and they often took on the herculean challenge of trying to “fix”
their parents (to stop their parents from using drugs or alcohol,
to stop one parent from beating another parent, or to protect a
younger sibling). They may also work on fixing themselves—being
good enough to be loved. Children will often be overwhelmed
with emotion and dissociate to survive. The tendency to dissociate,
or “check out,” may continue into adulthood, and the individual
may alternate between being numb and being flooded with emotional outbursts.
Other situations besides childhood trauma can also lead to the
development of C-PTSD. Emergency responders are repeatedly
exposed to multiple forms of trauma and thus are also susceptible
to the development of C-PTSD.
Emergency responders are first and foremost individuals with
different personalities, coping styles, and family histories. They may
have been raised in a healthy family, their needs being met, feeling
loved and safe and able to simply grow and develop. They may also
have come from backgrounds where their needs were not being adequately met or they may have faced abuse. In some cases, they came
into their profession with some degree of C-PTSD already. Burnout
may be directly related to working conditions that do not involve
the impact of trauma. These working conditions include a lack of
sleep, feeling unsupported, and just too many calls that don’t feel
satisfying. However, burnout may also involve exposure to human
suffering and, in some cases, be better explained by C-PTSD.
Mindfulness-based training is recognized as a highly effective
tool for stress management, chronic pain, addiction, depression,
PTSD, and anxiety disorders (Kabat-Zinn, J.). Mindfulness train-
ing was successfully used to help prepare marines for deployment
(Johnson, D.C., et al.). Those marines who went through mindful-
ness training experienced significantly fewer markers of stress than
the control group. Below, I will describe a mindfulness approach
I have developed specifically for emergency responders that I have
found to be highly effective.
We often think of burnout as related to compassion fatigue. That
is, when we overload our system from “suffering with” others, it can
lead to a complete system shutdown. Compassion avoidance can be
just as destructive. Many emergency responders are highly avoidant
of having any compassion for the people they are helping—that is,
they shut it off from the beginning. This avoidance may come from
the belief that having emotions displays weakness, having emotions
will hinder their ability to perform their job, or they will be rejected
by their colleagues. But, all our emotions seem to be on the same
rheostat control knob, and when you turn off one you turn them all
off. This results in becoming emotionally numb.
Not all emergency responders develop PTSD, C-PTSD, or
burnout. What makes the difference? Could it be family history,
personality differences, or biological differences? The answer is yes,
yes, and yes. Different reactions to trauma result from individual
differences in emergency responders. In my experience, those
firefighters who show the greatest resilience are those who DON’T
detach from their patients. Of course, when immediate action
needs to be taken on a call, that is the focus. Action, not empathy,
is required. But afterward, when the call is over, the more resilient
firefighters experience sorrow, empathy, and compassion in the
face of human suffering. Resilient people do not see compassion
as weakness or shame. They experience it, and they can then let it
go. Being able to both experience and then let go is crucial. One
way to let it go is to simply talk it over with trusted people (crew,
spouse, clergy, or counselor). If more firefighters could view their
work in this way, I believe there would be less burnout among
firefighters and other emergency responders.
Meet each person you encounter with compassion rather than judgment. This can be difficult at times, but detaching yourself from
Pick three different activities for mindfulness
practice. These activities should be something
mundane where your mind would normally wander.
This could be having a cup of coffee, walking the
dog, brushing your teeth, walking to your car, etc.