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By Jada Hudson, M.S., LCPC

More than anyone, firefighters know that in an emergency situation, their natural reaction is “fight or flight”. If the danger is surmountable, we may choose to stand our ground and fight. If we can outrun or avoid the danger, we will flee. However, there is another response that can occur when a danger seems so overwhelmingly hopeless that there is no chance of survival. We may freeze, like the deer in the headlights.

Even firefighters can have this response in life-threatening situations, and it is not always healthy in the long run. A 1989 study by van der Kolk and van der Hart showed that dissociation or “freezing” in wake of an event is a precursor to Post-Traumatic Stress Disorder (PTSD), along with phobias, panic attacks, obsessive-compulsive behaviors and various anxieties that may be traced to a “freeze” state that never had the chance to “let go” or “thaw out”.

The purpose of “freezing” is to give us a chance to disassociate from the trauma we are experiencing. However, when are asked to “freeze” or mimic the freeze response when we are physiologically ready to flee or fight, we cannot benefit from dissociating from the event. Instead, our body’s heart rate races, our muscles tense, etc. in preparation for the fight or flight. If we can’t do either, our levels of cortisol, the “stress hormone” that regulates our body for the response, builds up within us. Without a release, the cortisol can wreak havoc on our minds and bodies.

Firefighters, or anyone in life or death stressful situations, should remember that the freeze response is never your friend. Movement is good for us to release cortisol, and also to take action for our survival. In situations where movement is not possible, there is another suitable substitute to lower our cortisol levels and focus our action: intentional breathing.

From managing pain during childbirth to handling cases of shocking news, intentional breathing has been found to be soothing and effective in stressful situations. If you add light movement to the breathing, you have a formula for stress relief that has been proven effective, even in scientific experiments.

For example, a recent study of nurses from the University of New Mexico Hospital with positive PTSD symptoms were asked to participate in 16 sessions of 60-minute mind body intervention (MBX) sessions led by a trained instructor over a 8-week period. The program consisted of stretching, balancing and breathing with a focus on mindfulness. The group was asked to attend to their breathing, concentrating on inhalation, retention and exhalation. At the end of the program, the MBX group showed significant reduction in PTSD symptoms, serum cortisol and “improved sleep, stress resilience, energy levels, better emotional regulation under stress, and resumption of pleasurable activities that they had previously discontinued”.

On a call, firefighters aren’t able to lower their cortisol with yoga, but back at the station or in preparation for a call, performing mindful breathing can be surprisingly helpful as well as physically and mentally healthy for a firefighter. Back at the station, performing breathing and stretching exercises like those outlined below can help firefighters prepare mentally and physiologically for the next time our “fight or flight” response is activated, but we can’t do either.

RELIEVING STRESS THROUGH PHYSICAL MOTION

In an emergency situation, our bodies typically ramp up physically in preparation for the flight or fight response, dumping cortisol (the stress hormone) into our system. Our heart races, our muscles tense and energy surges through our body. If we are asked to sit still or “freeze” while we are in a stressed state, an unhealthy amount remains in our system, awaiting release so we can relax. How can we productively reduce our cortisol? Mindful deep breathing and simple stretches can do the trick. Here is a possible start:

BREATHING

Try on the way to a call, when awaiting dispatch or any situation where you may feel anxious.

1. Close your mouth and inhale quietly through your nose to a mental count of four.
2. Hold your breath for a count of seven.
3. Exhale completely through your mouth to a count of eight.

Repeat the cycle three more times for a total of four breaths.

BELLY BREATHING

• Place your hand on your stomach.

1. Breathe in deeply, attempting to make your hand rise.
2. Hold for a count of seven and exhale, mindful of your hand falling with your exhalation.

RELAXATION POSES

These are good to try at home or at the station when returning from a difficult call.

CHILD’S POSE

• On your hands and knees, spread your knees wide apart while keeping your big toes touching. …

1. Sit up straight and lengthen your spine up through the crown of your head.
2. On an exhalation, bow forward, draping your torso between your thighs while extending your arms in front of you, palms facing down.

Hold for a count of eight, then sit up and repeat.

THREAD THE NEEDLE

1. On hands and knees, place your right arm underneath your left arm until your shoulder is resting on the ground. Hold for three breaths.

• Come back to all fours and repeat, placing left arm underneath the right.

