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Keeping sane in a mad world

After suffering trauma piled upon trauma, Christchurch and its police have learnt the hard way about how to deal with tragedy. By Ellen Brook

The need for ongoing support, both psychological and financial, for the survivors of the Christchurch mosque terror attacks has been front of mind for organisations dealing with the aftermath of the mass shooting.

For the first responders who were near the epicentre of the tragedy, the pain was compounded by haunting memories of the city’s deadly earthquakes.

Fortunately, says clinical psychologist Marg Beekhuis, at least they had some idea of what to expect and Police, especially, now has processes in place to help its staff manage themselves in awful circumstances.

As emergency services entered full response mode, staff were drafted in from throughout the country in what has been the single biggest operation ever for New Zealand Police.

Marg was one of the few non-Police staff allowed into police stations during the emergency response phase. She was invited to staff briefings and, where necessary, offered advice that might be helpful to staff on the ground.

“Psychological first aid” she calls it.

At the request of Police, Marg spoke to groups of officers. “I would tell them, I’m not going to hold you up, but I need to remind you that you’ve had a hell of a shock. I told them their bodies were in high alarm mode, which was fine, and that’s how it would be for now. From there, it would be a process of what to do when that eased off.”

As the enormity of the atrocity on March 15, in which 51 people ultimately died, started to sink in, Marg joined Police wellness advisers, chaplains and Police Association staff at the central police station.

The first police on the scene at the Al Noor Mosque had been confronted with mayhem as people ran out of the building towards them. Officers passed the bodies of men and women who had been gunned down as they fled the scene. They found more bodies inside. They tried to assist the wounded. At that stage, they did not know if there were active shooters at the scene.

For most police, it was like nothing they had ever encountered before, or believed they would ever have to deal with.

Marg has been a Christchurch-based clinical psychologist for 40 years, with experience in trauma and complex conditions. She has worked with Police staff for more than 20 years, including during and after the Canterbury earthquakes that had a huge impact on Police staff.

A lot of lessons were learnt then, she says, and what was noticeable was that Police were making sure there were processes in place to tell police officers what to expect and how to manage themselves in awful circumstances.

“Police are on to it in terms of looking out for staff welfare,” she says, “and that’s an incredible change from previous times.”

The biggest change in attitude she says is “how Police nowadays seem to understand that a police officer’s body and brain are built the same as anyone else’s. They are normal, ordinary people. What they encounter in these terrible events would make anyone upset.”

The difference, she says, is they know they can’t display too much of their own feelings on the job. “They carry out their role. But once they are out of their role, that’s when they will feel sick in their stomach and find themselves weeping, be irritable, shut-down or downright raging.”

In the old days, some police might have felt that wasn’t right, she says, “but now they recognise that these are normal responses. Now, when they go through awful stuff, they know they are allowed to feel it, and they are much more likely to know what to do with it, instead of trying to make it go away!”

After the mosque attacks, she and other psychologists dealt with a range of staff, from the AOS and STG teams through to those working in admin.

By March 20, and with masses of overtime being worked, Police decided on mandatory counselling checks for particular groups such as scene guards, AOS, STG and DVI. Some days, Marg was seeing 10 people a day, back-to-back, for anything from a few minutes to half an hour each.

“I like working with Police,” she says. “They know how to sift and sort very quickly in chaotic situations, having to pay attention to details and assess what’s likely to be going on, pare it down and follow through, regardless of the type of job.”

What sets the mosque attacks apart from a natural disaster such as the earthquakes, she says, is the element of “human malevolence on a grand scale”.

However, she says, research shows that when bad things happen, it can have a protective effect if it happens to a lot of people. “It’s not just you who has been affected, so it can’t be perceived as your fault that it has happened. If you’re miserable, it’s better to be miserable in a group. There is a measure of comfort in that.”

There is also a predictable trajectory of psychological responses, she says (see next page), including delayed reactions. “It takes your mind a while to digest everything – it will try to sort it out in bits, but it needs space to do this. We need downtimes, even brief ones, in between longer periods of full-on focus on the task at hand.
Your nervous system has to reset after running fast for such a sustained period.”

In the weeks and months after such events, she says, it’s important to be alert for people who might be “getting stuck” as they go through that process, trying to make sense of what has happened.

