Medical discharge from the "family", moral injury, and a diagnosis of PTSD: is psychological growth possible in the aftermath of policing trauma?

The potential for acute and cumulative exposure to traumatic events associated with policing is well recognized. However, research exploring the subjective impact of that trauma, particularly when it results in discharge with a diagnosis of posttraumatic stress disorder (PTSD), is significantly limited. Drawing on a phenomenological epistemological position, this study explores the subjective "lived" experience of 7 former police personnel medically discharged with PTSD. It sought both positive and negative interpretations of (a) their personal experience of policing; (b) consequential discharge with PTSD; and (c) life after discharge. Using interpretative phenomenological analysis (IPA), semistructured interviews provided the data for transcription and analysis. One superordinate theme: moral betrayal, silence, and hope in policing trauma; overarched 4 subordinate themes: eroded identity; moral betrayal; confronting the silence; learning to depend on me. These interpreted themes mirror multiple layers of complex policing trauma in these participants that over time eroded hope. They reveal a growing awareness of moral injury that only found voice, postdischarge. Chronic exposure to policing trauma was experienced as a domino effect slowly diminishing self-worth and consequently corroding their earlier sense of purpose as police personnel. Intrinsically, shame was interpreted as having failed. Discharge dissociated them from the collegial support necessary to reintegrate into their postdischarge lives. Instead, former altruistic selves became reclusive. These participants attributed "felt" distress as directly attributable to organizational factors that left them feeling invalidated, betrayed, and without support. Over time, some experienced a newfound appreciation of "self", facilitated by hope. Implications for clinical practice and policy are discussed.