By Audrey L. Honig, Ph.D., Director, and Steven E. Sultan, Ph.D., Assistant Director, Employee Support Services Bureau, Los Angeles County Sheriff’s Department, Monterey Park, California
he reactions and symptoms that may accompany exposure to officer-involved shootings and other life-threatening confrontations can be devastating to the mental health and career of a peace officer, as well as costly to the organization. The organization can lose a valued and productive employee and may have to bear the costs of worker’s compensation, temporary and even permanent psychiatric disability, and replacing the worker. Individual and organizational exposure to litigation is also highly likely. Typically, these costs run into the millions of dollars. Many law enforcement agencies have come to accept that early intervention is a necessary and effective means of mitigating exposure to these long-term effects.1
In recent years, certain forms of early intervention, including critical incident stress debriefing,2 have come under fire in both the research3 and popular literature4. For the police administrator who mandates some form of intervention for his or her personnel after involvement in a shooting or other life-threatening event, such reports are worrying but they should not lead to premature changes in policy. Rather, it may be worthwhile to examine how such interventions are accomplished in the agency and by whom. The authors contend that risk-management issues for the individual peace officer and the agency continue to dictate the necessity, and reaffirm the value, of mandated interventions.
Bonanno describes resilience to loss and trauma as the ability of adults in otherwise normal circumstances who are exposed to an isolated and potentially highly disruptive event, such as death of a close relation or a violent or life-threatening situation, to maintain relatively stable, healthy levels of psychological and physical functioning.5 Bonanno also asserts that resilience is far more common in the general population than has previously been believed.
Resilience is an important concept in the law enforcement community. Unlike the general population, peace officers are typically exposed to multiple highly disruptive events, often involving violence and threats to their own life and the lives of others. Resilience is requisite to surviving a long-term career in law enforcement. Resilience in officers is typically achieved through effective pre-employment selection strategies and intensive, frequent, and repetitive training techniques. Resilience is also supported by comradely, peer, and organizational support and preventive care strategies that identify early warning signs of distress and direct appropriate resources to help officers deal with highly traumatic events in a way that minimizes disruption to normal functioning.
According to Bonanno, after exposure to a traumatic event, resilient individuals may experience transient perturbations in normal functioning (such as several weeks of sporadic preoccupation or restless sleep) but generally exhibit a stable trajectory of healthy functioning across time. He contrasts this process with that of individuals who are recovering from the effects of a traumatic exposure and experiencing subclinical and even significant clinical symptoms of depression, anxiety, or posttraumatic stress disorder (PTSD). The problem for the police administrator is distinguishing those individuals who are having reactions of at least moderate severity that can produce illness and impair job performance from those whose reactions are milder and likely to dissipate spontaneously with little or no intervention, as asserted by Bonanno.
This problem is further complicated by two factors. First, the reactions of resilient individuals and those of individuals who will need to go through some form of recovery may look the same (sporadic preoccupations, restless sleep) and differ only in severity. Severity may be manifested by either duration or symptom intensity. Even less severe reactions such as restless sleep, if lasting for several weeks, can reduce alertness and reaction time critical to performance in the field. Furthermore, it is well known that peace officers underreport symptoms or reactions that may be associated with an emotional or psychological condition. Additionally, initial reactions may be highly varied and severity itself may neither contraindicate resilience nor predict the development of a significant health problem. Similar findings are also being seen in military personnel,6 frequently considered a comparable group to law enforcement.
Although some of the current research cited thus far proposes that posttrauma interventions such as CISD actually can interfere with or even undermine resilience processes, the negative outcomes noted in these studies may relate more to the level and nature of training of the interventionists and the application or misapplication of the various intervention techniques used. In their initial study, Honig and Roland did not find any evidence to suggest that the interventions that were conducted produced harm to any of the subjects. On the contrary, virtually all subjects reported finding the intervention valuable. In addition, an evaluation of both worker’s compensation claims and stress disability retirements among this group lend further support to this type of intervention. As far as clinical efficacy, such interventions were never intended as treatment, were used on an individual basis only, were psycho-educational in nature, and were intended as a screening device to direct health care resources to those whose reactions warranted such care.
