remains and psychological impact
Human remains and psychological impact on police officers:
Excerpts from psychiatric observations
AbstractThis paper describes the transient psychological responses that may develop in police officers in response to the handling of human remains and death investigation. It is based on my 28-year study of human tragedy, as pathologist and police psychiatrist. It is a summary of personal observations made during 3900+ tragedy-related medicolegal autopsies, over 3200 associated death scene investigations, and 15 years of long-term informal follow-up of many hundreds of police officers with whom I worked those death scenes. This paper describes, in a totally anonymous way, thoughts, feelings, fantasies, and fears shared with me by these police officers.
Human remains and psychological impact on police officers:
Excerpts from psychiatric observations
Show me the manner in which a nation or community cares for its dead and I will measure with mathematical exactness the tender sympathies of its people, their respect for the laws of the land and their loyalty to high ideals. - Gladstone.
Most police officers consider human remains handling and death scene investigation routine. These tasks are laden with emotional significance and are often accompanied by sights, sounds, smells, tastes, and touch sensations of the most unpleasant kind. Both young and older officers are vulnerable to the emotional and sensory aspects of body handling and death scene investigation. Young police officers often have little life experience. Older officers may have been traumatized by military combat. Officers of any age may struggle with issues of depression, suicidal ideation, anger, aggression, separation issues, relationship problems, or childhood physical or sexual abuse. Officers with much life and street experience are much more resistant to the psychosensory effects of body handling and death investigation, but even they are not immune to them. Most police officers eventually develop tolerance for routine death on the street, and most death events would barely rate on their Richter scale of emotion. During years on the street, they develop mature coping strategies and responses, that allow them to shrug off all but the most vivid of death scene and dead body experiences. Some death events, however, by virtue of their magnitude, horror, bizarreness, or pathos, leave indelible impressions upon the psyche of even the most experienced and mature police officer. He may show no outward emotional response, develop transient responses to those events, or experience long-term psychological sequelae, with significant impairment and disability.
This paper concerns the transient psychological responses that may develop in police officers in response to the handling of human remains and death investigation. It is based on my 28-year study of human tragedy, as pathologist and then police psychiatrist. It is a summary of personal observations made during 3900+ tragedy-related medicolegal autopsies, over 3200 associated death scene investigations, and 15 years of long-term informal follow-up of many hundreds of police officers with whom I worked those death scenes. This paper describes, in a totally anonymous way, thoughts, feelings, fantasies, and fears shared with me by these police officers. Private moments of extreme grief, horror, and rage- at what man can do to fellow man, man can do to himself, and natural and man-made disaster and disease can do to the innocent and vulnerable- make up the body of this paper. All of these feelings were shared during the heat of the investigation, or in private conversations some time (even years) later.
Over the last twenty-eight years, I have worked with and come to know well over a thousand police officers in the field. This is their story, in their own words. Most contributed only one or two pieces to the puzzle of transient death scene and body response. Those who contributed more usually entered psychiatric treatment and recovered, or retired on medical disability. Their stories are recorded in a companion paper. This study is a subjective and practical formulation, not a rigorous academic one. It is a synthesis of every sort of symptom that these men and women have shared with me over the years. Most officers had only one or two of these symptoms for very short times. None had all of these transient symptoms at one time. I want to make it clear that these officers by and large were, and continue to be, very high functioning, both on the job and at home.
Mental health professionals (MHPs) deal with life, not death. They exist in a world of theory and practical application thereof in a pristine office setting. They usually have absolutely no experience with the unpleasant physical realities of death, much less experience responding to those realities. Yet these same MHPs may be called upon to speak with an officer acutely experiencing them. This paper demonstrates, therefore, the amazing array of possible transient psychological responses to bad scenes and bad bodies. The purpose of recording these responses here is to help MHPs understand that these symptoms usually are not pathological, and usually do not progress to diagnosable psychiatric disorder. In my view, they are premonitory of a condition that I call street fatigue, similar to military combat fatigue. (My conceptualization of that condition is discussed in another paper.) With that understanding, we begin their story.
