Tag Archives: Kent Laidlaw

PTSD and gendered mental health

30 Oct

Throughout this post-traumatic stress disorder series, we have seen massive misunderstandings about the illness and mental health in general, lack of funding yin yangfor proper support and care for those suffering, and alternative methods of treatment. But no matter what angle I look at PTSD and the way it affects men, it seems to boil down to a concept that is, as far as I’m concerned, the root of many social problems: disregard of the feminine and the reluctance of men to ask for help when they need it.

When I interviewed Kent Laidlaw, 25-year police force veteran, we had a fascinating discussion about PTSD, and he came out with a bomb. He said that while he was on the force during the 1990s, the popular and accepted view of PTSD was understood to be a “man’s” disorder, while women suffered from depression.

This is of course as ridiculous as it is untrue. Anyone can have PTSD and anyone can suffer from depression. I’m not sure if there is such a thing as a gender-related mental illness, but there are certainly gender-related beliefs around mental health.

“We assign a gender to human traits like emotional intelligence, and then “feminize” the act of asking for help, stigmatizing men who express they are hurting and need support,” says Jeff Perera, Community Engagement Manager for White Ribbon Campaign.

With associations like this, is it any wonder that men are terrified to show anything remotely suggesting that they are anything less than what is expected?

Socialized masculine stereotypes dictate that men are expected to know, to be in control of any situation, and to be self-reliant. With all of that real or imagined expectation, there is little room for their true selves. Constructed gender beliefs rob men of their authenticity and their naturalness, and this is alarming to me. I think it’s clear that men aren’t women, so it seems very strange to me that men insist on fighting tooth and nail to prove to the world that they aren’t women, even if it means sacrificing their quality of life and their health.

Bullsh*t gender expectations

Logic says that when we experience physical trouble, we seek medical help. Researchers now see PTSD as brain damage and this should warrant medical attention. Between the heart and the brain, the human body cannot function, so why wouldn’t someone seek medical help for a damaged brain, and how is it different from say, a broken leg or a malignant tumour?

In Why Men Won’t Ask For Help, Peter Griffiths says that “men can fall too easily into the “willpower” trap, and ignore available help at their peril. The wards and hospitals are full of men who refuse to go to the doctor when they have physical symptoms and who seem to prefer to pay the price rather than go for help.” How many of you can come up with an example of a man putting himself at risk because of this masculine code? I know a man who waited until he peed blood before going to a doctor after an excruciatingly painful sports injury.

As a society, we’re not going to get very far if we frown upon men going for help when they need it. It’s ridiculous and I believe, abusive towards men.

Masculine emotion and why men have trouble asking for help

Socially, we look through masculine eyes and make masculine judgements about the world around us. This distorted view not only disregards the feminine but promotes anxiety and violence in men who constantly try to prove themselves as men, and not women. Humans have dual nature and the feminine, like the masculine, exists within us all, but many men insist on fighting the impossible fight against this part of themselves.

While girls are socialized to be emotional and nurturing, it’s fine when they ask for help when it’s needed. However, boys are taught that emotions aren’t becoming to their gender to the degree that they may not even be able to recognize their feelings and thus, they cannot identify or understand them, let alone express them in a healthy manner. But whether or not the emotions are understood, they still exist, and attempting to deny them and take on the world can be devastating to a man and other people in his life.

“In many men’s minds,” Griffiths says, “if a man can’t handle everything, then he must be a failure. And if that’s the case, he feels embarrassed and afraid about others, especially other men, finding out he is “not a man”.”

The “grave” admittance of vulnerability and of relinquishing control is, for some men, an uncomfortable, if not, terrifying idea. Take the innocuous act of  asking for directions, for example. In Nick Collins’ Telegraph article, Men refuse to ask for directions out of “blind panic”,  he says that “while women are more happy to use all available resources to help them reach a goal, men will rigidly stick to their original “system”… even though it has clearly led them astray.”

He says that when confronting the idea that their system doesn’t work, it makes men flustered and causes them to do sometimes reckless things to avoid the reality of the situation/failure. Griffiths agrees, and says that men don’t like to admit or even recognize when they feel helpless, and can feel lessened at the thought of going to someone else who is better equipped to help solve their problem.

The social negativity around PTSD and mental illness in general keeps men away from getting help, an this is can be painful, devastating, and extremely damaging. Emma Watson, during her United Nations address this fall, drew attention to this idea as she summarized social problems that stem from society’s treatment of men: “We don’t often talk about men and gender stereotypes… but I’ve seen young men suffering from mental illness, unable to ask for help for fear it would make them less of a man. In fact, in the UK, suicide is the biggest killer of men between the ages of 20 and 49… I’ve seen men made fragile and insecure by a distorted sense of what constitutes male success.”

