How to stay ahead of stress. . .
By Hersch Wilson
As members of the fire service we are exposed to horrific events at a far higher rate than civilians. This exposure can lead to post-traumatic stress disorder (PTSD) or acute stress disorder (ASD), both of which have a significant impact on the individual as well as their family and department.
While there is no sure-fire way to prevent PTSD or ASD, research points to a set of behaviors that might help inhibit it from occurring and lessen the symptoms when it does. These behaviors come under the umbrella title of “Resilience” and help a person adapt to and bounce back from significant sources of stress.
The goal here is not to minimize the pain we experience after bad calls or to suggest that the damage to the brain caused by PTSD is not significant and potentially long-lasting. Even the most resilient individual would be traumatized by what we see over the course of our careers as firefighters.
But that doesn’t mean we should throw up our hands and think there is nothing we can do, or that we should just “suck it up.”
There is no magic pill or shot we can take to immunize ourselves against PTSD. But we can always be learning and taking small steps to help our departments cope with PTSD. This article is written in that spirit.
In the talks I give, I note that there are eight core practices that if learned, can lead to, if not an immunity from PTSD, maybe a fighting chance to stave off its worst symptoms.
Practice #1: Understand PTSD
Understand that PTSD is not a character flaw or a sign of weakness. PTSD is an injury to the nervous system. It is vital that department officers and firefighters understand what PTSD is and how it manifests. Knowledge is power.
Practice #2: Have a strategy for coping with stress
Firefighters who have coping tactics for dealing with stress are less prone to PTSD. Highly resilient folks have an active coping approach to deal with stress in their lives. They proactively practice ways to solve the problems that create stress or learn how to manage stressful emotions. In other words, after a bad call, it’s a good idea to have a plan in place for dealing with the aftermath. There are simple practices that when learned can help, from using breathing techniques, to mindfulness practice, to long walks, to yoga, to talking with another firefighter, or whatever works for you.
Practice #3: A regular exercise routine
Exercise is not just about physical strength and endurance. It also helps build mental and emotional “hardiness.” Exercise is a mood elevator; it releases endorphins in the brain that make you feel better. It’s also linked to increased brain plasticity – the ability of the brain to learn and to create and strengthen new neural pathways. A routine of running, walking, or just 30 minutes in the gym on a regular basis can help build emotional resilience and some protection against PTSD.
Practice #4: Optimism and humor
The fact is that optimism is a powerful tool. Optimistic people report that their problems are temporary and limited in scope. Individuals who are depressed tend to report that their problems are permanent and intractable. This can leave them more vulnerable to PTSD.
Humor has always played an important role in the fire service as a way to reduce stress. Humor can lighten the mood, and it strengthens the bonds in the department. It is also therapeutic; firefighter humor in the face of tragedy can release tension and stress.
Practice #5: Be in a community
Highly resilient individuals belong to communities. This is why we call the fire service a brother and sisterhood. Social support helps us keep our perspective, we discover that others share our same experiences and emotions, and it reduces loneliness (a predictor of PTSD.)
Practice #6: Purpose
Another hallmark of resilience is a sense of purpose, what researchers call a “moral compass.” It can be religious, spiritual, or secular, but the belief that we are dedicating our lives to a cause higher than ourselves is powerful.
Practice #7: Re-frame your thinking
How you think about your role in the traumatic events you encounter as a firefighter is crucial to your ability to “bounce back.” The vital point is that we have choice in how we think about and remember these events.
For example, it is not unusual for memories of a bad call to hijack our thinking and thus our emotions. The “movie in our mind” just plays and plays. In those moments, we need to consciously work on re-framing the memories. First, remember bad things happen, and they are out of our control. Second, frame the event by remembering that when that pager does tone us out, we run towards trauma to help others. Third, frame the traumatic event (or the career of traumatic calls) by understanding that the highest possible purpose any of us can have is to be in service to others — especially in their worst moments.
Psychologists call this “cognitive flexibility” or the ability to see and think differently about the events in our lives. It is a learned discipline, but one that can pay big dividends for us.
Practice #8: It’s not my emergency
Psychologists throw around the term “transcendent detachment.” It is really a reframing concept. It is the discipline in the middle of the bad call to remember, “It is not my emergency.” You can be passionate about getting the job done, about caring for the patients, and at the same time “be apart” from the intense emotions of a scene. This may take time and practice.