The present study builds on the initial work of Honig and Roland. The methodology is the same, but the population studied is much larger (N=982) and includes the 348 subjects in the initial study. Approximately 430 separate critical incidents are included, with over 90 percent being officer-involved shootings. The present study surveyed officers directly involved in all officer-involved shooting incidents occurring over a nine-year period. The findings were consistent with the initial study, particularly with regard to the issues of resilience, the type and frequency of reactions experienced, the tendency to not seek services voluntarily, and the extremely high rate of subjects who found these interventions valuable. This is significant, since several other studies have reported significantly higher rates of perceptual disturbances, memory distortions, or higher rates of PTSD.7 One explanation for the difference may be found in the differing methodologies. The current authors assessed all officers involved in a shooting within three to five days of the event. Neither issues related to selective sampling nor distortions in the officers’ perceptions of the event with increasing time were potential confounding variables. Nonetheless, all researchers have consistently found that memory and perceptual distortions do occur as a result of an officer-involved shooting.
An anonymous five-page survey was administered to 982 sheriff’s deputies involved in shootings (more than 90 percent of the 430 incidents) or other life-threatening incidents (including a major jail riot that led to officer injuries and a major traffic crash that resulted in officer deaths and injuries) between June 1995 and March 2004. Most of the data was obtained within 3-5 days of the incident, just before the subject participated in a mandatory post-shooting or incident intervention (PSI). Participation in the study was voluntary, but none of the subjects declined. Confidentiality was ensured through use of a coding system. For unknown reasons, not every subject responded to every item. The response rate for each item was above 90 percent.
The majority of survey questions can be grouped together to form seven content areas: perceptual disturbances, control and security, cognitive and behavioral, emotional, legal concerns, impact on job performance, and impact on home life. Responses were scored on a Likert scale of one to eight, with a not applicable option as well. For ease of comprehension, the Likert scale was converted to mild (a score of one, two, or three), moderate (a score of four or five), and severe (a score of six, seven, or eight).
The psychologist conducting the intervention evaluated the subjects: affect (blunted, extreme, labile, normal), level of denial/resistance (low, moderate, high), and rigidity (very rigid, moderately rigid, flexible). A Likert scale (low 1-3; average 4-5; and high 6-8) was used to assign a global rating of adjustment, and a prognosis for the subject successfully coping with and processing the event. Although such ratings were based on impression, and not highly scientific per se, they provide interesting data regarding the perceived resilience of the subjects by the psychologists.
Results of Study (Click to see the results)
Results are presented for both the total sample (N= 982) studied in 2004, and the sample from the original 1998 study (N= 348) to highlight the stability of the findings across samples and extended time periods. The most noteworthy findings are presented, but due to space constraints some information has been omitted.
Perceptual Disturbances: The perceptual disturbances noted in figure 1 can have both a positive and a negative effect on the officers’ performance at the time of the shooting, as well as their subsequent recovery. On a positive note, increased attention to detail and tunnel vision, as well as overall heightened sensory awareness, may help officers attain a level of focused concentration that leads to a type of dissociation or disconnectedness that improves the officers’ sense of control and ability to perform while experiencing fewer internal and external distractions. On the downside, this restriction of the senses may result in an increased tendency to screen out other information that may later have proven valuable to the officers. As noted by Bill Lewinsky, the things they are not focusing on could literally disappear from their awareness. In addition, expectations and contextual cues may now also carry greater weight in determining the officers’ response and ultimately their recall of events.8 Approximately 20 percent of officers consistently report memory loss for part of the incident. This finding is significant, given that the deputies will likely be expected to testify regarding their actions.
What appears to be relatively common perceptual disturbances that occur as a function of being involved in a critical incident have the potential of opening officers up to accusations of either lying or withholding the truth, as well as apparent miscalculations in response (such as seeing a weapon when one is not really there). In the absence of a completed memory, the natural tendency is toward confabulation or filling in the blanks. Over time, the officer may become even more convinced that his or her faulty perceptions are valid, even in the face of physical evidence to the contrary.
