G’day all! I’m going to post Chapter II on this topic today as tomorrow I must leave for a few days and I try to remain “electronically unencumbered” when I travel. I treat myself to a “book”. What’s that you ask? It’s one of those things with covers and pages that you can put on a shelf, admire from afar, and feel ever so intelligent as your library grows before your eyes; even if you are not.
I recommend that you brief yourself on the initial offering on this topic (Part I) to ground yourself for what is about to follow. Last time we spoke of moral standards, their universality, their ability to guide behaviour, how they must be activated to serve as guides, and introduced the idea that we have several mechanisms we can use to selectively activate or disengage our moral standards from our behaviour. I’d like to look at some of the major ones, in this piece, and as usual reserve the decision as to where to stop based upon how well I express myself. (I usually stop when I begin to confuse myself!))
Here we go…..we find it much easier to aggress against others if we can spin our behaviour as serving some moral purpose. With a moral purpose, what would usually be regarded by most as unacceptable, magically becomes acceptable. Perhaps an example might be the way the “Commish” shits all over the membership? It might be in his mind, that he is serving the Canadian public well by doing so. So with this moral purpose, what would be considered by most as unacceptable suddenly becomes acceptable. With regard to “terrorists”, violent acts become more socially and personally acceptable when they can be viewed as morally justified. Once moral justification has been established, we can view our aggressive behaviour as fulfilling a moral imperative.
Even well socialized people who have not previously considered aggressive action can be quickly converted into violent social activists (ever heard of a couple of “hombres” by the name of Ernesto “Che” Guevara and Nelson Mandela?) The process doesn’t require gross changes of personality, value systems, or aggressive drives. It simply requires the cognitive reconstrual of the moral value of the aggressive act. Ordinary people can do some extraordinarily violent and aggressive things when they are convinced they are saving the environment, animal species, democracy, a religious belief, fighting for the poor, or battling an evil social policy. There is nothing quite like a good crusade to get people to attack each other.
Violent social and religious reformers regularly appeal to morality to justify their coercive tactics. This leads to heated conflicts with government authorities over the legality and morality of their violent actions. Those in power often clumsily resist, with force if deemed necessary, any change in policy that would threaten their self interests (sound familiar to you RCMP members?) This self serving response creates fertile ground for violent conflict. (By the way, when I tell you that “blood” must be shed to gain your rights as workers, you don’t think I mean real blood do you?) Social reformers can now consider their violent tactics as morally justified because they are aimed at changing unfair or harmful social policies. Government authorities (in your case politicians, and RCMP Senior Execs) now denounce the violence as unjustified and unnecessary because less violent means exist to deal with dissatisfaction. The government now frames the violence as an attempt to force change without popular support; and a violation of the democratic process. Social/religious reformers argue back from a position of moral justification. They are firmly convinced that they are fighting under a moral imperative. Their argument is that when unjust or harmful social (religious) policies benefit the majority, at the expense of the minority, these policies receive widespread support. Therefore their violent tactics are justified, as the disadvantaged are either outside the system, or without the power necessary to effect changes from within using more responsible means.
It is with irony that both the social/religious reformers and those in power are able to morally justify their behaviour. The authorities (Mr. Paulson?, Mr. Hollande?) believe they are right in responding unfairly, cruelly or violently as they are representing the greater community, and the reformers believe they are right in using similar tactics as they are attempting to bring about social/religious change. This is where the old adage “one person’s hero is another’s villain” can plainly be seen. Moreover, here is the explanation for the failure of moral appeals to bring an end to the violence; both sides are able to justify their own behaviour while vilifying the other’s.
Moral justification is an effective tool in disengaging one’s morals from one’s behaviour. In reconstruing the violent act as having a moral purpose, no matter which party in the conflict uses it, not only do they impede self condemnation but they create self valuation. So whether it is ISIS or the “Commish” each can not only (and does) subvert self criticism for insensitive acts but rather pat themselves on the back for doing a good thing.
I think I’ll stop here. Are you getting this? More importantly, are you unsophisticated national threat assessment/behaviour analyst types following? If not give me a call. I welcome a call. No need to monitor from afar as I have heard you are. I’m not your enemy. The latter, may be the person who assigned you the “Webster” file? Can you see the human dynamic in it all? Can you see how responding in a “knee jerk” fashion will only keep the same dance going. A new dance is needed to resolve these things. One side is as guilty as the other for keeping it going. C’mon let’s hear from you! How would you resolve a conflict of this nature. I’ll be back in a week or ten days and will post your ideas.
Don’t forget to support the “wonder women” on or about the 25,26,27 of this month. I’d love to meet you for a drink. I promise not to lose my “fancy touch” and go all socialist on you.
And remember…….”THE WAR ISN’T OVER UNTIL BOTH SIDES SAY IT IS”
Dr. Mike Webster
G’day all! Somewhat more difficult to say this morning after what went on in Paris last night. First order of business is to “uncover” for your fallen comrades in France. You have some regular readers from several law enforcement agencies in that country.
Next order of business is to remain calm, gather yourself and not react in a “knee jerk” fashion as President Hollande has done with his early statement declaring, “this is an act of war”. If I were one of the disenfranchised attackers involved, I would immediately declare a successful operation.
