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How to survive: Stress response

Enhance decision-making, stress management and overall mental resilience in situations of extreme stress


Photo/Rapid City (South Dakota) Fire Department

Navigating the demands of a profession that is known for high-stress scenarios is no small feat. The allure of excitement and the call to make a difference are often what draw individuals to such careers. Yet, with each shift comes the inherent risk of encountering situations that are not just stressful but potentially life-threatening. You are well-trained and familiar with the risks; you know the protocols and the necessary actions. The real challenge often lies in maintaining calm under the extreme pressure of dangerous situations. This ability to stay focused and execute learned strategies amidst chaos is not just a skill, it’s an essential component of a firefighter’s professional arsenal.

In critical, life-threatening scenarios, our stress response can kick into high gear. It floods our bodies with adrenaline, heightening our alertness and priming us for either confronting the danger head-on or fleeing from it – your basic fight or flight response. This reaction can be beneficial, providing a surge of energy to navigate out of risky situations. But what if the key to saving our own life isn’t about fighting or fleeing, but rather about clear, focused thinking and deep awareness of the surroundings?

Unfortunately, our stress response doesn’t differentiate; it still floods our system with the same hormones and adrenaline, potentially overwhelming us and clouding our thought process. In such high-stakes moments, the ability to remain calm and think logically is vital. This is why it’s essential to have strategies to effectively manage this intense stress response. With the right approach, you can prepare yourself to maintain clarity and make sound decisions, even when your internal alarm is sounding loudly.

The following recommendations are designed to guide you when you find yourself on the other side of the call for help – guidance to enhance decision-making, stress management and overall mental resilience in situations of extreme stress.

Controlled breathing

Life-threatening emergencies naturally encourage panic, rapid heart rate and shallow breathing. This can lead to a decrease in oxygen intake – a serious problem as oxygen is essential for effective physical and cognitive functioning. So, the first order of business for managing acute stress is to control your breathing.

Slowed breathing, tactical breathing and prolonged exhale are all examples you may have heard of that can help you calm down. Using any is better than none in a life-threatening situation, but you may have a preferred method based on the following information.

A slowed, deeper breath can help slow your heart rate, increase your oxygen flow, and manage your stress response. In one study, slow, deep breathing, regardless of how it was done, reduced the biological stress response of a simulated active shooter drill (Dillard, et al, 2023). In another study, slow, paced breathing proved to be a promising technique to improve executive functioning, which allows us to focus, recall memory, plan and juggle multiple tasks successfully (Laborde et al., 2021).

Tactical breathing is a popular technique used in the military to help maintain calmness, focus and control under stress. It suggests a 4-4-4-4 pattern (four seconds of inhaling, holding, exhaling and pausing), repeated over and over.

One study compared tactical beathing against a simple prolonged exhale. This was done in a laboratory setting where individuals were engaged in a challenging cognitive task while under time pressure and noise distraction (Röttger et al., 2021). The results suggested that tactical breathing subjects showed lower physiological arousal, but the prolonged exhale subjects performed better on the cognitive task. So, an individual may want to consider using a prolonged exhale when they are actively coping while also asking their brain to help them focus and work through something that might help set themself free from harm.

Controlled thinking

In life-threatening events, it’s crucial to focus on what’s immediately controllable rather than getting distracted by “what ifs.” Considering what happens if things don’t go well, while tempting, can distract and detract from the necessary task at hand. Instead, redirecting thoughts toward the present moment – the “operation save myself” mindset – can be more beneficial. By consciously dismissing unhelpful thoughts and concentrating on actionable steps, you enhance your ability to make clear, decisive choices that are essential for your safety and survival.

Continuous training

Obviously, there’s no telling exactly when, where or how these events will happen. However, continuous training helps in automating responses, reducing the cognitive load during high-stress incidents (Driskell & Salas, 1996). To better simulate these types of situations, consider a technique like Stress Inoculation Training (SIT). SIT is a method that gradually exposes individuals to stressful conditions in a controlled environment. Imagine turning a focused skills training drill into a timed task with loud, distracting music playing while people need to problem solve. This technique helps build tolerance to stress and improve performance under pressure. Driskell, Johnston & Salas (1999) found that SIT effectively enhances performance in high-stress tasks by reducing anxiety and improving focus.

It’s hard to ignore that remaining focused amid chaos really emphasizes the importance of mental presence, something mindfulness and meditation help develop. Mindfulness and meditation practices have been shown to improve emotional regulation as well as cognitive focus over time and in stressful situations. A research review (Jha, Stanley, & Baime, 2010) found that mindfulness training can enhance the ability to maintain focus amidst distractions. An ongoing practice of mindfulness and meditation, not only great for health and stress reduction overall, might actually help develop some skills that could be useful if you ever find yourself in life-threatening situations.

Final thoughts

It is crucial to master control of your breathing, learn to block out distractions, and engage in rigorous training for the rare but very real life-threatening situations you may face on the incident scene. These practices will not only enhance your physical readiness but also increase your mental resilience, ensuring you can perform optimally under pressure. This holistic approach to preparedness is not just about survival; it’s about thriving when it counts the most.


1. Dillard CC, Martaindale H, Hunter SD, McAllister MJ. “Slow Breathing Reduces Biomarkers of Stress in Response to a Virtual Reality Active Shooter Training Drill.” Healthcare. 2023; 11(16):2351.

2. Driskell, J. E., Johnston, J. H., & Salas, E. “Does Stress Training Generalize to Novel Settings?” Human Factors. 1999; 41(1), 99-110.

3. Driskell, J. E., & Salas, E. “Stress and Human Performance.” 1996. Lawrence Erlbaum Associates.

4. Jha, A.P., Stanley, E.A., & Baime, M.J. “The Benefits of Mindfulness Meditation in Improving Performance in High-Stress Situations.” Mindfulness. 2010; 1(2), 95-103.

5. Laborde, S., Allen, M.S., Borges, U., Hosang, T.J., Furley, P., Mosley, E., & Dosseville, F. “The Influence of Slow-Paced Breathing on Executive Function.” Journal of Psychophysiology. 2021; 36(1).

6. Röttger, S., Theobald, D.A., Abendroth, J. et al. “The Effectiveness of Combat Tactical Breathing as Compared with Prolonged Exhalation.” Appl Psychophysiol Biofeedback. 2021; 46, 19–28.

Review the full “How to Survive” series.

Dr. Rachelle Zemlok is a licensed clinical psychologist in California, specializing in work with first responder families. She serves as the strategic wellness director at Lexipol, supporting the content and strategy related to first responder mental health and wellness, with a special focus on supporting spouses and family members through the Cordico Wellness App. Prior to joining Lexipol, Zemlok founded First Responder Family Psychology, which provides culturally competent therapy to first responders and their family members. She is the author of “The Firefighter Family Academy: A Guide to Educate & Prepare Spouses for the Career Ahead.” For more information on Dr. Zemlok or to connect with her please visit her website.