Warning grapic pics. A movie about PTSD on the frontlines.where Rubber Boot Warrior Walk the Walk in The Valley of the Shadow.
A working paper designed to address Post Traumatic Stress as it relates to the emergent field surrounding the professional Fire Fighter.
Gaining skill of what exactly post traumatic stress is and how it affects the fire fighter has become a objective that achievable given the decent background and insight as to how a fire fighter thinks and operates. As information is culled from the profession it will need to be updated. As extra data is made available and brought to the front lines for use by fire fighters the treatment of those under stress of the disorder should become more socially accepted within the culture of the profession itself. The skill gained can be transferred and is no different than that which is collective and instructed to the Rookie/Probationary candidate when they attend fire school and learn about the use of various contraptions and equipment.
In the cultural past and into the present, fire fighters have introduced themselves within the masculine predominated belief that as dudes, they have to “suck it up” and plucky the perils of their profession to the public they are to serve. Privately, within the domain of their own culture, there is a different view. After the events of 9/11, the public wished to know more about the people who risked life and limb to be there during such a catastrophic event which had so switched and altered our world.
In opening a general discussion on P.T.S.D a few observations can be reviewed.
One should ask what post trauma stress is not. For the average, if there can be an average person, the norm or abnormal description lays in the pages of the D.S.M.IV. or Diagnostic and Statistical Manual revision for used by professionals to define Post Trauma Stress.
P.S.T.D comes in two types. Type I encompasses exposure to events or the witnessing of events that are extreme and/or life menacing. Traumatic exposure may be brief in duration or involve prolonged, repeated exposure. Type Two P.T.S.D. is type involving repeated long term exposure (*Meichenbaum, 1994)
P.T.S.D. is not funny nor it is a “happy event” designed to permit the fire fighter who is experiencing its signs to evade working in his/ her profession.
P.T.S.D. is not for faint of heart. It has real consequences for the individual and their family and those the fire fighter works with.
P.T.S.D. can, with education, be understood. It requires maturity and wisdom to begin to understand how it effects the individual. It requires a level of time, energy and commitment in order to understand it.
P.T.S.D. statistic: Approximately 50% of individuals who have developed the disorder proceed to suffer from its effects decades later without treatment. (*Meichenbaum, 1994) There is remission for Type Two but, the effect of P.T.S.D. remains for the balance of the individuals lifetime once it has been detected and actually determined that the individual has it.
P.T.S.D. is a psychological disorder. It has such staggering influence on the individual that serious medical complications can and do result. These include diabetes, heart related problems, suicide (the silent killer), drug manhandle and family manhandle to name a few.
P.T.S.D. is not about drug therapy or drug intervention. It is about the use of drugs to provide improvised brief term ease from the effects of the disorder.
P.T.S.D. require testing in the clinical determination phase using recognized methods by a decently trained individual.
P.T.S.D. narrowed to the effect it has on the profession of fire fighting, has not been the primary concentrate of care givers or clinicians prior to the events of 9/11. For the front line fire fighter, there is no other source of comparison for the definition of the disorder until the writing of the paper. Prior to that, all fire fighters have been collectively placed into the general population and the definition found in the manual.
Fire Fighter Traumatic Stress Disorder (F.T.S.D.): the generic name given to include the D.S.M.IV definition is not presently in the D.S.M.IV manual. The manual itself is being updated and is scheduled for released sometime in the next few years. The term belongs to, and is the intellectual property of, Shannon H. Pennington of FireWorks Consulting (World copy right reserved). Until its writing, there is no other published documents relating to Fire Fighter Traumatic Stress Disorder (F.T.S.D). There is mention of a parallel under the title, “cop shock”, written to cover the description of stress and its effect on the police profession.
P.T.S.D. is survivable given the instruments and methods of understanding when coupled with the correct treatment to the care of the individual who are effected by its onslaught on the inward kingdom of self where the processing of traumatic stress takes place.
