John Durkin was a firefighter before PTSD and the suicides of two colleagues persuaded him to create a realistic solution for the future. With post-9/11 experience with New York’s police officers and application of two evidence-based techniques John contradicts the ‘top-down’ expert-led model aimed at symptom reduction with a ‘bottom-up’ experience-led model aimed at growth, and within a health and safety framework.
This approach saw John lead the crisis response for the Metropolitan Police Service following the 2017 terrorist attacks and Grenfell Tower fire. A positive return to duty was reported overall with no sickness absence or PTSD related to the critical incidents. A peer-support approach showing superior outcomes to an expert-clinical approach for post-traumatic stress will be discussed.
- Keep the team together and keep the mental health professionals away.
This is a shock, not mental illness. It is best to feel supported and not isolated, heard and not spoken to and helpful not burdensome. Most mental health professionals have disaster education, not disaster experience. The team is now the family – keep it together.
- Ignore anyone telling you this is a traumatic incident.
There is no such thing as a ‘traumatic incident’ only a traumatic reaction. Think of a ‘critical’ incident instead, one that has the potential to overwhelm how you normally cope, or is beyond your current abilities. Critical means it’s in the balance, traumatic means it’s already gone too far – it hasn’t.
- Rethink what you know to be an expert.
Psychiatrists have a ‘bible’ called the Diagnostic and Statistical Manual of Mental Disorders in which all the mental disorders are described. That makes them experts in those descriptions, not in what just happened to you. The experts you need are those who have been there before, survived and grown wise as a result. Find them and talk.
- Risk assess the survivor’s reactions.
Hazard: Shock, disbelief, catastrophic thinking, getting upset and having no-one to talk to. Intervene: Listen, ask “What happened?” and listen more. Take a genuine interest and don’t worry what gets said – it will change with recovery. Monitor: Meet again, ask and listen. Meet again, ask and listen. Notice the change – you’re helping.
- Take a tip from the Stoics: Everything you have in life is gifted to you from the Gods.
You have no entitlement to anything – health, family, possessions or friends. Meditate on losing each of these, one at a time, until it hurts. Then realise you’ve been given them back. Really, try it.
By John Durkin