Permission to be vulnerable

Why has the gender that gave us the Sistine Chapel brought us to the edge of cosmocide? Why have the best and the brightest exercised their intelligence, imagination, and energy and managed only to create a world where starvation and warfare are more common than they were in Neolithic times? Why has the history of what we dare to call “progress” been marked by an increase in human suffering?

-Sam Keene, Fire In the Belly

Emma Watson says “When [men are] are free, things will change for women out of natural consequence. If men don’t have to be aggressive in order to be accepted, women won’t feel compelled to be submissive. Both men and women should feel free to be sensitive…[and] strong.

“It is time when we all perceive gender as a spectrum, instead of two sets of opposing ideals. If we stop defining ourselves by what we are not, and start defining ourselves by who we are, we can all be freer… Men should have permission to be vulnerable and human, to reclaim those parts of themselves they’ve abandoned, and in doing so, be a more true and complete version of themselves.”

We must do a collective about-face around our beliefs of men and allow them to ask for help when they need it, receive it, and heal. Women are not outside of social conditioning and are just as much a part of this equation as men are. Women have to give men the space and the respect to reach out for help, support men as they strive to be better people, and allow them to be vulnerable. I for one, feel a great privilege when a man cries in front of me because this is the man at his most honest.

When we stop propagating a violent and angry culture and let go of  masculine expectations, when we stop expecting men to be something they are naturally not, when we get over the idea of believing that anything feminine is weak, then change will occur. If we change our perspective about asking for help and consider it a strength and a strategy to utilize everything at our disposal to reach our goal, change will occur. We do this every day in business, so why not for ourselves?

To be concerned with what other people think is one thing, but to sacrifice our health for someone else’s sake is quite another. The traditional masculine stereotype exists simply because we let it, but the stereotype doesn’t serve anyone; it is an idea that we allow to exist in our minds, perhaps because we are afraid of change, or that we don’t have the imagination to think outside of the traditional box.

To make things different around mental illness and general life, all we have to do is simply change our minds.

PTSD and first responders

2 Oct

“I think I’m too broken to ever be fixed.”
Text from Ken Barker, retired RCMP officer to his sister during a traumatic flashback

Barker was one of the first responders to arrive at the scene of the ambulancehorrific Manitoba Greyhound bus beheading in 2008. This summer, he ended his life. Since April 2014, Barker was one of an unprecedented number of first responders in Canada whose suicides have been linked to PTSD.

Post-traumatic stress disorder, considered an treatable anxiety disorder is a mental illness that can result from a traumatic one-time experience or accumulative trauma and stress on a personal or large scale. PTSD can bring the horrors of past traumas to life and wreak havoc in the minds and the lives of all it touches. PTSD can happen to anyone; the most vulnerable  people are rape victims.

PTSD has its roots and associations in modern warfare, and its incidence rate is highest among people who experience trauma every day – military and emergency services personnel. Symptoms include flashbacks to the traumatic event, nightmares, sleep disorders, and uncontrollable thoughts; anger, fear, distrust, personality changes, and extreme anxiety. PTSD can manifest physically as chronic pain and hypertension, and can induce self-destructive behaviour like drug and alcohol abuse, long-term addiction, and suicide. The collateral damage of PTSD is its effect on relationships, families, finances, and work and social status. It can be devastating on many levels.

PTSD in emergency services

The men and women of Canada’s public safety, military and correctional organizations witness human suffering up close and it sometimes becomes very difficult to cope with the aftermath. There is light at the end of that dark tunnel. There is help available, and we want to make sure these men and women – and their families — know where to find it.
Heroes Are Human

Vince Savoia is the founder of Heroes Are Human and a former paramedic. His organization focuses on PTSD research, education, and training, and acts as a peer and psychological support resource for Canada’s public safety organizations personnel.

Savoia says 16 – 24 percent of emergency personnel suffer from PTSD, but he believes this is a modest number. Paramedics are faced with more trauma more often, and run a risk of PTSD two to three times higher than in any other emergency service. Kim McKinnon, Superintendent at Toronto Emergency Medical Services (EMS), says PTSD predictors for paramedics include their “involvement in a critical incident like a mass casualty event, or an organizational or environmental event such as the death of a service member in the line of duty.”

EMS personnel tend to victims of horrific scenes large and small, they resuscitate the sick, and witness death. At the same time, they form a bond with sick and injured people as they spend time talking and giving hands-on treatment. This one of the reasons why Mr. Savoia believes paramedics are the hardest hit of any emergency service.