Unfortunately, experience doesn’t by itself give you protection. In fact, experience is a predictor of PTSD. Stress is cumulative. Stress adds up over the years. It is the discipline of how you manage those calls physically, emotionally, and mentally that are important in reducing the risk.
It’s important to repeat that there is no magic bullet, no absolute protection from PTSD. There will always be the call — or a career of calls — out there that will pierce the best defenses. But these eight practices can help.
In the fire service, we are only in the beginning stages of understanding PTSD and how it can “disorder” our lives. There are promising therapies and drugs that can help, but those are for after experiencing symptoms of PTSD.
Resilience is what we can work on and learn before we have the horrible crash or catastrophic fire — or ideally as we begin our careers as firefighters. Resilience is learnable; it can be a taught and practiced by the entire department.
As officers we have a responsibility to keep our firefighters and EMS folks safe. We drill and drill about safety procedures at fires and crash scenes. But our job is to also keep our departments, and the individuals who show up every week, emotionally safe. Teaching resilience, whether it is these eight principles or content based on your own research, is as valuable and important as teaching how to correctly use bunker gear. Both will save firefighters from injury and even death (firefighters have a higher risk of suicide than the general population.)
It means more work and another training concept or two every year, but it will pay off with a safer and healthier fire department. And that is something we can all get behind.
Hersch Wilson is the assistant chief with Hondo Volunteer Fire and Rescue in Santa Fe County, NM. He has been with the department since 1987. In his “other life” he is a writer and a soccer coach. Visit him at Herschwilson.com or on Facebook at ‘Hersch Wilson-Firefighter.’
 6 Keys to Resilience for PTSD and Everyday Stress: Teach Patients Protective Attitudes and Behaviors
By Haglund, Margaret; Cooper, Nicole et al. | Current Psychiatry, April 2007
I’m writing this on Tuesday, March 17, 2020. I thought it was important to date this column because things are changing so fast!
I got up this morning, watched a snippet of the news, and then decided there was nothing I could do and that the best idea was to walk our dogs. They were nipping at my heels with excitement as soon as I put on my running shoes.
It was cold, but the rising sun was just beginning to warm the air. Walking out the door, the dogs were all in. There were a thousand smells, other dogs to bark at, and even a rabbit. Nellie, our eight-year-old Berner, took it all elegantly in stride. Maisie, our little but fierce terrier-chihuahua mix, really wanted to go after the rabbit. She strained at the leash, seeing herself as a wolf, even though she is all of twelve pounds.
Dr. George Sheehan, one of the early running gurus, wrote, “Never trust a thought come to while sitting down.”
I have tried to abide by that wisdom. When things are tough or seemingly out of control, I walk. The dogs are the best companions because they are so in the moment that it helps me keep perspective. I try to see the walk as they see it, the best part of the day, a chance to be outside on a beautiful New Mexico morning.
So we walked, and I let my thoughts ramble.
These last few days have been a reminder of one of the fundamental lessons the universe teaches: stuff happens. It doesn’t matter if we are rich or poor, liberal or conservative, or how busy or beloved we are: stuff happens. Mike Tyson famously said that everyone has a plan until they get into the ring and get punched in the mouth. Well, we just got punched in the mouth.
It happens out of the blue, often with little warning. To think otherwise, to believe that we are magically protected or that we have it all under control is an illusion. The dawning truth of the last few days is that we have little under our control.
I don’t think of that as troubling or depressing, it is just the way the universe works, and it is how life has worked going back forever. Wishing it were otherwise is like trying to wish away gravity.
All we can control is how we choose to respond to what happens. We can choose to be calm, while all around us people are hoarding toilet paper. We can choose to help others instead of obsessing about ourselves.
Even though we are “social distancing,” we can stay in contact with friends and relatives and help them stay calm.
We walked. Maisie tugged at her leash, eager for the next smell.
Nellie trailed behind, having been down this road a thousand times.
I thought about the other thing that crisis illuminates. We learn to really appreciate the now, this moment, this walk, knowing that the future (as it has always been) is uncertain.
