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Resilience through Restitution, a Collision Investigator's “Bounce Back” from an Operational Stress Injury Road Trip
Written by: Traffic Sergeant Adam Carter, CStJ, BPhEd, CCISM, CTR, CST-ES
Growing up I wasn't always the fastest, smartest or strongest, and failed at many things, but before I lost my father to cancer when I was 16, he left me with two lessons that have guided my personal ethos; "you can accomplish anything that you put your mind to", and "if something is worth doing, then it is worth doing right the first time, but if you don't succeed, try again". From a young age my teachers, coaches and friends described me as persistent, always the "Most Improved Player", it drove me to persevere through sports, school, work, and life. I was raised in the Catholic Church, and from a young age I understood the virtues of compassion, empathy, and the importance of giving back to my community. However, in 1988 when I held my father’s hand and watched him take his last breath, this became the foundation of my trauma, and the greatest influence on my OSI road trip. Within a year of my father’s death, I experienced the passing of my grandmother and the sudden tragic loss of my soccer team captain to an impaired driver. I withdrew from my church, went into self-preservation mode, and only began to look out for #1. By 18, I was on my own making my way in life. An accomplished soccer player and aspiring physical education teacher, I ventured away to university in 1991. As with many, I drank away my first year, returned to my hometown to live with a friend for a couple years and got my life back on track. In 1994 I returned to university and two life changing events occurred; I started what has become a lifelong volunteer career with St. John Ambulance, through whom I have learned a great deal about servant leadership, and most importantly, I started dating Lisa, my best friend, soul mate, and my “Tiny Angel”. I finally completed my Physical Education degree in 1997 and made the decision to take a road trip into the world of law enforcement.
The issues of first responder mental health and suicide are at the forefront of today’s media, but in 1998 they were taboo to speak about. I did not realize it then, but I was bringing my prior traumatic life events, that I had not dealt with, into a highly vulnerable career. Like every young police officer working the frontline, I had my share of exposures to critical and traumatic events; two motor vehicle collisions during my first month on the job (I was passenger in both) and a 6 month old infant death (who was only 3 days older than my daughter) to name a couple. For the most part I chalked them up to being part of the job, just sucked it up, and didn't talk about them. This is the moment I started self-medicating, ceased working out, and began to avoid my young family.
In January 2004 I transferred to Traffic Services, where I have spent the rest of my career, with the exception of an 11 month posting as a uniform patrol supervisor. The first four years I served as a Traffic Enforcement Officer through a period of organizational dysfunction, chaos, and restructuring, and hit another speed bump in my OSI road trip; suffering a lost time duty injury after an accused tried to disarm me while conducting a breath test. I knew I should have pulled over and gotten off the road, literally and figuratively, but just kept going.
From 2007 till my promotion in 2017, I had left the frontline and took a detour into the detective office as full-time collision investigator, where I amassed nearly 600 collision investigations over the course of my career. This was without question the most rewarding job I have had in my policing career, because I was getting families answers about their loved ones in the most traumatic times of their lives, because no one can prepare for that knock at the door.
On April 3rd, 2015, for the first time, I had a collision investigation that touched close to home, a life-altering fail-to-remain investigation in which both victims were known to my children. This affected me greatly, but I felt like I needed to “be strong” for both my family and the victims. This was a major fork in the road for me, and I never stopped to evaluate which route was the best. I needed to take action for my wellness and mental health but didn’t, and this is where I really lost control of my journey. 2015 was the year I had been on-call for over 28 weeks and attended 76% of the unit’s collision investigations.
I was cautiously optimistic about 2016 because in my mind it was a milestone anniversary for my father’s death. Sadly, that spring brought the passing of my mother-in-law, which brought up a lot of oppressed memories of my father; anger, sadness, guilt, etc… all emotions that I professed to have dealt with, but found out how wrong I was. Within a week of mother-in-laws passing I found myself at a fiery single motor vehicle collision, in which I pulled a former university teammates charred and partially cremated body out of his motor vehicle. It was a collision that I never should been at, but was “ordered” to stay. Adding to these traumas were my ancillary duties as the Provincial Reconstruction Committee Chair, Team Leader, Unit Training Officer (training three new members at the same time), and I was competing in the ever stressful promotional process.