All living beings and systems have fail-safe mechanisms that can malfunction under stressful circumstances and eventually collapse when conditions are intense enough. Anyone (police officer, emergency responder, or an actual or vicarious witness of a death scene) can reach and exceed saturation point when exposed to the highly inflammatory emotional and sensory stimuli associated with dead bodies and death scenes. No one is immune. Each police officer, like any human being, can be pushed beyond the limit of his psychological experience and endurance, to a point at which he becomes overwhelmed. Even officers of the highest caliber training, and greatest spiritual, physical, cognitive, and emotional strength and experience can become over saturated at some point, in the right milieu, and with the right intensity of stimulation. Which specific individual death scene, body, or investigation leads to over-saturation in a given officer is idiosyncratic. That which is devastating to one officer may have little effect on another. Most police officers are prepared by their daily work on the street for a single body or a few bodies at routine death calls. However, a particularly poignant or awful tableau of sights, sounds, smells, tastes, and touch experiences can assault an officer's emotional Achilles heel.
Most police officers are bound by the emotional cultures of their departments. Many departments have historically subscribed to the idea that police officers should always be free of emotion. Any acknowledgment of emotion was considered weak, unmanly, or unprofessional. This philosophy is in part related to the myth that soldiers or grown men don't cry. The advent of modern warfare and the rise of military psychiatry have debunked this myth. Professional soldiers with the most advanced training and experience do express emotion about their combat and war experiences, albeit usually in very private circumstances. Their sharing is generally limited to colleagues who have been there. The myth that soldiers don't cry was shattered with Barbara Walters' American television interview of General Norman Schwarzkopf, by in his command tent during Operation Desert Storm. The general admitted publicly that he cried with homesickness, and showed the teddy bear from his family that he kept on his cot for comfort. This interview gave many soldiers the tacit permission and courage to acknowledge their feelings about their military duty, and even share them with their families.
In the my experience, highly professional police officers of great experience also feel strong emotion about their varied street experiences, especially body handling and death. These officers are willing to share their feelings under safe circumstance. Police officers do cry, and many told me that they cried for the first time while watching General Schwarzkopf's interview on television. However, like war-fighters, police officers shed tears only with those who can be trusted truly to understand- those who have actually shared similar street experiences. Bad scenes and bad bodies are responsible for many of these strong police officer responses.
I have found that the transient responses to bad bodies and bad scenes fall into several groups: 1) no outward emotional response, 2) awakening of core emotion, fantasies, and fears, 3) dissociative symptoms, 4) sensory symptoms, 5) arousal symptoms, 6) mood symptoms, 7) behavioral symptoms, 8) personal boundary symptoms, 9) secondary symptoms, associated with substance use, 10) re-awakening or exacerbation of major psychiatric disorders, and 11) symptoms related to the psychological struggles of fellow police officers (contagious symptoms). Civilians and members of the military may have similar groups of symptoms under situations of extreme stress. However, I have found that police officers have characteristic expression of specific symptoms within each group.
The American Psychiatric Association did not officially recognize these transient symptoms in the Diagnostic and Statistical Manual until 1994. In that year, trauma responses the first eight groups listed above were consolidated into a constellation of symptoms called acute stress disorder. To qualify for this diagnosis, the symptoms had to be present for a minimum of two days and a maximum of four weeks, with onset within four weeks of the event. No provision was made for the diagnosis of incomplete syndromes. Cultural allowances were only briefly addressed and concerned immigrants with histories of political and war-related torture (just as in the criteria for post-traumatic stress disorder [PTSD]). No mention was made of work-related allowances for police officers, members of the fire and ambulance services, paramedics, or medical death investigators. The 1994 criteria for acute stress disorder still stand today.
