Police could face this invisible injury

Story highlights

  • Joan Cook: Suffering repeated traumas and ethical dilemmas can cause deep moral injury
  • It's common in war veterans; we should consider whether police officers are also at risk, she says

Joan Cook is an associate professor at Yale University and president of the American Psychological Association's Division of Trauma Psychology. She is an Op-Ed Public Voices Fellow. The opinions expressed in this commentary are her own.

(CNN)Who in our country was not sickened by the shootings of the police officers last week in Dallas? And we should all be heartbroken about the continued killing of black Americans like Alton Sterling and Philando Castile. In response, which one of us doesn't scratch our heads, throw up our hands and say, "What is happening in our beloved country?"

There has been and will continue to be a lot of dialogue, though some might argue not enough, and some pretty important research showing that racial bias plays a role in police decisions to shoot.
    A recent fine-grained analysis of the factors that contribute to these killings place the blame on stereotyping and racial bias, as well as common characteristics of law enforcement agents and the nature of police work. The people who are attracted to positions of authority appreciate social hierarchy, hold values that promote order, and desire inter-group connectivity. However, these studies missed something, namely the high rates of trauma and moral injury in police officers. And if we want to solve this terrible black and blue divide in our country, addressing trauma and moral injury must be part of the conversation and the solution.
    Joan Cook
    There's no doubt that serving as a police officer, particularly in high-crime cities, can bring exposure to a wide variety of high-magnitude stressors. Job-related critical incidents include the homicide of another officer in the line of duty, shootings, dealing with victims of serious crime, assault, motor vehicle accidents, the handling of human remains, and death investigation.
    These aren't single traumas but occupational hazards of repeated exposure. The physical and psychological danger of police work can take a heavy toll on the men and women in blue -- from signs and symptoms of PTSD and depression, to on-the-job suicides, increased sick days, and poor work performance. In particular, killing or seriously injuring someone in the line of duty can bring about PTSD and depression in police officers.
    But in addition to these documented risks, we could also consider the concept of moral injury seen in the work with war veterans. Emerging research indicates that war events that go against deeply-held ethical beliefs and expectations -- such as perpetrating, failing to prevent, or bearing witness to cruel and inhumane acts -- can cause "moral injury" in veterans.
    Violence that goes beyond the call of duty or rules of engagement like mistreating civilians, torturing prisoners, mutilating bodies -- things that make soldiers cringe not crouch - pierce the mind in a deep way. As a trauma psychologist who works with veterans, I often wonder whether it is possible that moral injury may also be a problem for some law enforcement officers who are not only behaving in an unjust manner with unarmed black men and women across our country but who are also perpetrating trauma.
    Once a moral line is crossed, it's harder to go back over or un-ring that bell. But not impossible. Rather than vilify or condemn morally injured police officers, acknowledging and talking about traumatic stress in their lives might make them less prone to morally injurious acts. It also gives the world more understanding for when things go terribly wrong with our system and thus indicate potential ways forward.
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    Winning the struggle against post-traumatic stress


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    Winning the struggle against post-traumatic stress 03:28
    Mental health professionals and chaplains with years of experience working with soldiers and veterans believe interventions for moral repair should be spiritually, socially and individually directed. They advocate for forgiveness, amends, and writing from the victim's perspective. Let's take a page from the experts' playbook and put down the weapons of destruction: See the pain on both sides, restore trust and communication, and encourage mutual forgiveness.
    Life-threatening events in combat typically instill fear and anxiety-based responses. Although killing and acts of abusive violence in war are related to PTSD, suicidal thoughts and substance misuse, these morally injurious events not only cause psychological but also spiritual harm. These soul wounds are more guilt and shame-based.
    The rules of engagement in the military are somewhat similar to those for police. Just as violence should not be directed towards noncombatants and other vulnerable individuals for our military personnel, violence against innocents is a violation of the moral standards of law enforcement officers. Constant chaos and the need to make quick decisions in the war zone and in high-crime areas likely leave individual soldiers and police offers alike vulnerable to bad choices. And patterns of poor decisions can lead to hateful attitudes and dehumanizing behaviors toward those perceived as enemies. I think after this week, we can also see how that is problematic.
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      Surgeon describes treating Dallas officer (Part 1)


    Surgeon describes treating Dallas officer (Part 1) 04:41
    Let me be clear: I am outraged that the shooting of police officers in Dallas happened and that the killing of innocent black men continues to happen. But perhaps we are limiting our understanding of why it happens when we make it solely about racism, without including an understanding of the trauma of moral injury. That potential explanation does not excuse or forgive. These killings must stop. But how can we stop them if we're unwilling to examine all the contextual factors and how they may arise?
    What I'm saying is perhaps there is a larger context of moral injury that could apply to those in blue that could help in understanding their behavior and offer keys to a solution.
    Like many in America, my heart is broken for all the affected families, their communities, and my country. This cannot continue to happen.