interested in joining corrections.com authors network, email us for more information.

Archive

Archive for May, 2016

Part 2: What is Psychological Trauma? Diagnosing PTSD

May 18th, 2016

The following has been reprinted with permission from Correctional Oasis: Volume 13, Issue 4.

The examples presented below are based on actual corrections professionals’ experiences, with details changed to render them unidentifiable.

If you happen to get “triggered” (become emotionally upset) while reading this article, I strongly advise you to stop reading, and to contact the National Suicide Prevention Lifeline at 800-273-TALK (8255), and/or your agency’s EAP, and/or 911. For non-emergency situations you can also call Safe Call Now at 206-459-3020, and Serve & Protect at 615-373-8000. And you are welcome to contact me at 719-784-4727 or through our website. More general suggestions are also presented at the end of the article.

My special thanks are offered to Greg Morton, DWCO’s Training Manager, for his careful reading and compassionate edits of this article.

Those who work in corrections have most likely experienced at least one traumatic episode directly, and/or also encountered traumatic material indirectly, possibly repeatedly. You may still be bothered by these exposures, and might be experiencing some of the symptoms that are mentioned later on in this article. Remember, even the “toughest of the tough” show signs of wear-and-tear as the number and types of traumatic material to which they are exposed at work continue to accumulate. We should consider this wear-and-tear outcome to be an inherent and practically inescapable part of our profession, and therefore a subject worth acknowledging and validating by all involved. Peers and colleagues, support each other when you recognize signs of discomfort and strain in your coworkers. Administrators and supervisors, let your staff know that corrections workers, like police officers, fire-fighters and military veterans, do get affected more or less by what they experience at work, and that these effects have nothing to do with weakness. Not seeking help when help is needed is the actual weakness, just like not keeping one’s tools cleaned or one’s vehicles maintained reduces their utility.

That said, please read the following with care. We at Desert Waters are not implying that corrections staff as a general rule suffer from these symptoms at a diagnostic level. Rather, we want to note that these symptoms can exist on a continuum from mild to moderate to more severe. Just because you might recognize individual behaviors in the descriptions below, that does not indicate a diagnosable condition. However, it would also be a mistake to believe that the very real consequences of incidents that happen during a corrections employee’s career might never rise to a severe level of dysfunction. This information is provided so that the profession overall can begin to recognize the possible severity of these outcomes at their most extreme, both on and off duty.

According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, (DSM-5, APA, 2013)1, Post-traumatic Stress Disorder is comprised of four groupings of symptoms. These symptom clusters are intrusive remembering, avoidance, negative changes in thinking and mood, and increased arousal and reactivity.

If a certain number and combination of the four clusters of symptoms exist for more than one month following exposure to a traumatic stressor, a trauma-exposed individual can be diagnosed with PTSD. For such a diagnosis, however, experienced symptoms must also result in significant distress and impairments in functioning socially, occupationally, or otherwise.

Interestingly, it is possible that diagnostic criteria based on the above symptoms may not be met in full for six months or longer following exposure to traumatic stressors, in which case symptom expression is described as being delayed. That is, a person may show few if any symptoms at first, but months after the event they may start exhibiting enough symptoms to meet criteria for a PTSD diagnosis.

Again, please remember that PTSD, or any psychological condition, can only be diagnosed by a licensed clinician following direct contact, including a one-on-one interview with the person assessed, and perhaps also the administration of clinical tests. If you think that you are suffering from PTSD, please seek professional assistance. Your family and friends, not to mention all of us at Desert Waters Correctional Outreach, want only the best for you.

  1. Intrusive Distressing Memories

    This category of symptoms refers to repeated and unwelcome remembering of details of traumatic events. These details are based on our senses—such as, sights, sounds, smells, tastes, or textures related to the incident. It is as if sensory details are branded in one’s memory, popping up repeatedly in their raw format, unaltered, and like one hit the replay button. This involuntary remembering can be unexpected, “out of the blue.” Or it is cued (“triggered”) by reminders of the traumatic episode(s). Such reminders may be in the person’s external environment (for example, certain smells, sounds, sights, textures, people, locations, situations), or in the person’s internal environment (for example, their own thoughts and emotions). In the case of PTSD, intrusive memories are accompanied by intense emotional distress and physiological arousal, such as increased heart rate, shaking, or sweating. Flashbacks are dissociative reactions, a particularly disturbing type of intrusive remembering, when the person re-lives the event vividly, as if it is happening all over again. Intrusive memories can be experienced both while awake and while asleep (as in nightmares). Distressing dreams of traumatic events rob their victims of what is typically a refuge for all of us—peaceful sleep. Intrusive remembering can become so upsetting, that sufferers may resist falling asleep (trying to stay awake no matter what), as they do not want to re-experience their nightmares.