In my experience, symptom clusters not meeting full criteria for acute stress disorder, and symptom clusters defined as acute stress disorder in civilians, are quite common in police officers handling human remains and personal effects. Acute stress disorder is so common in psychologically healthy police officers that I believe that separate, culturally bound criteria should be established for law enforcement. If civilian criteria are applied to this population, a stigmatizing label of a psychiatric disorder will be attached to otherwise healthy and highly functioning professionals. This labeling induces further iatrogenic psychological injury, with its associated psychiatric morbidity and mortality.
I conceptualize these transient job-related symptoms as street fatigue (discussed in a companion paper), analogous to combat fatigue. I have found that street fatigued police officers respond to a different type of intervention from that used for PTSD. I have also found that street fatigue can progress to full-blown psychiatric morbidity, if the officer is treated as a psychiatric patient. He recovers much more quickly if he is treated like the high functioning human being that he is. Street fatigue is a normal and culturally related response to repeated exposure to extraordinary death scenes and human remains. If the situation is really extraordinary, or laden with extreme psychological significance to the officer, street fatigue can occur upon a single exposure. In my experience, street fatigue is also common among members of the fire service, paramedics, emergency medical technicians, and medical death investigators, especially after mass fatality disaster events. I have worked with many officers who experienced street fatigue associated the Delta Airlines crashes in Dallas, Texas (in the 1980s) and the Branch Davidian episode at Waco, Texas, and the bombing of the Murrah Federal Building in Oklahoma City, Oklahoma (in the 1990s).
No Outward Emotional Response.
Some police officers never outwardly manifest an apparent immediate, short-, or long-term emotional response to human remains, personal effects, the death scene, the forensic morgue, medicolegal autopsy, or (at mass fatality disasters) the personal effects warehouse. This non-response is actually a response. These police officers usually are older, have great life experience, and have come to a personal conclusion and philosophy about the roles of good and evil in life and death. They have examined the purpose of man, and his role in the universe. They may have spent much time in spiritual contemplation and deciding whether or not there is a power higher than themselves. Such officers are often profound sidewalk philosophers, and/or active in spiritual, religious, or political affairs. They often pursue intellectual avenues (advanced degrees, often in the social sciences, or psychology) or creative outlets (poetry, music, art). Most have had earlier experience with death, through farming, ranching, hunting, fishing, or military combat. Some officers have come to similar understanding by more rigorous means, having survived early childhood physical or sexual assault or abuse, and in rare cases, even homicide attempts by a parent or other family member. Repeated exposure to aggression and death (potential and actual), leads to fine honing of successful, mature psychological coping mechanisms. The officer can thus defend himself against psychosensory and physical overload at bad scenes with bad bodies.
In unusual circumstances, a police officer does not care about or acknowledge psychosensory experiences during body handling and scene investigation because of his personality structure, psychopathology, or psychiatric illness. The officer may lack empathy, as in antisocial or narcissistic personality disorders. Or, he may actually enjoy death, destruction, and carnage, as in sado-masochism and sociopathy. His enjoyment is similar to that of some arsonists and some who commit serial (especially sexual) homicide.
Transient and Long-term Psychosensory Responses.
Many police officers have a temporary response to bad scenes and bad bodies. These responses may be limited to the their time at the death scene, forensic morgue, or personal effects warehouse (in a mass fatality disaster), or duty time. Conversely, these responses may temporarily travel home with the officer in off-hours. His responses may be mild, not bother him, not cause any interference with his work assignments, duty, or home-life, and require only temporary respite to resolve. Or, his response to the body or the scene may be so overwhelming that he must leave his post. He may or may not be able psychologically to return. If he does leave (temporarily or permanently), his symptoms may subside to a tolerable level over the next few days and weeks, and disappear rapidly thereafter.
Much less often, the officer's symptoms persist for weeks, months, and even years. He may eventually integrate the psychosensory memories into his life experience. If this occurs, his daily and long-term functioning will not be impaired. This officer has found some sort of greater emotional, spiritual, and/or philosophical meaning in the incident, its associated memories, his role in it, his own survival, the fact, circumstances, cause, manner, mechanism(s), magnitude, and pathos or horror of the deaths of others. If he is unable to master his experiences, and bring some meaning to them, his symptoms may persist and interfere with his usual functioning. He is less able to function at work and home, with loss of quality of life, and inability to find or appreciate meaning in life, or its golden moments. He may subsequently develop mental, emotional, and physical illness, and even die (by his own hand, others, accident, or stress-related natural disease).
