Hines: “We tend to bond a lot, and we look out for each other. If we notice any changes in attitude or behavior, we either ask each other about it or we approach our colleague’s family. We are all attuned to each other and include our families in everything to further increase our bonding.” (Photo by Cary Ulrich.)
Firefighting has been rated as the most stressful job of 2015, according to a survey carried out by CareerCast, a premier careers-based Web site. It is physically dangerous and psychologically taxing, with consistently changing conditions. Fortunately, however, there are a number of stress management techniques that firefighters can use to keep stress from overwhelming them.
Stress in Firefighters
Firefighters routinely experience stress on the job, and while some amount of stress actuates peak performance, especially in life-threatening situations, too much stress for extended periods of time adversely impacts the body and mind. Indeed, prolonged stress is one of the leading causes of health problems among firefighters. If not identified and managed in a timely manner, excessive stress can manifest as symptoms of depression and anxiety, headaches, digestive problems, hypertension, and even heart attacks.
The United States Fire Administration’s records show that the probability of a firefighter dying from a stress-related incident is three times greater than the probability of dying in a vehicular accident. The constant pressure of the job, continual exposure to traumatic experiences, and exposure to suffering and death of fire victims all make firefighters susceptible to the emotional sequelae of line-of-duty incidents.
Job conditions often compound the problem of stress: Fire stations are short staffed and firefighting teams overworked. Lieutenant Tom Hines from Hutto (TX) Fire Rescue shares, “We work in 24- or 48-hour shifts. It is usually 48 hours, and we don’t get to sleep well. Although there are facilities at the fire station, we get calls in the middle of the night. Bigger cities have eight-hour or 12-hour shifts, but smaller places have longer shifts to deal with the staff shortage.”
Recognizing and Accepting Stress
Post-traumatic stress disorder (PTSD) is prevalent among firefighters. The American Psychiatric Association asserts that PTSD affects as much as 73 percent of firefighters and only 3.6 percent of the civilian population. Many firefighters suffer from PTSD without realizing it.
The first step in dealing with stress is recognizing its signs. While every person reacts differently to stressful events, dealing with it begins with acceptance of the fact that stress is indeed being experienced and that it impedes functioning on the job.
The persistence of stress is often unacknowledged. Many firefighters refuse to admit that they are experiencing emotional disturbance in reaction to the traumatic events they face on the job. Hines says, “Firefighters are typically Type-A personalities. They don’t want to admit they have a problem.”
Type A personalities are risk takers and unlikely to acknowledge experiencing emotional disturbance because of unmitigated stress. Disclosing emotional turmoil is looked on as weakness. Thus, to ease emotional turmoil, some engage in alcohol or drug abuse as a form of self-medication to dull emotional pain. Others, who don’t self-medicate with drugs or alcohol, may become moody, withdrawn, or emotionally volatile. The risk-taking trait, which impels them to take on the high-risk job of firefighting and makes them successful firefighters, is the very trait that renders them vulnerable to stress.
Since stress experienced by firefighters is cumulative, with repeated episodes of dangerous and disturbing situations intensifying the emotional turmoil, denying its existence only intensifies it. Therefore, on recognizing and admitting signs of stress, the next step is to tackle it with stress management techniques.
Stress Management Techniques
One of the most effective ways of managing stress is by talking about it. This is why Critical Incident Stress Debriefing (CISD) interventions among firefighters are effective. Firefighters supporting other firefighters increase emotional resilience. Hines shares, “We tend to bond a lot, and we look out for each other. If we notice any changes in attitude or behavior, we either ask each other about it or we approach our colleague’s family. We are all attuned to each other and include our families in everything to further increase our bonding.”
A CISD team typically comprises a mental health practitioner and a firefighter who provide support soon after a traumatic event and when the normal methods of coping are insufficient to meet the person’s needs. CISD is akin to first aid for stress and emotional trauma and therefore doesn’t replace therapy. The team responds within 12 to 24 hours after counseling is requested. It is a seven-phase program where personnel can begin to come to terms with a critical incident and initiate a dialogue with a psychologist or other trained health professionals for private therapy sessions.