Then came Wednesday, July 20th, 2016; after having worked 22 hours the day before, my body decided it had enough and it “turned the engine off” on me, and I crashed head-on into a brick wall. The trigger was a simple email about a procedural change, which no longer permitted me to perform certain administrative duties that I had been doing for the past nine years. July 20th is a blur to me; I have pockets of memory loss that I have been able to piece together, ironically through social media. I remember being very angry and deciding to go for a bike ride, but do not remember the ride, and only know where I went because my Garmin tracked it. 50 kilometres later, I found myself sitting on the side of the road crying at the same spot where a cyclist had died in the collision I had investigated the day before. I do not remember riding home, or taking the Police vehicle back to the office, but I do remember picking up my truck and planning on meeting with an old friend about an hour’s drive west. The next thing I remember is getting off the highway about 2 hours east of where I had intended. Wrong turn or right turn, I do not know, but I stopped at my old soccer field and took a picture, posting it online, but the location tag said I was in Darlington, Pennsylvania. This proved to be a good a thing, because it raised concerns for my wife, and Lisa called me asking where I was and what was going on. By that point I had continued driving further east and was sitting in front of my best friends grave stone crying. Again, if it wasn't for the picture and Lisa telling me about our conversation, I would not have knowledge of this. I do remember meeting my brother for a bite and a beer, and visiting our father's grave where we cried together for a good long time. The two and half hour drive home is a blur, and Lisa tells me that when I got home I cried for hours, crying myself to sleep.
In the immediate aftermath, Lisa reached out to her employee and family assistance plan because I did not want to call mine for fear it would affect my promotional chances. I met with a psychotherapist, but the next couple days didn't get any better, with increasing anxiety and panic attacks, uncontrollable crying, and little to no sleep. My family doctor was unavailable for at least a week, and I knew I could not go to the hospital as they would notify my Police service and take my firearm away. Exhausted, scared, and not having a member wellness program in place at work, or any type of guidance as to what was happening to me, I made a “cold call” to BADGE OF LIFE CANADA. The executive director, Bill Rusk called me back almost immediately, spending nearly three hours on the phone, helping me normalizing my experience, sharing his journey, and providing me with the professional resources to get help. The next few weeks got a lot worse, with periods of blurred vision, temporary blindness, constipation, bloodied incontinency, searing headaches, ringing in my ears, tooth pain, and only one to two hours of sleep a night. I went to my family doctor, chiropractor, optometrist, and dentist, even had an MRI, but nothing was “physically” wrong with me. They all told me I as “healthy”. I finally got into see a psychologist, and at first I was so lost and all over the road map during my appointments. The psychologist actually thought I might be suffering from survivor’s guilt over my father. I must admit at that point I thought the psychologist was really a “quack”, and had no clue what she was talking about because, like most men, I wasn’t stopping to ask for directions or for clarity on my father’s death. In my mind I had made my peace with his death, so what she said made no sense to me. I already knew why my father had died, he had fought an eight year battle with brain cancer, he was not taken tragically, nor was my life ever in jeopardy, and it had happened 28 years earlier. I was just looking for a map so I could figure my own way back to where I was going. So began my journey back, not to the main road, but to an alternate route, one of adaptive functioning, positive growth and my "new normal".
After nearly three months away from work, and against my psychologist’s recommendation, I attempted to return to light duties. This was short lived and a scenario which played out two more times before I finally returned to full-time duties in March 2017. In collision reconstruction we refer to these as secondary and tertiary contacts, but the setbacks I faced over the next three months had nothing to do with critical or traumatic events. They fell into two areas of critical incident stress management; sanctuary trauma and perceived injustice. We are supposed to feel safe at work, protected and supported, but when we are treated as a number, accused of untruths and ostracized, we start to perceive the unjust and our work sanctuary no longer becomes a safe place.