    Examples of Intrusive Distressing Memories

    A corrections case manager still has nightmares about violent incidents she witnessed during the course of her corrections career. The nightmares are like a movie playing or a slide show of still photos of the event. The images remain unaltered, identical to those on the day of the incident. Sometimes she hears sounds and smells odors related to the events. Invariably, she wakes up with a start, sweating, heart racing. To avoid her haunting nightmares that seem to strike unexpectedly, “out of nowhere,” and for no apparent reason, she tries to stay awake as long as she can. Or she has several stiff drinks before going to sleep.

    A corrections educator, who had been assaulted by an offender a couple of months prior, has a flashback of the attack while he’s driving. He “sees” the offender on his left side lunging at him, shank in hand. Overtaken by the vividness of the experience, and forgetting that he is in fact driving, he ducks and swerves to avoid the offender in his mind’s eye, driving his vehicle into the ditch. As the flashback subsides, he sits in his car shaking until he can compose himself enough to drive to his destination.

  2. Avoidance

    Avoidance is an attempt of trauma survivors to “insulate” themselves, to protect themselves from reminders of traumatic events (“trauma triggers”) in order to avoid or reduce the jarring distress they can cause. Trauma triggers may exist either in the outer world (that is, they are external), and/or they may be birthed in one’s own mind (that is, they are internal). Such trauma-related avoidance is persistent, active, effortful, and intentional. External re-minders that are studiously avoided may include people, places, activities, conversations, situations, and things. Internal reminders may be one’s own thoughts, emotions, or memories associated with traumatic events. It would seem relatively easy to avoid at least some of the external reminders. The harder part may be insulating oneself from internal reminders—from one’s own mind—that is, from oneself. How does a person escape their own haunting feelings, thoughts and memories? There is considerable research that suggests that substance abuse and other compulsive and addictive behaviors may be one method of attempting to avoid/block one’s own memories, thoughts and emotions that are associated with traumatic events.

    Examples of Avoidance

    Since he retired on disability due to work-related PTSD, a corrections officer avoids driving in the vicinity of the prison where he used to work, and he absolutely refuses to drive down the road that leads to the prison. When he needs to go to the next town, he takes a 40-minute detour in order to avoid driving by his old place of employment. He says that just thinking about the gate causes him to start having feelings of panic. He’s also told his wife he no longer wants her to fix spaghetti with spaghetti sauce for him to eat. What he did not tell her was the real reason for that. The sight of spaghetti sauce has now become a strong trauma trigger, a reminder of what he saw on the concrete floor of a cell following an inmate-on-inmate assault that involved serious brain injuries. He’s also quit deer hunting, which he used to love doing annually.

    Since an attempted sexual assault in her office by a mentally ill parolee she supervised, a Parole Office has been postponing reading parolee files, especially when they contain details of sexual violence. She has also been having an increasingly harder time coming into her office every day. Just looking at the desk behind which the parolee had pinned her while she was screaming for help, causes her to start sweating. Lately she has been seriously contemplating a move, either to a different parole office, or to an entirely different profession unrelated to criminal justice.

  3. Negative Changes in Thinking and Mood

    This grouping of symptoms involves negative changes in one’s thinking and emotions that start after exposure to traumatic events, and that become entrenched, habitual. They involve negative changes in one’s thinking patterns, expectations, and beliefs about oneself and/or others; the persistent experiencing of distressing emotions; and an inability to recall key details about traumatic incidents. Examples include persistent negative judgments of self or others; exaggerated or unfounded self-blame and/or blame of others regarding perceived causes or consequences of traumatic events; hopelessness; pervasive anger, fear, sadness, guilt, or shame; loss of interest in important activities or activities that were previously enjoyed; feelings of emotional detachment from others; difficulty experiencing positive emotions, such as affection, and not remembering incident details or having said or done things during a traumatic event that are on tape or that coworkers state they witnessed them saying or doing.

