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Navigating First Responder Mental Health: The Cabinet, Empathy, and Healing · Firefighter Nation Podcast

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This means that SFA is an approved training provider with the OFM, and the programs are recognized in Ontario. Check out their pre-service and expanding selection of course offerings at SouthwestfireAcademy.ca. Hello everyone. Welcome to episode 126 of Multiple Calls. I'm Scott Hewlett. I know it's noisy out there. I know there are things you have to address that demand your attention because there are consequences if you don't. I know you can't possibly do all the self-care things you're supposed to do every day on top of everything. And they usually come last if at all. Let this be a gentle reminder. Like a comforting arm around your shoulders, that there needs to be at least a few daily self-preservation commitments that are non-negotiable. If you are to be there for the ones you love. As the Zen proverb says, you should sit in meditation for twenty minutes per day. Unless you are too busy, then you should sit for an hour. Here's my chat with Destiny Morris. Start by telling me how you got into the work you're in. We went to school to be a licensed marriage and family therapist. And I grew up in a law enforcement family. So my dad was in law enforcement growing up. And when I was in grad school, I was in a relationship with a fireman and his dad was a retired DA. So first responder world was very much so a part of my upbringing, and then also when I was in school. And then my supervisor, who I was working under, she did all of the vet court and the mandated therapy for veterans as just a trickle effect of working under her. I also started working with veterans. From that I then created a private practice where I see primarily first responders, I see spouses of first responders, and then I see the couples and the children as well. I think starting with addiction would be a good place to kick off. Two things stand out to me when I think about addiction is Johan Hari's TED Talk where he talks about addiction being about disconnection. And then Gabor Mate and his take that don't ask why the addiction, ask why the pain. Yeah, addiction is a secondary response. Typically, there's a reason for addiction. Addiction is a mask, or it's a cover up, or it's a comfort, or it's a shield. So oftentimes in therapy, if I'm looking at a client who has struggled with addiction, we're typically going underneath where did this stem from? What age did we start using? What was going on around that time? Most of the time it's stuff that's been shoved aside and not been addressed before. So traumas. stuff like that. But I worked in a treatment center for a while, actually a couple of years, underneath that supervisor that I had mentioned previously. And I also worked in a psych ward where I would see people who were detoxing. And that was really interesting because they would put first responders with the general population. They did not separate them. And I found that to be really problematic. The first responders didn't align with that. They wanted their own homogenous group. Obviously maybe a little bit different for a firefighter, but think about a police officer who's getting put in the same so let's say a police officer who's detoxing off of something or they're there because they're having suicidal thoughts. They're getting put in the same exact general population with people they might have arrested or people who struggle with their mental health that are in and out of those facilities often. How can first responders have some more empathy when they are helping out with people in the field with addictions? they and especially people they see often. One thing that comes to mind is I've heard it said that you you don't excuse the behavior or you don't have to like the behavior, but you at least you can have some empathy for the person themselves. And especially it'll be hard over time if you're seeing someone frequently, time and time again. And it's easy to judge that it's just a selfish thing that they're doing. I think in order to look at empathy we have to look at the opposite apathy. I see a lot of first responders who struggle with being very apathetic. Or I see the spouse of a first responder who will say, My husband has no empathy. He is not able to hear about the things I'm struggling with and have any kind of emotional response to it. And this kind of circles back to your question as it brings up burnout, is number one. I see this often, right? If you're picking up the same repeat callers all the time, especially people who work on ambulance, right? You're just constantly doing this kind of work. If you're constantly re getting these repeat callers or the nursing home calls and it starts to become a burnout, right? You're not taking care of yourself, you're not decompressing in between work, you're just rolling straight into the next shift, you will become apathetic and you won't have empathy. I believe that empathy is only prevalent when we first give space to it. And in order to give space to it, we have to take care of ourselves. So there's a big disconnect sometimes with these first responders who Are burnt out because they're not decompressing properly and they're not taking the time to disconnect because it is very human to become irritated. Also, when you see the same things all day long, your threshold is a little bit higher as well as a first responder. So what might feel like a true emergency to you is way up here as a first responder, and something that someone Stubbed their toe when they called 911. you hear those kinds of calls to a first responder, it's stupid, right? And you don't have a lot of empathy for things like that because your threshold is a lot higher. And this sometimes carries on into the home and into relationships where spouses will say, Why can't you be empathetic about me telling you about my day at work? Or I was frustrated earlier with the kids because their threshold is way up here for distress tolerance, is typically why. So I think it goes back to taking care of yourself and that's how we are able to have more empathy if we're able to give space for empathy to actually be there. Maybe it's not so much a factor now. years ago it was more of emotion management of yourself. You wanted to throw a barrier up between you and the people that you're helping. And it was commonly said, Well, that's the only way I can do my job is if I shut off emotionally and just make it very much mechanical. Do you see that as necessary or is it an avoidance? thing because they're they're not sure how to engage with the emotions. Okay, I love this. This is my favorite thing to talk about. I call it the cabinet. Every first responder has a cabinet. And I to answer your question first, it's both is in my opinion. It's it's a tool, but it's not used properly. It's used improperly and it's not taught how to be used properly. So the cabinet is a tool. And we have to have the cabinet as first responders in order to do your job, right? You can't sit there and have all your personal emotions come up on scene. You have to stick