What was the worst call you have ever been on? How many different ways did that call and so many others adversely affect your health and wellness, your relationships at home, how you perceive your job and the community, and the quality of your life? Could you have been better prepared before and after, to more constructively process the acute stress and trauma of a professional firefighter?
Consistently being immersed in death, tragedies, danger, heartache, and suffering can often scar the spirit of any first responder – particularly firefighters and EMT personnel. Tragically, first responders are more likely to kill themselves than die in the line of duty. Each year, a fire station is 3-4 times more likely to experience a suicide rather than a line of duty death.
There are more than twice as many problem drinkers within the first responder professions than the general public. An estimated 15-18% suffer from PTSD, with an estimated 20-25% who will suffer at least one life-altering addiction during their career. It is essential for fire personnel to incorporate proactive emotional survival and wellness practices that nurture, protect, and heal their spirit—to bulletproof their spirit to prevent them from becoming victims of their profession.
The inherent adverse effects of a career as a firefighter or medic are poisonous and cumulative. Like a cancer, dedicated yet unsuspecting first responders have the potential to slowly succumb to the toxic, debilitating effects of acute stress and trauma with little training on how to effectively process the internal damage. The job has an inherent ability to turn us into someone our loved ones no longer recognize. Following is emotional survival strategies based upon the award-winning book, “Bulletproof Spirit: The First Responders Essential Resource for Protecting and Healing Mind and Heart,” (firstresponderwellness.com)
The Warning Signs
Emotional survival means having the ability to process stress, overcome trauma, while serving with compassion without the job being crippling either mentally, emotionally, or physically. If you are doing nothing proactively to develop and promote emotional survival, then you are allowing the job to victimize you.
Our spirit is the foundation for our physical, mental, emotional wellness and the quality of our life. Our spirit consists of everything within that makes us resilient, able to cope with trauma; it is our motivation to compassionately serve and help others; our
sense of aliveness; and it is what makes us human. And it is our spirit that suffers most from a career as a first responder. The first objective is to understand the several warning signs that a firefighter’s spirit has been injured and not processing stress or trauma effectively.
1. Isolation: Over time there is a natural tendency to become increasingly isolated. This involves withdrawing—preferring the company of work colleagues or being alone over associating with other friends, family, and their related activities. One develops the tendency to disengage, not wanting to make decisions away from work, and preferring not to be involved with others, even spouses and children. Eventually, you can become distant and reclusive.
2. Irritability: When affected, you’ll tend to develop a shorter-than-usual fuse, fly off the handle for seemingly insignificant reasons, respond to questions in one-word sentences, usually say you are “fine” just to stop any further conversation, and keep everyone near you walking on eggshells for fear of how you may react. You become increasingly more on edge, restless, and agitated.
3. Difficulty Sleeping: Having difficulty consistently getting a good night’s sleep—either because of sleep interruptions several times each night or because of only being capable of sleeping for a few hours—is a significant sign that you are not effectively processing stress and are being adversely affected by the job.
Being affected by trauma can not only cause sleeplessness, anger, extreme anxiety or depression, uncontrollable emotions, but may also cause one to “see” things or re-live traumatic experiences over and over again.
4. Anger: When seriously affected, you begin to develop a pattern of taking out your stress and frustration on others, often those they care about most. We tend to become increasingly more angry all the time, losing what patience we once had, thereby losing our ability to cope and be resilient under stress.
5. Emotional Numbness/ Feeling Dead Inside: Becoming emotionally numb or dead inside is inevitable, at least initially, and firefighters need to consistently work to prevent it from overwhelming them. The job will naturally tend to make you want to shut down emotionally as a way to no longer feel the sense of helplessness, frustration, stress, trauma, and emotional pain of the job. As you shut down emotionally, you tend to become disassociated with others, indifferent, and disengaged with life. However, this inevitably leads to seriously damaged relationships at home.
6. Lack of Communication: As one increasingly withdraws, they will tend to make the serious mistake of keeping everything inside. This becomes serious because, as their communication skills diminish, they will refuse to talk about how work is affecting them. Feelings of depression, anxiety, helplessness, anger, fear, and other negative emotions will then tend to intensify.
7. Cynicism, Distrust, and Loss of Work Satisfaction: If any of these warning signs are not addressed, you will likely become highly dissatisfied at work, extremely cynical, and distrustful of most everyone. This cynicism and negative outlook can send you into a downward spiral that eventually could affect every aspect of your quality of life.
8. Depression: Ignoring any of these warning signs eventually can lead to clinical depression. Left untreated, this may worsen and become potentially severe depression, resulting in substance abuse and addictions, broken families and lives, and a host of other debilitating problems, up to and including suicide.