To respond to attacks of this sort we do not want “mindless cowboys” on the team. They will do us more harm than good. This won’t be the first time that these types of threats will have been made by the authorities. And I ask you……..have they met with success yet? I play judo, and this sport is called “the gentle way”. I assure you that I can make you an offer that will be difficult for you to refuse, and when we are done you will feel good about us both.
Law enforcement and intelligence agencies throughout the world (in which I work now, thanks to your deluded employer) are showing an increased interest in “terrorist behaviour” and the management of “terrorists”. They are aware of the increase in violent demonstrations and the level of violence shown by some participants. Law enforcement (including intelligence agencies) and “terrorists” walk a fine line in the arena of dissent; for while the freedom to dissent is a democratic right, it does not provide the dissenter with the right to kill. When demonstrations of dissent escalate into “blood baths” the police are mandated to restore order, protect dignitaries, and ensure public safety. These varying mandates can degenerate quickly into violent tragedies. In an effort to understand the dynamics of such behaviour and prevent such tragic outcomes, I would like to share with you a different approach. Thanks to your employer, who will have nothing to do with me, these ideas are now provided for foreign law enforcement agencies who realize that as long as you keep your hand in the fire you will continue to be burned.
This article (that may end up being several articles…..let’s see how it goes?) will attempt to address the psychology of the minority of active participants (ISIS, al Qaeda) who seem determined, no matter what threats are made against them, no matter how many of them lose their lives, to perpetrate violence.
With regard to those in the organization who have decided to go beyond passive resistance, we might ask what psychological mechanisms set them apart from those who have rejected more violent means? The understanding of this question was provided for us by one of the most brilliant Social Psychologists who churned out a compelling body of research that has stood the test of time and context; Albert Bandura. Dr. Bandura noted that it is our ability to sanction or censure our behaviour that is critical in our ability to act violently toward others. As we develop (in ALL societies) we form a set of guidelines and deterrents for our behaviour. Once we gain control we begin to either sanction or censure the things we do. We try to behave in ways that are consistent with our moral standards as this brings self valuation and satisfaction. On the other hand, we try to avoid behaving in those ways that are inconsistent with our moral standards as this would bring self condemnation and dissatisfaction. In this way our ability to sanction or censure keeps our behaviour in line with our moral standards. Are you following this? (I’ve just decided that we’ll stop after “moral standards”, and save the rest for another chapter).
But first, problems arise as our moral standards do not operate on “auto-pilot”. To be effective, we must manually engage them. Unfortunately we have a variety of mechanisms that can be employed to selectively activate or disengage our moral standards from our behaviour. This dynamic explains how people with the same moral standards can behave in contrasting ways. In future submissions we will look at a few of these mechanisms and see if we can explain this seemingly “crazy” behaviour (which it is not……in terms of clinical insanity) and how these folks choose the course they take.
Until next time…….”THERE IS NO GOOD OR BAD, ONLY THINKING MAKES IT SO”
Dr. Mike Webster
G’day all!! D’ya think he could do it? There exists much debate on the question, let alone the leadership (or lack thereof, that he has shown with regard to the well accepted fact that it is ever present). I’m sure you are aware that Ms. Janet Merlo representing (approximately) 400 female members (both serving and retired), along with their counsel will enter the Supreme Court of British Columbia on or about the 25, 26, and 27 of November 2015 to allege that they were sexually harassed by supervisors and peers while in the employ of the RCMP. Are you aware that even though over 100 years of women in policing has passed, your female colleagues are still faced with issues of discrimination and harassment. The perpetrators of these acts are most often their male colleagues.
Moreover, it is commonly accepted that they encounter the “brass ceiling” more often than their male counterparts. That is, they are promoted less often for nothing more than being female. The females in most law enforcement organizations from “munies to mounties”, from fisheries to forestry, and from sheriffs to border services learn to overlook and/or minimize discrimination merely to survive.
An interesting body of research suggests that not only are they the victims of discrimination and harassment at work, but they are more likely to receive similar treatment from their domestic partner if that person is male and a police person as well.
Numbers from a major statistical study completed in 2009, using data from 35 different countries around the world, suggests that 77% of police women have been victims of male expectations ranging from “let’s you and I jump in the backseat of the police car” to those that they will act like men (e.g. swear, drink, “be tough”), while at the same time “be feminine” and not out perform their male colleagues. Females are also subjected to greater mobility, being more likely to be moved from one unit to another. In addition, they are more likely to rotate through assignments, less likely to be promoted, and more likely to remain in patrol for their entire careers.
Some recent Canadian data strongly suggests that females are significantly behind their male counterparts in almost all categories from entrance to advancement into Senior Management positions. Considering the extreme cases, 20% of police members across the country are female. Quebec and British Columbia were high at 24 and 22 % respectively. Some of the lowest rates were found in the North West Territories (12-14 %), Manitoba (15%), and New Brunswick (16%). Data collected in 2013 put the total of female commissioned officers at 10 % of the population in question. An unexplained anomaly was Newfoundland at 24%.
Some of the challenges of attracting females to policing, noted in the research, included the perception that policepersons must be “big and strong”, agile, and aggressive. There however appears to be a lack of convincing evidence that these factors predict success on the job.
Recruitment and retention practices emerge as areas of concern that prevent higher levels of participation by females in policing. The existing practices are more often geared toward males and without appeal to females, who bring a different set of strengths and skills to the job.
