The ‘Real’ Face of PTSD! By David Tredrea

(With this edition of TPSO magazine taking a long hard look at the Health, Safety and Well-being of front line security professionals, we have to address the huge issue of PTSD suffered by so many of our colleagues. Here we have one of the U.K.’s leading experts, David Tredrea, highlighting the day to day problems experienced by PTSD sufferers…. Please be warned. This article pulls no punches and may cause distress for those lucky enough not to have been touched by this area of mental illness……………. Ed.)

Joe was sitting quietly at his desk, all systems calm; he was very warm despite it being obviously cold and wet outside. He glanced the occasional cars passing by wondering which of the drivers were coming or going – and pondered those who may not even know! He’d just eaten his favourite large sandwich, burped then swallowed 1/3 of his thermos of tea.

Tomorrow was his daughter’s 10th birthday and he checked his mobile phone to see pictures of the new bike he’d bought for her, complete with pink handle-bars and tassels.

As his mind drifted, curiously and oddly, he heard a slight clinky sound and sensed, out of the corner of his eye, some unusual movement in the corridor set off behind his back. Then Wham! ….. quickly everything went black.

All he could hear were muffled voices and felt himself being dragged backwards by his feet to an area behind the photocopier. Gaffer tape was roughly put over his mouth, then rolled over (face-down) and similar tape over his wrists and feet. A woolly balaclava was yanked over his head that smelled as if it had just come off a sheep that had given birth. What Joe really needed was a pee … oh yeah, and his amber radio call-sign Delta 2 which he now remembered was in his jacket pocket draped over the back of his chair. He had also dropped his mobile phone when thwacked on the back of his head.

He felt – and knew – he was very vulnerable even though there was silence.

That was scary … and Joe was not easily scared after all his years of front-line exposure. For some reason, he kept hearing the worm-voice in his head repeating: “Daft bugger. You’ve just wasted a ton buying your daughter her bike …”

Joe knew from his military training that one day he might get taken and that he should keep cool and fill his brain with positive thoughts and images – a sort of “Safe-house in the sky”. It wasn’t working though so Joe peed himself because he couldn’t think of anything else to do – and that made him feel better.

About 2 weeks later, Joe came to see me for mental health support. His employer of 3 years was worried he was not fit for work and reported his buddies had noticed him dozy, with hand-tremors and possibly crying. Joe was reluctant to talk and seemed unable to focus on what he needed. His ability to concentrate was gone and his typical sense of fun and pranks had disappeared. He seemed angry with everyone but knew not why.

The back story was Joe’s company HQ had been bandit attacked by professionals – probably 6 experts according to others. Joe had been taken out first, then his 3 colleagues disabled for the 15 minutes or so it took to execute their heist. No-one knew what had been stolen but, of course, everyone knew that only the MD’s office and computer had been targeted.

Digital video was useless and there were (supposedly) no other forensics of merit. There was no media cover and a blanket-ban on all external communications had been imposed on all staff the following morning.

There was no forced entry and no real physical injury although paramedics had attended soon after the Police arrived some 30 minutes after Joe’s black-out.

Joe did not want to go to A&E as he thought he might miss his daughter’s birthday and, anyway, apart from wet pants felt OK. He was taken home in a police car and 2 days later gave a formal statement but the Police told him nothing of use about the incident. He had rung his colleagues to check they were OK and other mates had popped over to check if he needed anything.

His daughter had gone to school and his wife to work as a dental receptionist. HR and OH at work had told him to take the rest of the week off and to go to his GP is he needed anything further.

Although Joe was drowsy and disorientated, he felt OK and, anyway, thought he could do with a few days off to sort out his garden and generally catch-up.

Day 3 was fine but day 4 he started vomiting without good reason and had a bad headache. He went to see his GP and was signed off for another week with stress and tummy flu. He was not given any medication and told to rest and drink lots of fluid – but no alcohol.

For days 5 to 8 he remained in bed then started to feel better. By day 10 he was chopping down an overgrown tree in his garden. He returned to work on day 14 but came to see me on Day 16 looking tired, de-hydrated and sweaty.

I rang the GP as well as the employer’s nurse who both thought there might be PTSD brought on by the attack. They wondered if that could be ‘cured’ rather like anti-biotics might put right a problem chest or septic finger.

Well …. What do you think? Some of the PTSD signs are there but (imho) not enough – nor for long enough. Many experts are of the view PTSD takes up to 6 months after an event to justify the diagnosis.

Meanwhile, there are all sorts of physical and mental reactions to an overwhelming event that might (or might not) be temporary – transitional in medical jargon. It is reasonable to expect there may be a short-lived lack of concentration, sleep disturbance, flashbacks, anger, despair, frustration, appetite change, more booze intake even impotence – but sometimes an increased sexual arousal.

I will tell you in the next instalment about Joe’s recovery what we did, what he did, what I did and why I was curious as to why only Joe suffered when his colleagues who were similarly violated by the same people yet appear calm and peaceful.

To me, it is fascinating why each individual varies in their reaction to trauma – some overwhelmed by relatively small events (the straw which breaks the camel’s back) and others appear hardly affected by the most brutal of attack, rape and kidnap. Part of the answer lies in the rage of ‘red-misting’ – you can look that up on the search engine of your choice – and other parts lie elsewhere.

To help you out … it has nothing to do with age, race, strength, sexuality, intelligence, religion or pay-grade. Any ideas what was uppermost in Joe’s mind’s list of conflicts? If you want to send me your suggestions , I’d like to know! The rest of the artciles in this series will be posted directly to this website…

David has worked in the specialist international trauma arena for over 40 years – Later, as lead researcher in the rapid treatment of burns to front-line workers, David became very interested in how burn victims process pain; some do well yet others don’t, despite similar age, race, injury and treatment.

David Tredrea

David Tredrea

Just after ‘Black-Hawk Down’, David was in Mogadishu as UNICEF consultant in child trauma, then air-lifted to Rwanda for the genocide then into New York for 6 months to advise UN very top-brass on the nature of trauma in East Africa, especially for its own teams and aid agencies.

(Blimey! I’ve tried to produce a short mini bio for David…… And I just can’t. Sincere apologies to him and TPSO readers as this is just a minor fragment of his incredible history………Ed!)

Click here to see Davids full bio

Since returning to the UK, David has assisted many Police Forces and other major services still with the occasional overseas rescue mission such as the tsunami, plane crash and hostage. David tends to be a fast, no-bullshit operator, who gets to the roots of the problems quickly in order to find the best, durable, ethical, and most cost-effective solutions. These are often a mix of clinical, emotional, operational or financial imperatives – obviously each tailored for uniqueness. Best of all, David is fun yet tough, effective, rapid, discreet, remarkable at storing secrets, loyal and expert at seeing wider pictures of dread implications and finding best pathways quickly – MENSA style!

David Tredrea

dpt@consultant.com