PTSD does not discriminate. While it affects paramedics more often, PTSD afflicts 10 – 12 percent of police officers and 6 – 8 percent of fire fighters. According to a recent StatsCan report quoted in the Globe & Mail, PTSD rates among members of the Canadian Forces have nearly doubled since 2002; 1 in 6 Canadian soldiers have mental health problems after ten years in Afghanistan. And the numbers keep growing.

First responder organizations must create programs and supports for their employees, but this takes funding and resources that may or may not be available. Some emergency services have excellent support systems in place for their employees like Toronto EMS’ comprehensive suite of services for employees to proactively manage their health. With a focus on prevention, their resources include early psychological support with a staff psychologist, a peer support team, employee assistance plans, and other community resources.

Canada’s RCMP has nation-wide systems in place that utilize peer support, RCMP doctors, and chaplains. A Regina RCMP sergeant explained that the RCMP wants to make sure it’s there to listen to their officers who respond to major incidents like car crashes, deaths of children, multiple fatality incidents, shootings, and violence.

We’re fortunate that we’re finally acknowledging PTSD as a real illness with real consequences, but despite the good intentions of emergency services to their employees, the question is, are the support systems being utilized, and if not, why not?

Stigma, discrimination, penalization, and the John Wayne Syndromesuffering in silence

In the emergency services culture, there is stigma and perhaps a shame attached to being affected by trauma and asking for help. It is considered a “weakness” and it is the largest problem that first responders face because it is a deterrent to getting help.

Though more women are joining military and emergency services, men still form the majority of employees, and because they’re men, they are expected to adhere to the traditional masculine code that demands they use the “suck it up” method of dealing with harrowing trauma and stress.

Vince Savoia says that first reponders work with respect for the public who needs them, but the same respect is not offered to colleagues. “First responders who look for support are bullied by their peers and colleagues,” he says, “they are ridiculed and harassed. Mental health is viewed as a weakness, not an illness, and the expectation is that we should be able to stop it and move on.”

The mental illness stigma exists in all branches of emergency services and the armed forces. David Whitley, a paramedic who suffered his own PTSD from a terrible ambulance accident, now volunteers for a local emergency services support group that checks in with first responders who experience potentially traumatic events like shootings, suicides, crashes, and situations that involve children.

“We give [members of the group] an opportunity to talk because there is a stigma,” he told the Toronto Star. “First responders need to lower the trauma mask, and that’s scary because there are feelings of vulnerability and anxiety. But if you don’t do that it’s a precursor to mental illness, including PTSD.”

Kent Laidlaw, a retired police veteran in Burlington, Ontario, and principal of Canuckcare, a consulting service for people who deal with workplace stress and trauma, says that the systemic corruption that exists in police ranks ensures that officers who ask for help are considered “less than” and therefore a weak link in the chain. They are penalized rather than punished, a subtle difference that speaks just as loud.

New York State police veteran and police trauma and suicide researcher, Dr. John Violanti, observed in the Ontario Ombudsman’s 2012 report that the nature of the policing environment often goes against the goal of improving health: “The police culture doesn’t look favorably on people who have problems… Not only are you supposed to be superhuman if you’re an officer, but you fear asking for help… you may not be considered for promotions and you may be shamed by your peers and superiors. In some cases, your gun can be taken away, so there is a real fear of going for help.”

 ***

Emergency service workers are very well trained but cannot be prepared for every possible situation, so perhaps masking the emotional response to what they experience is the way to cope, but unfortunately, first responders are human, and part of being human is to be emotional. To expect that anyone could not be affected by horrific and traumatic events is ridiculous, and then to believe that there is no emotional aftermath is absurd, even abusive.

The code of masculinity that demands men to be stoic, brave, and in control, subscribing to what Vince Savoia calls the “John Wayne Syndrome”: the tall, rugged, macho cowboy who can deal with any situation and stand up for justice. Savoia believes that first responders have to be this way in order to do their job, but what happens after the mission is accomplished and reality sets in?

On his very first call, a house fire, Vince Savoia lost his first patient, a two-year old child. He wanted to talk to his paramedic crew about it, but when he tried to, “the crew was very stoic –just walls.” If this code prevents men from being able to get support from the experiences of trauma in their jobs, what purpose does it serve? A culture of hyper masculinity is a hindrance more than a help; it creates broken men who can’t do the job as well as healthy men.

Saskatchewan counsellor, Peter Griffith, says that men don’t like to admit, or even recognize when they need help, to the degree that they will ignore their own health problems sometimes until it’s too late. Hospital wards, he says, “are full of men who refuse to go to the doctor when they have physical symptoms and who seem to prefer to pay the price rather than to go for help.”