Retention problems have long been known to have deep and stubborn roots. As noted earlier there exists a “brass ceiling” (for females) based upon very little other than stereotyping and an “old boys network”. In addition, women who have or would like to start a family, find the working arrangements (shifts, overtime, etc.) to be awkward and inflexible.
Finally, violence and harassment issues remain the ugly “skeletons in the closet”. Female police members have been and continue to be subjected to these “skeletons” and it has been well documented in Canadian media reports (e.g. the present 400+ RCMP females alleging harassment on the job) and the academic literature. Policies put in place by seemingly concerned employers have been largely impotent and without substantive effect.
The debate continues as to how best to deal with the plight of female police members without alienating the entire (male?) membership? The traditional solutions (e.g. education, policy changes, civilian lead external units) don’t seem to have put much of a dent in the problem. Prospective female employees (and presently serving females) have changed their perceptions of their safety and security within the organization very little. The answer to the above posed question is slowly but surely moving toward a “do something different” approach; something entirely unpredictable! This suggestion refers back to the old adage, “if you keep applying the same solutions, you’ll continue to get the same results”……..and this is the definition of what???? I’ll give you one suggestion before I shut down, as I am getting somewhat “wordy” here. (Right m’lady?)
Think of solutions to the problem as lying along a continuum from “0” (more of the same) to “10” (an entirely unpredictable solution that is the exact opposite of what has been done and takes the offender by surprise). So just as a “spitball” exercise this could cover anything (up in the “8-10” range) from castration (just kidding….but you get the idea) to firing outright!!! Go ahead let’s hear from you. You know you’ve always believed you could do “his” job better than “he” can. Let’s hear from you?
Oh yah, the females could use your support!! I’ll see you there and you can buy me that drink you welched on at the AGM!!!
“IF A PRISONER WANTS TO FREE HIS COMPANIONS, HE MUST FIRST BREAK FREE OF HIS OWN CHAINS.”
Dr. Mike Webster
I wish you Mr. President the greatest success in the upcoming election (05/11/15), and if elected, in the tasks entrusted to you by the members of MPPAC. I write this piece to state my position (as member #969) on the most important points of controversy; and I will do so with a full sense of responsibility that the use of this blog implies, while at the same time fulfilling the unavoidable duty of speaking frankly and clearly.
The leadership of MPPAC must shake itself loose of the desire to satisfy both labour and management and move forward. I would like to see MPPAC’s leadership courageously begin its’ work and not stop at the first sign of conflict or confrontation. The RCMP Senior Management (and perhaps its’ puppet masters in government) would dearly love to turn your organization into an impotent organ unable to solve the serious problems that prevent it from it from its’ potential greatness. This must be prevented from happening. This AGM should not be remembered only by its’ date.
As member #969 and no longer depending on the Force for my paycheck, I have the freedom to speak as I do. I have always viewed myself (thanks to my late father, Lt. Cmdr. “Charlie” Webster RCN Ret’d.) as a pillar of workers’ rights. I have the freedom to fight for the rights of RCMP members, “24/7”. Our National Police Service should reflect the epitome of the members’ working conditions. Sadly, and even more so embarrassingly, it missed the chance to set the standard. It will be through the actions of the general membership (i.e. YOUR ACTIONS!!!!!) that you will show the Canadian Public that your heart is in the right place; and that your deepest concerns are for them. For it will be through obtaining the same rights as other police services across this country that you will be able to serve them better.
Of course their are personal and organizational issues that must be acknowledged, as MPPAC becomes slowly but surely stronger everyday. And at the same time we must recognize that there are more aggressive methods of struggle. The “union movement” (that’s right you heard me, it’s a union no matter how you cut it, with the right, but not the desire to strike!!) within the RCMP must maintain internal unity, faith in its’ destiny, and the irrevocable decision to fight “tooth and nail” to obtain and protect the rights of each and every member (even the “slugs” you think are undeserving!!).
It is my opinion based upon personal experience, that MPPAC will not secure a place at the table without “bloodshed”. Someone (or someones) will pay for their righteous agitation. IT IS INEVITABLE!!! Are you the one who is willing to make the sacrifice? Are you part of the problem or part of the solution? If your obligations and/or aspirations prevent you from putting others ahead of yourself…….your brothers and sisters will understand. All that is asked of you is that you stand aside and let another with less to lose, more modest ambitions or greater empathy, lead the way.
“First; to cooperate: last; to conflict”
Dr. Mike Webster
Reg’d Psych (#0655)
P.S. I am leaving to attend the AGM. Keep the cards and letters coming in, I’ll attend to them when I return. If you live in the LMD and can attend, please say hello. I’ll be sure to let you buy me a drink.
G’day all! As has become our routine, I would like to tip your Stetson (well earned, and still respected in many quarters, I might add) to our foreign visitors. I note that they continue to attend the blog in significant numbers and hesitate to contribute. I encourage them to “throw in” and ensure them of our ability to preserve their anonymity.
It seems that our latest couple of offerings on the illusion of what has come to be labelled as PTSD (my comments are meant in no way to discount your personal pain/suffering, but to suggest that it may be nothing more than a normal human response to an entirely “abnormal situation”) have stimulated great interest. Our daily readership has soared, but as you can see very few comments. I encourage you to come forward with your thoughts. Who knows, it could be cathartic for you? What do you think of this latest “injury vs. disorder” distinction? If you have become interested in it then “riddle me this”…….with regard to the injury argument, what’s broke?……..how do you know (i.e. how to diagnose)?…….what is the “mind”?…….can it be put in a cast, stitched, operated on?…….ah yes, it can be prescribed medications.