Police officers pride themselves on being unflappable and un-shockable. They have seen it all. Over time, officers develop great street confidence, and rightfully feel that they can handle almost anything. They develop a practical sense of invincibility, which is supported by their departmental and fraternal cultures. With this great confidence comes a comfortable sense of control and ownership of a situation. This mind-set accounts for the saying that, when a police officer arrives on the scene, it becomes his scene, under his total control. He can structure the scene and its participants in any way that enables him legally to gain control over it, with the goal of limiting further destruction and protecting the evidence. With practice and tutelage from more experienced peers, he quickly learn how to bring stability and control to the most chaotic of routine situations. The most common and effective technique is to set strict limits on his own (via standard operating procedure) and others' (via directions or commands) behaviors.
The officer is usually in both physical and emotional control of the scene and its elements. However, sometimes the circumstances of the death are such that routine structuring techniques do not bring immediate physical control of the scene. In these situations, the officer may feel an acute loss of both physical and emotional control. Mature coping strategies honed on the street can no longer quash previously unconscious fantasies that flare in the face of bad scenes, bad bodies, violence, mass destruction, or catastrophe. Primitive fears of annihilation, castration, mutilation, unrestrained aggression and rage, homicide, abandonment, humiliation, shame, betrayal, and inability to trust come rushing to the fore. The officer's fantasies, fears, and sense of loss of control grow at a given event, as the nature of the scene becomes more discordant with the expectations of reality, circumstances of the death become more violent, bizarre, or tragic, and/or the magnitude of fatalities increases. At ordinary death scenes, the officer may use intellectual defenses and bothersome aspects of the event to others. Intellectual defenses frequently fail at bad scenes with bad bodies, especially during mass fatality disasters. Mere words are found to be inadequate- indescribable terror, unspeakable carnage, and sorrowful horror. The officer normally expects and experiences an unusually high level of control at the scene. When he loses command of an extraordinary scene, the accompanying fear and horror magnify the overwhelming sense of helplessness, powerlessness, and sense of loss of control. The police officer no longer owns the scene; it owns him.
By definition, dissociative responses to trauma involve uncoupling of the usually well-integrated functions of consciousness, memory, perception, an/or identity. These symptoms appear primarily in the various dissociative disorders, but they also occur secondarily in acute stress disorder, PTSD, and somatization disorder. However, in my experience, isolated, paired, and clustered dissociative symptoms are common in otherwise healthy police officers exposed to extraordinary death scenes and human remains conditions. They also occur in similar circumstance in police officers with pre-existing psychopathology.
Police officers do not speak voluntarily of dissociative amnesia, but its presence is made known when groups of officers meet to discuss the event, informally or during formal debriefing. In my experience, selective amnesia occurs the most commonly. For example, I once met with a group of ten highly trained, high functioning surveillance officers who had suddenly witnessed explosion of a drug house and incineration of its occupants. Each officer had several points of observation that the others could not recall, but which were later verified on videotape of the event. Sounds, colors, textures, location of movable objects, relative positions of both landmarks and officers, and time sequences and intervals were all points of disagreement.
Similar disparities in recall of event details occurred with federal law enforcement agents who were in their offices in Fort Worth, Texas, when they were hit directly by a Force Three tornado. Disagreement on event details also occurred with officers who assisted in body search and recovery and general clean-up operations following the conflagration at the Branch Davidian compound in Waco, Texas. These observations were shared with me after the formal critical incident stress debriefings.
