Understanding First Responder Trauma

First responder mental health is a really important issue that we’re passionate about. First responders of all kinds, including firefighters, paramedics and police officers, deal with trauma every day. The long-term (and short-term) impacts of experiencing traumas are by no means light. We wanted to bring light to this issue by providing some education about the types of traumas that first responders experience, how it impacts them and some of the proactive measures we can take to lessen the impacts of those traumas.

We can also only imagine the heightened trauma that first responders have been experiencing over the last year with the coronavirus pandemic. There is a lot of traumatic work going on behind the scenes in ICUs, for example, that many of us don’t even know about. “We know that first responders, especially paramedics, are going through a lot right now. But we don’t necessarily see more of them coming in to see us. Why? That probably has a lot to do with the lack of funding provided to them to access mental health services,” says Andrea McTague, founder and registered psychologist at Shift Psych.

It’s also important for individuals who are not first responders to understand these issues, and to have a better understanding of the work that first responders do. Unfortunately, first responders do not always have the support that they need to deal with and manage these traumas, so we can all do our part to better understand this issue and even support first responders in our lives. You can view our presentation on first responder PTSD and trauma below, or continue reading to learn more.

Some stress is good.

The first thing to understand is that some stress is good, it motivates us to get things done. The good kind of stress is known as adaptive stress, and it’s the stuff that gets us to study and prepare for an exam, or to move out of the way if a car is approaching at a high speed. This type of stress serves a purpose, and we’re lucky to have it. However, our stress response can be triggered by different things; if we perceive something as a threat (when in reality, it might not be), we can trigger our stress response, which can be taxing on both our minds and bodies.  

When stress starts to last an extended period of time (chronic stress), or multiple sources of stress pile up on top of each other, we start to see post-traumatic stress, and eventually, post-traumatic stress disorder (PTSD).

A jar of marbles

Let’s use a jar of marble as a metaphor. You can think of each of the marbles as a trauma that you have experienced, either directly or indirectly. The marbles are all different sizes, and the same trauma can result in a differently sized marble for different people. The jar represents your threshold, in a sense, it’s how much trauma you can hold within yourself until the impacts of that accumulation really start to become apparent; though the impacts can start long before this. When the jar tips over, that’s when we see a lot of burnout and even PTSD.

First Responder PTSD Symptoms and Signs

As someone who might regularly experience trauma on the job, one of the protective factors is going to be the ability to recognize when you’re getting to the point that it becomes difficult to deal with the stress, or when you’re starting to experience post-traumatic stress. Some of the things to look out for are: 

• You’ve stopped doing things that you enjoy.
• Increased irritability.
• You’re experiencing anxiousness. 
• Withdrawing from friends and family.
• Spending an increasing amount of time on maladaptive behaviours like video games or drinking.
• Becoming more forgetful. 

You may recognize these changes yourself, or even in a colleague. The changes often start out subtle and might start to become more evident. In a colleague, you may even notice the following: 

• Avoidance,
• A change in personal hygiene,
• Being late to work, and
• Not engaging in self-care or hobbies that they used to.

How to protect yourself (the Kevlar vest for your mind)

There are different strategies and tools that you can employ to lessen the negative effects trauma has on you. You can’t really avoid trauma necessarily, it’s part of life and also part of the job. What you can do, is make sure you’re equipped to protect yourself as best you can. 

One way you can do this is to make sure your life is filled with what we call: ‘satisfiers.’ These are mental health-positive items. They align with your values and what is important to you, thus, satisfiers are specific to each individual. You can think of satisfiers as insulation, or maybe even armour. Examples of satisfiers can include:

• Going for walks outside
• Spending time with your kids
• Spending time on a hobby 
• Meditation 
• Connecting with friends
• Cooking

Another thing that we can do is to talk about it. This one might sound obvious but it’s important and a really good way to process the trauma. Open up to someone you trust, like a friend, sibling, parent, or partner, and tell them what you’re experiencing. 

What might be even more helpful is to talk to a coworker about what you’re experiencing, especially a coworker who experienced the same event. This can be difficult, especially when it’s not necessarily part of the culture. But this is a good way to process trauma and start to heal from it. Keep in mind that social connection is one of the most protective factors against trauma and aversive feelings.

When you’d rather not talk to anyone

Talking to someone you trust is a great strategy, but it might not be accessible to everyone all the time. It can be difficult to have these conversations with friends and family; sometimes people even feel like they’re burdening others. Other times, people just don’t want to bring their work home with them, as a home is almost an escape. 

What do you do in these situations? Well, there are other ways to process trauma. Some individuals process by creating something like art or music; others may enjoy a physical release of energy through sport, for example. 

There are many healthy ways to process trauma. One big (not-so-healthy) coping mechanism we want to avoid is avoidance itself. It can be really easy to just not think about or talk about a traumatic event that has happened, but this prevents us from processing the trauma, which is really important to prevent us from burning out or even experiencing PTSD. 

I don’t want to talk about it at all

That’s fine. Talking about it can be very difficult, especially if the trauma is deep-rooted. Sometimes things that you see on the job might trigger something deeper within you, maybe something that you experienced in your formative years. There are therapists out there (like us) who can help you process the trauma without asking you to retell the whole story and without you having to, in a way, experience it all over again. These therapists are trained to identify the root cause of the issue without you having to retell the story, and to help you process it. 

Once we identify the root of the trauma, we reprocess it using bilateral stimulation. Basically, this is a way to stimulate both sides of your brain to help you process the trauma, so that in the future, when you think about it, it doesn’t trigger as much of an emotional response. It’s still a memory, but it doesn’t trigger you and impact you in the same way it used to.

Unfortunately, there is still a stigma around not only accessing mental health services but also opening up and having conversations about trauma. Sometimes first responders (and other groups of people as well) don’t have the support that they need to process some of these experiences, and having stigma surrounding this makes it that much more difficult.

Seeking out mental health services or having conversations around emotions and trauma is not weak. It’s proactive and protective. Often, the easier route is to not talk about it and avoid it, but that’s when we see things pile up. You already take proactive measures by keeping yourself healthy, wearing specific clothing and even sleeping at night. Make the same effort to proactively deal with stress and trauma, however, that looks for you.

First responder mental health support

Our structured and directive therapy approach is well-suited for those looking to address previous traumas or protect themselves against new ones. Our therapy is a unique combination of cognitive behavioural therapy (CBT), bilateral stimulation and exposure therapy and allows us to address your concerns in an effective and systematic way.

Episode 013 Guest, Daniel Sundahl of DanSun Photo Art

In The Shift Show Episode 13 we speak to Daniel Sundahl of DanSun Photo Art. Dan has been a full-time firefighter and paramedic since 2003, and that’s where he gets all his motivation for his emergency services artwork. He has a real passion for raising mental health and PTSD awareness for his profession.

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