Originally posted March 6, 2018.
One day, Dave was having a quiet day in his workshop. He was working on his model trains, his favorite hobby. He was looking at the tracks, the way the lines interweave all around the room. And he started to think about what he had seen a few months ago in his work as a police officer. He remembered what it was like to be the first responder to the scene of a suicide. The image of the suicide scene was riveting; it seemed burned into his brain and into his retina. In his workshop, he became very distressed and started to sweat. His stomach hurt, and felt nauseated. Tunnel vision occurred and he felt all consumed by this one moment in time. He couldn’t get out of himself. Suddenly there was a flood of intense emotions, his heart started to pound, his breathing was shallow and erratic thoughts overwhelmed him.
He stood up, trying to shake the swirl of emotions and intense body feelings, that seemed all mixed together. It was like his stomach hurt but it was all tied into his emotions, too. There was no line between the physical pain and the emotional pain; his emotions and his body feelings were all tied together. He pulled into himself and felt like no one could possibly understand what was happening to him. Intense fear gripped him and he felt like he was leaving his body.
Secondary Emotions Make Dave Feel Worse
Dave felt ashamed and embarrassed as he felt like he had lost control. What kind of person acts like this? How was he going to do his job as a police officer? His secondary emotions: the shame, the fear about his body and emotions, made things worse. How could these out of control feelings be explained? What was happening to him? Why did he feel like he wasn’t in his body? He had never experienced this before, even though he’d been on the job for 10 years.
Dave’s symptoms might be labeled shell-shock or maybe a nervous breakdown, or just going crazy. Today, these symptoms would be identified as part of the constellations of symptoms associated with post-traumatic stress disorder and be labeled as a flashback. The constellation of symptoms associated with post-traumatic stress disorder are kind of all encompassing, so it can be confusing.
Pre-Existing Anxiety or Depression Contribute to the Overall Picture
Dave had some pre-existing anxiety, even before he worked as a police officer. He was shy when he was young and was socially anxious in middle school. He had grown out of that social awkwardness in high school: he made friends, joined the robotics club and even had a girlfriend and went to two proms. He was socially popular in college, made friends with his roommates and dated alot. The anxiety didn’t show up too much, just around finals. He occasionally smoked pot to manage his anxiety and it didn’t interfere with his life. After college, Dave began to work as a dispatcher, married and eventually made it into the police academy, and the anxiety didn’t really show up too much, just around performance testing.
But he noticed the anxiety creeping up more often as he juggled his marriage, his children, and then a complex job as a police officer. He loved being a cop and wanted to give back to his community and help people. But the job had a dark side as well that took its toll. So, Dave’s nervous system was already stressed when he came upon the disturbing suicide. And then his nervous system went into hyper-arousal. His emotional state became more anxious and distressed. He tried valiantly to suppress, so he could function normally on a daily basis. But he then was anxious about being able to suppress this and hiding it.
Post-traumatic Stress Disorder (PTSD) Constellation of Symptoms
The intense symptoms of a PTSD flashback can feels similar to the symptoms of a heart attack, which then gives rise to even more fear during the emotional episode. The sudden onset of intense fear and emotion reaches a peak quickly and can last anywhere from a few minutes to an hour to a few hours, and sometimes, the emotional effects can last for days. Dave’s flashback lasted about an hour, but it was prolonged by his secondary fear of the situation. He was unable to identify the trigger or fear that caused the event. Other flashback symptoms include:
Numbing
Decreased concentration
Feeling unreal or out of body
Shame or worthlessness
Irritability
Insomnia
Overwhelm
Panic
Loss of sense of self or “who I am”
Blocking of memories
Anxiety
Depression
Getting Help
Dave realized he needed help, but was hesitant to talk to his colleagues at work. They all seemed to have that command presence pasted on, in order to do their jobs effectively. He had heard about the Peer Support Team at work, but thought that was for sissies. But, one day, he surreptitiously wrote down the phone number posted on the bulletin board at work and called the officer running the peer team. He was found he wasn’t alone and was able to offload his fears.
The Peer Support Team members told him that while it was important to see his doctor to rule out a medical condition first, it was also important to care for his emotional health as well. They told him that ignoring and not treating the trauma symptoms can lead to an increase in the duration, frequency and intensity of his flashbacks, as he struggles alone.
They gave him referrals to both psychiatrists and therapists in the area that worked with the police. A psychiatrist gave Dave a proper diagnosis of PTSD and supportive medications, to help calm down the hyper-arousal in his nervous system. After interviewing a few therapists, Dave found one with whom he he felt comfortable. The therapist was trained in the newer trauma therapies of Eye Movement Desensitization and Reprocessing (EMDR), Somatic Experiencing® (SE) and an emotional skills based therapy, Dialectical Behavioral Therapy (DBT). He also had special training in working with first responders. His therapist made him commit to walking 30 minutes every day. He was resistant at first, but found time to meet his wife at the track after work on some days. Other days he walked while at his son’s soccer practices. After Dave was stabilized on medication and moving forward in therapy, his therapist also recommended that Dave see a bodywork therapist who was trained in CranioSacral, SomatoEmotional Release, or Myofascial Release, to work out the trauma patterns held in his musculature. Dave decided to join a gym and work out there twice a week. This helped keep the emotions moving through his body.
Post-Traumatic Growth (PTG)
Dave committed to his emotional healing so as to be able to move forward in his life more fully and more self-aware. He learned to allow himself to feel his feelings and not to sublimate them into his body. He learned to accept that he didn’t need to always be strong and that he needed to tend to his emotional garden, let himself feel, grieve, and be self-compassionate. As he moved through the feelings of the senses of what he confronted, he grew to be more complex as a person facing a complex world. Dave applied for a position on the Peer Support Team, received additional training, and was able to use his experience to mentor new recruits in the force. He allowed himself to learn and change and experienced new parts of himself in growth.
For Dave, a combination of medication, some rest, a culture of understanding at work (though hidden), counseling and bodywork and a renewed sense of purpose helped him heal. PTSD is a complex biological and emotional response to trauma and learning to heal and manage this isn’t short or easy, but it can be done.