Enough of that and to the topic at hand. When you think of psychopaths, you probably think of the likes of Clifford Robert Olsen or “Willy” Picton; and Theodore “Ted” Bundy to cite an American example. (Out of curiosity, are these people injured or disordered, “what’s broke”. do they suffer from PTSD after committing their horrendous acts, if not why not, once again what is a “human mind”, not so simple huh?). While you are correct to identify the previously noted individuals as psychopathic in their behaviour, there is another body of research that appears to have introduced a more accurate view of psychopathy. This thinking has its’ roots in the work of the brilliant Canadian researcher, Robert Hare; the noted expert on psychopathy. One recent offering (Dutton) suggests that some of the traits of the criminal psychopath are also found in the executive board room of many organizations, including the boardroom of your police service! Moreover, “organizational psychopathy” is not uncommon among politicians, world leaders and successful executives of many powerful organizations. This should not come as a surprise to you, and I’m sure you would agree that much misery and havoc has been wreaked upon the general membership that originated in that room!!
As I outline a series of traits commonly found in the profiles of “criminal psychopaths”, you may recognize some of them as being manifested in the profiles of police executives that you have worked with; e.g. a grandiose sense of self worth, persuasiveness, superficial charm, ruthlessness, a lack of remorse, and the ability to manipulate others ( c’mon this is too easy for you RCMP members!!).
Another body of work (Bobiak et al.) argues that while these psychopaths may not be ideally suited to traditional work environments, they compensate with other skills. They may lack the ability to develop healthy interpersonal relationships, while compensating for this with a keen ability to “read” others, and an uncanny ability to influence/persuade others; all in an effort to disguise their psychopathology. The extant research suggests that the level of organizational psychopathy among executives of all stripes (including police executives) may range from 3-25% of the population in question. Compare this with the 1% of “criminal psychopaths” in the general population.
Hare has listed characteristics common to “organizational psychopaths”:
I) anti-social characteristics
- poor behavioural control
- need for stimulation
- promiscuous sexual behavioural (which one of you giggled?????)
- criminal versatility
- parasitic lifestyle
ii) aggressive narcissism
* superficial charm
*grandiose sense of self worth
* lack of remorse/guilt
* emotionally shallow
* lack of empathy
* failure to accept responsibility for one’s own actions
A fascinating body of work out of evolutionary biology (e.g. Sun) suggests that these “organizational psychopaths” thrive in society as they have developed the skills necessary to avoid capture, arrest, conviction, and incarceration. It is important to understand that both types of psychopath are dangerous. However, “organizational psychopaths” specialize in verbal aggression, deception and emotional abuse rather than physical aggression.
It has been hypothesized that these organizational types avoid detection and arrest by ingratiating themselves with the “right people” while preying upon those with little power. They take credit for the good work of others and manifest an ingenious mix of fear and sympathy to obfuscate their psychopathic behaviour.
One management guru refers to these organizational-types as “psychopath-lite” (de Vries). They don’t often find themselves in the Criminal Justice System and instead, as we have seen, thrive in organizational settings. You will find them wherever power, status, or money is in play. We have all experienced the egocentric executive who talks of him/herself endlessly, constantly seeks the limelight, and is oblivious to the rights/needs of others. Moreover, while charming on the surface they remain cunning, hostile, and domineering beneath. They view their victims as nothing more than stepping stones, or opportunities to greater things. It seems that dominating their victims is not enough as they seek to humiliate them ( c’mon this isn’t even a challenge for you RCMP members?). For this type of psychopath, the ends always justify the means. The “organizational psychopath” shows little or no concern for the physical or mental health of employees as there is always a line-up to enter the organization.
Interestingly this personality disorder is over represented in politics, law enforcement, the legal profession, business, the military, and medicine. Additionally, the identifiers would seem bizarre in any other context. Yet the ruthlessness, lack of conscience, success at any price attitude, impression management, risk taking, domination, aggression (short of assault), and extreme competitiveness are highly regarded as necessary for success in the “organizational psychopath’s” world.
Sure, it’s all very interesting but what to do about it? Well, in the spirit of being the changes you want in the world, GET OFF YOUR ASS AND VOTE YES FOR THE MOUNTED POLICE PROFESSIONAL ASSOCIATION. You (RCMP) members are badly in need of labour representation.
“Manage your own expectations”
Dr. Mike Webster
Reg’d Psychologist (#0655)
G’day all! Before we get to the “unspoken stuff” related to “PTSD”, I apologize for my long absence. Once again I was on the road consulting with foreign customers. I remain “gobsmacked” at the similarities between police people, no matter where they are in the world. As has become our custom, I offer a tip of your Stetson to those who are reading this blog from afar.
May I suggest that if you haven’t read Part I of this topic, you do so before digging in to Part II. In general with regard to Part I, I went beyond questioning the “diagnosis”, to poking enough holes in it (without demeaning your suffering) to sink it! And I used the investigative skills that you taught me!! A proviso: When I outline the results of this investigation, I am not attempting to discredit in anyway what your emotional experience related to any single event (or series of events) may be. I am not attempting to be your therapist. I am not attempting to discredit your therapist, if you have one, or his/her theoretical orientation. I JUST WANT YOU TO THINK FOR YOURSELF!!!!