it somewhere. So we compartmentalize, we put them in the cabinet. Now the problem is, is a lot of first responders are taught this, like you're saying, it stemmed from many generations of taught, shove it in the cabinet, move forward with your day, go on to the next call, right? The problem is that no one's teaching these first responders to take it out of the cabinet later on and process it. So it sits in there for years and years. And what happens is the hinges on your cabinet, the doors are not closing anymore. They're starting to fall off because there's no more room for things. Our brains can only take so much compartmentalizing. So I do think it's a great tool, but I don't think it's being used properly because it's not being taught properly. Is it fair to approach it with I leave work at work? Whereas we're actually living a fluid existence. So how do you in your brain compartmentalize this certain part of your life and think that that doesn't have any effect on anything else. Yeah, I'm curious of your opinion. Do you feel like work can be left at work? Well what changed it for me is I like to flip things. So I th I wondered can you leave home at home? And you never hear anybody say I leave home at home. No. And why is that? Because you're living a fluid existence and your brain doesn't you can't shut off. You don't have spaces in your head that you can Like you said with your with the cabinet analogy is that you can put certain things aside in order to do your job, but I think you're leaving a lot on the table when you're not engaging with people on an emotional level. And I feel that you're also only left with the crappy parts of the call as opposed to maybe feeling like you were a good human being on the call and connected with the people or the family. So then when you're processing things you can at least take that goodness from the call. Yeah, yeah. I think this also stems back to the question about empathy too. Now, can you have empathy if you don't bring your emotions to some degree into what you do? Right. If we turn it off completely and we're just cold and become robots, are you actually doing your job from an empathetic standpoint? Or are you doing it in a rushed A plus B equals C? And then as humans, we need to have the feeling like we're doing something that's purposeful, right? So typically that does involve emotion. So I would agree with you that it's fluid. Did you ever See the show Severance. Have you heard of that? I've heard of the show. I haven't watched it. so interesting. It's basically where they sever the brain, where it ends at work and then starts a different existence at home. And the show had so many problems between doing that because it was almost like two different parts of yourself that were always stuck in that space. Yeah, not possible. What's the part of your brain that bridges the two hemispheres again? Remind me of the do you remember that? gosh. It's escaping you right now, but that's what it made me think of, right? So there's people that have because of a certain medical condition, they've had to sever that bridge between the two hemispheres. And so they it it it it becomes like they are living two in two different lives or within the same body. I'd have to look into it more, but that's what that made me think of. Yeah, very interesting. Yeah. I it I don't think it's possible. Just like what you were saying earlier, leaving home at home, it it doesn't happen. We can use the cabinet though. That's a great tool. If your spouse is upset at home or your kids are having a hard time, we can leave home in the cabinet while we're working, but at the end of the day, you have to open the cabinet and take home back out. And most people, I mean, they do that without thinking. Right. It's still there. It sits there and it waits and it it does become a weight. The cabinet is not a light thing that just floats around. It's something that first responders carry almost like a backpack cabinet. So if you got a lot of stuff in there, eventually you're going to be a first responder who's extremely weighed down and has maybe PTSD symptoms or trouble sleeping or addiction. Right. A lot of First responders use alcohol or sometimes cocaine, just depends on where you're at and what's popular right now. But a lot of times they use alcohol because it's the quickest way to decompress and to take off the backpack cabinet. But the problem is, is you're not actually fully decompressing. It's a pseudo decompression. So you feel like you are and it's just causing more weight over time, obviously, with addiction. It must be more challenging now because you're connected to home all the time with your phone. Not that you're at work all the time, but you are seeing work related, upregulating, nervous system challenging stuff more often than we ever did as well. absolutely. Yeah. The media right in your hands. I think of all the apps with the scanners on it. When I was with a firefighter in those years in grad school, I just remember how much we were checking, we have Pulse Point over here. And it's the app that has all the calls and all the fires and always a constant radio on in the background, pulse point in the hand. Even though you're off work and you're not getting paid right now, you have to stay hyper vigilant in order to know what's happening. What about volunteers? Do you work with volunteers at all? Because that would be an example of they're never really off duty and you have another job and you have your home and the call can come at any time. So you're kind of always in that state. Yeah, I do work with volunteers. Absolutely. That's a good example of that. They don't really get to take their work hat off. That is one of the most important things as humans, is that we're able to take our work hat off. If you are not taking your work hat off ever, you're not decompressing, and then you're also not able to have empathy and patience. Typically PTSD pops in somewhere around there too, because we're avoiding at that point. Like I don't walk around being a therapist twenty-four seven. I have to leave my therapist hat in my office and I get to just go be destiny after this. Versus responders have to do the same. Often when we think of addiction, we think of drugs. That's the first thing that comes to our mind or alcohol. but what about other things that are out there that are we're addicted to now? Phones is one thing. And how about things that are seen as healthy but that can be overdone so they actually become detrimental, but they're supported in the culture? It all is underneath the umbrella of dopamine. So first responders, I think in our generation, we all tend to be very dopamine seeking because we get it now. It's instant access. It's in our hands. You can go get it. You can grab it. It's it's very quick, quicker than it's ever been. But first responders, I treat a lot of first responders for this dopamine addiction. And it's interesting because sometimes it will come up with alcohol or sometimes it's food. I see pornography addiction a lot. I see phone addictions. And then the healthier things that can become addicting, over exercising. I see like more of the type A sometimes like the need to be in control