What happens when we take heroism for granted? For the average civilian, the approaching wail of a siren is both a sign of danger and of hope; the promise of rescue in the face of disaster. For firefighters, leaping  from a howling truck and into potentially life-threatening danger is rote – an expected part of the job at hand. First responders are paraded in children’s books and at career fairs as the brave and ever-confident public heroes who spurn anxiety and fear. We tend to envision the dramatic parts of a firefighter’s job: rescuing a child from a blaze, or enabling the safe evacuation of a collapsing building. In the face of that drama, though, we often forget that first responders encounter potentially traumatizing situations with far greater frequency than ordinary civilians. According to a study conducted in 2016, the prevalence of PTSD among emergency service workers is estimated at 17%-22%; this number stands starkly against the expected lifetime prevalence of 1%-7% within the general population. Clearly, the public conception of first responders as unflappable saviors is off-base.

 

Unfortunately, this trend towards promoting an image of infallibility continues within the fire station as a cultural trend as those within the profession are subtly discouraged from showing signs of work-caused vulnerability or anxiety. As Randal D. Beaton and Shirley A. Murphy explain in a chapter of the text Compassion Fatigue: Coping With Secondary Traumatic Stress Disorder In Those Who Treat The Traumatized, “This ‘conspiracy of silence’ norm is generally functional and productive because, without a certain amount of self-deception, firefighters might be overwhelmed by their fears.” As the authors suggest, firefighters face a catch-22: they either face their pain and risk hesitating during deployment, or keep their anxieties hidden and delay their psychological recovery. However, the oft-chosen latter option is only a temporary solution. Studies have demonstrated that under the current culture, firefighters with PTSD suffer from long-term emotional disorders, damaged relationships, professional burnout, alcoholism and substance abuse, and truncated careers. Hiding pain under a mask of bravado is not a sustainable solution to the problem at hand.
We need to implement a cultural shift towards acceptance, and make certain that our first responders have the tools they need to manage their trauma before its effects become critical or long-lasting. Those tasked with helping our firefighters should consider implementing mindfulness programs to equip responders with coping skills, increased emotional awareness, and greater resilience against stress. This idea isn’t unprecedented; previous studies in which mindfulness workshops were introduced to firefighters found that “mindfulness was associated with fewer PTSD symptoms, depressive symptoms, physical symptoms, and alcohol problems when controlling for the other study variables.” Additionally, increased social support from coworkers and family was found to lessen PTSD symptoms in sufferers. Thus, we must establish educational programs for those within and beyond the firehouse to equip first responders and their loved ones with the skills they need to weather the impact of post-traumatic stress disorder.