Copyright 2013 Ungvarsky and Trivette Resiliency and First Responders Jim Ungvarsky, PsyD, LMFT Sharon Trivette, PsyD, LPC Regis UniversityEl Paso County

Copyright 2013 Ungvarsky and Trivette

Resiliency and First Responders

Jim Ungvarsky, PsyD, LMFT Sharon Trivette, PsyD, LPCRegis University El Paso County Sheriff’s Office

Question• In a study1 of hospitalized survivors of motor

vehicle accidents, approximately what percentage did not develop PTSD?

a. 95% c. 40%

b. 80% d. 17%

1 Bryant, R.A., Harvey, A.G., Guthrie, R.M., & Moulds, M.L. (2000). A prospective study of psychophysiological arousal, acute stress disorder, and posttraumatic stress disorder. Journal of Abnormal Psychology, 109, 341-344.

Question

• In a study of PTSD among veterans serving in Iraq2, approximately what percentage had no psychological distress when examined within one year of their return to the U.S.?

a. 73% c. 40%b. 63% d. 3%

2 Sutker, P.B., Davis, J.M., Uddo, M., & Ditta, S.R. (1995). War zone stress, personal resources, and PTSD in Persian Gulf War returnees, Journal of Abnormal Psychology, 59, 444-452.

Question

• A 2002 study conducted by Resnick and others found that what percentage of Manhattan residents did not report having a single PTSD symptom the in the year following 9/11?

a. 60% c. 20%b. 40% d. 10%

Learning Objectives

• Differentiate between reactive vs. proactive models of mental health

• Distinguish the subtleties between prevention of illness and promotion of health

• Gain skills to promote resiliency in the face of traumatic events

• Identify the components of resiliency


Research Questions

• What can we learn from first responders?• What differentiates those who get PTSD from

those who don’t?• How do we enhance factors that promote

resiliency in adults?


Why focus on Law Enforcement?

• “Research suggests that police work is among the most stressful occupations in the world and officers typically suffer a variety of physiological, psychological, and behavioral effects and symptoms.”

McCraty, Atikson, Global Advances in Health and Medicine,


Why Study Law Enforcement?

• Officers are exposed to numerous Potentially Traumatic Events (PTEs)

• Keeping Law Enforcement Officers healthy is in the best interest of the communities that they serve.


Why Study Law Enforcement?

• Stress among police has the potential to affect society directly and in more critical ways than other occupations.

• Those in the occupation of law enforcement may be encouraged to detach from others and disassociate from their feelings.


McCraty, Atikson, Global Advances in Health and Medicine

The Paradox

• TO FUNCTION EFFECTIVELY IN OUR JOB, YOU MUST ANNIHILATE,SMOTHER, AND SUPPRESS NORMAL EMOTIONS LIKE FEAR,ANGER, REVULSION, AND EVEN COMPASSION. TO DO OTHERWISEIS TO INVITE OVERWHELMING DOUBT OR HESTANCY WHENDECISIVE ACTION IS REQUIRED. THE PENALTY FOR YOURACHIEVED COMPETENCE IS A MIND SET THAT MIGHT AS WELL BEA FOREIGN LANGUAGE TO YOUR SOCIAL CONTEMPORARIES. WEARE… VICTIMS OF OUR OWN SUCCESS. WHEN THESE SAMENORMAL AND APPROPRIATE EMOTIONS…SURFACE IN PERSONALRELATIONSHIPS, WE AUTOMATICALLY SHUT DOWN ANDWONDER WHY, OVER TIME, THAT THE PEOPLE WE CARE ABOUTTHE MOST COMPLAIN THAT WE ARE ALOOF, COLD, ANDUNCOMMUNICATIVE.

LT. AL BENNER, PSYCHOLOGISTCopyright 2013 Ungvarsky and Trivette

Operational Sources of Stress for Law Enforcement Officers

• Major disasters• Traffic incidents• Shooting incidents• Interpersonal violence,

including domestic violence calls

• Negative or confrontational interactions with individuals

• Sense of personal endangerment

• Fear of revenge/retaliation from criminals

• Subservience to an ambivalent, watchful public


Non-Operational Sources of Stress for the Law Enforcement Officer

• Shift schedules• Authoritarian

management styles• Poor interpersonal

relationships with supervisors

• Interdepartmental politics

• Lack of adequate planning and resources

• Lack of promotion and transfer opportunities

• Excessive paperwork• Lack of autonomy in

performing duties• Lack of recognition for

work accomplishments


Predictors of PTSD Reactions

• Lack of social support• Low intelligence• Lack of education• Family background• Prior psychiatric history• Dissociative reactions


Predictors of Symptoms* among 1st Responders to a Potentially Traumatic

Event

• Proximity• Duration• Intensity of Exposure



Ease•Adaptive state•Resilience

Dis-ease•Maladaptive state•Vulnerability

• How do we conceptualize functioning following a potentially traumatic event?