    Examples of Negative Changes in Thinking and Mood

    A corrections lieutenant feels like life has lost its flavor. Even pleasant family activities that he used to enjoy now feel to him to be empty, meaningless. He cannot feel affection for his own children like he used to, or compassion toward them when they get physically hurt or when they are otherwise in distress.

    A Probation Officer cannot stop feeling angry about how an incident was handled by her supervisor over a year ago. She is convinced that had her suggestion been taken, a probation-er she supervised would not have had the opportunity to rob and murder his elderly grandmother.

    A youth counselor has been feeling guilty about the injury of a coworker, holding herself responsible for it, even though her supervisor and administrators have told her that she did everything she could have possibly done to help—and by the book. She keeps re-playing the incident in her head, remaining adamant that had she gotten there just a minute sooner, her coworker would not have been stomped by a group of juveniles in the dorm.

    A corrections sergeant, who has been assaulted on numerous occasions by members of a certain ethnic group, has developed deep-rooted and hate-filled prejudices against all people of that ethnic group. He has tried talking himself out of that type of thinking, but has not been able to get rid of his sweeping negative generalizations. He feels ashamed, as the logical part of him tells him he’s wrong to think that way.

  4. Increased Arousal and Reactivity

    This refers to being ready to go off—on yellow much of the time, and ready to explode onto red at the least perceived provocation. That is, to be chronically agitated, irritable, “on edge,” and at times unable to keep oneself from going “over the edge,” quickly progressing to a “fight or flight” mode (which most of the time is “fight”). Examples include snapping at people; anger outbursts; verbal or physical aggression; reckless or self-destructive behavior (including self-injury and suicide-related behaviors); heightened sensitivity to potential threats; an unusually strong startle response; difficulty concentrating; and restless sleep.

    Examples of Increased Arousal and Reactivity

    A corrections officer feels angry much of the time. In fact, if you asked his family members, they’d tell you that’s he’s mad all the time. At work he sometimes purposely provokes inmates by staring at them and by saying humiliating things to them in front of their “homies.” A couple of times recently he confronted men in public as well, because he thought that they had stared at him disrespectfully. His wife has told him that she no longer wants to go out with him, because she’s afraid he’ll get in a fight. After particularly intense shifts he drives home at 90mph in 65mph zones, at times riding other drivers’ bumpers, screaming at the top of his lungs, and cutting them off. At home, he can see fear in his children’s eyes when he approaches them. His wife has pleaded with him to not give her “the prison look” any-more. She has told him that when he gets enraged at her, she is afraid he is going to hit her.

    After 10 years of working at a metro jail, a detention officer feels safe only when he is inside his house. He avoids going to grocery stores (his wife does all the shopping now), malls, movie theaters, concerts or the state fair—all activities that he used to enjoy prior to starting his corrections career. He also worries greatly about his family’s safety. He has installed several security devices in his home, and motion-triggered lights all around his yard. And he has hidden fire-arms and knives in secret locations in his house. He cannot sleep for more than two hours at a stretch without waking up. He feels chronically wired and tired at the same time.

In addition to the above four clusters of PTSD symptoms (intrusive remembering, avoidance of trauma reminders, negative changes in thinking and emotions, and increased arousal and reactivity), PTSD sufferers may also experience the following two types of dissociative symptoms, persistently and repeatedly. These are:

  • Depersonalization: feeling detached from oneself, from both one’s own mental processes or one’s body, such as having a sense of time moving slowly, feeling as if one’s body is not real, or experiencing events as if they were dreams;

  • Derealization: feeling as if one’s surroundings are not real, or as if the surroundings are distant or distorted.

If you identify any of the above issues in yourself, here are some suggestions:

  • Acknowledge that you are still bothered by extremely stressful situations to which you were exposed;

  • Talk to significant others, peers, or spiritual advisors about this;
  • Seek help from knowledgeable medical and/or behavioral health professionals;
  • Engage in activities that are positive, health-promoting, body-calming, emotion-calming, and nurturing physically, socially and spiritually, such as physical exercise, outdoors activities, psychotherapy, journaling, hobbies, or attending support groups or faith-based gatherings; and
  • Abstain from substance abuse or other addictive behaviors.