By: Jada Hudson, LCPC

Cancer. For some it’s just others’ distant tragedy, but for some it’s the enemy that ruined the family. For many firefighters, cancer is a reality that they may have to face because, in the fire service, cancer rates are higher than in other occupations. According to a study produced by the National Institute for Occupational Safety and Health (NIOSH), those in the fire service are two times more likely than non-firefighters to be diagnosed with brain cancer and liver cancer, 2.8 times more likely to be diagnosed with colon and rectal cancer, 2.5 to 3 times more likely to be diagnosed with bladder cancer, and they have a higher incidence of non-Hodgkin’s lymphoma and urinary cancer than non-firefighters. Sadly, cancer hits often in the fire service.

For many, cancer diagnoses can surface unexpectedly, raising feelings of desperation, uncertainty, anger, and resentment, mixed with feelings of determination, hope, and courage. Firefighters, who are used to being strong, may feel exposed and vulnerable, or they may try to hide their true feelings with a “make the best of it,” cheerful façade. At the same time, the family surrounding the cancer patient is often blindsided by their own feelings and responsibilities as they support their loved one.

Sadly, the strains cancer puts on a marriage relationship are often suffocating, and many times can end in a couple separating or divorcing. Relationships begin to break down because of poor communication, grief over the loss of what was, guilt, inability to cope with stress, fear of the unknown, fear of death, uncertainty, shame, feelings of powerlessness, and anger for being put in this position. Often, family members cope by turning to their own “comforts,” such as alcohol or substance abuse, infidelity, or other types of “acting out” behavior. When children are involved, their primary source of emotional pain will come from lack of communication about the disease or avoidance of the topic of death.

Additionally, within the firefighter’s surrounding community, there are psychological, social dynamics that change when cancer is present. Firefighters may feel helpless. They may search for meaning. They may have a sense of failure, and they may fear stigmas that come with having a disease. They may feel isolation or even a lack of support from health professionals. Even physically, patients may wrestle with the side effects of treatment or the uncertainty that comes with having a disease.

While cancer wreaks havoc physically, it can also be wreaking havoc emotionally beneath the surface. So, how can firefighters and their families overcome cancer’s unique emotional wellness challenges?

They can move forward by managing fatigue, adjusting to physical changes, and sorting through the financial issues, address changes, and relationship dynamics associated with a cancer diagnosis. But, they need not feel alone. By increasing communication with family members and peer supporters, cancer patients can cope with processing the physical pain, the thinking about end of life, and with bereavement. In addition, seeking family therapy at regular intervals during recuperation and remission can help families stay unified through such a trying time. Simply understanding that there is a possibility of the patient or members of the family developing situational depression will help when emotions are overwhelming. And, gaining a better understanding of the firefighter’s changing physical needs, and establishing a “new normal” routine will make life more comfortable and less stressful.

Being surrounded by support changes everything for firefighters. Cancer can be scary, but it cannot take what you refuse to let it take. So, fight for your family and let diagnosis, treatment, and remission, bring you together, not apart.

The name Teflon is synonymous with a chemical that is applied to cookware creating a nonstick surface.  A cast iron skillet treated with Teflon (a discovery of the DuPont company), was the first to be sold on the open marketplace with the slogan “Nothing Sticks to Happy Pan.”  So what does this innovative product (a delight to cooks-home and professional alike) have to do with being a first responder or peer support team member?

The life of a first responder is by no means an easy one, and nobody should have ever spoke to the contrary.  On an annual basis we are exposed to: environmental elements, toxic products of combustion, bodily fluids, communicable disease, and hard strenuous work when it is called for just to name a few.  We have all been there, done that, and got the free t-shirt when it comes to this business.  Our calling is not only taxing on the body, but to the mind as well.  Every time I have the opportunity to talk to the civilian population about my job, I always relate that I have seen things during my 20+ year career that the echoes of my mind will never, ever, let me forget.  In other words, unlike the non-stick “Happy Pan” we are not Teflon-things can, and will stick.

Enter Illinois Firefighter Peer Support to the dynamic world of the fire service where no two days are alike.  We have now become an organization of over 100 strong who have chosen to step up and help our brothers and sisters in need.  There is not a request for assistance that goes by without several members answering the call at a moment’s notice.  We all have come with our own story that may resonate with a peer in need.  Although we do not have a magic wand to wave that will erase the echoes of the mind, it is our caring demeanor and understanding ear that can help them to reshape their doubts and fears into a different perspective.  If they need services beyond our capacity- we can offer that as well.  This begs the question- Do we wear a coat of Teflon as a peer supporter?

