Example One: Male Law Enforcement Officer---Job-Related Trauma

Example One: Male Law Enforcement Officer---Job-Related Trauma

A wife’s perspective of her law enforcement officer husband’s behavior after he had been through a critical incident at work where four people drowned and, during his attempt to rescue these individuals, he believed he would die. The partner who accompanied him during the rescue panicked, and he had to rescue her from drowning, as well. A high official accused him of being responsible for two of the deaths, although he later received an apology. The traumatizing event happened two years prior to his receiving MTP. Treatment eliminated these symptoms in two sessions. His wife was interviewed three weeks later and was asked about husband’s symptoms. The couple had been married eleven years and gave permission to use this information.

The Wife’s Perspective:

"His face lost feeling. He stopped laughing (restricted range of affect; feelings of detachment).

"His breathing changed when he was driving, sometimes it kind of bubbled when he breathed out, or he would breathe in a very shallow way (shallow breathing is a sign of stress).

"His speech was choppy; he would say three words and pause, three more words and pause (difficulty concentrating).

"He stopped playing with the kids. He had roughhoused and tumbled with them, and he stopped. He became intolerant, focused and single-minded. We had shared picking up our son from private school, but I got so I didn’t call him to pick him up, because he seemed "put off’ (irritability) and I was afraid that he would be that way with our son. I started having our neighbor pick him up. I thought ‘I’ve lost him for a life time’. My kids just responded like he was dead. I told them that their daddy had been through something that had hurt his heart so much that it had changed him (restricted range of affect; diminished participation in significant activities).

"He had lots of trouble sleeping. The first month, he had a lot of nightmares (distressing dreams). Since then, he yelled out and was frantic in bed, about once a month and he jerked in his sleep, especially in his legs. If I tried to wake him up to stop the nightmare, or bumped him in his sleep, he was instantly and loudly awake. If he fell asleep on the floor, I could not wake him up gradually...he startled awake. (Problems of arousal, problems sleeping, hypervigilence, flashbacks).

"His stomach was really bad for months; he said it just ached. He gained 20-30 pounds, even though I couldn’t see that he ate any more than he used to" (the response of the body to stress; high levels of cortisol secreted during times of stress can cause weight gain and deposit fat in stomach area).

"He drank a little more, but not much. I’m not sure if this helped him to sleep".

"Ever since this happened, he would say, ‘You’re not listening to me, I just told you that.’ But he hadn’t just told me that. I think he must have been thinking the words in his head, and thought he said them to me, but he didn’t" (feelings of detachment or estrangement from others; problems concentrating and paying attention)

"If I wanted him to listen to me, I had to make direct eye contact with him to make sure he was listening, or he wouldn’t hear me. He was in his own world. (Feelings of detachment from significant others)

"He would tear out things from magazines and keep them; things seemed to mean more to him than they had before.

"Before this happened, we related as adults...we listened to each other, and respected each other and helped each other. My first marriage had been to a very controlling man and we had agreed that he would not try to control me, tell me what to do and we would be a team of two adults. After it happened, he wanted things his way. He started treating me like a child and tried to control me. He started wanting me to do things like he wanted them done. He even started telling me what to do with problems at work. I thought, ‘Oh no, he’s acting just like my first husband’ "(Safety issues)

"If something bothered him, he left. He would go in the next room or out in the back yard, or leave in the car (efforts to avoid recollections of the trauma). Before this happened, he never wanted to be away from home. After it happened, he did not want to be around groups of people he knew; we would be the last to arrive at a party and the first to leave. He didn’t want to be around his friends (diminished participation in significant activities; paranoia due to sleep deprivation). He would sit in the dark for hours and smoke. We used to drive around on Sundays in the car and just talk - that stopped. One day he came home and just picked me up and put me outside. He never got violent and he was slow at expressing anger, but he just couldn’t stand to be with me (irritability; feelings of detachment). I called his Chief and the Chief said he hadn’t noticed that there was anything wrong with him.

"Sex decreased in frequency and became mechanical"(feelings of detachment).

"He lost patience. He couldn’t tolerate standing in line, being stuck in traffic, doing the normal things that make a family run, like paying bills (irritability). We had shared the duties, but I had to take over all of them (diminished participation in significant activities). He thought most things weren’t important enough for him to participate in. It was as if this event was so important that nothing else could compare, so he didn’t want to hear the normal everyday problems of the children and me. I started having to handle them all."

"When driving, he was more rigid, forceful and impatient (irritability). He drove faster and the safety zone between him and the car in front of him disappeared. One time he was driving and a tunnel was ahead. I could tell he was having a flashback and I didn’t think he was going to make it through (re-experiencing of the trauma through a flashback). He did it, but I could tell he was scared. He also froze when we took the kids to a water park and they wanted to go through a long tube with water in it. He did it, but I could tell it took a lot of determination for him to do this (re-experiencing of the trauma through a flashback)."