that can become an addiction as well, right? Needing to have the home feel like the firehouse and needing to conduct your home and your family like your fellow firefighters. Yeah, I think it's under the arch of dopamine. That's where it stems from. And the reason why first responders struggle with dopamine is because again, your threshold is very high. So the things that are exciting to you are way up here. And things that are exciting to non first responders are typically down here. And because of that, it takes a lot more for that dopamine response to kick in. So I do a lot of nervous system regulation and dopamine resetting with my first responders as well. Yeah. So I mentioned it earlier and you just mentioned it now. So it's just I think focus on this a bit more because I think it's important for people to hear this often, upregulation and down regulation of the nervous system and how it's common for first responders to have a lot of upregulating things that they do as their extracurriculars and they don't truly know how to downregulate. So maybe just focus on that for me. I think of it as like revving up for something and then defrosting. So typically it takes a first responder one to two days, and that's if they're good at it, to be able to defrost or to downregulate. Up here is where you're hyper-vigilant. At work, you're very hyper-vigilant when you're sleeping, you're listening for tones at the same time, right? You're not fully just relaxed knowing that you're not going to be woken up to do your job. When you're out in public, you're constantly surveying, you're taught to survey. The hypervigilance is something that makes you good at what you do. We cannot exist in constant hypervigilance. There's a lot of health issues that come with that. We must decompress or downregulate, like you were saying. And to do that, I can talk about the skills and what that can look like, but it usually takes one to two days. And then typically when you're downregulated, then you're able to be emotionally connected to your spouse, emotionally available for your family, present for your friends. And then what happens is it typically takes one more day to get back up to where you're at when you're revving back up to go to work again. You can't stay down here. That's unsafe for a first responder. You must go back to hypervigilance. So it's a constant down up, right? And it takes a few days. And then typically you're only getting a few days off. So how do you squeeze all of that in, right? I want to touch on that point you just mentioned about 'cause I could as we're talking about it, I can hear the first responders screaming at the radio that they only get two days off or they only get three days off and then they're maybe right back on again. So Now, I guess going into the skills, how can they do the best they can, even if they can't completely down regulate, or how or maybe it's even more important that they even try because they don't have time on their side. Yeah, I have a lot of first responders who only get one day off. And I think that's pretty common sometimes, unfortunately. When that happens, they are not fully coming down from their shift. It's impossible. There's I mean, it just doesn't happen. You could come down a little bit, but not fully. I do believe it takes a whole day to get there. Typically, because you think of how many days you're at work versus how many days you're at home. It takes longer to undo that and to get back down to home than it does to rev back up to go to work again. But some things that can help everybody is different. Hobbies are really great. A lot of first responders, it's so funny because I get their spouses in therapy and they come and they complain to me. When my husband comes home, the first thing he does is he starts to mow the lawn and then he'll clean out the cars. And in my opinion, as the first responder spouse, those things are not relevant. I've got laundry, I've got kids, I need help inside. Why are they outside leaf blowing? And the reason they're outside leaf blowing and mowing the lawn and cleaning the cars is because that is their way of downregulating. That's how they're finding their middle ground between work and home after they've mowed the lawn, after they've cleaned the cars, then they're able to decompress and sit on the couch and be present with their family. But there typically has to be something in the middle. For some first responders, it's exercising. Maybe it's going for a walk with the dog when they get home. Maybe it's hitting the gym. This is where communication is really important in relationships where you're able to check in with your spouse and say, hey, these are my needs. This is what I need to do right before I get home so that I can be more present or I can be a better partner to you or a better father or whatever that looks like. So there typically has to be some kind of activity that happens. in order to gradually get you to decompress. And then also it's going to be different every time. I think this is one of the hardest parts of being a first responder is that it's not a formula that you can follow every single time. It is not a copy and paste because it depends on how much sleep you got. It depends on what mood you're in. Depends on how much stuff is in your cabinet that you haven't unloaded yet. It's going to be different, right? Some people might come home and have more energy to go to the gym. Other people might come home and they might decompress by needing a nap. They might need to re-regulate with sleep or with food or with rehydrating, whatever that looks like. Those are healthy ways. Obviously the unhealthy way would be home to come home and drink a six pack of beer or go home and lock yourself away or isolate yourself. Those would not be healthy ways to decompress, but we typically need an activity. You mentioned about it's not necessarily a copy and paste, but I was thinking about are there ritualistic things that you can do regardless of what's going on in your life to set the tone. So I personally have made a decision a long time ago not to drive into work in my uniform. All my uniforms and everything are just kept at work. They always have been. So I'll get to work and I I change into my uniform. Or having a shower before I left work. So change out of your uniform, you have a shower. And mentally that was my reset. Okay. And washing the shift off, however you want to phrase that. And then get in my clothes and I go home. Right. So that kind of habit or there's certain things that you listen to in the car if you're commuting. Those ways to be purposeful in that regard. Yeah, I do think that we need to have like signals. First responders need to have a signal to their brain that, okay, we're no longer in work mode now, we're in home mode. Now I think that that's really important. Wildland firefighters have a little bit more interesting time because they are technically on call when they are off. They could be called back. They could be recalled at any point. Obviously, you can get recalled as a firefighter regularly, but there's typically a window of time and you have the choice. But wildland fighters are a little bit different in that regard because