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Vicarious trauma: Understanding traumatic stress in first responders

Vicarious trauma: Understanding traumatic stress in first responders

The nature of a first responder’s job often requires them to be present at the worst moments of other people’s lives; every day is an exercise in facing and resolving tragedy. Too often, we forget the toll this takes on emergency response workers.  

To discuss this issue and what can be done to help first responders navigate traumatic stress, I spoke with Susan Farren, the founder and executive director of First Responders Resiliency, Inc. Her organization works to provide emergency workers with “education and skills vital to our mental, physical, and emotional wellbeing”. 

Susan Farren, founder of First Responders Resiliency, Inc., stands in a small field behind a house.

The impacts of traumatic stress are well documented and understood as they relate to personal events. However, the medical community is coming to understand that workers whose jobs involve crisis management often experience psychological and even physical effects as a result. 

You can think of this a bit like an x-ray. There is no real danger associated with the radiation from an x-ray provided you don’t have them done too often. However, an x-ray technician is constantly surrounded by low doses of radiation which can be dangerous over time. 

Similarly, watching another person go through a traumatic, life-altering event does not always cause psychological distress. However, constant exposure to these events can build up over time to create real, damaging effects. 

Farren explains, “the body keeps the score, and every part of our bodies, all of our tissues recall every event that we’re exposed to. And every time we recall that — in conversation, in support of each other — we get to relive that call on some cellular level”. 

While proximity to disasters is an inevitable part of working as a first responder, understanding and managing the side effects of second-hand trauma can help improve the quality of life of the hundreds of thousands of Americans who work in the field. 

What is vicarious trauma?

Vicarious trauma occurs when someone experiences a crisis secondhand. This may happen as first responders face a crisis head on, or even in debriefings where individuals share stories and information.  

Unfortunately, those who are trained to be more empathetic tend to be at higher risk for vicarious trauma and related conditions. Individuals like first responders, who have dedicated their lives to helping people, are often expected to act with incredible compassion. 

As Farren explains, “we have personal connections to some of the patients that we see, some of the events we witness, and our brain will spend an enormous amount of time in this hypervigilant mode trying to process the information.” While this makes for successful emergency workers, it also makes this line of work psychologically taxing and even dangerous. 

Experiencing vicarious trauma as a first responder

Depression and burnout are very common in those with second-hand trauma. “For many of us, the exposures are so consistent and so traumatic that we begin to lose our joy, and we don’t know why it’s happening,” Farren said. 

“Research indicates that when you’re exposed to things that are traumatizing to your brain, your brain spends an enormous amount of energy trying to sort it out, trying to make sense of it, trying to create reasons for this kind of thing.”

This process is exhausting, particularly when an individual is emotionally invested in the people and events they work with. It becomes much easier to shut off the persistent feelings of hopelessness and depression than to work through them.

Anxiety and panic disorders often occur in tandem with internalized blame or self-judgement, a process often magnified by social pressures and public opinion.

“I wish people realized that when they think or say things like, ‘well they knew the job was going to be tough when they got into it’… nobody knows, you have no idea. You can’t train enough, or read enough books, or watch enough movies, or do enough ride alongs, to prepare you for the kinds of things you’re going to be exposed to in this career…” Farren said.

“You’re going to see life at its very hardest, and its very cruelest. We’ll see more trauma potentially in a shift than most people see in their entire lives.”

While secondary traumatic stress can often feel unmanageable and exhausting, it is not hopeless. Organizations like Susan Farren’s First Responders Resiliency, Inc. work tirelessly to bring life-changing tools and coping mechanisms to emergency workers. 

Our next article will consider those strategies and how they can be best used by first responders as well as department leadership to improve quality of life and mitigate the effects of vicarious trauma. 

By Kate Marin. Questions? Get in touch at kate@perimeterplatform.com.