Localized amnesia is less common. An example comes to mind of a police officer who specialized in white-collar and cyber-crime in a large department. His academic background was in finance, computer science, law, and accounting. He had little experience in street-oriented policing, other than his requisite rookie year in a very quiet suburban jurisdiction, and had extremely limited exposure to urban violence. He had recently been transferred to a multi-city task force unit that assisted a nearby urban violent crime team, and had occasion to interrogate a suspect in a drug-related torture-homicide. He had been with the search and recovery team when the body was found. It had suffered massive antemortem blunt force injury with a shovel. The officer was stunned, when during interrogation, the suspect began smiling and laughing, while describing the means of torture in great detail. The suspect then related with great glee how much he had enjoyed seeing the young woman plead and bleed. The officer readily recalled the beginning of the interrogation and the interchange up to that point. However, he was very concerned that he could not recall what questions he had asked the suspect during the middle and end of the interrogation, until several days later. He had been amazed to hear his own voice, and that of the suspect, on the audiotape made at the time.
Depersonalization is also a common response to overwhelming death scenes and grotesque body conditions. The police officer with depersonalization describes himself as a robot or an actor in a play. He is just going through the motions. Some officers describe themselves as videographers, watching themselves in the viewfinder of the camera. One officer described feeling like a marionette, walking weightless on the moon. Another officer, who assisted in the collection of fragmented body parts from a high speed, high impact, two car crash site, recalled watching his gloved hands (seemingly unattached to his body) picking up the pieces, like it was on TV. A third officer recalled gathering up body fragments at a bomb site, but he could not recall any feeling in his hands as he did so. Yet another officer saw himself on television, giving a report about a young child burned to death in a house fire. He recalled interacting with the news reporter in front of the camera, but thought at the time that his voice belonged to someone else. One officer, who handled remains at the Branch Davidian compound in Waco, Texas, after the conflagration, noted that his mind became the S.O.P. (Standard Operating Procedure manual). It was on autopilot. I wasn't even attached to it (his mind), yet I knew what to do.
Derealization is also very common. The police officer may report that he is the only real person in a film and that others are automata. The physical world seems wrong. Objects seem much bigger or smaller than they actually are. Loud voices seem quiet and far away, while whispers sound like shouts. Colors may appear gaudy and loudly fluorescent, when in fact they are muted. Reds seem redder and purples seem more purple, especially in blood stains and puddles. The officer may suddenly experience comfort smells. He may smell perfumes used by a beloved mother, aunt, or grandmother when the officer was a child. Or, he may smell meatloaf and mashed potatoes (or other comfort food). Another common comfort smell is that of soap used by the officer as a child. Time sense also becomes warped. Complex ballistics investigations that really take hours may fly by in minutes at a particularly violent and bloody mass gang shooting. Conversations really lasting moments may seemingly last hours. Total time spent at a difficult scene or with distorted human remains may be grossly over-estimated or under-estimated.
For the vast majority of the police officers, these symptoms disappear after several hours at the scene or within several days of leaving the scene. However, I have worked with many officers who experienced recurrent prominent sensory and time distortions at a series of bad scenes with bad bodies, even though they were symptom-free between scenes. They were not free of such symptoms during scene investigation until they had worked five to ten such scenes. Curiously, all of these officers reported histories of childhood physical abuse and yet were high functioning. I also worked with several high functioning officers without childhood abuse histories, but who served in military combat during the Viet Nam and Desert Storm wars. They too had frequent depersonalization and derealization symptoms at bad scenes with bad bodies, in the absence of clinically diagnosable stress disorder symptoms. One officer had a history of combat stress (battle fatigue) and childhood sexual abuse. He developed chronic depersonalization and derealization in the context of borderline personality disorder, and was forced to take medical retirement after serious self-mutilation following investigation of the suicide of a neighbor in his small town. He eventually hanged himself.
Several high functioning officers with history of childhood sexual or physical abuse have told me that they have learned to dissociate at will (go into a trance, just to get the job done) at bad scenes with bad bodies. While in the trance, they report being oblivious to the sights, sounds, smells, tastes, and touch experiences of carnage scenes. They also told me, however, that both they and their partners thought that they were fully in tune with the investigation, their colleagues, and standard operating procedures. One officer describes willed dissociation as a combination psychic gas-mask and biohazard suit. Several officers reporting this voluntary phenomenon have received commendations for their work at catastrophic scenes.
