Police Officer PTSD: The Mindfulness Treatment Shows Promise

By Dan Fish

police officer PTSD - LexipolPolice officers are often exposed to more stress and trauma in one shift than some people may experience in a lifetime. Natural disasters, serious accidents, intentional acts of violence, combat exposure, child sexual or physical abuse, terrorist attacks, sexual or physical assault, and betrayal by a trusted friend or provider—all these can cause post-traumatic stress syndrome (PTSD). And you don’t need to be the victim; simply being witness to these incidents can also cause PTSD. Of course, police officers see these types of cases every day.

One of the most common symptoms of police officer PTSD is hypervigilance—a preoccupation with possible unknown threats, constantly watching and scanning surroundings, startling easily and having a persistent sense of insecurity. Hypervigilance keeps police officers safe and alive, but when experienced over a long period, it can become dangerous, even deadly.

PTSD is usually treated with psychotherapy and/or medication therapy. The most common forms of psychotherapy currently include Cognitive Behavioral Therapy, which includes forms of Cognitive Processing Therapy and Prolonged Exposure Therapy. Eye Movement Desensitization and Reprocessing has also proven helpful. Medications typically include Selective Serotonin Reuptake Inhibitors.

However, not all patients respond to traditional treatments, and sometimes the stigma of counseling or the side effects of medications are too much. That’s where a relatively new treatment method for PSTD shows promise.

What Is Mindfulness?
According to the National Center for PTSD, mindfulness is a way of thinking and focusing that can help victims of PTSD become more aware of their present experiences. As the Center notes, “Practicing mindfulness can be as simple as noticing the taste of a mint on your tongue. There are some things you might do every day without even thinking of them, like brushing your teeth in the morning. Mindfulness involves paying attention to the feelings and sensations of these experiences.”

Mindfulness practice or therapy has two main components:
1.  Focusing attention and awareness on the present. Our minds often race from thought to thought, jumping ahead to the next thing. As in yoga practice, mindfulness attempts to slow down this mental activity and focus on what’s happening now. Many people find it helpful to start by focusing on their breath.
2. Accepting your thoughts and feelings without judgment or reaction. In mindfulness, sensations and thoughts are not inherently bad or good or negative or positive. They simply are.

If you try practicing mindfulness for even a few minutes, you’ll probably find it quite difficult. It is challenging to keep our focus on the present, way too easy to become distracted by our thoughts or to react to them. But that’s OK; those who teach mindfulness coach patients to notice where their thoughts take them, and then how to bring their attention back to the present moment.

Looking at the above two components, you can probably see why mindfulness can be effective for those suffering from PTSD. Hypervigilance is all about being one step ahead, the mind attempting to anticipate what might happen and react accordingly. Mindfulness tries to break that cycle, to slow things down, to avoid impulsive behavior.

Mindfulness can also be a valuable addition to traditional PTSD therapy. In Cognitive Processing Therapy and Prolonged Exposure treatment, patients are asked to write or talk about trauma with the guidance of a therapist. According to the National Center for PTSD, mindfulness can prepare the patient for these treatments by giving them the skills and confidence to handle their feelings. Mindfulness patients can become more willing to think and talk about personal trauma and cope with difficult thoughts and feelings. This can enhance the benefit of the PTSD treatment.

Does It Work? 
Mindfulness is still a new treatment for PTSD, so the jury’s out on how it compares with other PTSD therapies. The National Center for PTSD notes, however, that mindfulness has proven effective in treating anxiety and PTSD symptoms, such as avoidance and hyperarousal..

While additional research is needed, two studies had promising results:
• Researchers at the University of Michigan recruited Veterans Affairs patients suffering from PTSD. One group was assigned to an eight-week mindfulness-based cognitive therapy program—which included focusing on emotions and breathing, focusing attention on individual body parts and mindful eating—while the other group received typical PTSD treatment. By the end of the treatment programs, researchers found that 73 percent of those who underwent the mindfulness therapy saw improvements in PTSD symptoms, compared with just 33 percent of those receiving the standard PTSD treatment.

