By Dr. Tania Glenn, Psy.D, LCSW, CCTP
These are very tough times for many first responders and their family members across America, as law enforcement, fire, EMS and air medical find themselves dealing not only with the furnace blast traumas associated with public safety, they are also confronting the complexities of the grief process and attempting to heal after the very painful loss of their friends and coworkers.
In twenty-six years of practice, I have found that many first responders are not properly equipped with the tools or abilities to heal from grief. Public safety folks are very good at fixing problems quickly, creatively and efficiently. Over time, many of our police, fire and EMS professionals attempt to adopt this strategy for their personal lives and problems. They soon realize that this does not necessarily work, and they experience a significant amount of frustration on top of everything else they are going through.
When I teach my class, First Responder Resilience, I frequently remind my audience that human beings are not light switches. We don’t simply flip on or off to create change or work through the pains of trauma and loss. It takes time, patience, diligence and a willingness to go through the process.
So, let’s talk about grief…
In a nutshell, grief hurts a lot, it takes a while to get through it, and causes significant changes in how you feel and operate on a day-to-day basis. There is no magic pill to make it go away, and the more you try to suppress or ignore it, the longer it takes to get through it.
In On Death and Dying (1969), Elizabeth Kubler-Ross proposed five stages associated with grieving. These stages are denial, anger, bargaining, depression and acceptance. These five stages represent the highlights of what one may go through in the grieving process, but in no way are meant to fully encompass what everyone’s grieving process might be. At any given time, someone who has sustained loss may be going through any or all of these, along with any countless number of other reactions. For example, Kubler-Ross conceptualized the five stages based what she observed in patients who were diagnosed with and suffered through terminal illnesses. I would propose, after many years of working with first responders in horrible situations, where the loss is usually sudden and unexpected, that an additional stage must be considered. This stage is shock.
Shock: The unexpected trauma associated with the sudden loss of a loved one often induces a sense of numbing or dissociation from one’s feelings. Human beings frequently employ this defense mechanism in order to make it through the first hours and even days following a traumatic experience. The result is a shutdown of emotion and sensory experiences. This protects individuals from experiencing too many of the painful emotions that they may not be ready for initially.
Denial: A natural reaction for a person to have in response to an overwhelming and distressing event is to not believe, at least initially, that it is occurring. A good example is the commentary of the newscasters on 9/11 as planes flew into the Twin Towers. Many still wondered out loud, even after the second plane had hit, if the problem was with the Air Traffic Controllers. Denial, like shock, serves to protect the individual from facing what he or she is not yet ready to consider.
Bargaining: As reality begins to set in but the finality of a situation still seems too overwhelming, many people will begin to bargain. They think and say things like “If only I had…” or “If I could just have him or her back I would say or do…” Bargaining is mind’s way of beginning to grasp the concept that a loss has occurred while a person is still not able to accept the loss on an emotional level. It is a transition that allows a person to both begin to look at reality while still maintaining some level of denial.
Anger: As the initial shock and denial of a situation wears off, people generally have a tendency to become very angry, thereby expressing any emotion they might have in the form of hostility or frustration. This is very common in emergency services, where the culture tends to disavow the expression of emotions that are considered “weak” such as sorrow and fear. Anger is a safe expression of other emotions that may be too hard to relay. Anger is considered an “umbrella emotion” in that it is used to cover up pain, vulnerability and intense sadness. Anger is not necessarily a bad emotion. When directed in the right way, anger can be useful in allowing people to get through rough times. My favorite example on the usefulness of anger was demonstrated by John Walsh and his TV show, America’s Most Wanted. Mr. Walsh’s young son was abducted and murdered, so to work through his pain, he created a TV show that hunted down perpetrators. I often tell first responders to take that anger and turn it towards a project that has meaning, a new workout regimen, or a goal to run a longer race than you have ever run… the idea is to make anger make you a better person.
Depression: At some point in the grief process, reality seems to hit hard and fast. The result is an onslaught of sorrow and sadness that coincides with changes in eating patterns, sleeping patterns, energy levels, attitude, outlook, problem-solving and familial relations, just to name a few. Getting through each day is a challenge, as people in this stage just feel rotten. The main issue for folks in emergency services is that they hate feeling this way, and just want to get over this. The fix is, and I realize first responders hate to hear this, to allow yourselves to go through the process of feeling the way you do for as long as you need to. Your mind is doing this for a reason, and any attempts to suppress or ignore this stage are futile. At some point this stage will rear its ugly head again and again until you give yourself the time to work through how you feel about losing someone you care about. The bottom line – you can deal with it now or deal with it later.
Acceptance: When people are able to contend with the grief process, they eventually begin to move forward. Life is not the same, but people who reach acceptance are able to continue on with life and feel as though things become somewhat normal again. Seeking the support of family, peer support, effective counseling and friends, along with allowing the grief process to run its course are effective ways to recover and move towards final acceptance of this new situation. It is a difficult process, but the human mind has amazing powers to adapt and overcome.
An additional complication in grieving is something called traumatic grief – when there is a traumatic loss intertwined with the grief process. This is a very complex and painful process to go through. Getting help from professionals who are trained in addressing the complexities of traumatic grief is paramount. Many first responders know exactly how painful this process is, and many whom I have treated have regretted the fact that they delayed getting help.
Finally, please remember that first responder families, including children, are along for the very bumpy ride. It is very normal for them to have the same or similar full range of reactions, to be extremely stressed or worried about their first responder, and to struggle with coping. Family members need care as well. They need the time to heal and restore their resilience. Remembering this and asking for assistance will help strengthen first responder families.
#suckitptsd #ArmorUp #changethenarrative
The Mission:
As a clinical practice based in Austin, TX, Tania Glenn and Associates, PA provides counseling, consultation, and training in the mental health arena. Tania Glenn and Associates, PA, along with the Trauma Defense Team, is dedicated to serving the mental health needs of veterans, first responders and their families, both locally and nationally through the use of effective, appropriate, and proven interventions. For more information: Click here
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