I have also been told of volitional use of dissociation by several police officers who handled human remains at the Branch Davidian compound, at Waco, Texas, the bombing of the Murrah Federal Building in Oklahoma City, Oklahoma, and the two crashes of Delta Airliners in Dallas, Texas. All of these officers were high functioning before these incidents. Some of them had significant histories of childhood physical abuse, but others did not, and just stumbled onto the technique, or learned it from a partner. At much later dates, all of the officers with histories of abuse, still high functioning, recalled using voluntary dissociation techniques as children. Yet none of these officers connected that phenomenon with their voluntary use of dissociation at bad scenes with bad bodies. Well after the death incidents, several of the officers (both with and without abuse histories) told me that they continued to use their abilities, to induce trance-like states for relaxation, meditation, and study of the of the martial arts.
While the specific dissociative phenomena of amnesia, depersonalization, and derealization are common at overwhelming scenes, general dissociative phenomena are even more common. Most police officers recall their first death scenes, whether an unexpected natural death, high-profile mass fatality disaster, or something in between. In my experience, most police officers, immediately upon entering their first death scene, make some sort of remark indicating their state of extreme cognitive discomfort (dissonance). Many describe their first death scenes as a dream state, associated with tremendous slowing of both their thoughts and actions. I was wading through gelatin, as one officer put it. All of their senses feel muted, and there is also a sense of being in a fog or in a daze. Thought processes no longer seem to shift from one idea to the next with alacrity. Most officers comment upon a perceptible delay between stimulus and response, particularly with respect to sounds. Some perceive a profound lag between a thought and its final utterance. One officer describes the sensation as wearing a translucent blindfold for all the senses. Another describes a large wad of fuzz intervening between his thoughts and their expression. Many officers known for their quick study described fuzzy thinking when I worked with them at their first death scenes. Fifteen to twenty five years later, these officers still recall those perceived sudden changes in mental acuity. Officers who worked the Delta crashes and the Branch Davidian affair tell me that their dazed feeling was present for the first two to three days, and then began to wear off rapidly. They were completely connected again by the end of the first week. All of these officers remain high functioning today.
By my observation, the most common dissociative response at a bad scene with bad bodies is a total lack of feeling of emotion. While the literature uses terms like numbness, flatness, or detachment, police officers tell me that the experience is much more profound. It's like your being and self are encased in concrete. Everything is black, white, or shades of gray in your thinking and experience. It is being in a hyper-analytical state, with thinking so crystal clear and rigid that you think it might break. Many officers liken this state to becoming a computer-brain. Everything is a data bit keyed in. Nothing has any meaning. It's just facts and observations. They're all sterile and unconnected, except that they are in my brain. Associated with this state, many officers report increased rigidity of thinking and decision making, strict and obsessive reliance upon the letter of the standard operating procedure, and over-attention to detail. As one officer put it, The worse the body and the worse the scene, the more computerized I become. Keeping it in RAM (random access memory) means I can download it and get rid of it as soon as I leave the scene.
Almost all police officers who have a strongly negative psychological response to body handling and bad death scenes have intrusive and recurrent images, sounds, smells, tastes, and touch memories of the event. These symptoms can occur singly or in clusters, as well as spontaneously or in response to reminders (triggers) of the event. When clusters of sensory memories occur, the officer re-experiences or re-lives the event. At times, he can identify the symptoms as being just that. At other times, the symptoms are so convincing that he cannot tell them from reality. A dissociative response combined with sensory re-experiencing results in a full-blown flashback.
At other times, the sensory events become entwined with dreams or nightmares. Officers mistakenly, but descriptively, call this combination of symptoms night terrors. The significant other is usually the first to know of (and report) this phenomenon, when her flailing, yelling, but quite asleep partner kicks her out of bed. When awakened, the officer is quite convinced that the event he dreamed about really recurred. Similar events can occur waking hours; locally, they are known as daymares. They are as equally frightening as their nocturnal counterparts. Poignantly, one officer, whose small son suffered from true night terrors, found comfort when he was offered a well-loved and bedraggled teddy bear, which had already seen similar duty.