Now to the “unspoken stuff”. It seems that a relationship between subjective symptom experience and financial benefit can play a role in the “diagnosis” of PTSD. When researchers review the medical records of patients they discover a consistency and uniformity in subjective reports. This of course could reflect the development over time of a more precise set of diagnostic criteria and/or the reliability of diagnosticians; it could also reflect the expectancies and unfounded elicitations of the examiners. This is not the first time that this cultural bias has been noted; it can be found in the reports of patients suffering “shellshock” and “contusion” (English and Russian precursors to “PTSD”, respectively) during WW I. The interesting thing is that these early diagnoses had different symptom pictures that would qualify them as traumatic responses, but were characterized by the same uniformity we see today. Historically victims were prone to shaking, stuttering, limping, deafness, muteness, and blindness. They did not report the intrusive, avoidant, re-experiencing, anger, or numbing symptom picture that we see today in trauma patients. Moreover, there does exist today examples of applicants for financial compensation being coached as to how to present themselves to examining physicians who will be central in the determination of their disability benefits.
In closing, it is commonly noted in military settings that the report of the patient is incongruent with military records. One seminal study found that 32% of the patients assessed had no evidence in their military record to support the details (e.g. battle experience) they reported. Several studies have reported that those who aggressively pursued compensation were more likely to over report and exaggerate their symptoms. A 2005 report from the US Veteran’s Administration Office of the Inspector General noted that veterans’ symptoms increased in severity until their compensation reached 100% disability; followed by a decrease of 82% usage of mental health services and NO change in the use of other medical services.
So in summary, it can be strongly suggested:
I) Current diagnostic criteria for “PTSD” are unsatisfactory.
ii) It isn’t easy to distinguish between what may be an actual disease entity (PTSD) and A NORMAL HUMAN RESPONSE to trauma.
iii) It is difficult to sort out anxiety, depression, and substance abuse disorders.
iv) The diagnosis of “PTSD” today relies on largely unverified and subjective reports of trauma, and symptoms.
v) Financial compensation, could be (even out of the patient’s awareness) an important factor leading to secondary gain.
Well there you have it. Let’s hear from you? Personally, I find this very liberating! I remain the “Captain of my own ship” and continue to have the ability to plot my own course. And please never, ever forget………”There is no fear! We are in error when we view life’s challenges as unjust impositions rather than the simple facts of life; or just another opportunity to grow”.
Dr. Mike Webster
Reg’d Psych (#0655)
P.S. I’m on the road again. Keep those cards and letters coming in. I’ll get to them in about a week when I return. In the meantime “riddle me this”………..if you don’t who does, if you can’t who can, if you won’t who will? There you go……..so just ‘DO IT”!!!!!!!
G’day all! First another tip of your Stetson (if I might?) to our foreign visitors. I remain amazed at the great distances between us here in Canada and some of the far off places from which we draw readers; and in addition, to how police persons from around the globe share similar concerns.
Today’s topic is a sensitive one, as I know many of you have received a diagnosis of “PTSD”. You may have sensed from the tone of the two previous pieces that I was leading up to an article like this one. I have always been uncomfortable with the history (derivation?) of this “diagnosis”. For what is about to follow, you must take some responsibility. It was you who taught me to be an investigator during my time at “Depot Division”, where by the way (chest puffed out) I was the Valedictorian of my Troop.
Anyway, I have followed the leads and investigated this controversial disorder. The comments I will make in this piece, although well supported, commonly held and controversial at the same time, are not meant to erode your confidence in health care providers that disagree with me and my like-minded colleagues. Most importantly my comments are not made to serve as therapy, only to provide another perspective; and to get you thinking like an investigator again. I want you to grasp that human emotional pain may be universal but suffering is not. My mission is to get you out of your head and into your life!!
So, away we go! I’m sure that it will be no surprise to you that the US’s Veteran’s Administration (VA) is the world’s largest recipient of per patient funding for “PTSD”. The VA cares for between 250 and 300,000 combat veterans, each year, who have received a diagnosis of “PTSD”. The total annual cost is approximately $4.25 billion. However, strangely enough extant (current) research does not support the existence of such a distinct and discrete syndrome. In other words, “PTSD’s” diagnostic formulation, from its’ inception to this very day, continues to remain invalid. Please believe me, those of you who have experienced traumatic exposures, my intention is not to diminish your pain, or the needs you feel for comfort and understanding. My objective is to educate you as to the quality of the research evidence; the impact of culture on diagnosis; to get you to understand and perhaps re-consider the consequences of a traumatic exposure; and maybe even get your employer to find a less conflictual way of caring for you, and returning to you, your autonomy.
Ready for a little (largely disregarded) history? In the earliest days of the diagnosis (1980) the DSM 3 (Diagnostic and Statistical Manual Third Edition) included the diagnosis of “PTSD” after its’ authors were lobbied by Vietnam Veteran’s Associations, and anti-war social workers, psychologists, and psychiatrists. The argument for the recognition of a special disorder related to traumatic combat exposures, was that memories associated with these exposures were persistent and emerged in the form of a “PTSD”. While interesting, this argument focuses on the fallout from a traumatic exposure, rather than the psychology that lays behind the suffering experienced by the patient. A huge assumption was made, and it was suggested that an organic brain injury was suffered concomitant to the arousal of extreme stress. Unfortunately this “wild ass” hypothesizing was coupled with the secondary assumption that the patient was destined to become chronically disabled. (All with absolutely no proof!!).