Do not put it off any longer. Pursue your healing!

Yes, you can work through traumatic experiences. And you can even grow in self-awareness, compassion, and appreciation of life and of relationships as a result of doing so. As many wise people have said, the greatest challenges in life also present the greatest opportunities for growth and transformation. As corrections professionals, you have jobs that on certain days may cause you to encounter the worst in life. But every single one of you also has the capacity to grow stronger afterwards. And that is one of the many things to be proud of as corrections professionals!

Here are the resources mentioned earlier: National Suicide Prevention Lifeline at 800-273-TALK (8255); Safe Call Now at 206-459-3020; and Serve & Protect at 615-373-8000. Safe Call Now and Serve & Protect serve all U.S. first responders and public safety employees, including corrections staff and their families.

[1] American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5) (Fifth Ed.). Washington D.C.: American Psychiatric Association.

Please note: This series on Psychological Trauma will be continued in future issues of the Correctional Oasis.

admin Uncategorized

Families Under Siege

May 10th, 2016

The following has been reprinted with permission from Correctional Oasis: Volume 13, Issue 3.

A study of correctional officers, which was reported in 2014 by Sam Houston University’s Correctional Management Institute of Texas, concluded that work-related demands and tensions were among factors that adversely affected the officers’ work-home life balance.

When the emotional fallout of work-related tensions follows corrections staff home, and when that happens often, staff are likely to react to their loved ones in destructive ways.

What might such negative behaviors look like? They may run the gamut from minor irritability to physical violence. They can manifest as impatience; agitation; overreacting to even minor frustrations; a “short fuse;” angry outbursts (when there has been little or no provocation); rudeness; verbal put-downs; intolerance of others’ opinions, preferences, or wants; or social withdrawal and stonewalling—isolating and not communicating. In more serious cases, the behaviors of chronically “stressed out” staff may escalate to verbal aggression, such as threats of physical harm, and/or actual physical violence toward people, animals or objects. Heavy substance use or substance abuse can make such behaviors worse.

It is not hard to imagine that when these behaviors occur, especially when they occur repeatedly, staff’s family lives are strained—at times to a breaking point. That is why even at the slightest sign of verbal or physical aggression toward loved ones, staff need to seek help for themselves, to nip such behaviors in the bud, not allowing them to become part of their lives.

The following is an actual encounter I had years ago that describes parts of a correctional family’s journey in dealing with family violence.

Have you ever had the sense that someone behind you is studying you? I had that experience the other day at the grocery store. Instinctively I turned around to see who was looking at me and “caught” a woman in her forties watching me intently. I half-smiled and pushed my cart down the next aisle wondering absentmindedly about what might be on her mind.

Suddenly she was right next to me again. “Are you the one who reaches out to corrections officers?” she asked sheepishly. “You know, Desert Waters?” I lit up. “Yes, I am.”

She went on. “I recognized you from a photo in an old newspaper that a friend gave me.” “Do you work in corrections?” I asked. “No, I don’t, but my husband does. He’s been at it nine years now.” She hesitated for a brief second, and then her eyes filled with tears.

Seeing that, I motioned her to follow me to a quieter area of the store. After regaining her composure, she whispered, “What you’ve been writing about is SO true. We’ve been through SO much as a family over the years.” She then stopped like she was weighing what to say next, took a deep breath, and then threw open the floodgates. “It’s much better now. But just a year ago I wasn’t sure we were going to make it as a family.”

“I’m very glad things are better now,” I replied. “And I feel for you, for all you’ve been through.” Then I asked, “Where does your husband work?”

She gave me the name of a facility where I had heard that incidents of violence were an all-too-common occurrence. (I remembered a correctional staff member telling me that working in that type of environment for even just a few years could change a person to the core—and not for the better.) I felt my heart ache for this couple. “Corrections!” I thought to myself. “We need the prisons and the jails, yet what a toll they can take on staff and families alike!” I then repeated, “I’m glad things are better now at home.”

