“Be more resilient” has become a platitude encouraged by well-meaning people, but it is one that often lacks any sort of substance. In short, resilience is a series of choices made before, in the moment, and post-adversity; choices bolstered by a deep resolve that life is still worth living to its fullest extent; and that in the end, we are simply bigger than anything bad that can happen to us. What does that mean for first responders? How can we practically incorporate this into our daily lives both at work and at home?
Pre-, Peri-, and Post-Traumatic Factors
For as often as it’s talked about, most first responders do not go on to develop post traumatic stress disorder (PTSD). We’re getting better at talking about the post-traumatic factors that can factor in, but there are also pre-traumatic and peri-traumatic factors that have major influence on our ability to recover after such an event. So much about our post-bad-incident experiences is actually determined before the call even comes.
Pre-traumatic factors include everything in your daily life in this present moment. We don’t do our jobs in a vacuum, but we walk onto emergency scenes carrying our existing stress levels, current life perspectives, and current coping skills. What do you currently do to cope with stress? Who do you turn to when you feel like you’re reaching capacity or when you’ve had a particularly bad day? What do you do when life feels out of control? How did you see stress being dealt with in your house growing up? What was modeled for you? Do you rely on any substances to sleep, calm down, or cope?
Peri-traumatic factors have to do with the incident itself. Was it a really bad car accident that has a clear beginning and end? Or, was it a major weather event, like the devastating multi-state impact of Hurricane Helene, whose impact will be felt for years to come? How quickly did you feel like the event was over and that you could take a breath? What impact did you have personally? Were any mental health resources available to you? How quickly? Did you decide to use them? Were they helpful?
While working on my thesis for graduate school over the summer, I was researching the mental health impacts on first responders when it comes to incidents of mass violence. I found an interesting factor we can directly correlate to the long-lasting mental health impact called PTSD. This insight also provides an area of our life that we can improve before a bad call comes, a pre-traumatic factor we can strengthen.
Around 9 p.m. on November 13, 2005, in Paris, France, a series of coordinated terrorist attacks began that would eventually kill 130 people. Suicide bombers struck outside a soccer stadium, other terrorists opened fire on restaurant patrons, and a third group took hundreds of people hostage in the Bataclan theatre. Forty-five medical teams, untold numbers of firefighters, and countless police officers responded to the attacks, dividing up between the sites. Medical examiners arrived to begin cataloging the bodies and detectives gathered crime scene evidence (Rothrock, 2024). A groundbreaking study was done with 663 responders. “Gender was not affiliated with higher rates of PTSD but … having a higher degree of social isolation was affiliated with higher rates of PTSD” (Motreff, et al., p. 143, 2020).
What Can You Do Today?
If you knew that in 30 days from today you were going to run a call that was going to rattle you for whatever reason, what would you change about your current life to better enable you to fully meet that stressor and be more resilient? Thinking about the data gathered after the Paris attacks, we know that helping bolster our connection to other people is a major protective factor against PTSD. It’s natural to want to isolate when we’re going through something difficult that we don’t feel like we have words for. We don’t want to be judged, and we don’t want to be the only one struggling. After all, we are practiced problem solvers. But, ensuring we are connected to those who care about us—people who will notice if we start to isolate too much—that is a major factor we can work on bolstering now.
So, if you knew such a call was coming in a month, what would you do today? Would you prioritize sleep? (You get your best sleep in a room that is cold, dark, and as quiet as possible.) Would you find a better way to mentally transition between work and home? Would you start a fitness routine or restructure your current one to make it easier to stick to? Keeping promises we make to ourselves is a way to bolster our self-esteem, which leads to higher rates of resilience. How would you start to talk about your job differently to your spouse if you knew this call was coming? Would you reconnect with an old friend or family member who has been a good support for you in the past? What communities would you invest in so that when the time came, they would invest in you?
Bio:
Ali Rothrock joined the volunteer fire service in 2005. She is the CEO of On the Job and Off and the Executive Director First Responders Care. She has her master’s degree in Human Services: Trauma & Resilience, is a certified trauma responder through the Association of Traumatic Stress Specialists, and is the author of After Trauma: Lessons on Overcoming from a First Responder Turned Crisis Counseling.
References:
Garza, H. M. (2021). Effects of mass shootings on life satisfaction of first responders. [PDF]. (Doctoral dissertation, Walden University).
Motreff, Y., Baubet, T., Pirard, P., Rabet, G., Petitclerc, M., Stene, L. E., … & Vandentorren, S. (2020). Factors associated with PTSD and partial PTSD among first responders following the Paris terror attacks in November 2015. Journal of psychiatric research, 121, 143-150.
Rothrock, A. (2024). Exploring the Mental Health Impact of Incidents of Mass Violence on First Responders (Master’s Thesis, Concordia University, St. Paul).