they can try to decompress, but again, there's still that one foot in work mode, one foot in home mode, so that they can get. ramp back up if they need to at any given time. The few years where I got to volunteer sort of gave me the perspective too of how when at work and the truck was checked and the gear was the way that you want your gear, everything set up, there was some peace of mind in that. But then we already talked about the volunteers where the call can come at any time. There was that stress of okay, the call and am I late to hear it? You have to drive to the station. And I even I found it stressful to just have to go in and get all your gear together or half of it on and then pile into the truck and then you're with whoever's on the truck and you're draw trying to put your stuff on. that perspective shift from full time and the habits I had to volunteer really open my eyes to the stresses that volunteers are under. Again, very similar to that wildland firefighters, you have to be ready to go. Yeah, that's it's a lot. And and again, ideally we would have this much space. We would have the day to decompress. We would have another day to ramp back up to that hypervigilance and be ready. That's lovely if you get a full what four days off. But a lot of times first responders don't get that. They get the one to two days. That's just the decompressing. So it's a lot, there's a lot of layers here. There's the decompressing and then the revamping back up. But on top of that, you have relationship stuff that's in there too. So there's, you know, you're supposed to bring up things that maybe got swept under the rug or put aside last time you were home. You're supposed to catch up with your spouse. You're supposed to be intimate with your partner if you have one. You're supposed to catch up with your friends and family and you're also supposed to do your laundry and get ready to go back. So there's so much that happens on these days off that unfortunately there doesn't seem to be a whole lot of time to just kind of decompress and do these hobbies or outside of work things as well. Yeah. And I guess we're also not talking about the fact that many people have to have two jobs. So you add that in where you're leaving your one job to go to your other job or your Second of your three jobs that it's a very real fact these days, more so than ever. Yeah. And I also think about female firefighters who are moms. I mean, that's a second job as well. I know some exactly what you're talking about, but my brain went there because I have a lot of female firefighter clients who they go to work and then they come home and then they're mama and that they're primary. So they have a second shift almost that they're going into. Where they're not fully decompressing at any point because they're going in from one level to the next. But yeah, physically some people also have two different careers or two different jobs in order to pay their bills. Yeah. Let's shift to PTSD. Everyone's heard of PTSD. There was a time where the language, people were uncomfortable with the language, so they wanted to call it post traumatic stress injury. And then luckily or fortunately, the conversation around post traumatic growth became more to the forefront, which is really important. So maybe just walk me through what you've seen over the time of your work. How are you seeing that shift and how you seeing it being approached and handled? Yeah, I mean this really goes to stigma is what it is. Right. We come from past generations where PTSD was not talked about. It was deeply shamed in the fire department, where if somebody was experiencing PTSD symptoms, anxiety, depression, any of those They would be looked at, even if it wasn't out loud spoken to. Typically it was in that generation, but it was looked at as a weakness, right? Why can't you do your job? You were trained to do your job and to see these things. Why are you having issues with it? So there was this stigma that was built over time. Now we're in a generation where therapy is a bit more popular and it's talked about and PTSD is talked about more, thank goodness, because it's very common. And I don't think that first responders back then, because they weren't talking about it because of the shame they didn't recognize how common it was. So many other of their colleagues were also struggling with PTSD or PTSI. I call it PTSD because the D is what helps insurance cover it. That's all it is. It's the same thing. You can call it whatever makes you comfortable calling it, but it's also not a stamp that we've put on someone's forehead. So if I have a client who's coming in and saying, hey Destiny, this is my first time in therapy and I'm really struggling with having empathy and I'm short patient at home and I have a hard time sleeping and I'm having dark thoughts and I just feel like I'm being a burden. Right. Typically what I do with them is we'll look at the cabinet, right? I'm not going to sit there and stamp on their head, you've got PTSD. I'm just going to say, hey, so we have this thing called a cabinet. And we usually stick stuff in there. Have you ever taken your things out of the cabinet? I know you put things in there, but do you ever take it out? Most first responders will say no because they were not taught to take things out. They were taught to shove it and keep it closed and sit on it, right? Put it away so we don't have to see it. Part of therapy for PTSD is I like the analogy of me and the client with a flashlight looking around on the shelves and going, interesting. Did you know that was in here? look at this over here. I do something called EMDR therapy, and I find it to be the most gentle approach. For doing this kind of work with PTSD in relation to the post traumatic growth, I love that because it's not a forever diagnosis. Once you are diagnosed with PTSD, it does not mean you suffer with it for the rest of your life. It's not an ailment that's gonna like slowly drain you unless you're not getting treatment for it. It absolutely has taken lives. We all know that. But if we are actively working on it and you're going to therapy and you're doing EMDR, And you're talking to someone about these things, there is growth that will happen and it becomes maintenance at that point. It's not something that's constantly popping up because in therapy, you should, if you're in good therapy, you should learn the tools to take things out of the cabinet so then it doesn't pile back up again. Cause when it piles up, that's typically when we have PTSD. Where do you see the stance on medications, psychedelics? in that regard about how people are being able to approach this uniquely for them to find their way through? My personal approach is I'm I'm more on the holistic side of things. Anytime we're looking at a medication, we are also looking at side effects. And so the question that I would ask a client is these are the side effects. Are we is it worth swapping, right? Is it worth swapping the anxiety for the side effect from an anti-anxiety medication? Because those are typically very uncomfortable as well. Right. And if we don't have to do that, and in my opinion, we don't have to, let's try some other things. So