"He stopped talking and going out with his friends from the job (efforts to avoid people that arouse recollections of the trauma). The only friend he would talk to was a friend whose son had died."

The Officer’s Perspective:

"I slept about two or three hours a night. I got earphones so I could watch television and not bother my wife while she was sleeping (problems sleeping)."

"Whenever I turned on the shower, it reminded me of everything in the event. I hated how it made me feel. It colored everything I did and said and felt and thought (recurrent and intrusive recollections of the event)."

"My mind was always racing and on a thousand things; I would be hearing someone’s voice, but I would be thinking about all kinds of other things." (Persistent symptoms of arousal; problems concentrating; feelings of detachment).

"I don’t think that I ate more; perhaps I was less active."

"I looked but never saw. I became paranoid. I kept wondering what everyone was thinking about me" (persistent avoidance of stimuli associated with the trauma; feelings of detachment; paranoia, probably related to lack of sleep).

"I couldn’t concentrate or read (problems concentrating). I wasn’t interested in anything (feelings of detachment; numbing of general responsiveness; efforts to avoid stimuli associated with the trauma). I just sat in the dark and smoked; when I was sitting in the dark, I spaced-out, I didn’t feel anything."

"I was very shut down. I know the trial is coming up and I am going to have to go through this again. I dread it" (feelings of detachment; avoidance of stimuli associated with trauma).

Wife’s New Perspective after Husband Received Treatment.

"The smile is back on his face; he’s laughing. We’re talking about things like we used to. It’s like the old husband is back, but deeper. His breathing is calmer and his speech isn’t choppy any more. He was listening to me and paying attention."

"I noticed that he did not get too close to cars or drive as fast. He didn’t jump in his sleep and he woke up slowly. He slept well the whole night. We talked and talked and talked. I noticed on the way from the airport, I was reading the map and he was treating me like an adult. In the past two years, he would have been telling me what to do. He let me read the map myself, without his advice."

The Officer’s Perspective Following Treatment:

"I’m sleeping; I’m laughing, I’m calm and I can read."

When asked about the weekend he had just spent with his wife, "Sex was great...better than its been in years"

Example Two: Female Law enforcement officer - Job-related trauma:

"It happened to me over a series of months and while working traumatic situations. My family and friends recognized what was happening to me before I did. I gave up my hobbies, stopped reading anything I didn’t have to read (difficulty concentrating), and stopped food shopping. I ate whatever was available. I didn’t care about nutrition (markedly diminished interest in significant activities). I continued to exercise, that was not affected. However, I started isolating myself (feelings of detachment or estrangement from others). I didn’t call my friends or talk to my family about the problems I was having. I very much wanted to talk about the horrible things I saw and was having to do on the job, but I didn’t want to upset them."

"I had disturbed sleep...I was just sleeping a couple hours a night, waking up all night, having nightmares (difficulty staying asleep). I went to a sleep clinic; the doctor reported that I never got into REM sleep. He told me, ‘You have to learn to cope with stress or get out of the job.’ He didn’t help me at all. I worked harder and became obsessed with the job and working. I was disappointed that I was not being recognized for all the work I was doing - and all I did was work. When I took time off, that is when it ‘caught up with me’, so I didn’t take time off (efforts to avoid thoughts, feelings or conversations associated with the trauma). I didn’t have a Christmas or New Year’s for the past four years. I had to work on some; volunteered to work on the others (markedly diminished interest in significant activities). Even with working, I had time to see my family, but I isolated myself (feelings of detachment or estrangement from others). I didn’t feel like having fun or being with a group of people. It was easier to be alone. I had more illnesses (the response of the body to stress). I was exhausted and short-tempered everywhere and with everyone. I had very little patience and I snapped at people inappropriately (irritability). I felt overwhelmed and stopped enjoying simple pleasures. I had snap flashbacks of a moment, a scene, a feeling (traumatic event is persistently re-experienced). After working the scene of an airplane crash, I couldn’t eat certain seafood. I got nausea just looking at them (triggers which are reminders of the traumatic event). I started drinking too much (efforts to reduce symptoms). I stopped caring what I looked like, how I dressed (markedly diminished interest in significant activities). I dropped out; I was not in touch with friends and family. I wasn’t talking to anyone...they were reaching out to me and I was telling them, ‘I’m too busy, I’m too busy’ (feelings of detachment; numbing of general responsiveness). They were telling me that they could hear it in my voice that I had so much stress. I didn’t hear it."

"I hid my problems from my supervisor and from other people in the office. I was afraid that my job would be affected and, if they found out, it would be career ending. No one knew that I wasn’t sleeping, or was having flashbacks."

Following Two Sessions of MTP:

"People are saying, ‘we have you back. You’re smiling again. You look so happy.’ I’m dating again; in fact, guys are coming out of the trees."