In April 2017, I got promoted and transferred out of Traffic Services into my new role as a frontline supervisor. I still had a lot of work ahead in my recovery but I was just happy my world had final stopped spinning out of control, and the road ahead looked straighter and brighter.
Collision reconstruction is about putting the whole collision back together to find out what, how and why it happened. In order to do that for my OSI road trip, I had to find what was going to work for me. I tried several recommended self care activities which did not work; peer group counselling proved toxic and left me crying all the way home, and meditation is good but not for an impatient person. Learning to breathe properly and to become mindful of the here and now were useful tools, and journaling proved to be invaluable for the release of my emotions and providing a great amount of information for self reflection. My addictive, type ‘A’ personality kicked in and my obsession for learning “everything” about a subject took over, so I started educating myself about what was happening to me and the differences between post traumatic stress, critical incident stress, operational stress, etc… This became a form of cathartic rehabilitation, and kept my mind busy which was both good and bad. Some days it emptied my tank and other days it filled it up. My solace was transitioning from the soccer field after nearly 35 years of involvement, back onto the bicycle, ironically a Scott “Solace” road bike. It helped create balance between my body and mind throughout my return trip to adaptive functioning. Having a goal to join the Police Memorial Ride to Remember every September, a five day, 700 kilometre bicycle journey that required me to train regularly and for long periods at time. This transitioned me away from appointments with the psychologist, to CYCology appointments with Mother Nature, and is now my “go to” therapy when I need to decompress from a stressful day or refuel my resilience tank. Like preventative maintenance on your car, or a check up with your dentist, I still check in with psychologist every six to eight months!
Since my OSI road trip, I have upgraded to a more fuel efficient and environmentally friendly version of myself. I have logged over 33,000 Kilometres on my bicycle, dropped 30 lbs, and now use my renewed love of cycling to keep the conversation about mental health, wellness, and resilience rolling with the wheels of my bicycle. I’ve learned a few lessons along my OSI road trip; 1) it is not about winning or losing, you either succeed or you learn, and you cannot succeed without first learning. 2) You must learn your strengths and limitation before you can help others. 3) Knowledge is not power, the power comes from sharing your knowledge with others and helping them to better themselves. I occasionally still take the main road home, but more often I find myself using the less busy, more scenic alternate routes, because I have learned that life is not about any one single road trip, it is about enjoying the whole journey.
My next road trip is with resilience, I am currently the Coach for my service’s Cops for Cancer Team, and Team Captain for their Ride to Remember Team. In 2019 I rode in the Big Move Cancer Ride and participated in the inaugural Peloton Ride for “mental health and suicide awareness” with two dozen of my LEO colleagues from around the province in support of BADGE OF LIFE CANADA. In 2020 I will be riding with Team B1UE in the 3-Day Wounded Warriors Canada Highway of Heroes Ride "in support of those living with OSI and PTSD". I am working hard to help make a culture shift across the first responder community. My Police Service now has a Member Wellness Program, and I am proud to be part of both their Critical Incident Response and Peer Support Teams. I am now a Mental Health and Wellness Master-Instructor for ST. JOHN AMBULANCE, working towards my Mental Health First Aid and Law Enforcement First Aid Instructor status, and just finished a review and revision of the Ontario Critical Incident Awareness Program for their frontline volunteers. I am a part of the INTERNATIONAL CRITICAL INCIDENT STRESS FOUNDATION’s Approved Instructor Program cadre, and continue to educate myself in the field of CISM and Peer Support. My destination is unknown, but the mission is simple: share my knowledge, pay forward my experience, and help educate my colleagues about resilience so they can have a safe work ~ life journey, without experiencing any collisions along their road trips.