Initially the American Psychiatric Association (APA) entered the fray under some pressure from the VA, and began by using the military’s diagnostic criteria. The purpose of the DSM is to provide health care professionals with the research behind the diagnoses that they apply to their patients. The diagnostic process is complex, and as with all decisions made by humans there is a subjective component involved. The APA (composed of M.D’s specializing in Psychiatry), to its’ credit, wanted to respond to criticism and made changes. There were 11 changes made in the revision of the DSM 3 (1987); followed by 15 in the DSM 4 (1994). In the latter edition there were nearly 200 symptom combinations that could equal a diagnosis of “PTSD”. With the DSM 5 (2013) when the “new and improved” criteria were applied by researchers, 30% fewer patients received a diagnosis of “PTSD” than they would have using the old DSM 4 criteria. (Are you investigators following this? It’s all right there in black and white…..all you have to do is educate yourself……call me). Now get this, when the researchers used BOTH sets of diagnostic criteria (i.e. from both the DSM 4 and the DSM 5), and an equivalent sample size, more subjects received the diagnosis under the DSM 5 criteria than the DSM 4. You think you’re confused? Dr. W. Hoge, Director of Research at the Walter Reed Army Hospital concluded “……the new criteria do not have greater clinical utility” than those of the DSM 4. Remember them? They are the ones that can produce 200 different symptom combinations that equal a diagnosis of “PTSD”. Sorry, but that is like me looking out the window and telling you we have “weather” today!!
Another problem for the diagnostician arises in that the symptom profile associated with “PTSD” overlaps with several other mental conditions e.g. mood disorders, anxiety disorders, and substance abuse. In one study I read, published in 1995, the authors reported that 88% of men and 79% of women with a diagnosis of “PTSD” had at least one other diagnosis along with it. Any clinician could tell you (subjectively) that depression would be the most common comorbid (goes along with) diagnosis; it was detected in nearly 50% of those with a diagnosis of “PTSD”. The “PTSD” cluster contains so many nonspecific indicators of psychological distress common to other conditions, the validity of the diagnostic category (i.e. “PTSD”) remains in question.
A much more critical concern (and then I’ll stop for now……OK M’lady?). Crazy as it sounds, “PTSD” symptoms may not even be related to the experiencing of trauma. Another group of researchers have demonstrated that when a cohort of patients, who were being considered for the pharmacological treatment of depression, were tested, 78% of them, traumatic history or not, met the diagnostic requirements for a diagnosis of “PTSD”. In another interesting piece of research, the investigators demonstrated that their subjects (university students) without a traumatic history were more likely to meet some diagnostic criteria for a diagnosis of “PTSD” , than those with a verified traumatic history.
As long ago as 1988 a Vietnam Veterans Readjustment Study discovered that 31% of their subjects met all criteria necessary for a diagnosis, however only 15% of them had been assigned to actual combat. When narrower diagnostic criteria were employed (similar to DSM 5?) and the veracity of reported trauma exposure was investigated, rates reported ranged from 3-15.5%.
I’ll stop for now and let you chew on Part I. Next time (Part II) we will look at the tenuous position the patient is put in when he/she is confronted with the relationship between illness and financial benefit.
” DON’T PUSH THE RIVER, IT FLOWS BY ITSELF”
Dr. Mike Webster
G’day all! I have returned from my journey. Once again, I offer you all, including our faithful foreign visitors a tip of your Stetson. When I last spoke with you I was suggesting that it was our capacity for language, and its’ ability to anticipate and solve problems, whether out loud or nonverbally, that was the culprit when it came to our emotional difficulties. For example, this cognitive ability seems to work well when we are dealing with such practical issues as, “……aha, this equation is not working, as this variable SHOULD NOT be here, rather it SHOULD be over there”; but not so well when dealing with emotional issues such as “……..aha, I am miserable because he (she, they) SHOULD NOT be treating me like this”; or, “I SHOULD NOT be feeling this way, I SHOULD be feeling like this (happy, content, stress free?) instead”. In sum, and as I left you last time, I was suggesting that it is our misplaced, ill-informed desire to avoid natural human emotion that is the true culprit in human misery. We are really suffering the result of “feeling bad about feeling bad”, when as a human you can’t avoid “feeling bad” sometimes; moreover, it seems to be part of the human condition.
It seems that when we attempt to rid ourselves of painful internal experiences, we tend to make them worse. Think about it for a moment (those of you who struggle with it) where did your over-attraction to alcohol come from? Wasn’t it an attempt to lessen the pain of unwanted thoughts, feelings, memories, etc? So then what have you done in the “long run”? You’ve created a problem on top of a problem (or is it really a problem?).
The more you battle with your unwanted thoughts, feelings, (internal stuff) the more you are likely to make yourself miserable in the long run. Let’s use depression as an example. It’s not really the pure existence of sadness that creates the heart of a depression. Actually, sadness is a normal human emotion that we can all experience, and should in the face of meaningful loss. At the heart of a depression, without fail, I will find that you are locked in a battle to avoid or rid yourself of this (normal) sadness. There is a tonne of reliable and valid research that suggests you, and others like you, if you are (chronically) depressed, anxious, or traumatized (for example), are more involved in avoiding your experience than those who deal with equally serious issues but are more acute in their path of recovery. ( Actually, when compared to what Indigenous, Black, Lesbian, Gay, the Disabled, many Females, or the Mentally Challenged, for example, have to deal with on a daily basis…….your issue may pale).
