This is an Open Access journal. It adheres to the CC BY-NC-ND 4.0 Creative Commons licensing guidelines for copyrighted material. For terms and conditions of permitted uses, please see https://creativecommons.org/licenses/by-nc-nd/4.0/legalcode. CSHR y Vol. 1, No. 2 y September 2019 48 Vol. 1, No. 2 September 2019 Fighting the Enemy Within the Fortress Konstantinos Papazoglou, PhD Yale School of Medicine 230 S. Frontage Rd. New Haven, CT 06519 Yale School of Medicine, email: konstantinos.papazoglou@yale.edu Katy Kamkar, PhD, CPsych, katy.kamkar@camh.ca Work, Stress, and Health, Centre for Addiction and Mental Health Prashant Aukhojee, prashant.aukhojee@mail.utoronto.ca Health Sciences, University of Toronto Abstract. Posttraumatic stress disorder (PTSD) is a debilitating psychological health condition that jeopardizes the wellbeing, holistic health and functioning of police officers following exposure to traumatic, stressful, and life- threatening experiences. While resiliency is expected of officers, the recurrent encounter to traumatic incidents eventually influences the expression of symptoms that collectively constitutes PTSD. In addition to exploring the definition of PTSD and how it affects officers, this paper intends to inform police officers suffering from PTSD of the availability of effective treatments (e.g., prolonged exposure therapy, cognitive processing therapy) and to explain major parts of PTSD treatment to ensure officers are able to understand the processes involved in the treatment. This article hopes to clear up any skepticism about the efficacy of PTSD treatment and help officers become more informed about PTSD treatment. Keywords: police trauma, police mental health, posttraumatic stress disorder, prolonged exposure therapy, cognitive processing therapy, cognitive-behavioral therapy Police PTSD: Fighting the Enemy Within the Fortress Exposure to critical incidents is inherent to police work. Police officers are not only mandated to respond to violent crimes, but they must also make split second decisions, often in order to save the lives of civilians, as well as to defend themselves from imminent harm. In addition, police officers are often the ones who respond to critical incidents before other frontline professionals, and thus find themselves in situations where they also need to provide emotional support to the victims of crimes. Considering that officers are mandated to act as “street fighters” as well as “social service workers” while on duty, the role of the police officer is versatile and complex (Manzella & Papazoglou, 2014), prompting Chopko (2011) to describe police officers as “compassionate warriors.” In addition to being exposed to multiple critical incidents over the course of their career, they are also expected to be more resilient compared to the general population (Galatzer- Levy et al., 2013; Marmar et al., 2006). The authors refer to Bonanno's (2004, 2005) definition of resilience as the human capacity to flourish during exposure to adverse situations and to recover (bounce back) after exposure to deleterious stress and potential trauma. All the above findings are not surprising considering that during the recruitment process, police organizations exclude applicants whose profiles indicate severe forms of psychopathology or other personality disorders that would prevent them from performing their police duties effectively (Cochrane, Tett, & Vandecreek, 2003; Reaves, 2010; Sarafino, 2010). In addition, police officers attend intense training (e.g., realistic, classroom type) that promotes their resilience and job performance in critical situations (Andersen, Papazoglou, Arnetz, & Collins, 2015; Andersen, Papazoglou, & Collins 2016). Nonetheless,