I'm holistic is a lot more my approach. There's supplementation that can be really helpful for nervous system regulation. I'm a big, big fan of cold plunge and sauna heat exposure and cold exposure is amazing for the nervous system as well. EMDR therapy, again, that's you're actively working on it. There's a lot of different tools and coping skills. I like to think of it as a toolbox that somebody would learn to have in therapy. There's a lot of things we can do before we go to medication. Medication is a band-aid over a bullet wound, in my opinion. It's not fixing the root. It's just covering it up. So if someone doesn't want to do the work and they just want to take a pill so it's dull, sure you can do that, but it doesn't make the cabinet any lighter. It's still there. You're still numbing it. And while you're numbing it, you might also be having side effects now. I will say this there are some instances where someone has done the holistic things or their symptoms are so persistent that they are to a point where they don't want to be here anymore. And that is like way up here. It's like a nine out of 10. At that point, we will, I will say, let's let's look at medication evaluation because sometimes we need something to help us and aid us through the process. So I'll have people who do EMDR with me. that we're in a very severe situation and we will go ahead and do medication management, but we will also slowly start to work on a more long-term approach. Yes. Yeah. D are you familiar with Dr. Eamon? No. Ooh, okay. Dr. Eamon, he is out of Los Angeles, California, and he scans brains. He's a I believe he's a psychologist. And he is so interesting. He has this theory that when you go to the doctors, And you say, my arm is really hurting and there's something wrong with it, they'll typically look at it. They'll maybe x-ray your arm if they can't see anything wrong, right? They'll ultrasound, do all the things. The brain is the only thing that we don't look at when it's hurting or has a symptom, and we just jump to medicate it. And it's interesting because not everybody's brain metabolizes the same medications the same way. So I might take a medication and be fine. But somebody else might take a medication and have further suicidal thoughts because of the medication as a side effect. Right. So we don't know whose brain does what because we're not looking at it. So if someone was able to actually scan their brain and then we could see, interesting, you don't have enough serotonin here. Let's try these things or let's try this to give you more serotonin, that would make sense on a medication standpoint in my head. But just to throw it out as a blanket statement, it's To me, it's it's ignoring the deeper root of why the anxiety is there or the depression or the PTSD in the first place. Psychedelics, I don't have enough experience with and I don't administer them. So I can't really speak on it personally, but I have seen a lot of research and a lot of people have said that it's something that has been really helpful for them. I also think it has to be in a controlled environment, obviously, because it's still a substance. I could go both ways with that. It's not something I have a very strong opinion on. And there's a lot of promising studies with psychedelics or addiction as well. Yes, I've seen that, which is interesting, isn't it? Mm-hmm. And aren't there structural changes that occur with trauma, post traumatic stress disorder? Maybe that for long enough you actually get structural changes. So like you're to your point of peo everyone's brain being different. So EMDR rewires the brain. That's the purpose of EMDR. It's actually physically you're Neurons are re rewiring the brain and how your brain is compartmentalizing these different scenes or trauma, or it's typically not one event. A lot of times it's complex PTSD with first responders, where it's over many years of holding space for those things, it just becomes heavy. And that I think can be very confusing for first responders because they'll come and they'll say, I can't even think of one event that upset me. I was Fine. I went to all of them and none really maybe stuck with me once or twice, but I don't understand why I would have PTSD. Well, then that's when we have to go. Well, it's because you're really, really good at compartmentalizing them in the cabinet. Then everything in there is just taking up too much space. It's not a matter of you not being able to do your job or this one thing that you went to or this one call. It's typically not that. A lot of times it's just that you don't have any more space in your cabinet. It's not anybody's fault, right? We can't choose what affects us and what doesn't. Our brain the way that our brain wires, that is typically what chooses it. It's probably very frustrating. And even if the the job was something that it was part of it, it may not be the whole story, right? Because not everyone comes into the job as a blank slate. There are things that we come into the job with. And if those haven't been processed or dealt with or investigated, then it's hard to parse out What's the job and what was before? So I guess at least if the job, if people feel the job isn't an issue for them, there's no harm in at least eliminating that as a possibility if you're gonna be pulling out dusty boxes and taking a look. And a lot of times PTSD comes from personalization. Like I said, sometimes it's complex PTSD where it's a lot of things, but a lot of times it's also, man, I went to a call with the same age as my children. Or this person resembled a family member, my wife, or my mom. The personalization is not something that anybody can help. It's part of being human, right? Our brain, we can't stop it from going, my gosh, how awful. That's their kids, they died at the same age as my kids. What would it be like if my kids died? I see this a lot with suicide calls too, or my first responders will struggle with suicidal thoughts and then they'll go to these suicide calls at work and they'll automatically personalize. It'd be like this for my family? Would it be like this for the first responders? That right there is a lot of times where PTSD comes from as well. So it's not about shutting off the emotions. It's about learning how to not well, you're saying you can't stop the depersonalization, but I guess if you're aware of the fact that the personalization is happening is all you can do for it. Yeah, we can't stop it, but we can manage it. Right. The next, I guess, follow up of that of what you can do. So let's say you're starting to have that, and every first responder's had that at some point. I don't know any first responder who's never had personalization because we're human and we come from experiences, right? So things are going to naturally remind us of things, other people or events or very no part of being human. So when that happens, like you said, number one, acknowledging it and saying, okay, this is what's happening. I'm personalizing because these children are the same age as mine. And then the second thing is to talk about it. It doesn't have to be in therapy. Therapy is not for everybody. I'm not gonna say that everyone should go to therapy