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
I’ve just read the exerts from John Durkin ‘Bottom up Thinking’. I have worked from the ground up before ‘accidentally entering the field of Health and Safety and have been able to assist with operational issues when no one else seemed to have a safe system or approach to a problem, which I put down to the fact that I have been on the tools as they say.
But after reading John’s approach my experience pales by example – this gentleman has obviously got a great insight into his field with experience that I envy but would not want to learn as he obviously has.
I am project based and looked at the dates and location and had already decided I wouldn’t attend, but now after reading Johns experiences I will revaluate my decision just to listen to the man in person.
Paul, we so value you taking the time to comment on John’s sincere thoughts and beliefs.
He is an incredible man who passionately wants to make a difference.
There’s no doubt his presentation will stimulate a change in many hearts and minds.
We look forward to welcoming you to The SHE Show South and introducing you to John.
Best Wishes
Vicki
Thanks Paul.
I’ve just scan-read the recently published Kerslake review of the Manchester Arena bombing. I was struck by the criticism directed at the senior Fire Service managers seemingly stuck in what I see as a ‘top-down’ mentality. The leadership thinking was to follow policy, stay away and keep safe (top-down) and ignore the calls from agencies and even personal phone calls from people on scene (bottom-up). Quoting from the review:
“The Greater Manchester Fire and Rescue Service (GMFRS) did not arrive at the scene and therefore played no meaningful role in the response to the attack for nearly two hours.” p.8
This example should emphasise the danger of submitting to authority over experience.