9. Drinking as a Perceived Need or Habit: Drinking or consuming other substances because of a perceived need or by habit is a major warning sign. Alcohol abuse is a serious problem among firefighters and medics. Drinking because of a need or habit tends to only intensify already serious problems and emotional issues, as well as problems at work.
The first step for a firefighter to bulletproof their spirit is to learn to become more self aware of not only how the job may be adversely affecting them, but what emotional survival methods may be effective to maintain their wellness. First responders should periodically seek opinions from their spouse and loved ones regarding whether they believe you have been changing in any way, how the job has been affecting you, and what specifically the first responder can do to improve their relationships.
Periodically ask yourself how you cope and manage career stress, and whether what you have been doing is healthy. It’s helpful to think about what positive things you can do that you enjoy, that will help to breathe life back into your spirit; how to become more engaged with family and life-enhancing activities, and how to promote your health and wellness more consistently.
PTSD – Unresolved Trauma
PTSD is not a weakness. It’s not about what’s wrong with you; it’s all about what happened to you. PTSD is really an injury to the brain’s ability to process a traumatic incident or acute stress. The brain’s natural processing ability becomes injured, or stuck, which can cause a person to repeatedly re-live the experience while experiencing crippling emotional reactions.
Such was the case with a La Mesa (San Diego County) Firefighter who for whatever reason, after one particular fatal drunk driving accident, began seeing blood everywhere in his mind’s eye – blood on his daughter’s face, his wife, in the shower, and on his hands. He also kept having repeated nightmares where the dead woman who he had recovered from the tangled debris, suddenly opened her eyes and said the firefighter
had killed her. The more he tried not to see these images, the more often and more intensely he would see it.
A colleague told the firefighter about a PTSD therapy treatment called EMDR (Eye Movement Desensitization and Reprocessing). The officer tried this therapy with the Fire Department’s psychologist and after only 2 sessions, never saw phantom blood again and never again had that nightmare. The therapy is specifically designed to heal the brain’s ability to process the trauma and place it in its proper perspective. Although you will always remember the incident, with treatments such as this you can remember it without being emotionally crippled during those memories. (Trained EMDR psychologists can be found at EMDR.org)
Wellness Practices to Bulletproof the Spirit
Firefighters and medics are not invincible. They feel fear and are helpless at times. They suffer heartache, suffer with their victims, and bleed just like everybody else. Wellness practices for the spirit, or spiritual wellness, is a concept fairly new to first responders, but learning how to nurture, protect, and sustain one’s spirit is critical for survival.
Following are several emotional-survival and wellness principles that firefighters and medics can develop. All of them can help improve coping ability, mitigate stress, prepare a first responder to more effectively process trauma, and enhance overall wellness.
1. Serve with Compassion: Search for ways to express and demonstrate service with compassion – to strive to make a difference. The virtue of service is fundamental in making a first responder feel alive and useful, while finding purpose in their work. The most meaningful things in life cannot be seen or touched, but are felt with the heart. A first responder with a healthy spirit is driven by the heart to solve problems, help those in need, and make the world, home, community, and work better places to be. It is important to their spirit to learn to focus on what their spouse, children, community, work colleagues, and others need from them rather than what they want from others.
2. Remain Involved with Outside Interests: First responders need to remain involved in activities they found fun and interesting before becoming a first responder. Most firefighters spend significantly more time watching television and using a computer than they did starting their career. Such activities tend to keep them isolated and away from more productive, life-sustaining activities that serve to breathe life into their spirit.
3. Establish a Support System: Develop a trusted support system and discuss how they can best support and most effectively help you. Your physical, mental, and emotional health and well-being, as well as the quality of your life, all depend on their level of preparedness and the development of an effective support system that is non-judgmental, caring, and supportive.
4. Get an Annual Emotional-Survival-and-Wellness Checkup: As a form of prevention and wellness maintenance, first responders should consult with a psychologist specializing in treating emergency first responders and trauma to determine if they are being adversely affected by past trauma and to gain insight into how to deal with trauma and stress more effectively.
The idea behind an annual checkup like this is not that “something is wrong.” Something may or may not be affecting you, but the emphasis is on getting a wellness check and discussing the previous year—both professionally and personally, as a preventative and wellness-maintenance measure. This is similar as going to a physician each year for a physical checkup.
5. Questions to Discover Purpose in Work and Relationships. First responders should determine the following:
1. What gives meaning and purpose to their professional and personal lives?
2. What provides hope, comfort, and happiness?
3. What are their ethics and character values and how can they be improved?
4. How do they maintain perspective and keep in touch with the most important people in their life – and demonstrate each day how important they are to you?
