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:

MOOD:

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, “Emotional Survival for Law Enforcement: A Guide for Officers and Their Families”. This refers to the effect of first responder work on biological and emotional systems. It is the endless yoyo experience between heightened arousal states at work characterized by high energy, excitement, and joy, then offset by the dip in arousal coming off the job which is most often felt as lethargy, disconnection, and irritability.

There are ways to counteract this effect though. Building insight and awareness coupled with learning new coping skills through the help of a trained therapist can help you get back behind the controls and off the rollercoaster for good.

RELATIONSHIPS:

After a while the all-too-familiar griping of your spouse or family about how “different” you are now, or how they miss the way you “used to be” begins to fade into the background. You almost stop hearing your kid’s voice, “daddy look at this, daddy watch me, daddy, daddy, daddy” as you scroll through your phone or become absorbed into the television.

You do so many things for so many people all day long and you’re thoroughly burnt out by the time you get home. You can’t seem to make them happy no matter what you do so why even bother? These relationships are actually critical to your wellbeing and seeing them begin to suffer is a good hint that it may be time to seek help.

The down cycle of the hypervigilance roller coaster can often leave us associating home and the people who live there with the negative feelings you are experiencing. This is not just an unfortunate side effect of first responder work, a certainty that we have to accept as part of the job. This is a sign that we and our entire support system are strained and suffering.

BEHAVIOR:

In a desperate attempt to avoid feelings like depression, anxiety, despair, and hopelessness, it is common to begin engaging in behaviors that may feel good at the moment but are quite dangerous in the long run.