Trauma: How to Help Firefighters and Police

In the previous post we started talking with Elizabeth Barney about trauma in first responders, like police, paramedics and firefighters.  Today we continue with a discussion about trauma treatment.

Q: There is often stigma for first responders to seek treatment.  Are there studies or known strategies that help reduce stigma? 

First responders delay or avoid seeking treatment for mental health issues for a variety of reasons. There is little research on mental health and responders that is substantive. Some good resilience research exists, and I feel that it could easily apply to the first responder community. Dr. Everly has done some phenomenal work identifying factors that decrease a person’s resilience - role ambiguity, lack of job satisfaction, role overload and burnout; all of which can be seen in the first responder community. His work also highlights that increased resilience can be seen when a person has strong support including leadership at work, hobbies and a healthy lifestyle.

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First Responder Trauma

In these next two posts, we talk to Elizabeth Barney, who has almost ten years' experience with first responders and trauma, both as a first responder herself, and as a public health expert on responder resilience.  Read more about her experience below.

Q: Who are first responders?

A: Anyone who is on the front-line for emergencies.  This can include fire-fighters, police officers and ambulance staff.  Other officials respond to emergencies as well, though in a different capacity, like morgue technicians, emergency dispatch and on-scene crisis mental health teams.

Q. Are there any common myths or misconceptions about first responder mental health that you would like to correct?

A. Many stigmas and myths about general mental health apply in the first responder community as well. I think the myth that mental illness is for weak, or weak-minded people is still prevalent among first responders. First responders serve others, and it can be very hard for a responder to solicit the same help they so often provide. Some of that is bravado; it seems that some responders feel the need to show an impermeable façade – even when they aren’t on scene. I think there has been a very positive conversation in the first responder community lately about being proactive and addressing stress and repeated trauma before it becomes consuming. Programs like Psychological First Aid, CISM and Code Green are helping that dialogue.

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trauma therapy

Travel as Treatment

Most people would agree that they feel refreshed after venturing to a new location. Eat, Pray, Love: One Woman's Search for Everything Across Italy, India and Indonesia, by Elizabeth Gilbert further popularized the concept of a literal journey of self-discovery. A simple google search for “healing travel” yields almost endless results.

But if it does work, what is it about travel that’s so rejuvenating?

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What Would [Role Model] Do?

I’ve been getting annoyed more than usual the last few days. I’m not sure if it’s because I’ve been dealing with some difficult people (maybe) or I’ve just been in a place that I’m more easily annoyed (maybe), but the result is the same. I’m uncharitable in my assumptions. So when I get a discourteous email from a stranger, I don’t think, “Wow he must be having a rough day,” I think, “What an a$%hole!”

And why does it matter which assumption I make? It really doesn’t, to him. We will remain strangers either way. But for me, choosing compassionate energy is much is better for my overall mental state, long after the email is gone. I really like how I feel when I understand how someone reacts to something or when I’ve given someone the benefit of the doubt.

Lately, I’ve been reflecting on the phrase, “What would So-and-So do?”

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coping skills

Pendulum of Change: A CBT Activity


So therapy is going well.  Maybe you used to be really passive and now you're standing up for yourself.  Maybe you used be afraid to try new things, and now you dive right in.

What I notice about clients who have spent their entire lives hiding and running, is that when they finally stop, there is a bit of a pendulum effect.  And I see a lot of these on a lot of levels: intimate relationships, office-sized systems, and societal.    The Pendulum Effect is worthy of its own blog post, but for now enjoy this mock case-study.

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Why Are You Obsessed with Narcissists?

People diagnosed with Narcissistic Personality Disorder make up, at most, 6% of the U.S. Population and generally less in other countries (from DSM 5).  Yet articles about recognizing and dealing with narcissists are so abundant that an alien reading mental health headlines would be forgiven for assuming that over half the population are people with grandiose visions of themselves, demand admiration and lack empathy.

Even though people get busy and it’s easy to rush by someone in need in most urban settings and sometimes people say really insensitive things, I do think that most people desire real connection with others and are willing to help when the need and the way to help is clear.  So then why do articles about narcissists resonate so loudly with readers?

One reason is that they cause so much pain.

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Tale of 2 Disasters

Three weeks ago, Houston was inundated with 10 inches of rain. Six people died, and another of others had to be rescued from flash flooded that swept away cars and filled homes. Last week, a lot of rain was dumped on Accra, Ghana though there is no report of how many inches were in the deluge. We don’t know how many people died, but estimates range from 150-200. About 100 of those were lost an explosion at a gas station where many people huddled, waiting for the rain to pass.

Ghana has about ½ as many people as Houston, yet 30 times as many people perished in a disaster that most people in America never even heard about. But the real pain and anger come from the fact that these deaths were preventable.

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Johnstown Flood: Anniversary of a Catastrophe

May 31, 1889, a small river near Pittsburgh grew to the size of the Mississippi when the South Fork Dam overflowed and then broke apart, releasing 20 million tons of water into the valley below and killing over 2,000 people.

The river valley had hills on each side and became a chute for all this water, funneling it the 14 miles to Johnstown. The 40 foot wall of water ripped up trees, houses, businesses and even railroad cars and pushed it down the valley. The velocity of the water and 14 miles worth of landscaping and development would easily have been enough to take out the Johnstown bridge but there was a turn in the valley just before and the hillside took the force of the blow. So instead of washing out the bridge and carrying on, the bridge’s supports quickly filled with the junk that was being pushed along, creating another dam. Thus, the lake created by the South Fork Dam reformed over Johnstown, which is why it is called the Johnstown flood.

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