First responders help everyone but themselves

Mass shootings, burning buildings, car accidents, domestic violence disputes, suicides, child abuse, sexual assault …. the average person may never witness any of these horrific events in their lifetime. For first responders, this is their life. Victims depend on the actions of a first responder – often to save their life. Firefighters, police officers, paramedics, EMTs and other emergency personnel risk their life almost every day to save another life. 

They are trained to rush into a burning building or respond to a domestic violence call, but their mind is not trained to cope with the trauma they will witness. They see the worst of the worst – plane crashes, burned bodies, beaten children. They are forced to suppress their emotions because they worry it is a sign of weakness. 

Contrary to what most people think, first responders rarely become desensitized to horrific events. All the training in the world cannot prepare first responders for what they will see on the scene. They carry tremendous pain and grief inside, which they often hide from co-workers and family members because they are in a profession where they are supposed to represent toughness and strength.

A 2015 national survey of more than 4,000 police officers, paramedics, firefighters and emergency workers showed that a first responder is 10 times more likely than another person on average to attempt suicide. Approximately 37 percent of firefighters and EMS professionals have contemplated suicide.

Studies also show the disproportionate rate of mental health injury for first responders, yet they are far less likely to seek counseling or treatment than the general public. 

They are the first to help others and the last to help themselves.

How do these heroes cope with the tragedies they face day after day? 

A retired Florida police officer who was part of the response team at the Pulse nightclub in Orlando, Florida in 2016 where 49 people were fatally shot and 53 others were injured, says he spent nearly five hours inside the club identifying, moving and body-bagging victims. His nightmares and flashbacks of that night never stopped. The sight of a white sheet, used to cover the dead bodies, automatically triggered flashbacks of that traumatic night. His wife doesn’t buy white sheets anymore. All of their bed linens are blue.

Tragedy is going to happen, and first responders need help to deal with the emotional repercussions.

It’s important for these individuals to know it is normal to have an emotional response to tragedies. They are human, they have emotions; they need to build self-awareness and get professional help and support. First responders can’t just erase the trauma from their mind, but they can learn coping skills to deal with their emotions in a healthy way. The effects of witnessing traumas day after day will compound over time. This secondary trauma can be overwhelming if they don’t have support or treatment resources.

A first responder’s instincts tell them to push traumatic memories deep into the back of their mind and bury them, but it is not possible to suppress these emotions. In fact, it does more harm than good. Untreated trauma and PTSD can lead to anger, depression, anxiety, flashbacks, insomnia and many other emotional and mental health issues. It can impact relationships with family and co-workers.

Here are some common warning signs of a trauma’s emotional impact:

• Re-experiencing the trauma, replaying the memory over and over as if the brain is trying to make sense of the experience or figure out how to respond differently for a better outcome
• Nightmares – the nervous system has taken a major shock, and the brain continues to process the event, even in your sleep
• Insomnia or sleeplessness
• Flashbacks – reliving the trauma all over again
• Fear and anxiety – this probably is the most common emotional reaction
• Anger 
• Depression
• Suicidal thoughts or attempts
• Numbness – sometimes first responders shut down emotionally
• Irritability, chronic agitation and other mood changes; angry outbursts – they suddenly have a short fuse and lash out at people 
• Difficulty concentrating, lack of focus, forgetfulness
• Social withdrawal and self-isolation
• Marriage and relationship difficulties
• Physical issues (eg, headaches, chest pain, heart palpitations, high blood pressure, decreased immunity, increased fatigue – the stress and trauma get buried inside and resurface with a variety of physical symptoms
• Alcohol or substance abuse – many first responders use alcohol as a coping mechanism 

Sometimes, first responders feel their life is unraveling because the trauma seeps into every core of their being. Many will struggle with PTSD. 

Here is some advice for first responders to help cope with trauma:

• Find some positive social outlets. 
• Exercise.
• Talk to friends, family and co-workers about what you are feeling and thinking. They may have some coping strategies that will help you.
• Resist the use of alcohol or other substances. This only brings on another whole series of problems and addictions. 
• Do things that bring you pleasure and relaxation.
• Avoid negativity – it intensifies the situation; do your best to keep the workplace tone positive.
• Take a mental health day. Plan for a day of relaxation.
• Unplug for a day.
• Meditate.
• Be open with your family. It will bring you and your family some comfort. Your family also is impacted by what is happening to you, and they could use some healing, too. This is another step toward dealing with your issues in a healthy way.
• Accept the things you cannot change. Trying to control the uncontrollable only causes more stress. 
• Focus on the lives you’ve saved and the people you have helped.

Learn to recognize the signs of stress and take steps to manage your symptoms. Consider counseling or therapy and find a mental health professional who is trained to deal with first responder issues. The issues of first responders are unique, and learning coping skills will better prepare our heroes for future traumatic events. 

As a therapist trained to work with first responders, I find they have a great deal of emotional obstacles to overcome, especially with separating work life from home life. 

Avoiding treatment can be dangerous. The resulting stress from a crisis can result in serious mental and physical health problems years later. 

You can’t avoid on-the-job trauma, but you can practice habits to help reduce its emotional impact. Always consider seeking counseling if you cannot manage the effects of trauma on your own. Remember, it is okay to get some help, in fact, it is a wise decision. 

Laura Feeney has extensive training in working with first responders and their issues as a result of traumatic events they experience on a daily basis. She also has crisis interventional training and EMDR training. She works with firefighters and police officers on a regular basis.

Laura Feeney, LMSW (licensed master social worker), specializes in addiction, trauma, behavioral issues, chronic relapse, life transitions, oppositional defiance, peer relationships, personality disorders and other mental health issues. She also has special training in rape crisis intervention and working with at-risk youths. She has been in practice for 25 years, working with a diverse population of all ages. 

To schedule an appointment with Laura, call The Center for Relationship and Sexual Health at 248.399.7447 or visit the center’s website at crsh.com, and book an appointment online.