because I don't think everybody needs therapy, but I would say to talk about it with somebody that's trusted. Right. And if you can't talk about it with somebody that's trusted, then a therapist is a great place to do that as well, a culturally competent therapist. And when you're talking about it, you're airing it out. Think that's a really helpful thing. The more we talk about it, the more we air it out. And then the warning signs would be if you're having trouble sleeping, if you're having trouble thinking about not thinking about it, having a lot of anxiety towards your own children, whatever the release. Another big one is avoiding the place where, let's say you work where you live, which is really difficult. Maybe you're taking a different route because you don't want to go where an accident was. Those are the beginning warning signs of PTSD. And that Would be when you would want to see a professional so that we could just do a little bit of work around it so it doesn't develop into being this like cinder block inside of your cabinet. That's a little harder after it's sat for a while. You mentioned stigma, which I think we've we've done a pretty good job, I think, over the last 10, 15 years of trying to talk that through and be make people aware that it's not helpful. But in that same vein, shame and guilt. So we started talking about addictions. We talked a bit about post-traumatic stress. Gabor Mate talks quite a bit about this, right? But you talk about the root and there's always a lot of shame and guilt attached to that. So how do we learn to face that better in order to help ourselves with these root issues? This is so silly and it's so simple, but it's really deep if we can practice this. For anybody that has children or has been around children or is an uncle or an aunt, think about how you would approach a child that came up to you and said Hey, I'm having a really hard time, maybe a small child. I'm having a hard time at school. I feel like I'm not being included or whatever their issue is, right? Would you yell at that child and say, What is wrong with you? You can't deal with that at school. Go sit down, like go get away from me. Typically, not a a nice person. A nice person wouldn't treat a child like that, especially their own child. So why is it that we talk to ourselves that way? Right. A lot of this is how we internalize. Gosh, what's wrong with me? Why would that call stick with me? I was trained to be able to compartmentalize. That is where stigma comes from is this unrealistic expectation and unkindness towards self. So I challenge a lot of my clients of the way you would talk to a child would be, hey, come over here. Let's talk about it. That's all right. That was hard. Like, let's talk about some tools for next time you feel left out. Like, What can we do to to work on this? let's just take a break and rest our brains for a little bit, right? That would be a loving parent. If we were to talk to ourselves in that way, we would have less of a stigma. And then if we were able to be brave enough to share that with other people, or instead of shaming people for their symptoms, we were able to say, Hey, you know what? That's really common. A lot of people really struggle with that man. Like if you ever want to talk, I'm here for you. That right there is what makes stigma go away. And if we could practice that over time and that spreads far, we would do a really good job with eliminating stigma. But I also know that's not realistic for every department because not everybody has people who are kind that they work with. Yeah, really the bravery we talk about when people speak about their struggles, that only exists because of the culture that they're in. Right. It wouldn't be a brave thing if it was just normal. So we focus a lot on the people and saying, my God, you're so brave and thank you for being vulnerable. Well, it's It's only vulnerable because of the culture that I'm in. And think about this too. I get a lot of work comp cases. I take work comp insurance. And the way that work comp fights my clients to prove that they have PTSD, because they could be lying, they could be doing this for money. They could be doing this to get off work. And my clients have risked their lives for twenty, ten, however many years in this career. And are go having to go to court with lawyers to prove that they have these symptoms. And I'm having to write letters to work comp to prove that they're not doing it just to get a paycheck. I mean, that is where some of the stigma comes from as well, because the system doesn't even believe you have it, right? They want to ignore it. I think it's common that we see 30 years plus of emergency service work as the success. Is there any validity to the thought that not everyone has thirty years in them to do this kind of work? Maybe it's five for some, fifteen for others. But they very much get stuck in that process. And if you're pigeonholed in your skill set and how do you change out of it, and there's there's finances that are tied to it, and maybe it's common for people to stay way longer than they mentally should have for them personally. Well, I think it goes a bit deeper than that too, for our first responders, because I have a lot of them that say, I want to be done with this work. I've decided that it's not helpful for my mental health or for my family, but I didn't go to school for anything else. And now I'm in my 30s or 40s. What am I supposed to do? Go back to school or work at McDonald's? Like what what do I what's next for me? And I see that that is a lot of times the issue is they don't have a r an exit route or an exit plan of what could be next. Now there are other options, but it takes a lot more brainstorming and figuring out, what's available in area, do you want to go back to school? And then also there's the financial piece, right? A pension that builds over time. And thinking about your family and if you have children, well, if I stick it out for this many more years, then at least my kids will get to go to college one day. I mean, do think that it's a it keeps you in this the system, but absolutely not. You don't get an a an award for finishing those years at the end if you have PTSD and you never worked on yourself. The paycheck isn't going to erase, especially after you are done with your career. That is one of the hardest transitions, is because you're a part of this culture that you're so immersed in. And that's also a a piece of the puzzle with changing careers halfway through, is you're exiting a very immersive culture into a world that is different. All you know is what you're in. It's like the goldfish in the water, right? Doesn't know it's in water, it's just in water. That's a first responder world. If you take that and you try to put it somewhere else, it's there's gonna be a really it's a difficult time. It's not impossible. But I think that's why a lot of first responders stay for the 30 plus years, also because it's this culture that's known. And even though it's oftentimes toxic, at least they know what to expect and what it looks like. But it is hard when people retire because then they're no longer in that culture. That's why a lot of people will