I have been a psychologist for 20 years, and I have worked with firefighters or their family members for the last 10 of those years. I’ve estimated that I have spent somewhere over 10,000 hours talking with firefighters who walked through
my door for help with a wide range of life’s struggles. Sometimes,
the problem was post-traumatic stress disorder (PTSD) or burnout
or the secondary effects (divorce, alcohol abuse, discipline issues at
work, etc.). I’ve started to wonder: What’s the difference between
PTSD and burnout? Are they uniquely different or versions of
the same phenomenon? Ultimately, the goal of understanding this
at a deeper level is to provide more effective prevention of, and
treatment for, PTSD and burnout. One promising approach is
mindfulness-based training, which I’ll discuss later in this article.
Emergency responders are exposed to human suffering, tragedy,
and personal danger as part of their daily work. They are also told
that they should not have any emotional response to facing the
dark underside of life again and again. In fact, it is common to
encourage detachment as a way to stay healthy. But does this really
work? Emergency responders too frequently experience burnout or
PTSD and, without treatment, they may also experience the subsequent unraveling of their lives. Below, I describe burnout, PTSD,
and complex PTSD (C-PTSD).
Burnout can include the following:
• Cynicism: Anger and criticism toward the general public using
• Judgment: Harsh criticism of the administration, officers, other
crew members, and family.
• Detachment: Feeling disconnected from others including work
colleagues, friends, and family.
• Irritability: anger, short fuse.
• Lack of satisfaction from work.
• Feelings of being ineffective.
• Unhealthy life choices: alcohol abuse, lack of exercise, poor
PTSD can include the following:
• Intrusive symptoms: intrusive thoughts, images, and other sen-
sory memories; nightmares; and intense distress when exposed
to reminders of the trauma.
• Avoidance: Actively trying to push away images and memories,
avoiding exposure to reminders, and inability to recall certain
aspects of the trauma.
• Negative thoughts and mood: Persistent negative thoughts about
oneself or others, distorted thoughts about the cause of the
BY KAREN JACKSON