5. In what ways do they work to improve the quality of their relationships?
6. In what ways do they harm those relationships?
7. In what ways do they show the most meaningful people in their life how much they are valued?
8. In what ways do they nurture their spirit?
9. Who and what are they responsible for at work and at home, and how consistently do they fulfill that obligation? How specifically can be done to improve?
6. Get More Consistent, Good Sleep: Lack of good sleep will worsen a first responder’s mood, decrease their alertness, interfere with their decision-making ability, impair their task performance, cause serious emotional and physical problems, and reduce their ability to concentrate and generally think. Eighteen hours of sustained wakefulness, is equivalent to a .08 percent blood alcohol level.
7. Exercise as a Way of Life: Maintaining a vigorous and consistent exercise activity level is essential, because it will significantly reduce your stress levels, reduce your chances of getting injured, and enhance your coping abilities. Consistent exercise will reduce your chances of getting a heart attack or acquiring type 2 diabetes by 58 percent. It will also significantly reduce tension while you’re off duty and enable you to get more consistent sleep.
8. Strengthen Character: The quality of any person’s character is related to their integrity, dependability, trustworthiness, dedication, compassion, hard work, and selflessness. A first responder’s character can always be improved upon. Focusing on
strengthening your character will help to improve over-all wellness, peace, and coping ability while providing more meaning to life and work.
9. Control: Focus only on what you can control, which ultimately is only your reaction to things, your compassion, your integrity, and your professionalism.
10. Practice Letting Go: First responders need to learn to be aware of how much they identify with negative thoughts and emotions, as well as being affected by past trauma, while learning to let such thoughts and emotions go. Work to replace negatives with more positive thoughts and feelings. Often remembering to say something like “That’s not helpful” can help to release or let go of adverse thoughts and negative emotions.
11. You Are Not Your Job: Working as a first responder is merely a role; it is not who you are. You have many other roles, such as a parent, spouse, friend, coach, etc. When you identify so much with the job to the exclusion of everything else, anything that affects the job (management decisions, etc.) tends to have a devastating effect on you because everything is taken so personally.
12. We All Need Help at Times: If you ever think you may need help or are told you may need help—you are already significantly past the time of needing that help. Peer support, Department chaplains or psychologists are there to offer essential help that we all need from time to time to survive this profession.
Support from Home is Essential
The most-often overlooked pillar of support for emergency first responders is the most essential—support from home. By learning how to nurture their first responder spouses, they can become hidden partners in achieving overall wellness and emotional survival.
Firefighters and medics need to create an atmosphere at home where their spouses feel comfortable to approach them to let them know that they have noticed something may be bothering you. Often we are the last to know when the job has been adversely affecting us. It is imperative for spouses to provide us with that feedback and insight that we may not be acting like ourselves. Then, hopefully we can do something about it before we turn into someone our loved one no longer recognizes.
First responders need to remember how difficult it is to be married to us, with us never being home, dealing with how the job affects us and the family, and everything else with being married to a first responder. Our spouses and children can become victims of our profession, just like we can. PTSD significantly affects all the members of the family and can be very traumatic for them as well. First responders should be asking their spouses what they need from us, what we can do to be partners in their emotional survival and wellness; so that both can work as partners to insure you, your marriage, and family, both your health and wellness, survive the profession.
A career as a first responder involves sacrifice, a giving of oneself, and a selfless devotion to protect and give life to others. Inherent in this noble profession is a continual assault upon your spirit. Reacting to tragedies, being immersed in heartache, while trying not to suffer with their victims makes it a daily struggle to emotionally survive.
It is not inevitable that a first responder will suffer and become a victim of their profession. The consistent practice of emotional and spiritual wellness principles can enable first responders not only to emotionally survive but to thrive throughout their career. It is imperative for first responders to work to bulletproof their spirit because the protection of their community, the quality of their personal and professional life, the happiness of their family, and the wellness of their spirit all depend upon it.
Readers interested in discussing this topic further, or having Captain Willis present an emotional survival class to your station, can reach Captain Willis at firstresponderwellness.com or firstname.lastname@example.org Bulletproof Spirit: The First Responders Essential Resource for Protecting and Healing Mind and Heart” can be obtained at: www.firstresponderwellness.com
Captain (ret) Dan Willis served with the La Mesa Police Department for 26 years. He is a former crimes of violence, child molest, homicide detective and SWAT commander, and La Mesa’s Wellness Coordinator. He is a graduate of the FBI National Academy and is the author of the emotional survival book, Bulletproof Spirit: The First Responder’s Essential Resource for Protecting and Healing Mind and Heart (New World Library, October 1, 2014). FirstResponderWellness.com