Post Traumatic Stress Disorder (PTSD) is a concept formally coined in 1980, although its symptoms had been evident for many years. McGill graduate psychoanalyst Chaim Felix Shatan worked with Vietnam veterans in the late 1960s, and by collaborating with a group including Robert Lifton, Nancy Andreasen, Arthur Egendorf, Mardi Horowitz and Harley Strands, managed to get this terminology adopted into scientific journals of the day.
PTSD, as a shifting research enquiry field, loosely is concerned with the emotional impact and response to trauma, affecting both thinking and behaviour which straddles a spectrum rather than being a singularly defined condition (Elsevier, at al, 2014). Much literature has focused upon the individual’s experience as victim and survivor in response to trauma, because the field has become predicated around a form of diagnosis criteria (Foa, et al, 1997).
Thinking more laterally, Bloom (2010) considered an organisation also as a living entity might be affected at a cultural level by PTSD whilst Strand (2017) started to consider if generalised trauma impact could exhibit systemically within an organisational culture (rather than just via an individual’s psyche). Here we consider those possibilities in policing.
Have you got it?
Within the slowly adopted clinical practice built around PTSD, definitional and diagnostic criteria were articulated to help practitioners screen case allocation (Gates, et al, 2012). Within such survey-screening the trigger questions (although designed for individuals) given a little imagination can – laterally – be applied to organisations.
For example, the international Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) (Prins, et al, 2003) asks about flashback memories, avoidance of similar conditions, being constantly on guard, being detached from people or surroundings and feeling a sense of guilt of when things have gone wrong in the past.
If we apply these topics to policing, as a generalised working culture, is it possible to interpret policing as an institutionalised PTSD culture? If so, the implications might represent a culture in a sense toxic, sequitur, maybe partially explaining the attrition rate of new applicants rapidly leaving the profession.
Who is burned out? Us or it?
We might assume that attrition casualties (leavers) are burned out, but it may be that the working culture is the thing that is burned out; affecting (or infecting?) those joining within a relatively short space of time. With an average national rate at just over 9%, (NPCC, 2024) whether such attrition is worse in some working conditions (such as large metropolitan forces) is a moot point but one worthy of further consideration.
If we were to entertain the concept that PTSD can exist at a systemic, rather than just individual, level we might consider if the attrition casualty is a victim of an individual event (or series) such as attending, or experiencing, violence incidents, or if the attrition is more generally linked to exposure to the working culture. Assuming, for an instant, the occupational working culture is PTSD based, this could trigger the equivalent to what is known as codependency (for example when you are living with someone with PTSD) and your own outlook, thinking and behaviours start to be adversely affected (Morgan, 1991). Codependency coping mechanisms tend to accentuate self-awareness and understanding the situational context, but if in our instance, policing was an unrecognised PTSD culture, its inhabitants would not be recognised as codependents.
Worse still, that codependency might also contribute towards understanding the context of Cohen and Massey’s (2021) exploration of normalised cynicism and emotional exhaustion in policing occupational working culture. That’s not to defend normalised cycnicism, but if we were adopting therapy models around PTSD firstly we should seek to understand before we judge (Yang, et al, 2017).
Policing thinking and behaviour
If we were to personify the policing organisation (as a generalisation) there are trends in its control systems and processes that tended be risk averse to guard against mistakes of the past to the point that some professionals working within the system find them almost counter-productive (Heaton, 2011; Chowdhury, 2022).
There is a reported cultural habit of blaming within policing (Tomkins, 2020; Farrow, 2024), as opposed to the psychological safety of a learning culture (Edmondson, 2019), again which leans into the trend of victimhood or survivor status of PTSD. The healing stage beyond PTSD, which at an individual level shifts into a thriving stage, is less evident in policing suggesting its very culture is perhaps scarred beyond repair (Naparstek, 2007).
Is it possible policing culture is stuck in a kind of undiagnosed numbed phase of PTSD which denies its condition, leaving itself susceptible to the implications of untreated PTSD, limping through repeated episodes in survival mode, rather than transitioning towards reform and change (Herman, 1992)?
New recruits: onboarding a sinking ship?
Policing has no doubt always been a tough job with its outside operational pressures, but maybe its internal pressures now are perhaps more evident (Violanti, 2020). We could screen new recruits for resilience to cope within a tough working environment more in the future. But we might also ponder why is the working culture the way it is and ask ourselves are we blaming the attrition rate when that might simply be a stark symptom of an intrinsic cause closer to home?
If we took notice of the PTSD (individual) recovery guidance (Martin, et al, 2021) we find trends around references to a place of safety where people can talk and listen to each other in order to grow and change positively. Are you seeing any signs of that? Or is this about an Ongoing Traumatic Stress Disorder (OTSD)?
Whilst stuck with living with the problem, within some sort of transactional coping and survival mentality, we have a self-imposed limited capability to be solution oriented, which also maybe explains the lack of progressive and transformative change leadership towards something better.
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