TimeEvent

Dis

rupti

ons

in n

orm

al fu

nct

ionin

g

Mild

Mod

era

te

Severe

CHRONIC

DELAYED

RECOVERY

RESILIENT

Research

• 50%-60% of the US population is exposed to traumatic stress

• Only 5%-10% develop PTSD (Ozer at al., 2003)• Est. chronic PTSD range from 6.6% to 17.8% of

those exposed to PTE



Pathogenic or Negative Responses

• Traumatic stress symptoms• Secondary traumatic stress• Compassion fatigue• Burnout


Resilient Responses

• Compassion satisfaction (Stamm)– Positive feelings

• about helping others, finding meaning in one’s effort• and challenges, fulfilling one’s potential, contributing• to the work setting and even to the greater good of• society, and the overall pleasure derived from being

able• to do one’s work well.


What is Resilience

“ability of adults in otherwise normal circumstances who are exposed to an isolated and potentially highly disruptive event, such as the death of a close relation or a violent or life-threatening situation, to maintain relatively stable, healthy levels of psychological and physical functioning”

Bonanno


What is Resilience

• The process of adapting well in the face of adversity, trauma, tragedy, threats, or even significant sources of stress – such as family and relationship problems, serious health problems, or workplace and financial stressors. (American Psychological Association)

• It refers to the ability of “bouncing back” from difficult experiences


Ordinary vs Extraordinary

• Research supports that we all commonly demonstrate resilient behavior

• Being resilient does not mean a person doesn’t experience sadness or distress – these feelings are ordinary.

• Resilient people have an extraordinary trait to survive such experiences without it holding them back


Common Questions

• Where does resilience come from?• Do some people have more of it than others?• Is there some unique quality only special

people have?• What role does the environment and culture

play in hindering or helping one’s resilience?


The Simple Answer

• Resilience is not a trait people either have or do not have; regardless of race, age, gender, creed, etc.

• It involves behaviors, thought, and actions that can be learned and developed by anyone.

• In fact, those we would define as resilient often have the skill thanks to action learning through life experiences that involve considerable emotional distress.



Building a Scaffold of Resiliency

http://www.google.com/url?sa=i&source=images&cd=&cad=rja&docid=hsjZ2lMcNA85AM&tbnid=G6xRPSz0le3yiM:&ved=0CAgQjRwwAA&url=http://www.nullislove.com/2008/06/27/crud-scaffold-generator/&ei=L78GUem5HubC2gWDl4HABg&psig=AFQjCNHzC84NldJC2UCbiFcP30UlKpkOGw&ust=1359483055527424

Standard OneConnections & Community

• Forge positive relations with others helps increase one’s emotional strength

• Feelings of belonging and emotional connection to a community

• Perceived influence over the community• Perceived opportunities for fulfilling one’s needs

(including need for belonging)


Standard TwoCollective Efficacy

• What people choose to do as a group, the effort they put into it, and the perception of the group’s ability to accomplish its major tasks


Standard ThreeCoping & Appropriate Perspective

• See Crisis Events as They Are – Crisis events are not viewed as insurmountable

problems– You can not change what has happened. You can

however control how you respond to that event– Don’t make mountains out of molehills– When confronting mountains, view them in

perspective of the greater challenge ahead– Appraise PTEs as being less threatening


Standard FourAccept Challenge

• Surrender yourself to the fact that change is part of life

• Accept that from time-to-time certain goals may no longer be attainable as a result of adverse situations beyond your control


Standard FiveContribution

• Take Action– Do something about achieving your goals– If you don’t have any, get some!– Set achievable goals rather than wasting time on

“learning to fly without any wings.”


Standard SixControl

• Be Decisive – Do not avoid facing adversity – confront the

problem head-on and take decisive action to improve the situation or ensure it does not repeat itself in your life


Standard SevenCompetence

• Self Improve – Be active in finding ways to improve yourself and

don’t be frightened to get to know yourself better– Find reasons to have a strong sense of self-worth

and value to the world


Standard EightConfidence

• Develop an Ego – Take the time to find reasons why you are

important and focus energy on developing confidence

– Trust yourself and your instincts so that they can better help you and your world to problem solve


Standard EightConfidence

• Self-Efficacy– The individual beliefs that one holds regarding

one’s own capability to exercise some measure of control over in how one functions and of environmental events


Standard NineOptimism

• Be Hopeful – Find the optimistic outlook for even the most

devastating event– Learn to see what you want rather than worrying

about what you fear – which is what we often confuse as what we see.


Standard TenCharacter & Self-Care

• Take Care of Yourself – Pay attention to your own needs and feelings –

but don’t be self-centered– Keep yourself healthy, fit , and well. Invest energy

into eating well, gentle exercise, and maintaining a positive frame of mind

• Hardiness


Dimensions of Resilience

Next Steps

• Resiliency training– Heart Math– Biofeedback

• Efficacious use of resources• Utilizing the law enforcement community as a

support system


Thank you

Documents

Copyright 2013 Ungvarsky and Trivette Resiliency and First Responders Jim Ungvarsky, PsyD, LMFT Sharon Trivette, PsyD, LPC Regis UniversityEl Paso County