volunteer or do the fire prevention side of things after they retire because they don't know how to stop. They feel like they need to continue. Is the identity piece really just tied to value? Like you feel it's very easy to say the title, firefighter, police, paramedic, and then your value to the community and your value to the culture and the world really, right? So how do you if you leave that now, what value do you have to anybody? What value are you without your service? Yeah. Once you become a servant to the public in that way, I believe you are always one. It's hard to turn that off, right? It's something that feels good. There is stability in also a feel-good emotion that is associated with having pride in what you do. I think there's a pride to it. There's also a dark side of that, and this kind of puts us in a different direction, but I see a lot of people who have narcissistic disorders who tend to seek out these positions because of that pride. Because they want to say, look what I do. I do this for a living. But I think the more h the holistic side of it, aside from that, is that there is it does feel good to be able to have pride in your work and to be able to serve in a way that most people will never get to. You mentioned EMDR a number of times. I hope that everyone knows what that is. But if they don't, can you just sort of walk us through it? Yeah. It's a tool in a toolbox. It's not everybody's thing, but it is a very, in my opinion, productive way to do therapy. So we could do talk therapy where we sit down and you tell me about things and I listen and I acknowledge. That's great. There's nothing wrong with that. Sometimes that's all somebody needs. I would say most first responders need something a little deeper than that. And that's where EMDR comes from. EMDR, it stands for eye movement desensitization, reprocessing. That sounds really weird. I know that. But typically The way I break it down so it makes a little bit more sense and doesn't sound super weird, your brain stores emotions, sorry, not emotions, memories. There is a trauma file, and that's where we've compartmentalized things that feel very emotionally heavy or they have negative emotions tied to them. What EMDR does is it takes that file, it opens it up, and what we do is we go back into those memories again. So a type of exposure therapy and re-rewire the brain and how it associates to that memory. So I can't wipe your memory, or I would be so rich if I could do that. my gosh, can you imagine? I cannot wipe anyone's memory. But what I can do is I can take through EMDR all of your negative associations. So the symptoms and the side effects, I can remove them from the scene that we're dealing with. And the goal is to be able to have a very neutral. association to it. So I could bring up a car accident that felt really heavy. And we work on it by going back and exposing it. And then we're desensitizing you to it the more we go over it. And then at the very end, you would have no negative feelings towards it. It would be your brain almost gathers closure towards it. So it's a really interesting process. Are you seeing upstream, are you seeing things that departments and maybe individuals are doing to maintain their their resilience and hopefully prevent or mitigate some of these issues? Yeah, some of the departments. Absolutely. I think unfortunately there's some that do it just to check the box. They have these wellness events and get these massage chairs and and I think that those are check the box situations. But I also see some very genuine departments who will have therapists on call, right? Or have them come in and do routine checkups with their personnel just to make sure everyone's good. Debriefs, I think, are getting a little bit better. Sism teams are being activated a lot more. I don't think it's completely solved or fixed, but I think it's a work in progress. And there are some departments who do a better job. Yeah, there's been some issues with the Sism model, I think, over the years. And maybe it hasn't been approached as it was sort of approached as the solution to everything, right? Right. But it's a good way to air things out in my opinion, but you're not doing the deeper work with SISM, especially because it's typically pure led, which is great, but it's not a clinician-led thing most times. It's usually pure chaplain, which is again wonderful to air it out, but you're not doing that deeper rewiring of the brain in Sism. Individually in the way that that individual needs. Yes. And also the stigma, right? Who wants to be the first one in a SISM debrief to be like, yeah, that was so hard. I had tears in my eyes. Most people don't want to be that first person unless you have a very safe and close bond with the people you work with, which is great if you do. Right. And the timing may not always be great too. It's like, well, we have to do this. This is the only time we have to do it. So we're gonna do it right now. And that may be the right time for each person that's in the group. Right. It becomes a checkbox. We have to do the SISM because we went to this call and that's what we do. And then we move forward. Yeah, so it's not so much about what each person needs, which really I mean it's not the the job isn't the only culprit and the employer isn't the only solution, right? So there has to be a self-driven ownership piece and then real support in your circle outside of work as well. I really like pictures and analogies. I find it to be helpful and with explaining different parts of therapy, but have you ever backed Like a trailer or a camper that's hitched to a truck before. Yep. Okay. It's never a good time. I don't know if you've had a good time doing it. I've never met anyone. Yes. But it's typically you need someone outside to kind of direct you because you'll have blind spots in mind. I mean, that's very normal. You don't have enough mirrors and space to see everything. You'll need someone outside to say, a little to the left, a little to the right. That's exactly what therapy is. I'm that person on the outside that's saying a little to the left, a little to the right. That doesn't mean that I know more than you do or my clients. It just means that I see things from a different perspective that you are physically unable to see because it's a blind spot. I'm a therapist. I go to therapy because I also have blind spots and that's a human thing. So that's the picture I like to use for therapy and doing the work is it's not a detriment to you. It doesn't mean you can't do it. It just means you're in. You're incapable 'cause you're human. We all have those. Is it pretty common you feel for behaviors have got us where we're at sometimes and it and it gets us good things, right? Like so we've made it a number of years and we have our pension and the kids are off to school and add them all up, it looks like it's been done really well. You've done all the things, but maybe your your way of getting there is the only way you knew and it wasn't necessarily the healthiest for you. It's almost like a a negative well it's a positive feedback loop, but you could have done it in a healthier way for you, for your own health and longevity, it could have