• Sara Speed, LMHC

Do I Really Need Therapy as a First Responder?

As a first responder, you are entrusted with the care and well-being of an entire community. With your training and experience, you carefully size up every scene and act accordingly. Your years of education and training have equipped you to be the source of knowledge, the voice of reason, and the lighthouse in the darkest storm. If only it could be that easy in your own life!

Something happens when you cross that familiar threshold to your own home. All that valuable objectivity goes out the window, you are no longer the foremost authority on everything, the zeal and vigor that got you through your shift seem to have all but melted away on your drive home.

And what is left in its place? Exhaustion, exasperation, irritability, or worst of all… nothing. But you’ve got this, right?! You’re the one with all the answers at work, surely you should be able to see your way through this.

But what happens when you can’t? What happens when you try so hard to listen attentively as your partner is talking about their day or be patient as your toddler fumbles through tying his own shoelaces when you’re already ten minutes late for school?

What happens when you can barely keep your eyes open but every time you lay down you just toss and turn for hours? Or when the only shred of happiness you feel is when you’re six beers in or driving 100 mph down the highway on your bike? It is often said that doctors make the worst patients, and sometimes, helpers have the hardest time accepting help.

You are not like everyone else. You are different, your job is different, your life is different. When our primal brains evolved, they were designed to manage short spurts of hyperstimulation for survival purposes only.

Your role requires extended periods of hypervigilance and a prolonged state of fight or flight often accompanied by sleep deprivation and poor nutrition. This is then layered with the firsthand trauma of the loss of partners and comrades, and the endless vicarious trauma of being witness to the most difficult events in people’s lives. Compound this over a thirty-year career and it becomes hard to imagine how anyone could do it without a little bit of help.

So how do you know when the stress of your life has surpassed your coping abilities? Nobody around you seems to be in therapy and you’ve made it this far so what’s the point?

You are an expert on scene size-up, so let’s do a self size-up to help determine if therapy is right for you:


First, let’s look at your overall mood. We are not robots, and it is healthy and normal to experience a wide range of human emotions. We will never be able to fully avoid sadness, anxiety, or anger. But when these emotional states become our new normal, we are in the danger zone.

There is an actual physiological phenomenon known as the Hypervigilance Roller Coaster outlined by Dr. Kevin M. Gilmartin in his book, “