As I stood looking in the mirror, the person staring back at me was a complete unknown: bloodshot eyes, dark circles, exhausted. I realized things had gone too far. I needed help. That evening, I took the number for our employee assistance program (EAP) and tucked it in my pocket. Later that night was the last straw. I snapped at my peers.
This traumatic incident was not the worst I have responded to and not nearly as bad as what many other brother and sister responders have seen or been through, but it did affect me deeply. The intrusive memories, for me, were the worst. The incident replayed in my head, like a tape on a loop. It wouldn’t stop. Once the “tape” got to the end, it started over again. This was a continuous loop, never stopping, no matter the time of day or night. The smell, the sound, everything was replayed in living color. I was filled with sadness and anger. I began to avoid talking about the incident following a discussion with my wife. As caring and loving as she is, she didn’t understand. She suggested perhaps “it was time to do something else.”
My response to that comment was to shut myself in. I decided that no one would know what I was going through. I felt as if discussing how I was feeling would become burdensome. The strain of my trauma was a strain on my family. I became very withdrawn. I began to avoid the things I loved. I didn’t want to go to the firehouse. I didn’t want to see my friends. I began to have problems experiencing positive emotions, often feeling emotionally numb. I was losing the ability to see the good in things. My relationship with my family was becoming strained, and my physical and emotional responses to this stress were affecting my family. My family began to suffer the same stresses as me. My wife was suffering from secondary traumatic stress. She began to mirror my stress. We both became cynical. We were disconnecting. I was irritable, I was angry, I wasn’t sleeping. I was on a downward spiral and needed help. Yes, I said it … I needed help.
I have been a firefighter for 30 years. I have seen more trauma than I could have ever imagined. I have seen more sadness and death than I could have ever imagined. What was it about this incident? Why now? Why me? These were questions I had no idea how to answer. I was referred to a trauma therapist and the long, often grueling journey to my healing began. I was diagnosed with post-traumatic stress disorder (PTSD), which as defined is a mental health condition that’s triggered by a terrifying event, either by experiencing it or witnessing it. Symptoms may include flashbacks, nightmares, and severe anxiety as well as uncontrollable thoughts about the event.
Every time we respond to an incident, we are responding to the unknown. The fire alarm can turn out to be a structure fire as easy as the car into a pole is nothing more than a fender bender. With each incident we respond to, we each will be affected differently. Some will walk out of the firehouse, never to be seen again. Others will be fine for five years. Some may not have effects for 20-plus years, if at all. It only takes one event, one incident to become “the one.” Things like sadness, helplessness, and guilt are normal emotional responses. Normal physical responses include pounding heart, cold sweats, and racing thoughts. The effects of traumatic stress include intrusive memories, flashbacks, and recurrent unwanted memories; avoiding talking about the incident or avoiding people or places; negative feelings about one’s self, feeling emotionally numb, and having a difficult time maintaining close relationships; and changes in emotional reactions, such as irritability, self-destructive behavior, and trouble sleeping.
The trust between the therapist and patient must be present from the beginning. The ability to open the deepest, darkest closets, as well as explore all the demons that are inside each of us, is imperative. My trauma therapist is a kind and caring soul who, while able to open those dark closets, is always able to help clear them and close that door again. She began by hearing my story and then explained how the therapy would work. Words like intrusive memories and secondary traumatic stress became commonplace in our conversations. Emotional and physical symptoms were discussed in depth. The therapy that was decided on is called eye movement desensitization and reprocessing, or EMDR.
Sessions were intense, often leaving me drained. The brain is taught to see the traumatic incident in a different light. It doesn’t make you forget but rather makes you see the incident in a less distressing way. The process of EMDR can take a few sessions before results begin to show and often doesn’t require long-term therapy. I cried through many sessions, often questioning why I was doing this to myself, but I refused to let this incident control me. It would not define who I was. I was better than this. There were days I hated my therapist but, ultimately, I knew she was truly there to help me. And she did. I continue to work with my therapist on a regular basis as we continue to identify other areas of trauma and stresses that have been kept inside for many years.
Therapy today is not the taboo subject it was 10 years ago. To accept that there is an issue bothering us is now acceptable. To admit we need help following an incident is much better than drinking away our demons. In the past, we would return from a bad incident, head to the bar, and drink and joke and make light of the incident. This has led to many firefighters developing drinking problems, creating problems at work and home and even leading to divorce. The issues we face today regarding traumatic stress, PTSD, and even depression are leading far too many brothers and sisters to take their own lives.
We can no longer continue to push our demons into a corner and expect to come out alright. This is an epidemic that we must be on the forefront of. We must care for each other and look for the signs of traumatic stress in each other as well as within ourselves. We need to be able to identify safe people, people who will listen without being judgmental. Often, we just need to be the proverbial shoulder to cry on.
If we learn to identify the signs of traumatic stress in our brother and sisters and, more importantly, within ourselves, we can work to stop the dangerous trend. We can take mental health in emergency services head on and make sure help is available to all who need it. If we can save even one brother or sister from committing suicide, we have made a start.
Jacob Oreshan III is a 30-year veteran of the fire service and an assistant chief with the Boght (NY) Community Fire Department. He is a New York state certified firefighter, fire officer, fire service instructor, code officer, fire investigator, and hazardous materials specialist as well as a national certified firefighter, fire officer, and hazardous materials technician. Oreshan has developed several specialized courses in the field of hazardous materials and homeland security, including first receiver decontamination; terrorism, bombs, and schools; and chemical suicides: information for the first responder.