By Nick Halmasy, MACP
Imagine for a moment, that our stance, our drive, our entire philosophy was geared toward being aware of hazardous materials. Not to strive for technician level, able to comfortably handle any hazardous material incident. Imagine the bragging rights and comradery that would come from whoever could be more aware.
Difficult? Of course it is, because in the fire service, we strive toward being as educated and skilled as possible. We want technician-level certifications to show, not only our awareness, but our expertise. Only a few in this service are comfortable with wanting to stand on the side lines and not get their hands dirty. Yet, when it comes to our mental wellness, we demand nothing beyond awareness.
Full stop.
Be aware, and then pass the responsibility on to someone else. In an era saturated with mental health awareness, we could use a little technician-level education in working with mental wellness topics in our halls.
To start, we need to get comfortable with the idea that this role is a career of trauma. What this means is that no amount of effort, short of closing departments, will save our folks from exposure to traumatic events. What we need, then, is to first accept that this is an inevitable event that we cannot control for.
Once we have arrived at this understanding, we can now begin to have real conversations about how to engage policies and procedures, accepting the very thing we fear, to become stronger and better firefighters, and, subsequently, stronger and better people.
Post-traumatic growth and firefighter resilience
Post-traumatic growth doesn’t seem to penetrate the media limelight too easily, and yet it could very well be the savior to many of our brothers and sisters in the firefighting world. But, what does this mean? Well, the idea is simple, but its impact profound: the introduction of trauma/stress could develop resilience and strength in those who experience it.
What is your approach to problem solving? Likely, some head scratching, some trial and error, some choice words and creative sentence enhancers. One doesn’t have to look too far in the firehouse to see problem solving at work – for instance, when the probie is trying to figure out how to fill a tanker … and instead ends up wearing what’s left in the tank.
Through a frustrating cascade of weird behaviors, if we stick with it and work our way through the process, we come to a satisfactory conclusion and can easily navigate that problem in the future. Well, trauma isn’t necessarily the problem. Instead, how we deal with trauma is the problem. In our culture, we have been told to repress or suppress issues or concerns that don’t match up to the status quo of the cultural image we are going for.
My favorite icebreaker in presentations is to have folks pull out their phones and Google search “firefighter” in images, which is what our supposed culture is built upon. Collective images of heroism; perfectly snapped photographs, mostly out of context, are used to build the scaffold for our hero image. What is a surefire way to tumble such a fragile image? The acknowledgement of weakness – which is a misperception of mental wellness concerns – a weakness of character, a flaw or as a non-existent issue.
Therefore, when trauma responses rear their ugly heads, we are ill-suited and ill-advised on how to properly treat ourselves. We drink ourselves to sleep and to numb the emotional upheaval. And we find that, over time, this strategy not only doesn’t help, it perpetuates the problem. Our cultural view needs to shift to distinguish between mental illness and mental wellness, and identify that mental wellness has a place within the field.
In learning that trauma is unavoidable, we can plan for it within our training and policies. This means, however, we need to let go of the comfortable foothold in how we have always done things.
Don’t give responders an out with check-ins
When your crew has been exposed to trauma event, what is your first step? Check-ins. Of course it is, and of course you know how to run a roundtable right? We’ve all been a part of them. Usually, command sits everyone down to one at a time, ask, “how are you doing?” And, of course, we all respond with “I’m fine,” because we are asking the wrong question.
“What is one emotion that call brought up for you?” That is a better question, that doesn’t give responders an out. Talking about the call in these terms is the first step toward taking away trauma’s incredible power. You don’t need to be a professional therapist to inquire into your folk’s emotional state. You just need to be an accountable and accepting leader firefighters trust won’t pull them for identifying that they are feeling helpless because they weren’t able to save the victim at the last call.
Orient toward normal post-call experiences. Assure responders that nightmares, trouble sleeping, and irritability are expected results from a call that bugged them. Post-trauma growth comes with an understanding that not everything is PTSD manifest. Indeed, taking away the approach to diagnose every single firefighter with PTSD simply because they experienced a tough call will go a long way toward truly appreciating the debilitating and negative impact PTSD has. Assure responders that working within the field does not automatically mean that they will develop PTSD.
Make Mental Wellness a priority
Where do you see mental health comments, issues and topics? At the bottom of the list, below the newest nozzle tech and that new, more breathable, bunker gear. Post-traumatic growth is not a passive process. To ensure growth, we need to focus on creating workplace priorities.
If we believe, as we should, that firefighting is a career of trauma, then we understand that just like clean trucks, mental wellness is a priority. Programming could include things such as resources available to peer support networks and regular clinical check-ups (no different than a physical in that sense – once a year or when things are acting up) with trained personnel who are both passionate about mental wellness and respected. Peer support networks are among the highest ranked for success within the services. Lastly, leadership that both understands and believes the impact of mental wellness is real is crucial.
Create training programs and partnerships with local professionals to come in and teach emotion regulation, mindfulness and distress tolerance. These issues encourage overcoming the phobic attitude toward talking about trauma that still seems to burn bright within the fire service.
Moreover, open discussion teaches firefighters and responders to be able to listen to one another and understand that they don’t need to rush out and fix the issue. Instead, compassionate understanding that a fellow human is suffering can lead that sufferer to a world of healing because someone else gets it. And, through this understanding, they don’t feel alone.
Policies
Don’t make the mistake of thinking that word of mouth or best practices beliefs are enough to ensure that this approach is taken seriously. Indeed, creating a small process by which it can be ignored or avoided will go a long way toward ensuring the collapse of your program. Effective policies and procedures are required.
Can you live on water and bread? Probably. But, also you’re probably not too happy about that and it likely doesn’t provide you with all that you need to be healthy. So, why then provide bread and water approaches to mental wellness?
We need to understand (as we slowly are with fire attack techniques) that research is out there to inform us how to better handle mental wellness issues. Simply offering EAP programming and believing that this is enough is ignoring what the research suggests is helpful. But, by developing a large tool box that folks can draw from, you are instead embracing the research that suggests that people are largely different, and mostly require different approaches toward healthy growth.
Promote the positive side of the fire service
Talk about the positive side of engaging in this career. Post-traumatic growth is a wonderful antidote to the wholly negative image developing. The pendulum has swung too far in one direction and we are ignoring the basic premises of why most of us got into this field in the first place.
We are compassionate people, with the mental and physical drive to complete tasks in the worst possible conditions to ensure that the safety of life, limb and property is upheld. We are resilient. We have just been exercising unhealthy resiliency techniques. But it is wrong for us to show that we aren’t coping in a healthful way, and then simply pull the rug without replacing it. The idea of post-traumatic growth can be that idea which creates promise in a land that has lately been striped void of any such golden promises.
We need to think differently about our approach to trauma. We can’t run from it. Embrace it, head on. Only through this total acceptance will we understand that the way forward is to use that experience as a tool for growth.
About the author
Nick Halmasy is a registered psychotherapist and recently retired from a decade in the fire services. He is the founder of afterthecall.org, a free, mental health resource for first responders and their families. He is also the clinical director for After The Call CISM team in Ontario. He can be reached at nhalmasy@afterthecall.org.