Anecdotally, officers often report recalling details of the event during the PSI that they had not previously remembered. This is likely due to issues related to memory storage and recall and its interface with the debriefing process, wherein emotions are used as a method by which more detailed information can be accessed. Additionally, factors of time delay allow the officers’ memory an opportunity to process and organize the information, a process that further enhances recall. The cognitive interviewing approach can also be beneficial in this regard.9 Failure to address this issue can result in increased litigation and liability.
Sense of Helplessness: Approximately 8 percent of the total number of officers involved in a shooting incident felt completely helpless, as if the suspect definitely had the upper hand. This finding is quite stable. In the 1998 study, 9 percent of the total number of officers involved in a shooting reported feeling completely helpless. Although the percentage is not large, it is still worthy of note in that feelings of complete helplessness may dramatically heighten the sense of danger, vulnerability and ultimately the level of trauma experienced by the officer. This sense of lack of control may also significantly affect the officers experience of perceptual distortions, and hence his or her performance and recall of the event, due to the heightened stress response.
Questions making up the Reactions section are grouped together to form seven content areas: perceptual disturbances, control and security, cognitive and behavioral, emotional, legal concerns, impact on job performance, and impact on home life. Data for both the 2004 and 1998 studies are presented. It should be noted that the numbers reported for mild to severe levels reflect a percentage of the total subjects reporting the reaction, not a percentage of the total number of subjects in the study.
As is the case with other measures, the percentages of officers experiencing the reaction are remarkably stable. Almost half of the total sample, as in the earlier study, reported experiencing flashbacks or feelings that they were reliving the event. The majority of reactions are in the mild range, but noteworthy percentages of individuals experience flashbacks, nightmares, and intrusive recollections at the moderate and severe levels.
Control and Security: A number of questions addressed the areas of control and security. Approximately half of all officers (in the current study) acknowledged a sense of vulnerability and/or heightened sense of danger with approximately 31-35 percent classifying their reaction as moderate to severe. Forty-two percent also reported fear about future situations, with 24 percent describing the fear as moderate to severe. It should be kept in mind that these figures may reflect underreporting more so than other measures, as officers may be less likely to acknowledge reactions or feelings associated with fear and vulnerability. This defense mechanism of denial may to some degree be adaptive in allowing officers to confront danger when their natural survival response may be to freeze or flee. Anecdotally, it appears that the issue of vulnerability, and the officers’ ability to regain their sense of safety and security, is key to whether or not the officer is able to return to the job with the least amount of negative residual effect. Ultimately, the persistence of such feelings may be a major factor in those officers who become permanently unable to return to police work following a traumatic event.
Cognitive Behavior: More than one-third of deputies in the study indicated experiencing increased startle responses, concentration problems, and physical distress after the shooting incident, though the majority only identified the reaction as mild. These are often considered important precursors to the development of posttraumatic syndromes when intense or prolonged. It is also interesting to note that relatively low numbers of deputies indicated an increased use of alcohol following the incident. It is unclear as to whether this reflects underreporting or the fact that alcohol is being used less than has previously been thought as a coping skill subsequent to traumatic events.
Approximately 40 percent of respondents reported feelings of anger or rage after the incident, with 13 percent of those reactions rated as severe. Overall this amounts to 5 percent of officers experiencing severe anger or rage after the incident. Underreacting was reported as frequently as overreacting, though in the former case the reaction was significantly more likely to be perceived as severe. On a positive note, however, officers appear to be experiencing fewer and less significant legal concerns.
Coping Activities: As in the previous study, the three most popular means of coping with critical incidents such as shootings include talking to peers, talking to family, and reviewing the incident in one’s mind (purposefully, as opposed to ruminating). The numbers of respondents endorsing these activities far exceeded the next most frequently endorsed activity, talking to non-law enforcement friends (43 percent in the current study).
Job Satisfaction and Style of Law Enforcement after the Incident: Two questions were designed to assess the impact critical incidents have on perceived future job performance. The first asked whether there has been a change in job satisfaction, while the second question attempted to assess changes in policing style. Eighty-three percent reported no change in job satisfaction with the remaining equally split between perceiving the job as less enjoyable and more enjoyable. Notwithstanding that over 80 percent reported no change in their policing style, 14 percent described themselves as more aggressive in their approach, possibly in response to their increased sense of vulnerability. This increase in aggressiveness could translate into higher levels of use of force if not addressed. As with the vast majority of data presented, these findings were stable across time.