Sergeant Carter started his policing career with a large municipal police agency in Ontario in 1998, after graduating with a Bachelors Degree in Physical Education from BROCK UNIVERSITY. He served his first five years in uniform patrol and then transferred to traffic services where he spent four years as a traffic enforcement officer. In 2007 he began a 10 year run as a fulltime collision investigator, before being promoted and serving one year as a uniform patrol supervisor. Since March 2018, Adam has been a Sergeant in-charge of a Traffic Management and Road Safety Team. In 2016, after close to 600 collision investigations, Adam went off work for nearly six months with an Operation Stress Injury (OSI).
It was through his OSI journey that led him to a new found passion and purpose, and he now volunteers his time with his Service’s Peer Support and Critical Incident Response Teams. Adam is a Certified Trauma Responder with the ASSOCIATION OF TRAUMATIC STRESS SPECIALISTS, holds a Certification in Critical Incident Stress Management from the UNIVERSITY OF BALTIMORE, MARYLAND COUNTY, and obtained his Certificate of Specialized Training in Emergency Services with the INTERNATIONAL CRITICAL INCIDENT STRESS FOUNDATION. Outside of work Adam continues to dedicate his time to community service, and has been a governance and leadership volunteer with ST. JOHN AMBULANCE since 1994, and part of their Instructor Development Program for more than 15 years, most recently as a Master-Instructor for their Mental Health and Wellness Course.
Adam is also an internationally licenced soccer coach with more than 20 years experience, and an avid cyclist who volunteers his time to coach his Police service’s Cops For Cancer Cycling Team, as well as captaining their Police Memorial Ride To Remember Cycling Team. He has been with his wife Lisa since 1994, is the father of two young adults, Jared and Erica, an adopted dad to Caitlin, and grandfather to her sons Ryan and Lukas.
Sergeant Carter has been recognized for his “outstanding commitment to community service” by four different Governor Generals of Canada. He is a Commander in the Order of St. John, with whom he has also received a Provincial Commissioners Commendation, a Life Saving Award, and the Long Service Medal of The Order. In 2002 he was the recipient of the Queens Golden Jubilee Medal and was awarded the Police Exemplary Service Medal in 2018. Professionally, he was named the District Officer of the year in 2003, has received 3 Chief of Police Commendations, was awarded the Traffic Safety Leadership Award in 2015, and most recently was recognized for his continued efforts in Peer Support Assistance by BADGE OF LIFE CANADA.
Serving your nation is one of the most truly noble acts that a person can do in life. Setting aside your own desires, dreams, and plans to help secure the future of someone else’s way of life is an act that many people are unable and unwilling to perform. But for those who make the sacrifice, their return to the civilian side of life can be a major adjustment. Friends and families left behind during a soldier’s tour of duty feel their absence and miss their loved one, but they continue with the monotonous routine of everyday life; dishes, groceries, bills, and carpools don’t get put on hold. When their soldier returns, they often expect that person to step right into the “normal” everyday life they have been experiencing.
But for that returning soldier, their everyday “normal” didn’t include ball practices and dance recitals, math homework and leaky roofs. The everyday experiences they had included roadside bombs, always being on the lookout for tripwires, feeling distrust of any unknown individual, sleeping in terrible conditions, and being subjected to all elements of the weather. Witnessing close comrades being killed or seriously wounded changes someone; they cannot simply walk back into the life they knew without learning how to accept that things are different and a healthy way to decompress. Unfortunately, the number of returning troops with some of the most serious and life-altering injuries is staggering. Injuries both seen and unseen are reaching an all-time high. And the main resource for the U.S. Military, the Veteran’s Administration, is struggling immensely to keep up and provide the services these soldiers and their families need. Many soldiers have turned to alternate means to try to function and deal with the emotions they experience. Substance abuse is at a record high among soldiers. Depression and suicide are at crisis levels. More and more soldiers are coming home only to realize that they feel completely out of place and at a loss on how to function in civilian society.