Please don’t misinterpret what I am saying! Not all forms of avoidance are pathological. It’s not really a problem (well maybe just a wee bit) if it is your habit to have a beer when you get off shift to “unwind”. When it becomes a larger problem is when you down “a halfsack” after every shift; shift after shift! I’m sure you can see how an emotional control strategy like this might work in the short-term, but could be a “killer” in the long run? So when the family wants you to take them to the movies (beach, skiing, amusement park, hiking, camping, etc.) or your dog wants to go for a stroll, just like the “old days”, don’t decline. “Begging off” might feel good in the short term however, in the long run it is likely making things worse. Gettin’ the picture?
” THE MAGIC CURE COMES IN REALIZING THERE AIN’T ONE!!”
Dr. Mike Webster
Reg’d Psych. (#0655)
G’day all! Before I begin, I would like to offer a tip of your Stetson (if I may be so bold) to some regular foreign viewers of “re-sergeance”. I’m not sure you are all aware that we have visitors from afar. I can see them on the “stats” page behind the scenes. I wish to thank them for their interest and to encourage them to “throw in”. I would welcome their comments and I’m quite sure we would all find it interesting. These visitors include places like the UK, Trinidad and Tobago, Japan, France, South America, European Union, Australia, and of course our neighbours to the south, the US.
So to begin…….the kind of Psychology I studied during my undergraduate and graduate days was based upon (and to the greatest extent still is) an assumption that there is something called “a healthy normality”; that is, by nature we humans are psychologically healthy, and if we have the right ingredients e.g. environment, life-style, social context etc. we will be mentally healthy and happy. You may have noticed by my general tone, that I question this. I’m not sure that a degree of psychological pain is entirely abnormal. After spending 70 years as a human, and over 40 as a psychological clinician I’m not entirely sure that psychological pain is abnormal. I have begun to question whether psychological difficulties are really disease processes fueled by pathology.
Check this out! Take a moment to ramble around your “googler” and you may be surprised to find stuff like this: Pick a year, any year, and you’ll find that approximately 30-33% of the world’s population is suffering from clinical levels of Depression (depending upon which site you pick). The World Health Organization (WHO) estimates that depression is consistently among the top 3 psychological problems in terms of cost and patient debilitation around the globe. It is thought that within the next couple of years it will move into the top 2. This would suggest that within any week, go ahead and pick one, fully one tenth of the world’s population is suffering from this clinical mood disorder. Moreover, one fifth of us (globally) will suffer clinical depression at some point during our time on this planet. If you think that is “jaw dropping” check this out…..one in four of us will become addicted to drugs or alcohol at some point during our lives. Statistics for the US, alone, suggest that there are now approximately 22-25 million alcoholics in that country (no wonder Donald Trump is such a ……..but I digress). To continue, in support of my earlier statement, and again depending upon whose numbers you use, it seems that at least half of us will seriously consider suicide in our life time. In short, there seems to very little correlation between our standard of living (that continues to rise) and our psychological health.
I recently completed some postdoctoral study (can you tell?) that makes a strong case for a destructive normality vs. the old healthy normality perspective. This (well considered and researched) approach suggests that our language is the culprit. Not the particular language we speak (e.g. English, French, Italian) but our ability to speak (in any language) a system of complex symbols including words, images, grunts, facial expressions, physical gestures etc. This ability can be used in a couple of ways; the public and the private. When we use the ability publically we are speaking, writing, singing, gesturing and such. In the private domain we are thinking, imagining, planning, visualizing and so on. When you refer to “cognition”, this is the stuff you are speaking of.
Now here comes the part that will take you out of your “comfort zone” (…….I can say this as I think I know you somewhat). When you really think about it the “mind” isn’t a thing that you can touch, like a brain or a heart. It’s more like a very complicated bunch of cognitive processes that include visualizing, evaluating, comparing, analyzing, criticizing, planning, etc; and all of these rely (on what?), our ability to use language. (Nice try……….. even if you are mute you use language in the sense I am describing). So you might even say that the word “mind” is synonomous with human language itself (OK, OK calm yourself and hear me out).
While useful, our ability to speak has a downside. On the up-side it allows us to “play nice” by cooperating with each other in community, to plan, to predict, to create stuff, to share knowledge, to learn from others, and the past, and to communicate with one and other. However, as I am hinting, there is a downside as well. The mind can be used for a list of anti-social purposes ranging from mistreating to killing each other in a variety of ways. We use it to obsess about the past, to rehash painful events, to catastrophize about the future, to judge, to condemn, to criticize others and to create unrealistic and crippling expectations.
I’m going to stop here (a very special reader has told me that I go on far too long!), but first (until the next installment on this topic), I would like you to consider strongly that it is our capacity for language that catalyzes suffering for human beings. It seems that as we have this capacity to anticipate and solve problems through the evolutionary advantage of human language, we just might be trying to avoid natural human emotion (and its’ constituent pain) and “feeling bad about feeling bad”………..wherein the real problem may lay?
“Pain is universal, but suffering is not”
Dr. Mike Webster
Reg’d Psych. (#0655)
(P.S. I’ll be on the road for a few days; send in your comments and I’ll get to them when I return).