A Zen story. A Zen monk is being chased by a tiger. He comes to a cliff and sees that the only way down is a large vine that trails down off the cliff into the fog below. The monk immediately begins to climb down the vine. To his horror, he looks up and notices that the tiger is climbing down after him. He looks down the vine and notices there is a boa constrictor, the largest one he has ever seen, climbing up the vine towards him. So a tiger above and a snake below. Then, he noticed on the vine a beautiful strawberry. He paused, picked the strawberry, ate it, and enjoyed it.
It feels as if we are surrounded by tigers and snakes, but we can also appreciate that at this moment, we are alive and well. We can enjoy the strawberry.
As we turned to go up our driveway, both dogs patiently waited for me to catch up. And I thought about one last thing, probably the most important thing that a crisis can teach us. That is to be kind.
A lot will happen over the next few weeks or months. We will be stressed and stretched. But through it all, we can be kinder to each other. We can take care of each other. We can remember that in times of trouble, we are responsible for each other.
Be Brave. Be Kind. Be Useful.
We have old dogs now. Our two Berners, Nellie and Tank are both approaching nine-years-old, which is getting up there for Berners. Nellie, the wiser of the two, would reject the idea of “old” and just think of herself as “mature.”
Old dogs are settled in their ways. They know the routine. Our dogs meet us in the morning at our bedside like they have since they were puppies. Nellie nudges me out the bedroom door towards the food dishes, as she has every day since I can remember. Interestingly, she is much less aggressive with her “nudges” than when she was a young dog. Then it was a friendly battle between our enthusiasms about the morning, who could get out the bedroom door first. She would bark and jump up, nipping at my heels, happy to be up and awake.
Now, knowing that I’m not a morning person anymore — nor is she a morning dog—, she is gentle but still insistent that we get going lest the whole morning be wasted.
Tank, true to his colors as the Beta dog, tags behind, a whine in his voice for he doesn’t like any shenanigans that might get in the way of him being promptly fed.
Yet neither of our dogs eat as voraciously as they have in the past. Nellie sometimes skips meals altogether.
The rest of the day is a well-worn path, although now we’ve had to make some modifications. After breakfast, we walk. But now we leave Tank behind because he has trouble with his hind legs. He barks valiantly, but I’m pretty sure that he’s comfortable with an after-breakfast nap.
Nellie still loves our walks, although she’s now one-eye’d (cancer took her left eye) and limps (three surgeries on her back legs). She is a constant reminder that we are all “TABS,” that is Temporarily-Able- Bodied. She limps, I limp, we laugh.
Our walks are calm now. In the past, every dog, car, or individual caused an uproar of curiosity and leash pulling and often led to embarrassing moments (for me) like having two leashes wrapped around my legs and being taken to the ground by enthusiastic Berners.
Now, nothing really distracts. It’s just the sound of our breathing and the feel of old muscles loosening up after too much laying around.
The rest of the day is spent avoiding the heat of the summer and finding the cool places to sleep. This is rotating work as the sun climbs in the sky and descends in the west heating different areas of the house. Tank arises with a groan when it is too hot, finds the next cool spot and collapses and is deep asleep within minutes — a daily routine. I could tell the time by just knowing where they are sleeping.
We don’t play anymore. We try. I can get Nellie worked up to chase me around the house, but it’s not the same. The fierce desire to catch me has been replaced by the comfort of knowing that I’m now an easy catch. She merely has to wait me out rather than run from one end of the house to the other. It turns out, that’s fine with me.
At night, after the dishes are done and we settle down in the living room, Nellie is on the couch, as close to me as she can be, a 130lb lap dog. There she falls asleep, snoring as she has a right, as an old dog, to do.
Tank, depending on the heat and if there are thunderstorms, curls up on the floor next to us. This he’s done every night throughout his life.
When we go to bed now, Nellie inexplicably is out the dog door and prefers sleeping outside on the portal (part of a fenced-in yard). An old dog under the Milky Way and the night sky. Occasionally we hear a deep-throated “woof” as she warns the coyotes that she is still in charge.
We’ve all grown old together. We’ve worn down the same path, constant companions. We’ve had great times in the mountains, and had fun sliding in the snow.
I know they are looking forward, as am I, to winter and cold temperatures. And I know, I know, that our time together is finite. But that makes the “now” so much more precious and sweet.
We are TABS. We are old dogs. Let’s make the most of it.