Soldiers are experiencing a trauma in various forms; themselves, other soldiers, and civilians. Many have TBI’s (traumatic brain injuries) which can have an altering effect on personality and mental acuity. Soldiers with multiple amputations is at another all-time high. Young, otherwise healthy men and women are returning home having to face a future far different than what they envisioned. While their peers at home are concerned with what college or vocation to pursue, what newest restaurant to try, or contemplating childcare options, they are having to relearn how to walk, talk, and function. Many have experienced injuries causing infertility. Some addictions may start out with medications prescribed to help ease pain received from traumatic injuries and proceed to abuse. Many soldiers are facing multiple tours of combat, leading to even more exposure to traumatic events.
Why are we seeing such a large number of people who are having such extreme difficulty returning to civilian life? Four letters: PTSD. Post-Traumatic Stress Disorder. Those four words have changed thousands of lives and without proper acknowledgement and treatment, a person may never regain a functional life. PTSD is talked about across news stations and in training sessions around the country. But what does it mean for the person struggling to get through a day? PTSD differs from encountering a traumatic experience, feeling shaken but walking away from that situation with anything more than added caution and gratefulness. PTSD can occur after a person experiences one single traumatic event or a series of events. Symptoms can appear soon following the event(s) or years later. It all relates to the physiological effects of the body’s “fight or flight” response. It is a protective measure your body uses in stressful situations to insure the best chance of survival. Your body dumps massive amounts of adrenaline, your blood flow increases, and you become alert; literally ready to stand and fight or flee from imminent danger. In PTSD, your body doesn’t turn off that fight or flight response. You become constantly on edge, awaiting whatever is coming. PTSD can exhibit itself in various ways. Some people experience anxiety, a restless sensation, constant fearful feeling, difficulty sleeping, lack of concentration, and increasing frustration or temper, guilt, or apathy¹. So how does this relate to substance abuse in veterans? The National Center for PTSD estimates that 1 out of 3 veterans who are struggling with substance abuse also have PTSD². “
So, with so many veterans struggling with these problems, why aren’t more coming forward for help? Why is the suicide rate so high? An overall culture of discouraging soldiers to ask for help and repercussions of being labeled as a drug-user keep many from stepping forward³. The VA is starting to issue campaigns, encouraging those struggling to come forward for help. But do the veterans actually have accessibility to that help? The numbers of suicide, drug abuse, and homelessness are not decreasing. Per the Substance Abuse and Mental Health Services Administration, 70% of homeless veterans were fighting substance abuse⁴. Families are not immune to the issues their returning soldier is facing. Spouses and children are dealing with the effects of substance abuse in their daily life.
What options exist for a veteran and their family? Where can they go to get the help they deserve? Church sponsored support groups offer a community for veterans to turn to; local governments can connect veterans to sources. Private treatment centers can offer a private and focused plan that includes the veteran and the family. New programs are being developed, many by veterans themselves, to provide realistic, affordable, and relevant care. Therapy with animals, from adopting rescue dogs to working with horses, has shown very positive results. Outdoor related activities, like hiking, camping, hunting, and fishing, offer real-world environments for a veteran to adjust to civilian life.
The mission of the Association of Traumatic Stress Specialists (ATSS) is to organize, educate, and professionally certify our world-wide membership in order to assist those affected by trauma. We encourage all members to share with us any trauma resources available for the brave men and women of the military.
Author: John Becker Jr. MHS-C, CTR (Former Detective Sergeant)
Should emergency services workers maintain work routines after exposure to trauma?
As a police manager I’ve thought about this question because I’ve seen officers who take time off after witnessing trauma, and I’ve seen others that stick to their normal work schedule. I’m not talking about just taking a day or two off, since that wouldn’t throw your work routines out of whack, however some officers get a doctor’s note giving them a few weeks, sometimes over a month off of work. That would definitely throw their routines off.
