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Can Police be trained in trauma processing to minimise PTSD symptoms?

Dr Jess Miller
Director of Research
Police Care UK

Introduction

Our 2018 research (Policing: The Job & The Life) revealed alarming levels of Complex Post-traumatic Stress Disorder (C-PTSD) in serving UK police at 12%. C-PTSD is where, as well as the symptoms of PTSD (such as hypervigilance, sleep disturbance, re-experiencing etc), individuals begin to experience feelings of low self-worth, like they've failed and can find it hard to regulate their emotions when they are upset. Such high prevalence of C-PTSD in policing may have been masked up until now.  This is partially by a certain social acceptance of the ‘drip-drip-drip’ effect of trauma exposure on the job, that ‘burn out’ inevitably awaits the long serving.

As contemporary policing adapts to fewer resources and changing demand, it is all the more vital to challenge this resigned acceptance. Last year, over 60% of officers told us that they didn't have enough time to process and make sense of a difficult incident before moving on to the next job. We believe that giving the mind time and space to do this is key to trauma resilience and may help towards preventing trauma related disorders in the future.

Our aim is to share new practical skills to give the mind time and space to help process everyday operational trauma exposure. We will train trainers, forces and police networks in straightforward trauma processing techniques across the UK. The techniques are simple to learn, immediately effective and can be undertaken at work or at home. All that's needed is a commitment from individuals and from forces to make time and space to apply them when they are needed most.

Our research team explored and developed techniques based on common sense, a bit of neuroscience (from studies in police, military and civilian populations since 2010 and a new study with GMP this year), Achieving Best Evidence (where sketch maps and timelines are used in training for Tier 5 interviewing and the Cognitive Interview), and some talking therapies (where counsellors might advise clients to picture a situation from above, to give them a sense of more distance from the event).

What are the techniques?

It's all about creating perspective. Rather than having a difficult incident up-close-and-personal in your memory, playing on your mind, we need to have them filed away with a time and place so we can recognise that everything is safe and move on to the next job. This helps us stay present, focussed and generally happier in the here and now.

Time

Space

Safety

How do the techniques work?

The techniques work by boosting a particular part of the brain (the hippocampus) and plays an important part in the consolidation of information and management and filing of our memories. Ironically this part of the brain also gets damaged by stress- which makes it harder for the brain to process the difficult incidents we really need it to.

In addition to this the hippocampus also puts into context the alarm signals that something isn't quite right. These alarm signals will keep firing (from an area of the brain called the amygdala) unless the hippocampus gives the memories a context of time and space: what happened where and when. Again, this process is made more difficult by stress damage.

To boost the hippocampus we have to force it to map incidents and put them in some order. We do this by encouraging very specific shifts in perspective. As humans, we usually remember events on the ground, but the techniques we use for trauma processing take us up in the air to look down on the scene to see the bigger picture, sort of like a map.

The new techniques also encourage us to recall the incident from other peoples' perspectives to assist us in the realisation that it wasn't "all about us". This helps us feel connected to our peers and in many cases,  this helps officers recall those who might have helped out at the time and what worked well.

Putting events in order also helps us to create timelines. Rewinding to just before the incident can help us get a sense of what else might have been happening at the time, over which we had not control, allowing us to let go of hang-ups about "what we could have done" and "if onlys". Bringing to mind the moment we really felt that the incident was over is also helpful. This enables the brain to recognise that the danger and upset from the incident had an end point and helps us reconnect with feelings of relief and safety which we may have forgotten about.

Does it work?

We trialled the techniques on over 70 newly recruited officers at GMP, after the Manchester Arena attack.  The results were really encouraging, and show us that enough people found the techniques helpful to begin teaching them to those interested in boosting their resilience on the job.

Participants said that they felt significantly "more at ease" with the events they needed to process after applying the resilience techniques. What is more, there was a large effect size (which is a good thing in science!) and there was no one who reported feeling worse. This suggests that we can be confident the techniques do no harm (a very important factor to take seriously in trauma interventions!).

A staggering 97% of officers were able to recall the moment after a job when they felt it was over and they could move on (called "safety cues"), and over two thirds said they are likely to remember to use the specific maps, timelines and safety cues next time they have a difficult job. What is more, 63% said they recalled new details after having applied the techniques which is not just good for wellbeing, but a definite positive for investigation and performance all round.

If you would like to access training in these techniques, keep an eye on our website for dates of training events in the UK, starting in November 2019. We hope to see you there!

Full article published in the Police Journal

If you would like a copy of the full article, you can access it through SAGE publications

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