Prior to their meeting with a psychologist, officers were also asked if they would have attended a debriefing if it were voluntary. Sixty percent report that they would not have attended on their own accord. After the debriefing, however, 100 percent reported that the debriefing was valuable. This finding may reflect concerns about the stigma associated with seeking assistance. In any case, the finding provides support for continuing mandatory post-shooting intervention policies.
Summary and Training Implications
The current study clearly confirms the findings of the earlier one, and the results are remarkably consistent despite the fact that the sample size was nearly tripled, that data was collected fro a longer period, and that the number of separate incidents involved is quite large.
Clearly the results of both the current and earlier study tend to support the concept of a high degree of resilience in peace officers after exposure to a life-threatening event. A separate unpublished study by one of the current authors examining 540 deputies involved in shootings occurring between 1998 and 2002 also found that only two officers subsequently filed worker’s compensation claims for psychological conditions attributed to the life-threatening event, and none retired as a result of a stress-related disability. It is the authors’ contention that the acceptance of and participation in post-shooting interventions and follow-up care as needed is at the heart of these results.
While supporting the concept that peace officers are resilient, the data from both studies also indicate a high degree of reactivity and self-reported symptoms within three to five days after the incident. A wide range of potentially serious reactions, including increased startle responses, nightmares, sleep disturbance, flashbacks, intrusive recollections, and increased feelings of anger and rage, were reported by approximately 30-50 percent of respondents.
Although some researchers might say that among resilient individuals most such reactions will dissipate on their own, it remains impossible to predict with any degree of certainty the course of restabilization. Bonanno reports that among resilient individuals, one might see transient perturbations in normal functioning, lasting several weeks.10 The performance of a peace officer is clearly likely to deteriorate after several weeks of restless sleep, nightmares, intrusive recollections, or other such symptoms. Increased feelings of anger and rage or increased startle response in a peace officer could spell disastrous consequences for both the officer and the organization when those reactions translate into impaired performance and decision making on the street.
As a practical matter, mandatory interventions after a shooting or other life-threatening event, combined with realistic training to build an officers decision-making skills under stress and positively exploit the adaptive stress reaction, remain the most effective and efficient approach to reducing the negative impact of the event on the officer and the agency. Stress survival strategies, including controlled breathing, positive self-talk and visualization or mental rehearsal, trained to a level of confidence and competence, may be critical to both improved performance under stress and increased resilience after a traumatic incident.
1 Audrey L. Honig and Jocelyn E. Roland, “Shots Fired: Officer Involved,” The Police Chief 65 (October 1998).
2 J. T. Mitchell and G. S. Everly, Critical Incident Stress Debriefing: An Operations Manual for the Prevention of Traumatic Stress among Emergency Services and Disaster Workers, 2nd ed. (Elliot City: Chevron, 1996).
3 George A. Bonanno, “Loss, Trauma, and Human Resilience,” The American Psychologist 59 (January 2004): 20–28.
4 Jerome Groopman, “The Grief Industry,” The New Yorker (January 26, 2004): 31–37.
5 Bonanno, “Loss, Trauma, and Human Resilience.”
6 Charles W. Hoge, Carl A. Castro, Stephen C. Messer, Dennis McGurk, Dave I. Cotting, and Robert L. Koffman, “Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care,” The New England Journal of Medicine 351 (July 2004): 13–22.
7 Alexis Artwohl, “Perceptual and Memory Distortions in Officer-Involved Shootings,” FBI Law Enforcement Bulletin (October 2002): 18; J. Stratton, D. Parker, and J. Snibbe, “Posttraumatic Stress: Study of Police Officers Involved in Shootings,” Psychological Reports 55 (1984): 127–131.
8 Bill Lewinski, “Stress Reactions: Related to Lethal Force Encounters,” The Police Marksman (May/June 2002).
9 R. P. Fisher and R. E. Geiselman, Memory Enhancing Techniques for Investigative Interviewing (Springfield, Ill.: Charles C. Thomas, 1992).
10 Bonanno, “Loss, Trauma, and Human Resilience.”