The images and smell memories of the human remains, personal effects, and death scene especially haunt new police officers, those inexperienced in body recovery or transport, and those who have never witnessed a medicolegal autopsy or visited a forensic morgue. Smell memories are usually the main response to mass fatality death scenes. These memories may be strong or weak, transient, lingering, or overwhelming. Smell memories are also the sensory responses that last the longest after the event. Illusions are also frequent, as are changes and distortions in interpretation of other sensory stimuli.
Some officers report that the vividness of visual memories of a death event can reawaken sounds, smells, tastes, and touch memories of the body and scene. One officer likened this experience to his response to seeing a television advertisement for fried chicken. He developed a subsequent image in his mind of dinners at his grandmother's house, associated with smells, tastes (even watering of his mouth), sounds of family laughter, and memories of the feel of juices from the chicken leg running down his chin. Other officers noted that a visual image strongly reminiscent of the body or scene could re-ignite the slowing down of time, and mute or magnify real-time sounds, reproducing the experiences that he had at his first death scene. The changes in sound are more likely, and the more intense, at mass fatality death scenes. However, they can also occur with routine and regular death scenes, with one or a few bodies.
Physical and emotional exhaustion based on sleeplessness is one of the biggest physical and psychological dangers to police officers working a death scene and handling bodies, especially, during mass fatality disasters. At a bad scene with a bad body, or a disaster scene, the associated adrenaline surge makes it difficult for the officer to remember or want to sleep. If his partner intervenes and insists that he take a break, he may find it impossible to fall asleep. Many things may keep the officer awake. He may be 1) replaying the events in his mind, 2) critically reviewing and assessing the actions of the responses agencies, the individual responders, and his own actions, inaction, or omissions, 3) incessantly berating himself and others for not doing more, or being unable to do more, 4) ruminating about why he is alive and others are not, 5) consumed or overwhelmed by survivor guilt, 6) worrying about the deceased and their families, his own mortality, and that of his own family, 7) bombarded by images, sounds, smells, or nightmares of his experiences, 8) refusing to fall asleep, for fear of dying in his sleep, 9) pondering the need to be on call twenty four hours a day, seven days a week, three hundred and sixty five days of the year, to prevent potentially fatal emergencies in his own home, 10) planning, and experiencing in fantasy or dream, his own funeral, and 11) having hallucinations upon awaking or falling asleep of his funeral's reality. He may do anything to avoid sleep. Even when over-saturated emotionally and physically by the death event, he may watch its television coverage, or return to the scene to volunteer for a double or triple shift. Frequent attempted contact by media representatives, continual stimulation by repetitive media accounts, and constant questions from voyeuristic, well-meaning, and fearful family and friends can also keep him awake. It may not be possible for the officer to escape from or to turn off the death event, its body, and the scene.
Lack of sleep and intrusive psychosensory symptoms combine forces to interrupt the officer's attention and concentration. Officers who are normally highly focused describe their faculties as going to mush, scattering like feathers in the wind, or going from a laser beam to a flashlight beam. Distractibility also plays a role. Their short-term memory is impaired, and they lose patrol car keys, forget orders unless they are repeated, and rely increasingly upon pocket calendars and note cards to recall important dates and facts. In one extreme case, an officer who had not slept for seventy-two hours following a mass disaster, and who was having strong smell memories, repeatedly misplaced firearms and ammunition.
The exhausted officer's usual high alert status and street paranoia are enhanced by his constant hypervigilance and scanning for specific psychosensory reminders of the event. As the paranoia and scanning increase, he develops increasing physical (muscle) and emotional (psychic) tension. He feels wired, tightly wound, or keyed up. His physical and psychological agitation are reflected in marked motor restlessness and thoughts bouncing from one to another in no particular fashion. Some officers suddenly increase their workout routine frequencies and intensities after bad scenes with bad bodies, but they may or may not consciously make the connection between the case and the need to let off steam.