P.T.S.D. symptoms often co-occur with other psychiatric conditions. This is referred to as co-morbidity (e.g. substance manhandle, depression, personality disorders). It is significant to assess for co-morbid (in other words “others”) disorders when observing a patient who presents with trauma induced symptoms (*Traumatic Stress: An overview by Joseph S. Volpe, PhD).
F.T.S.D. (Fire Fighter Traumatic Stress Disorder) is presently the co-emergent number one disease of fire fighters who serve on the nations front lines. It ranks beside cancer, heart attacks and lung disease (Approximate figures display that in the United States of America there are some 1.1 million fire fighters on the front lines and at risk.). As an extra note, not every fire fighter will practice F.T.S.D. but everyone has the potential to fall victim to the disorder.
There are many reasons that the disorder is not being addressed, or assessed at the level it should be. The literature needs to be generic in content to the profession and speak to the core issues that are emergent from a decently assessed examine of the problem as it relates to its professional attachment to all aspects of fire fighting but, more specifically to the “emergent needs of the front line fire fighting individual”. In many, if not all cases, the individual works in a team/team-like setting but is treated in a individual manner. This adds to the separation anxiety and stress that has provided the link for safe networking which the injured person needs in order to assist in understanding the event as it is happening to them. In the last century, many of the support networking systems for the fire service are simply non-existent or stress rooted using old behaviour models that are no longer relevant given the increase in the requirement for a broader based service delivery which includes medical, fire, hazardous materials and, now current to the fresh reality, terrorist events.
It will require many of those fire fighters who are exposed to the disorder to reach for the necessary contraptions to aid them in gaining an understanding. It will take massive amounts of courage and resources to give those who need it, a step up the ladder of recovery.
It starlets with the “Very first STEP” acronym developed by the writer:
S ound Off
T ell a Friend or Co worker, someone you trust
E mploy all available means of assistance including competent
P sychological help from someone trained in stress / asd / ptsd assesment treatment.
If the care givers and clinical professionals begin to take the steps toward helping those, within the time-honoured profession of “Fire Fighting”, who are suffering needlessly when there is help at forearm, then the future will have truly been embraced. The challenge is there, the need is excellent, and the clock is ticking. The front lines in the fresh reality remain entire for the time being.
On a final note:
It is natural evolution for those who serve the front line to reach out the “fresh reality” of the 21st century (including post 9/11) instead of looking back into the early years of the profession, when muscle and sweat and raw determination were the primary characteristics that made the individual effective.
The common denominator of courage that trusses the old with the fresh will permit the lay person and medical community to begin to understand that there is superb agony, and injury from that ache, that needs to be addressed if the individual fire fighter is to lead a healthy life beyond the profession and into the privacy of his/her own family as well as a sense of well being.
It is the very least that the public starts to understand the professional and volunteer fire fighter. In doing so, the community the fire fighter serves will be rewarded with a longer serving, healthier and capable individual who is worth and has earned the right to be heard from. It makes sense to care for the care givers in our community and nations. Not just in the myth that has been built up from the public imagination of who or what the profession does for a living but, for the reality that is.
The acronym: “Very first STEP and HOPE” are the intellectual property of Shannon H. Pennington of FireWorks Consulting (World copy right reserved). Permission to reprint this article is given by the author.
Dr de Blois uses Mindfullness Training along with Equine Assisted Therapy.click the link below to view her web site and view her extensive credentials. She is a very certified Trauma Informed Clinician.
Station House’s residential program is designed to help very first responders overcome substance addiction. The program is sensational to very first responders.
“If you have no capacity for violence then you are a healthy productive citizen: a sheep. If you have a capacity for violence and no empathy for your fellow citizens, then you have defined an aggressive sociopath—a wolf.
They can help you get back to the job or to a fresh beginning and quality of life with the devices necessary to master critical incident stress.
Stephanie Conn, Registered Clinical Counsellor, R.C.C. specializing in issues affecting emergency services personnel. Former law enforcement officer and CISM peer support. Vancouver B.C.
Diakonos Retreat Society
West Coast Trauma Retreat