Saturday, November 29, 2008

Too Close to Home

I was watching a commercial on television the other day and found myself tearing up. Instantly, I snapped out of it and tried to critique the whole thing and figure out what had affected me like that. Obviously, I had personalized the situation and it touched an emotional hot button.
What does that mean? I could analyze everything and never learn anything about myself! The commercial was easy to figure out. It was a holiday dinner table with family sitting around it. I filled in the blanks with memories of my own childhood holidays . It is easy to see where the 'good tears' came from. (and the bad memories)
These same mental gymnastics happened to me as a firefighter in a more negative way many times. It is so easy to think about you own wife and kids when pulling up on the scene of a fire or automobile accident , or heart attack victim, etc. It was usually just a fleeting thing, over in an instant, because you don't really have time to dwell on it.

[I don't know how people experience this, especially firefighters and other public safety folks. I don't believe I have ever asked anyone so I'll do that now. Comment on this post and tell me if this has ever been something you have experienced.]

In a business like the fire service, you really need to develop the ability to disassociate, even repress, these thoughts and memories if your going to keep yourself from melt down. Of course you have to try to be objective, right? Then again, are their situations where identifying with victims the way we almost instinctively do, may help us do a better job? That is a factor always present in counseling, I know for sure. Even when you try to stay objective and professional, if you are a human, or at least an honest human, you have to be touched emotionally to really have empathy for your client, don't you? I mean, I'm asking, do you agree or disagree?

This is a real dilema for the helping professional. To just deny and repress the feelings one has to experience on emergency situations is a recipe for disaster, or at least burnout eventually. On the other hand, if you let yourself identify with every fire or accident victim and 'feel' for them, you are the one who will end up an emotional 'basket case'! I believe the best path is a balance of both ends of this continuum. Honest expression of the way you feel about some of calls you experience ( especially the bad ones) and a learned, professional , detachment from the scene which allows rational thinking. This is obviously not an exact science. Again, I'd be interested in the way others have experienced this and perhaps dealt with it. post

tom hudgens


David said...

Great subject! I have often wondered how the pieces of this emotional puzzle fit together. I certainly think it is different for each individual but we may be able to narrow it down to groups. Here is what I have seen and experienced.

Having a family certainly changed my method of operation on fires. It forced me to slow down and maintain a better situational awareness where before I was more of a knuckle dragger (see fire..much attack..pull hose..kill fire). There was little thought of personal safety etc. Then post family I seemed to think about what could go wrong and how would I get out. I didn’t’ loose any aggressiveness I just thought things through and made contingency plans in my mind. Now I do the same for the firefighters I direct at fires. Some of that comes with experience but I do credit the beginning of the maturity process with the family connection. Maybe it is a transition from selfishness to one of responsibility?

Kids seem to give us the biggest problems. Burned, decapitated, mangled adults seem to become “that thing over there” but kids are still kids. Of course when you have kids of your own this emotional state is even more personal and you can’t help but think about your kids. However, with adults I don’t seem to think about anyone in particular it is just the unknown faceless victim.

I have seen individuals cope in three categories:

1. The most common seems to be group therapy within your station or unit. Most often this begins sickly enough with jokes “gallows humor” and the like. I can remember recovering a body out of creek bank that had been there for several days. The smell was bad enough that we had to wear breathing apparatus. There was skin crawling maggots and loose flesh. This really bothered my Captain and we could all see his color turn green as the vomited and had to bailout on us. Of course that night I cooked a chicken and rice casserole with lots of rice and gravy. He vomited again in the middle of dinner and couldn’t eat rice for about 3 months. After that we were more interested in telling the story about the Captain than remembering the horrible site.
In another incident we have 4 children that we pulled from a fire. They were all unconscious and we had them in the front yard providing CPR. Our lieutenant totally lost it and left the scene during the middle of the action and started walking back to the station. The kids lived a couple days in the hospital but all of them died from their injuries. We had a very close crew and we recounted the events over and over to see if we could have done anything different. We stayed up all night. Our lieutenant left work on sick leave. By the next shift we were all back to “normal” the department sent a counselor out to “fix us” after the traumatic call. She came in and was immediately rejected by all of us as an outsider. She asked if we wanted to talk about the incident and we told her we already had and invited her to stay for dinner. She didn’t know what to do but she did stay and eat with us and we never saw her again. Again, we are more comfortable talking through things with our peers than with people we don’t know.

2. Another coping style that I have seen in the last 10 years is individuals being withdrawn from the group and needing outside intervention. Most of the time they know it and they feel more comfortable talking to a total stranger about what happened than the peer group. I think they feel they will be perceived by the group as weak if we hear what they have to say or they may not be a part of a close crew and just don’t feel comfortable. The professional help makes a difference for them and they remain functional and move on from the experience.
3. The last coping style is withdrawal. These individuals are too proud and will not let there ego admit that something bothers them. They don’t want to joke or talk to anyone. This “tough guy” stance usually leads to an off duty drunken binge or worse! Short term they seem to get back to normal but over a period of time and numerous incidents these individuals have engaged in some pretty self destructive behaviors. Some don’t catch up to them for months or even years. This is the most dangerous and is a testament to the need for understanding post traumatic stress syndrome.

As you said nothing here is exact and some individuals may use all three styles based on the type of incident. I have seen a guy handle most everything within his peer group but one day after one particular incident he requested help. I guess so many factors are involved such as genetic heritage, prior experiences, age, family status, etc that the art of helping someone in need is to find the right outlet. If as a councilor you realize that the individual is better off with peers then guide them that way don’t force them on the sofa. Drop a card of to everyone so that they can call you privately without the group knowing. My 2 cents-

Tom said...

Good input! I've taught a lot of stress management material over the years but stressors like you describe and we all can identify with, are above and beyond our normal coping mechanisms(traumatic stress)! The first response most of us experience is what happened with your lieutenant, fight or flight, and it is pure autonomic nervous system, all chemical! We run away from the situation if we can or stay and flail away at it. Situations like you describe are too overwhelming for us to wrap our brains around so the system goes haywire, tilt, etc. and we can't cope.

I agree with your catagories and the fact that we differ according to our perspective (and age, experience, maritial,family status, etc. I was always identifing with the children we came in contact with and 'seeing' my kids in peril.

I can also identify with the counselor sent to you. We fire fighters are a hard group to gain trust from! I really think the most therapeutic thing we can do is talk about it like you guys did. Especially hard for 'knuckle draggers' as you describe (which is just about all firefighters at some point in their careers.........)

speaking of gallows humor, what about is good and can you think of probems with using it? Just be interested in your thoughts.

also, you mentioned getting 'back to normal in a few weeks, or months, etc.. Do you think one is reallly back or does the trauma remain and ripe for resurfacing . do you think it plays a part in long term burn out of fire fighters? Whats your experience in that regard? Sorry lots of questions........