall once your are conscious of it is within your control. A simple acknowledgement of “oh yes, I know what that sound reminded me of”, might be enough to calm yourself to enable you to get on with the job at hand. Being able to ground yourself is important – remember the brain is trying to keep you safe and you are often in situations, unlike members of the public, where it can be tentative. If you are reminded of something that happened in the past during the here and now then this is the brain’s emotional memory kicking in to assist you and keep you safe - whether you need it or not! The environment may be completely safe and once your are sure of this, then this is the time to talk constructively to yourself, being able to reassure rather than being critical of your reactions.
All of our senses can activate a pattern match, usually within one second. Sights such as colours and particular objects, sounds and smells can activate our emotional memories, good and bad. Once this reaction is within our consciousness then we can start to move towards managing the situation and our reactions.
Many of us have heard stories of emergency service personnel responding to tragedies and being more distressed by an abandoned ringing mobile phone with 'Mum' calling someone who is no longer able to answer their mobile or a discarded wallet with photos of children and perhaps a love note inside, than the lifeless body once in possession of these items. These items are what can make us relate to a 'victim' and instantly personalise our own circumstances and ponder our own mortality. There is nothing like other people's grief to induce our own experiences of loss. Also imagining the 'what if' scenarios and the impact they would have.
A past client of mine describes giving a death message to the husband of a woman who had died suddenly of ill health away from home. Whilst delivering this distressing news, something she had done many times before, she noticed a young girl, presumably the recently deceased's daughter, sitting at the bottom of the stairs in the same dressing gown as her own daughter who would be a similar age. This bothered my client for a number of weeks as she had dreams of being the woman who died and her own family trying to deal with her death. Over a few weeks, my client was able to process the event more fully by talking it through in some detail with me. She had not long experienced the death of a parent and worried about her own mortality; not wanting her own family to experience the loss of the young family she delivered the death message to. There is no doubt that the connection and association with the dressing gown impacted on how this officer would have normally dealt with these type of sad events.
Fortunately for my client, she was able, after a little time, to develop a more positive coping structure to help process her reactions. She began to exercise and watch her diet more closely - determined that she was going to reduce her chances of ill health. She was also mindful of what what was important to her and became conscious of spending quality time with her family and the morbidity of her thoughts disappeared.
Personalisation can occur in many forms - a person, a situation, an object, absolutely anything that prompts familiarity to you, your life, relationships or memories.
I spend many hours in my week talking to police officers and staff about their work lives and it never fails to astound me the amount of exposure they have to potentially traumatic events in one set of shifts. From sudden deaths to assaults, domestic violence to firearms incidents, suicide to road traffic collisions. They are of course well trained to deal with these types of incidents, however there is always a danger of overload.
It can take up to 72 hours for the brain to process one traumatic event, therefore exposure to more than one in a few days is pushing anyones mental health. If you also take into account other stresses in life such as relationship issues, financial problems, loss/bereavement, house moves etc. then the capacity for coping with trauma is reduced even more. This accumulative effect of stressful situations can cause mental health issues, or at least a delay in processing.
There are other factors which can affect a person in terms of coping with a traumatic event such as the support they receive at the time, particularly from line management and peers. Also, personal experiences and how someone has coped with stress and trauma previously. However the above four characteristics of traumatic events are pinnacle to how well we process the event.
See my page on trauma advice for top tips following potentially traumatic events.
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