G’day all. I would like to begin this piece by apologizing to “The Kraaken” for my snide remarks. I admit when I read his critical words, I was offended (hurt?). Those of you who know me personally know I have a moderate to large ego. I continue to work on this and my only solace comes from the Buddha who said “To know the ego doesn’t exist you must first have one”. I’m sorry “Kraaken”, I’m a work in progress. On the other hand, we did create a lively discussion! I will invite others more qualified than I to respond to your latest comment.
Now to business. Is it only crisis that brings out the resilience in those that have it? Do we all have it to the same degree? Even more importantly can it be developed like a muscle?
Those that are highly resilient seem to possess a handful of characteristics in common. Moreover those characteristics seem available to improvement in us all. Let’s take a look at them:
Highly resilient folks are easily recognizable by their flexibility. They thrive on change and adapt quickly to new circumstances. They possess a firm belief that they can “bounce back” from almost anything. You know, the old “As long as it doesn’t kill me…..” attitude? This attitude is characterized by the supreme confidence that they can adapt to just about anything.
Some of us seem to be “born” with these qualities; and others, not so much. However, there is no need to despair if you think you are in the latter group as we can all learn to be more resilient. It seems to me, based upon clinical experience, that the critical variable is the way we perceive and think about ADVERSITY. If we view it as a temporary thing, and as being susceptible to influence and change, we “have a leg up” on it. On the other hand, if we reside in the group who view life’s challenges as fixed and unchangeable, we likely lack resilience. For example, if you spend inordinate amounts of time, energy, and emotion in what the RCMP (whether supervisors, NHQ, other members, Health Services, Div. Reps., etc.)has done to you, prattling on about “right/wrong”, “fair/unfair”, “should/shouldn’t” have, you likely lack resilience.
But aren’t you fortunate, I am the “bearer of glad tidings”; for resilience is not only a set of skills to be used reactively, but they can also be deployed in a preventive fashion. What follows are a handful of coaching points that are made up of my observations of you; when you have sat across from me in therapy and taught me how it’s done:
- The Importance of Attitude: You resilient types experience a full range of emotion when you are “up against it”. You mourn loss, endure frustration and the depths of depression but you have the ability to see the “silver lining” in the darkest of clouds. You have within you, the constant ability to find the potential to learn and grow even when immersed in the toughest of times. Research psychologists working in this area used to think this was the old General George Patton philosophy of “NEVER, NEVER, NEVER GIVE UP”!! However today an ever accumulating mound of data indicates something different. It seems the attitude is more like, ” HANG ON, I’VE BEEN THROUGH TOUGH TIMES BEFORE, I CAN SURVIVE THIS. THINGS COULD BE WORSE!!” Get busy and practice this. Start small and gradually get bigger. You can build your resilience just like you can build a bicep (they’ll never be as big as………..oh shit there’s that ego again!)
- The Natural Ability To Reframe: Resilient types seem to be able to reframe challenges into opportunities to learn. The same “bits and pieces” are there, but you have the ability to put another frame around them; challenges become opportunities to learn, pain becomes an opportunity to build new mental muscle, loss, the opportunity to build independence. Give this a try. Once again start small and get bigger. Before you reframe the RCMP’s treatment of you from “malicious intent” to “inept management” try something smaller like reframing your child’s behaviour from “bad” to “thoughtless”.
- Showing Empathy: The resilient among you turns to others and demonstrates a genuine understanding of their plight. The resilient person develops the ability to be “other centred”. This ability builds more resilience, in addition to the neurotransmitter serotonin that is associated with feelings of happiness and well-being; that will lead to (can you guess?), that’s right more energy (really, positive mood states) to undertake and engage in further acts of kindness. Try it! (I didn’t apologize to the “Kraaken” just because he deserved one, but because it would be good for me as well).
- The Razor’s Edge: Sure, it’s important to be in good emotional shape (e.g. out of your head and into your life) but what about physical condition? You won’t like to hear this but I have an easier time working with the “hut, huts” (ERT types) and I’m convinced that they stay in good physical condition even when they are “up against it”. Being physically fit actually builds your resilience; physical fitness in combination with mental muscle built through things like reading, relaxation, meditation, cross word puzzles, hobbies….as long as you aren’t reading RCMP policy (sorry Kraaken) or meditating on your next move in your battle with the “outfit”.. This type of mental activity keeps your stress hormones low. So, get busy……take the dog out for a walk and focus on your steps as you walk. Count them up to ten, and then start over again. If you lose your focus, be gentle with your self, just begin again…..1………2…….3……4……….
- Bust Your Gut: Laughter, laughter, and more laughter; the more the better! (And you must admit, you have an endless supply of comic material coming out of NHQ?) You are a champion if you can laugh in the face of adversity. Since the time of Hans Selye (the stress guru), a tonne of research has accumulated demonstrating that laughter reduces stress to more moderate and manageable levels. That same research suggests that “playing” or “experimenting” with a situation is a healthier solution to a challenge (even the big ones!) than “sheer determination”.
So there my dear friends is the recipe. Can you do it? If you wish to be the ” Captain of your own ship ” rather than have a bunch of pseudo-sailors at the helm, then build your resilience factor. The revolution is coming, we are amassing in the hills and forests waiting for the right moment, you will be needed! Look after yourself and those who depend upon you. I believe you can do it!
“Be the Changes You Want In The World”
Dr. Mike Webster
Reg’d Psych (#0655)