Some officers are on such high states of alert after a bad scene that they develop hair trigger reflexes, associated with a marked startle response. When the officer has access to his duty weapon, this combination of symptoms can be deadly. Unfortunately, innocent family members have been accidentally shot, when they have unwittingly surprised such an officer, who misperceived their actions and intent, and reacted spontaneously.
Rage is a common underlying theme in the police emotional response to body handling and grotesque or tragic death scenes and circumstances. Most officers mask the rage well, allowing only anger or irritability to emerge. This anger or irritability may flicker, erupt sporadically, or develop into long-lasting and externalized rage.
The anger and rage are merely masks for the deeply hidden roiling core emotions that occur in almost every officer exposed to death scenes of any intensity. These emotions come bubbling to the surface in even the most experienced and mature officers after bad scenes with bad bodies. The degree of anger and rage increases in proportion to the magnitude of the officer's sense of loss of control, fears (of annihilation, castration, uncontrollable aggression, homicidal impulses, humiliation, shame, abandonment, and betrayal), and his increasing inability to trust. The irritability that accompanies the anger also has a physiological component; it is associated with the general state of arousal at and after the scene.
The anger also masks a sense of helplessness, which further fuels the rage. The officer develops a heightened need to do things for himself, so as to regain a feeling of some degree of control in his life and over the death situation. It is very difficult for him to be immersed in brutal and often grotesque death at work, and then suddenly be exposed to life and all of its vicissitudes immediately upon arrival home. At home, the officer's sole focus must shift rapidly from the darkest corners of human existence, to the mundane routines of everyday life. He must relinquish his psychological armor that he dons daily to confront and protect himself from the horror of violent death on the street. He must instantly be able to relate in the usual way to the lives of those he loves, but who cannot possibly understand- spouses, children, parents, and civilian friends. (The latter are scarce for many law enforcement professionals and their families, for that very reason.) All of these people demand his full attention and his full appreciation of the events of their lives. These events are of greatest importance and significance to them, but only of small or little significance to him, compared to the events from which he has just returned.
Repeated exposure to bad bodies and bad scenes changes the officer's view of life. What he sees as important and of priority may be radically different from what his family considers important and of priority. Over due bills and mechanical difficulties in the family car headline the family news bulletin given the officer when he returns home from work. A supper grown cold, while the family waits [again] for the officer to return home (when he has forgotten to call, to say that he will be late), is an urgent event. A child's illness constitutes a crisis of greatest significance to the family. However, after immersion in a tragic death scene, the officer has different thoughts of importance. He contemplates and ruminates about many issues of deep personal significance- the sanctity and fragility of human life; the suddenness and capriciousness of death; the ubiquitous opportunities for catastrophic injury and death for family, friends, and self. He experiences great irritation at the stupidity of things that otherwise intelligent people do to put themselves at un-necessary risk. He feels the urgency to savor the insignificant' things in life. He desperately searches for golden moments, to help restore his rapidly waning faith, confidence, and trust in his fellow man.
Suddenly, the police officer and the ones he loves are on two widely divergent roads. If the officer and his family are far enough apart, and if his family has not been educated and prepared as to what to expect and how to react, a great schism can develop between them. If not addressed in time, even the strongest personal, marital, and filial bonds can snap. The resulting failed relationships and divorce are especially common among homicide detectives, tactical and gang unit members, youth division and high risk patrol officers, and members of dive, search and recovery, disaster, and dog teams. (Similar high rates of failed relationships and marriages are also seen among other emergency responders, members of the fire service, and medical death investigators.) Police officers who handle human remains and/or personal effects directly and/or on a regular basis are at even greater risk. Even officers frequently exposed to human remains in a virtual way (by photographs or graphic written reports) are also at risk.
This article is referenced only from my personal and professional observations and experiences working with the men and women of law enforcement.
Massey University, New Zealand
Last changed October