• Researchers at the University of New Mexico focused on the role of the stress hormone cortisol. Although high levels of cortisol are not good, those suffering from PTSD often have extremely low cortisol levels. The study involved 28 nurses, 22 of whom experienced PTSD symptoms (nurses, like police officers, are at high risk for PTSD). Half of the nurses received mind-body training classes twice a week for eight weeks, while the other half did not. Those who underwent the mind-body training experienced a 67 percent increase in cortisol levels and a 41 percent improvement on a PTSD symptom checklist. Those who did not undergo the mind-body training experienced a 17 percent increase in blood cortisol levels and a 4 percent decrease on the PTSD symptom checklist.

These initial studies, combined with others that show mindfulness is effective in enhancing emotional control, decreasing anxiety and reducing depression, point to the theory that mindfulness may be effective in treating PTSD. The National Center for PTSD states, “Combining mindfulness or other skills to strengthen emotional control with existing, data-supported PTSD treatments may improve outcomes.” Those improvements may include:

• Engaging patients who might otherwise avoid therapy or can’t tolerate traditional treatments.
• Preparing patients for trauma-processing therapies, which can elicit negative emotions.
• Reducing the tendency to obsessively reflect on negative or painful thoughts and memories.
• Enhancing compliance in patients using traditional treatments so they are more likely to complete therapy.

Worth a Look
Although we have much to learn about mindfulness, it clearly has the potential to offer significant mental and physical benefits. Further, it seems perfectly matched with the stresses law enforcement officers experience on a regular basis. And it has the added benefit that it can be practiced at home, by anyone, with no side effects (coaching from a trained provider is recommended).

Mindfulness may ultimately evolve into a stand-alone treatment for PTSD or it may find its home as a force multiplier used in conjunction with the traditional therapies. Either way, the law enforcement profession should explore the potential applications of this therapy. Any practice or treatment that can reduce stress and anxiety and curb hypervigilance is something law enforcement leaders should embrace.

Lexipol’s Law Enforcement Policy Manual and Daily Training Bulletin Service provides essential policies that support officer safety, health and wellbeing. Contact us today for more information or to request a free demo.

Dan Fish - LexipolDan Fish is Professional Services Representative for Lexipol. He retired from law enforcement in May 2017 after a 30-year career where he served in all ranks of the Petaluma (CA) Police Department including Chief of Police. Fish earned his bachelor’s degree in criminal justice from Sacramento State University and he holds a graduate certificate in law enforcement leadership from the University of Virginia. He holds several California certificates including the POST Management Certificate and the Phi Theta Kappa International Honor Society Leadership Development Program. Fish is a graduate of the POST Executive Development Course and Command College, the LAPD West Point Leadership Program and the FBI National Academy session #263.

References
• Davis D. and Hayes J. (2012) American Psychological Association. What are the benefits of mindfulness? Psychotherapy. 2012;48(2):64. Retrieved 8/26/17 from: http://www.apa.org/monitor/2012/07-08/ce-corner.aspx
• Huffington Post. (2013) Mindfulness could help ease war-related PTSD symptoms. Retrieved 8/26/17 from: http://www.huffingtonpost.com/2013/05/05/mindfulness-ptsd-symptoms-war-related-combat_n_3187437.html
• Huffington Post. (2013) How mindfulness training could help people with PTSD symptoms. Retrieved 8/26/17 from: http://www.huffingtonpost.com/2013/05/29/mindfulness-ptsd-symptoms-cortisol_n_3348593.html
• National Center for PTSD. (2015) Mindfulness practice in the treatment of traumatic stress. Retrieved 8/26/17 from: http://www.ptsd.va.gov/public/treatment/therapy-med/mindful-ptsd.asp

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