Anna Baranowsky, a clinical psychologist who works with police officers in private practice, explained to the Toronto Star in 2012 that “people can recover[from PTSD], but if we see ourselves as being strong and we won’t tolerate any kind of weakness, then what we might end up doing is pushing (ourselves) until we are past the point of recovery, and that is really dangerous.”

Experts say that the stigma attached to mental health needs to change for us to get anywhere. It could be as simple as changing our perception of what it is to ask for help and equate it with responsible prevention, with the power to keep oneself healthy, capable, and strong. Putting a positive spin on the consequences of responding to a traumatic situation is much more agreeable than demeaning someone who can’t control their mental health response.

The PTSD misunderstandingshattered glass

There is a very interesting argument happening right now around PTSD. Some, like Vince Savoia, believe that PTSD is responsible for taking the lives of more than 20 first responders since the spring, but some mental health professionals like psychologist, Dr. Paulette Laidlaw, believes that PTSD has become something of a blanket diagnosis for many other problems.

While it’s true that in some cases, PTSD symptoms can worsen after an emergency service employee retires, Dr. Laidlaw wonders why is it when we hear “police suicide”, we make the automatic assumption that it is related to PTSD.

Dr. Paulette and Kent Laidlaw do not believe that first responder suicides are exclusively job-related, but are more likely a combination of many stresses including work, finances, and relationships. They say the individual’s long-term mental health should be examined and more questions asked about a first responder’s life before we slap the PTSD label on them, just because that individual happened to work in the armed forces or emergency services.

Dr. Laidlaw explains that PTSD is not as commonplace as we are led to believe. “PTSD affects only 8 percent of the population,” she says, “whereas depression affects 30 percent and anxiety touches 20 percent. We’re in murky water trying to distinguish PTSD from burnout, acute stress, trauma, grief, or clinical depression”.

We see PTSD in the news a lot and it has become something of a “trendy” disorder. Media reminders of the illness can cause people to self-diagnose via the Internet, and all hell can break loose. Dr. Laidlaw suggests that PTSD is the “sexy” disorder of the day, and with any popular disorder, like we saw with childhood ADHD, suddenly there are specialized medications and “PTSD therapists” come out of the woodwork. PTSD can only be diagnosed by registered psychologists and medical doctors.

How will change happen?fireman

“I wish I had cancer because then people would understand.”
-Veteran paramedic Ken Barker communicated to his sister shortly before taking his life

Mental illness is not something tangible, something that hurts, something that can be fixed with a cast or a bandage. It affects the brain and though it may not show on the outside, it can torment the mind from the inside.

Regard for mental health is changing, albeit slowly, but Vince Savoia believes that cultural change in PTSD acknowledgement has to come from the top down, and says that “we must respect mental wellness as an issue and stop the harassment and bullying from the bottom up. It has to be a grass-roots movement to encourage people to take responsibility about how they treat themselves and their colleagues.”

Dr. Violanti agrees:  “If I tell you that the first time you see a dead body or an abused child that it is normal to have feelings of stress, you will be better able to deal with them; exposure to this type of training inoculates you so that when it does happen, you will be better prepared. At the same time, middle and upper management in police departments need to be trained in how to accept officers who ask for help and how to make sure that officers are not afraid to ask for that help.”

This means changing the culture from one that ridicules people who need support to one that supports and embraces human vulnerability.

Dr. Jeff Morley, former RCMP officer and psychologist for Canadian Forces and Veterans Affairs says “Canada needs a national mental health strategy for first responders, but the political will does not exist right now.”  He says that to change the system, we need a high-profile person to promote the cause, like Romeo Dallaire who played a big role in the beginning but retired from senate this year.

“That, or if the government clues in that the high financial cost of not doing anything (i.e. disability costs, sick time, leaves of medical absence) exceeds the cost of early intervention, education, and prevention.” He says that the RCMP spends tens of millions of dollars per year on PTSD disability claims, but asks how much they’re willing to come up with to prevent it.

The Globe & Mail reports that global estimates for antiviral drugs have run close to $10-billion since the SARS outbreak of 2002.  The authors of the original report in the British Medical Journal acknowledged that the “important benefits have been overestimated and harms under-reported”. Imagine if the Canadian government spent the same amount on long-term mental health as it spends on stockpiling useless drugs for unlikely flu epidemics. Imagine if people shrugged off the toxic masculine codes that keep men from flourishing and actually paid attention to what they need. And can you imagine the tremendous benefits of supporting the mental health of the people we depend on to take care of us?