She smiled and nodded. I could tell that she was once again weighing whether to open up some more or not. Then she took the plunge. “My husband became so mean after a few years on the job. He’d fly off the handle over ridiculous things. He’d put me down over nothing. He didn’t want to be around people. He had never been like that before. His goal became to work nights. He quit doing things with us as a family. I felt abandoned, like a widow.” She paused again as if impacted by her own words. I found myself almost holding my breath. The moment felt sacred. One human being making true heart-to-heart contact with another without even exchanging names.

The woman looked me in the eyes ever so seriously. “My husband is a good man. We’ve been married 16 years. I did not know what to make of it when he started becoming violent. He’d throw things. He’d break things. He even hauled off and hit me once. I just couldn’t believe it! Up to that point he had never done anything like that.” Her tears were flowing now. And my eyes were misty too. “I did not call the cops. Don’t ask me why not.” She looked away, seeming embarrassed. “I could tell he felt bad afterwards for what he’d done. And the kids were terrified. They were in the next room and heard it all. After that, we all walked on eggshells around him. No noise, no requests, no complaints. Did not want to set him off. And we didn’t even know what might set him off! After a while I knew I couldn’t go on living like that. I told him we had to get help, or we were history. He kept refusing until the day he hauled off to hit me again, caught himself at the last second, and put a hole in the wall instead. A week later we started counseling.”

She smiled and I smiled back. “Thank you for trusting me and sharing this with me,” I said. “And I’m so glad you took action and that he agreed.” “You know, I finally realized that I had to do something for our family,” she replied. “I refused to go on living in fear and worry. I refused to have the kids’ lives ruined. And it’s been better. We talk more. He is more respectful. There are still things he is working on. His occasional yelling. His talking to the kids like a drill sergeant. Treating us like inmates sometimes, ordering us around. But on the whole our home life is so much better. He does back off when I ask him to. We’re growing close again one day at a time.” We both sighed a sigh of relief.

“I know the kids will need more help,” she added wistfully, as if talking to herself. “We’re thinking about what would be the best way to do that. I can tell that at times they’re still scared of their dad, and mad at him, too. He’s apologized to them, but they need more. In our counseling we talk about ways he can rebuild bridges not only with me, but also with them. The other day I sat our children down and told them that sometimes daddy’s work is very tough , and that he’s still all revved up when he gets home. I told them that we’re getting help.” “You’re doing a wonderful job,” I said, admiring her courage. “Last week I caught my son putting his sister down just like his dad used to treat me. I got on him right away. Told him that I was not going to tolerate disrespect in our home. I made him apologize to her. It felt so good!”

We both smiled again. “Yay for mom!” I cheered. She changed tone. “Thank you for listening. Thank you for caring.” “You’re welcome,” I answered. “Meeting you made my day. When you can, visit our website and see about getting on our mailing list.” “Will do. Keep praying for us in corrections!” she said as we parted ways to continue our shopping.

Afterward I kept thinking about our call to come alongside corrections folks and share the burden with them. What a privilege it is to have the opportunity of such encounters—whether groups in training or one person at a time! And I also thought of you all who support our mission through your giving. Thank you.

And going back to the Sam Houston University study, the Correctional Management Institute developed a brochure for correctional officers to recognize signs of stress and for ways to address them. Here are some of the suggestions:

  • Exercise regularly

  • Maintain proper nutrition
  • Get enough sleep
  • Reach out to co-workers, friends and family
  • Do something enjoyable every day
  • Use meditation and other relaxation techniques as part of your daily schedule
  • Avoid drugs and alcohol
  • Use your employer’s confidential Employee Assistance Program

And if you have suffered intimate partner violence, please get help for yourself. Resources for victims of violence are many, both in local communities and nationally. Here’s a start: http://www.apa.org/topics/violence/partner.aspx and http://www.womenshealth.gov/violence-against-women/types-of-violence/domestic-intimate-partner-vi.

You can also call the National Domestic Violence Hotline at 800-799-7233 or TTY 800-787-3224.

And in case you’ve crossed the line, and became physically violent with a loved one, PLEASE get specialized professional help right away. Your most important support system is at risk.

MUCH is at stake.

admin Uncategorized