I recently read an article from Journal of Adolescent Health (2006) Maintaining Routine despite Ongoing Exposure to Terrorism: a Healthy Strategy for Adolescents? The researchers (Pat-Horenczyk, Schiff, Doppelt) studied high-school age youth in Jerusalem during the Al Aqsa uprising of 2002-2003. During that time there were 26 suicide bomb attacks in Jerusalem. They happened in buses, coffee shops, fast-food restaurants, shopping centers, and in the downtown area. Those are all areas that teens would typically go to hang out with their friends.
Of the 1336 Israeli adolescents examined, the majority (approximately 70%) continued with their routines and did not avoid buses, malls and restaurants. Even adolescents who reported exposure to terrorist attacks were as likely as teens reporting no exposure to maintain their level of routine activities. Thirty percent of the teens avoided taking buses and going to those locations, either because of their own choice or due to parents not allowing it.
The study found that a reduced level of routine was a significant predictor for higher post-traumatic stress and functional impairment. Interestingly, it didn’t matter why the subjects avoided going out, whether it was their own choice to avoid danger, or whether it was due to their parents limiting them, the outcome was the same – significantly higher rates of PTS and functional impairment. Maintaining routine was associated with less PTS, and parental encouragement for maintaining routine was associated with less PTS.
The article also mentions that it is consistent with other coping theories suggesting that “avoidance” coping strategies, including avoiding routines are associated with greater PTS than “approach” or active coping strategies.
The study doesn’t go as far as to determine why, but I’ll give some of my thoughts on it. It may be because teens stuck at home without their friends are more isolated and don’t have their normal support system of peers. It may be due to the avoidance behavior increasing their fear, instead of facing their fear which would likely reduce it.
It may be that the adolescents who continued their routines felt more confidence and self-efficacy and felt more in control of their environment. Despite the fact that they placed themselves in more physical danger, it was psychologically protective.
Does this apply to emergency services personnel? In my opinion it does. I think depending on the level of exposure to trauma, in most cases the members should be encouraged to return to work and re-establish routines sooner than later. I wouldn’t question the recommendation of a clinician, but often the subject is also getting advice from peer support teams or CISM members. Even after minimal exposure, sometimes their advice to the member is to take time off work. This is done with sensitivity and caring for the member, but may actually increase the chance of PTS and functional impairment.
I had one member who was involved in a traumatic incident. He told me that the peer support member told him he could take a month off work if he needed it, but he told me that his father used to say “When you fall off a horse you get back on”. He was back at work the next day. That was healthy for him.
Should EAP counselors, CISM teams, and peer supporters encourage members to get back to work as soon as possible? As a manager I may be biased, but I would like to hear your opinions and your experience with this.
Brad Coulbeck CTSS, Vice-President, Board of Directors, ATSS
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Our ATSS Board of Directors has reviewed your very thoughtful comments in our recent member survey. And we agree that we need to improve communication and engagement with our members and provide opportunities for connection with one another. We are not simply an association that provides opportunities for professional recognition through certification. We are an established and committed community of caregivers that edify, support and strengthen each other.
I think we’ve got the first part down, so now we are moving towards creating the community. We can do that through the blog, surveys and other communication to the membership.
As the blog evolves, we hope that it will provide:
- New research
- Opinions on different intervention models
- Experiences of members
- Tips on job opportunities
- Stimulating dialogue and comments
- A forum to share success stories
- Links to interesting articles
- A place to get to know each other
- And More!
Of course with any articles about psychology there are differences of opinions. We, as committed a Community of Caregivers, will be no different. We have members who will disagree with some things and will be able to back up their positions with peer-reviewed scholarly articles or quotes from leading researchers. Even leaders in the field don’t agree on everything. We encourage that dialogue, but request that it be done respectfully and without personal attacks. Have fun with it though. It’s for you.
Brad Coulbeck CTSS, Vice-President, Board of Directors, ATSS
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