The seven phases are made up of the following:
- Phase one involves introduction of the team to the group of people participating in the program. The program is voluntary, and none of the firefighters are forced to sit in.
- Phase two engages the group into giving concise statements regarding the facts of the event. At this stage, emotional details are avoided as short statements of facts provide the opportunity to unload and pave the way for future discussions.
- Phase three requires the participants to acknowledge their thoughts. Conceding how they think and feel in reaction to an incident is decidedly easier than speaking of the event itself.
- Phase four calls for participants to reveal their reaction to the situation and divulge their personal feelings about the incident.
- Phase five entails a discussion to define which symptoms the participants have noticed in themselves since the traumatic event.
- Phase six involves coaching by the CISD team members where they provide explanations for the symptoms and feelings that participants have been experiencing.
- Phase seven summarizes the discussions of the program and encourages members to ask any questions. Handouts are also provided for extra reading.
If a CISD team agrees that a particular member requires further counseling, one-to-one sessions are then arranged. The CISD program isn’t intensive or comprehensive enough to ensure full recovery, but it does allow firefighters to feel comfortable enough to share their feelings. Several studies suggest that firefighters participating in CISD programs have significantly less stress-related symptoms than those who don’t take part in such programs.
Further sessions with a trained psychologist are recommended, and although the healing may have begun, one-to-one therapy is often needed before a firefighter feels completely rejuvenated. Treatment provided by a psychologist for PTSD is varied and adapted according to the needs of the individual but generally involves the use of cognitive behavioral therapy (CBT).
Stress Release Mechanisms
In addition to finding professional support, firefighters are encouraged to self-manage their individual stress levels by incorporating activities such as exercise, meditation, and hobbies into their routine.
Exercise: Exercise is a superb way of relieving stress. During exercise, neurotransmitters known as endorphins are released in the brain. These neurotransmitters cause the “feel good” factor and increase feelings of well-being. During competitive sports, the mind is focused on the game, distracting the mind and shifting awareness from stressful events. Regular exercise clears the mind and makes it less susceptible to cumulative stress.
Hobby: Taking time to pursue a hobby is a good way of easing tension. Painting, writing, music, bird watching, or any activity that brings happiness and requires focus should be followed regularly. It is important to keep connected with yourself, and practicing a hobby is a great way to achieve this.
Time with family and friends: Those close to us can often help to lighten the burdens of stressful jobs and traumatic experiences, either through talking or just from knowing that there are people who care. Children are natural psychologists; they can drain the pain away just by their presence.
Deep breathing: Although this is often taught in therapy sessions, it is good to take some time out from a busy schedule and just breathe. Deep breathing relaxes the body and fills it with oxygen. This helps flush out toxins and replenish the body with oxygen, giving a face lift to the cells in the body. It also has a calming effect.
The key to dealing with any stressful job or event is to be honest about the emotional impact of those critical experiences. Firefighters’ work is exceptionally valuable but they can only fulfill this role when they are physically and emotionally healthy. This means taking care of themselves and doing what is necessary to keep mentally, emotionally, and physically fit.
Stress and trauma will always be part of firefighting, which is why stress management must be integral in a firefighter’s everyday routine. While support systems are available for firefighters, much more needs to be done. Instruction in the prevention, treatment, and management of stress should be implicit within firefighter training. Awareness of the possible trauma they will encounter in the field and of the corresponding emotional impact is the most important first step in managing stress.
PTSD can strike anyone-but especially firefighters. It is silently debilitating, emotionally devastating, and even life-threatening. Take your life into your own hands, and don’t let stress get the better of you. Stress management is a life-long process, so if you don’t already have stress-management tools at the ready, now is the time to start.
Signs of Stress
Type-A Personality Traits