Recently, I have reflected at great length on this subject matter to which the answer requires further investigation or at the very least a serious conversation.  It has always been my understanding that professional counselors and psychiatrists (who spend years in the listening field) themselves need someone to talk and debrief in order to cleanse and avoid trauma to their psyche.  If they do it, why not us?  Think back when you attended the initial peer support training and listened to your classmates each in turn tell their reason for being there.  Did this affect you in anyway?

It is the greatest honor and privilege to be a part of this organization that lends a helping hand to others in need.  So, to answer whether or not we are coated in Teflon- I am leaning towards not.  I think it would be prudent to reach out and debrief with someone, even if just to say “I am doing okay.”   It would be awesome if any of our clinical consultants or other team members could weigh in on this topic and add their level of expertise to this conversation as well.  Please submit to timgrutzius@gmail.com

Stay safe and be well,

Tim

Lets, for one second look at the job of a firefighter/paramedic as a sport. The reason to do this is because there are a lot of similarities in each. The physical and psychological demands placed on professional athletes can be related to that of firefighters. Then the question becomes do firefighters train and prepare as an athlete??

How are firefighters similar

1. Team- Most sports and every firehouse operates as a team. Every person has their role and usually the best person for each spot plays that role. Set each person up for success, if one is a great engineer let them drive/pump. If one is a great paramedic let them lead the calls. It is not a matter of what someone wants to do but what they are great at.

2. Physical demands- Sports require a level of physical capabilities, different ones for different sports but in general a physically capable person. Firefighting is no different in fact demands a little bit more because firefighters are not able to prepare for everything they may face. Firefighters try to and they do a great job at that but the unknown is always against them. There is also the wide array of tasks that are required by firefighters. An athlete only has to deal with one certain task all the time. While a firefighter has to be able to do so much more at a moments notice.

3. Psychological demands- Sport is just not physical but also requires mental toughness. Most people have  heard “get your head in the game” well its true. Athletics is one area that one can clearly see the strong connection between mind and body. Professional athletes are very capable but sometimes when you watch on T.V. their performance is sub par. It is a mental breakdown and the impact on the physical ability is tremendousness. Firefighting has the same demands and requires that mental toughness more so than an athlete. If firefighters become emotionally ill, it can have a negative affect on how well the job gets done, just like an athlete. A firefighter also has greater risk of becoming emotionally ill because of the situations they face day in and day out. An athlete has none of that.

4. Practice- All teams and athletes always practice right. So do firefighters, however the training requires firefighters to train like their life depends on it because it truly does. Firefighting training covers many areas because they do not know the enemy they will face day in and day out. Athletes can prepare for a certain opponent on a given day. Firefighters can prepare for many opponents but will never know when they may face it. So practice all the time, perfect the skills and get better.

There are more similarities like having leaders, followers, a strategy etc… I can go on and on but the list above are a few main topics. As I continued to write the similarities I noticed that a firefighter’s job is much more challenging then a professional athlete. It requires more demands physically and psychologically. It requires much more than an athlete. The scary part……Do firefighters train and prepare like professional athletes. In general the answer is no they do not. This can change and discussing openly is just the start of something much greater.

I plan on utilizing this blog to talk more about the wellness of a firefighter openly. Areas I want to focus on are wellness, what is it and what does it look like. The emotional impact of the job and how we can better prepare for the stresses firefighters face. Make a connection between mind and body and talking about how being physically well can positively effect emotional wellbeing and visa versa. I will discuss foods and what happens to nutrients when we face stresses and how to overcome and supplement that. We all can do our part and learn that what firefighters do is hard…very hard and it is okay to say so. The challenges placed on the physical side are known and the challenges faced that no one sees or talks about is something the ILFFPS is changing right now. Firefighters suffer and it is okay, I am here to tell you we can better prepare for every aspect of our job.

The mind and body are very vulnerable yet very resilient and strong aspects of one’s being. They both require great care especially in the profession of firefighters. The demands are great and the risk for injury and death are great. There are many ways to go about taking care of firefighters and getting them ready. Train like a professional, prepare for the unknown and work towards a goal of becoming always ready for anything.

Semper Paratus,

Kyle Matousek

Kyle.ff81@gmail.com

“Interpersonal communication is an exchange of information between two or more people. Communication skills are developed and may be enhanced or improved with increased knowledge and practice. During interpersonal communication, there is message sending and message receiving. Successful interpersonal communication is when the message senders and the message receivers understand the message” (source: Wikipedia).

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