International Critical Incident Stress Foundation, Inc.
International Critical Incident Stress Foundation, Inc.
By: Sergeant James Sullivan
University of Massachusetts Amherst Police Department
Western Massachusetts CISM Team Member
“I wish people could see how much we agonized over our decisions and prayed they were the right ones. Those choices don’t always translate into hesitation…. or racking self-doubt, but sometimes it was enough to sit awake… just thinking about them” (Fick, 2005, p.261). What else could I have done? That sentiment could sum up the common experience of many law enforcement first responders over the course of a career.
From my experience delivering peer support in the group setting, a theme continues to emerge in the form of a constant question from the group and individuals. “What else could I have done?” Given the time constraints, surrounding circumstances, level of training, and limited information available at the time, often, if not in most cases the answer is that there was not one more thing that those first responders could have done to affect the outcome. We do not rise to the occasion, we sink to the level of our training, “performing the commonplace under uncommon place conditions” (Pressfield, 1998, p. 113).
While not a perfect comparison Supreme Court Justice Oliver Wendell Holmes Jr. wrote in his opinion on Brown v. United States “detached reflection cannot be demanded in the face of an uplifted knife.” With little to no opportunity to process our experiences in times of stress there is limited chance to reflect on the morality of the situation, we continue to stare down the “uplifted knife.” Peer support attempts to interrupt the pattern, allowing those affected to “take a breath” and process the traumatic experience by reflecting upon it. However, something is still missing. We can do more to educate our peers on the value of peer support before traumatic experiences.
Prior to my work on the Western Massachusetts Critical Incident Stress Management Team, I faced the challenges that arose from a lack of time for reflection. Perhaps ironically, I now view this challenge as a benefit in working on a peer support team. It has forced me to acknowledge that challenge and attack it head-on, carving out time to process my own experiences. The 3-day CISM training does a fine job of instilling the value and virtue of peer support for those who will be facilitating it. What was covered in less depth was how to gain buy-in from our peers, and how to simply describe peer supports function in building resilience. As one who delivers peer support, I find myself asking, what else I could have done to prepare my peers before a traumatic event to educate them on the value and virtue of peer support?
The simple act of studying our experiences and analyzing them is itself an acknowledgement of accepting reality out of a desire to understand it. The “Stockdale Paradox,” a term coined by author Jim Collins helps us understand this in more depth. James Stockdale, a U.S. Naval Officer was held as a Prisoner of War in Vietnam for over seven years. While being held, he was subjected to repeated torture. In an interview with Jim Collins, Stockdale recounted, “You must never lose faith that you will prevail in the end – which you can never afford to lose – with the discipline to confront the most brutal facts of your current reality, whatever they might be” (Collins, 2001, p.85). I have seen this lesson played out through experience. In the search for meaning and understanding within what has been described as the “storm system of group suffering and need” (Pynchon, 1966, p.144) I have, as a result, found myself far more in control of my actions and reactions to traumatic incidents.
In facing the brutal facts of my own reality through peer support, I am able to more easily compartmentalize my experiences when faced with traumatic events, secure in the knowledge that peer support exists for me. To be forewarned is to be forearmed. This may suggest that when we pull away the layers of a traumatic experience and explore them, we can not only better understand and rationalize that experience, but are better able to predict and protect ourselves from the lasting trauma of future experiences. It is the opportunity for exploration and the discipline to confront the brutal facts of that reality not the shying away from those traumatic experiences that places us in control of them and ourselves.
Understanding comes from reflection. In policing, historically the lack of time to reflect is the single biggest deficiency we face as a profession. While some of this could be attributed to the culture within organizations, it may be more constructive to examine the demands of the work itself. Responders go to a call, have an experience, then close the call for service and move to the next. The pattern repeats with little to no time to process what we had just endured. Prolonged exposure to stress causes the human body to experience hormesis, characterized by a falling out of the biologically favorable hormetic zone. Conceptually this can help to explain the host of health-related side effects first responders experience over time. Every decision made on scene has a cascade of second and third-order consequences not directly related to the initial decisions made or not made in the moment. Separated by time and space from the individual decisions and actions, if left unchecked, the risk for developing compassion fatigue increases. This can have deleterious effects on outcomes for not only the individual first responder but for the people they are working with and trying to help, both in the present and in the future.
If something is predictable, it is, to some extent, preventable. In peer support we posit that healthy human reaction to traumatic events is, to some degree, predictable. Peer support works to build understanding of healthy human reactions allowing the individual to recognize unhealthy human reactions inhibiting, overriding, or more to the point preventing a healthy response. This helps us normalize the act of talking about our experiences to help us better contextualize them, understand them, and ultimately memorialize them. However, all of this work seems to happen after the fact. If human behavior is predictable, those of us who deliver peer support should ask the question; what else could I have done to prepare other first responders prior to exposure to acute traumatic experiences? “What has been will be again, What has been done will be done again; There is nothing new under the sun” (The Holy Bible, new international version, 1984, Ecclesiastes 1:9). We do not need to reinvent the wheel; we just need to turn the map around and look at it from the other side. We have an understanding of the predictable healthy human response to trauma, now we should look to how to make unhealthy human response more preventable.
What I can do.
Those of us working in peer support have become increasingly adept at employing it after traumatic events; however, our work may be aided by creating a more comprehensive and deliverable training program that introduces peer support and the concept of Critical Incident Stress Management (CISM) into the initial training of first responders. For example, as a society we have a visceral memory of September 11, 2001. Indeed each geographic area of the country has events that have shaped the localized collective experience. In Massachusetts for example we need only look to the Boston Marathon Bombing to see a cultural touchstone. While not entirely analogous to the acute trauma of the individual, these collectively tragic incidents may present us with a training opportunity. I propose that regional peer support teams collaborate with the respective first responder training groups to deliver a group peer support session centered on such localized events with those in training before they ever begin working.
Conducting pre-incident education sessions with first responders within their training environment would holistically and pre-emptively introduce the concepts and value of peer support, as well as normalize the models utility, before they actually need it. Specifically, I’m recommending a group session centered on a unique event that occurred within a specific geographic area, while acknowledging that it holds historical context for those with lived experience of that event. The goal of such a training is to set the stage for what peer support looks like in form and function. Peer support would no longer be an unknown that a first responder encounters only after a traumatic event occurs. In this model, the unknown is replaced with a shared experience that normalizes the advocacy of peer support within the first responder community.
In summation, understanding the “Stockdale Paradox” we continue to employ peer support to reflect on the brutal reality of traumatic experience after events have taken place. Recognizing that we can predict healthy and unhealthy human reactions to traumatic events we can use pre-incident education training sessions as a preventative measure to educate first responders about the form, function, and value of peer support before they need it. Those we wish to serve will better understand the process and potentially be more open to the benefits of peer support.
And so I ask you, what else could I have done?
Brown v. United States. 256 U.S. 335, 342 (1921)
Collins, J. (2001). Good to Great: Why some companies make the leap and others don’t. New York: HarperCollins.
Fick, N. (2005). One bullet away: The making of a Marine officer. Boston: Houghton Mifflin.
Pressfield, S. (1998). Gates of fire: an epic novel of the Battle of Thermopylae. New York: Doubleday,
Pynchon, T. (1966). The crying of Lot 49. New York: J.B. Lippincott.
The Holy Bible, new international version. (1984). Grand Rapids: Zondervan Publishing House.
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