I often present to first responders, whose response to my presence is all too familiar. In presentations across the nation, I watch groups of first responders and healthcare professionals funnel into conference rooms, occupying the seats furthest from the front. Police departments typically have little trust in outsiders, whereas military groups dread yet another meeting. Nearly every time, the group’s arms are crossed—a nonverbal sign they are determined there is nothing to gain.
I begin each presentation with stories similar to their own, weaving in my experience and expertise from years of service in their community as a retired trauma therapist and CEO who has served over 10,000 people. My experiences are extensive and far reaching, including partnerships with police departments, fire departments, special forces, and emergency medical services (EMS) organizations. I have sat with countless individuals haunted by images and plagued by the belief that life as a responder means living with insufferable trauma and nightmares, requiring significant effort to suppress.
As the hour passes, I often see tears fill my audience’s eyes as they struggle to maintain composure. After the meeting, a long line forms, with many using the familiar phrase, “I need help.”
First responders’ sacrifices are astounding. Firefighters, police officers, and EMS personnel are our community’s front line, protecting us and providing care when we need it most. It is critical for those entering the field of first response to learn essential skills early in their careers to protect not only their bodies but also their minds. Failing to do so often results in burnout, exhaustion, breakdowns, post-traumatic stress disorder (PTSD), anger issues, isolation, and fragmented relationships at home with those whom they love most. Yet despite meeting with organizations across the nation, I rarely encounter a first responder who has received this priceless education.
The nature of these jobs mean that first responders witness some of life’s most horrific tragedies—rape, murder, and suicide. Eighty percent of first responders are exposed to traumatic events, and within the first six months of their career they experience more than the average person sees in a lifetime.
The Impact of Trauma on First Responders
Trauma’s Impact on the Body
When individuals encounter trauma, their bodies release cortisol, the stress hormone. This causes the brain to shut off the parts responsible for decision-making and rationalizing, conserving energy for survival.
Although this response can be beneficial in life-or-death situations, first responders are repeatedly placed in such scenarios, requiring them to make critical decisions amid chaos. It’s estimated that 15-20% of first responders suffer from PTSD. Depression, anxiety, substance abuse, and suicide are significantly higher among this population compared to the general population.
Eighty-five percent of first responders experience symptoms of trauma, such as poor performance, difficulty concentrating, tardiness, poor motivation, and memory loss. They may suffer from shock, irritability, and emotional instability, all of which impact their confidence and self-worth. Some develop a cynical worldview, believing the world is dangerous, while others experience self-doubt, feeling they should have done more to help.
Long-Term Effects
Trauma leaves an imprint on the soul, deteriorating relationships and leading to disconnection, avoidance, and ultimately divorce. Recurring memories and symptoms manifest as bodily sensations and health issues like obesity, diabetes, and heart disease. First responders have a 73% higher risk of mortality than the general population, necessitating psychological first aid.
First Responder Exhaustion Syndrome (FRES)
FRES results from unaddressed trauma, including embodied memories, compassion fatigue, and negative beliefs. Although not yet included in the DSM-5, it affects many emergency personnel, causing depression, anxiety, insomnia, substance abuse, isolation, and emotional and physical fatigue.
A hallmark of FRES is an inability to seek treatment due to stigma. Many first responders fear that seeking help will make them appear weak or incapable, and some worry that a diagnosis could jeopardize their careers. They mistakenly believe that residual trauma is an inevitable part of their job.
How to Heal
Changing the culture within these environments is essential. Leadership must go beyond merely offering employee assistance program flyers to those in crisis. Leaders need to be knowledgeable about effective mental health treatments and set an example for their teams.
Trauma-informed training, particularly that focuses on eye movement desensitization and reprocessing (EMDR) and accelerated resolution (ART) therapies, can help first responders heal. These tools effectively address severe traumas, such as witnessing burning bodies, child homicides, and horrific car accidents.
Substance abuse is a concern among first responders, often linked to prolonged exposure to trauma. Offering intervention protocols and resources can help those affected find necessary support. High rates of substance and sex addiction are byproducts of living in chronic fight-or-flight states without proper training to return to a baseline of peace and calm.
The truth is that nightmares and haunting images can be cleared with the right tools, allowing first responders to achieve peace. They are more than the traumatic images in their minds; they are dedicated professionals who sacrifice much for their communities.
Leadership, peer support, and individuals must prioritize addressing workplace trauma proactively. Employers should review protocols and processes to identify potential issues, such as long hours, sleep deprivation, and inadequate “return to duty” standards. Open discussions about emotional regulation and the complexities of transitioning between work and home life are crucial.
This article is part of a three-part series providing insights, expert knowledge, and strategies to enhance resilience and performance for first responders, both professionally and personally.
Melanie Boyack is a crisis management and intervention expert who frequently addresses military units, SWAT teams, and first responders. She is also a published author and retired trauma therapist. She has a master’s degree in social work and comprehensive training in behavior analysis. (www.melanieboyack.com)
