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