“I have seen many people who have been so upset and offended about what has happened, and they have struggled to understand why they have continued to be so distressed.”

The psychologist’s job is to help people understand what to expect and how to keep themselves well. “It’s all about avoiding post-traumatic stress down the track. And this is not new. The research on this has been clear for decades.”

Marg says it’s always good to get positive feedback from “cynical old cops”, such as the ones who told her, “I didn’t think there was any point in doing this, but it has been really good.”

It’s also worthwhile, even in terrible circumstances, she says, for police to be able to take pride in their ability to impose order on chaos.

“They are dashing about with as many numbers as they can muster – all pitching in. There is connectedness and meaning in that work. It’s actually a bonding exercise, reinforcing the cohesion of police.”

Psychological first aid

  • Dampen physiological arousal. Exercise burns off muscle tension and gets the endorphins going. Get sleep, rest and do other restorative activities.
  • Being informed about what to expect.
  • Ground yourself. Get back into familiar places and routines – your own home, your own bed. See that your kids are at their school where they should be.
  • Put your attention in the present to lessen the chance of staying stranded in the awfulness of the recent past. But, when it does pop into your attention, reflect on it. We need time to digest what has happened, which may take months.
  • Stick to meal times, even if you’re not hungry.
  • Be around people. Try not to go home to an empty house. However, do take time to be alone when you feel like it. If someone presses you to talk, and you don’t feel like it, say you will talk, but not right now.
  • Even if you feel detached from others, do not reject company. Suggest going to a film, a sports game, etc, even if you consider that most of it will bypass your brain.
  • It is normal to not have words for an overwhelming event. Brains instantly record the sights, sounds, smells, your emotions, what your body felt, etc, but it takes longer to create the “story” of what happened.
  • Rein in the drugs, cigarettes and coffee; you’ve had enough body stimulation. Likewise with alcohol and sedatives. It might seem like a good idea to prevent yourself from feeling, but avoiding your reactions is one of the best ways to prolong them.
  • Try to keep your usual sleep routines, but don’t lie in bed tossing and turning – get up and do something relaxing (ie, not coffee and computer games).
  • Take charge of your thinking: remind yourself you are safe now; remind yourself your reactions are normal.
  • Allow yourself to acknowledge sadness. Avoiding sadness, or any other unpleasant emotion, will only store it up and risk it dragging you down in the long run.
  • If intensely negative feelings persist, consider what you think is the worst aspect of the whole event for you.
    For many people, it’s that they feel they caused it in some way or could have done more. Allow yourself to ponder this, rather than avoid it because it feels unpalatable.
  • Remember, your brain is not in its usual shape, so you need to take care, for example, when you drive. Accidents are more common after stress. Ask someone to check your reasoning if you have to make important decisions.

Tell-tale signs

People are pretty resilient at recovering from terrible events, but if the normal reactions don’t subside within the first few weeks that can be a predictor of more serious post-trauma complications.

What to look out for:

  • Disrupted sleep – reliving the traumatic event in nightmares and flashbacks.
  • Appearing numbed or stunned. Actively avoiding others or seeming more withdrawn than usual. Avoiding places and things associated with the traumatic event.
  • Appearing “uptight”, jumpy and easily startled.
  • Emotionally over-reacting, or being unusually quiet. Mood is “flat”.
  • Anger. It is safer to be angry than to be “flat” or withdrawn, because anger is a defence that stops us accessing the fear-related brain functioning. Check it is not blaming. Angry blaming of others is a predictor of longer-term problems. Blaming others for responsibility, plus having poor impulse control and lack of empathy are causes for concern.Increased use of alcohol, drugs or gambling.
  • Increased cynicism and references to the pointlessness of life or the job.
  • Some people go into overdrive and overwork. Working long hours can be a way of avoiding being alone with one’s thoughts.

Current best practice is to refer people with these symptoms for specialist help. Intervention is straightforward in most cases, and early intervention avoids suffering and further complications.

NEED HELP?
If members feel they need assistance, or just want to talk to someone, they can contact their local reps or field officer. The door is always open for a chat and advice. Contact details are available on our website, www.policeassn.org.nz (log in to see Your Representative under the Support section),

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