been more enjoyable. Do you find that that's really hard for people when they're they seem to be ticking all the boxes in their life that they're supposed to do, but yet they're still struggling, but because they've the mechanisms and coping strategies that they've used are not necessarily the best, but they've got them where they're at. So why would they change? Yeah. I think that would be the question I would pose to someone that brought that into a session is it Is what you're doing working for you still? It's worked for you this long, but is it still working for you? are you feeling at peace with yourself? Are you content with where you're at? Are you able to decompress and relax without background noise and stimulation and being on your phone all the time? That's a big sign that your nervous system is dysregulated if you're unable to sit in silence, right? If you always have to have something on or talking to someone or watching or reading or scrolling. To me, that's a very dysregulated nervous system. I see that a lot with, I call them my crusty crunchy first responders. They're my favorite. They are from the generation with the stigma. And they will come to therapy and say, Man, they've been doing it there towards the end of their career, and they'll say, I'm very frustrated because I was not ever taught anything different. This is the way that I got here. And I wish that I would have done therapy 20 years ago. I wish that I would have known I have to take things out of the cabinet. I wish I knew I even had a cabinet. And a lot of some of our work is just going through this grief of that sucks that we have to do the work now. Because if you do the work and you catch it early on, it's a lot easier. I will tell you that. It's still work, but it's a lot easier because we're working on it as we go and then you're improving it as you go on in your career. Whereas some of these people who have not had those tools and just got to be by following. A plus B equals C, they were told to, they're having to backtrack with these huge cabinets and they're usually in therapy with me for a little bit longer than the person who started their career with therapy because there's a lot of stuff that got thrown in there and they didn't have the tools. So there is definitely a frustration with folks who didn't have those tools. And then tying back to the shame and the guilt, or you could feel stupid for not knowing better. But like there's a lot of that negative perspective you could put on yourself, but It's never too late. Like you're still here. You can still make the best of the years that you have and it's not a final thing. No, as long as you're breathing and you got a brain in your head, it's not too late. Maybe talk to me about some people that you know, I mean not people specifically, but are you seeing a positive shift? Are you seeing a lot more post traumatic growth? Are you seeing a lot more people taking their mental health seriously? And working on their health and maintaining their health as opposed to waiting until they're sick to deal with it. I probably have a very biased opinion of this because all I do all day long is help people grow through these symptoms. So I do see it. I have only been in this career for a handful of years. So I can't say like, I've been in this career for twenty years and it's I've seen it shift and change. In the handful of years I've been in private practice working with first responders, I have seen a lot of people from past generations who are now speaking up and are wanting to get help. And I have heard from my colleagues who have been in the field longer that there has been an uptick of people wanting to do the work for themselves. I only take a small portion of insurance, but I typically don't. I usually work with nonprofits. And the reason being is because there is still a little bit of stigma there where people are not wanting to go through their EAP systems because then there's a paper trail that they had mental health issues and that they needed to get help. So they'll come and see someone like me who works in private practice and they'll pay cash or they'll go through the nonprofit anonymously and get financial aid and they'll pay cash for them to see me so that there's no paper trail of it later on. But yeah, I do, I mean, see it all day long and I'm I feel so thankful to do the work that I do. It's so rewarding to be able to help people have this growth in their life and be able to leave old patterns and heavy cabinets. And I've seen people transform their entire lives in therapy and it's it's truly amazing. When we were talking about the positive things we can do, the skills that we can do each day, the things we hear all the time about sleep, exercise, eat properly, don't abuse alcohol or drugs, smoking, like you you can go down the hit list of the things that we know that we should or shouldn't be doing. Is there anything else else you'd add? Are there things outside of those main drivers that you've seen benefit people. I can narrow it down to just two. And it's gonna sound silly because they're so simple. One is a type of breathing. I make all of my first responders do it. Sometimes they roll their eyes at me. And it's totally fine with me. It's almost like a exhale that is like a sigh. So it's a slow inhale through your nose and an exhale where your shoulders drop. Most people do not breathe. Throughout, especially first responders, when you're hypervigilant, you're typically not breathing your full breath. And it's interesting because when we breathe like that, it actually sends signals to our brain that we are safe, that we are relaxed, and that we are not in danger. That kind of breathing can also help decompress while you're still at work. So I encourage my first responders to do those kinds of like big sigh exhales throughout the day. So that they're not waiting to decompress at the end of their shift. They're slowly decompressing throughout the day. After every single call, maybe they take a big big sigh, right? I guess, unleash some of the tightness that we carry, right? We t we tend to carry it in our neck and our shoulders. That's why we drop our shoulders when we exhale. So that's one is breathing. Sounds simple, but it it does do wonders. And then the second thing is cold exposure. I am such a spaz for it. I think it's amazing. I love what it does for first responders in their brains and their dopamine levels. If you can do cold exposure, even if it's just your face in ice water twice a week, maybe three times a week, if you can get in a cold plunge or take a cold shower, these are amazing just for resetting. And I think it's really helpful for decompression as well. So I would say both of those are really great habits that first responders could absolutely look into. having a hobby obviously outside of work is a really wonderful thing that's gonna help you with your transition outside when you do retire one day because you have other things on the other side waiting for you. Something interesting I saw recently was the benefit and you see athletes do it all the time of the jumping or the shaking of their arms and their hands. That's actually physically helping them move that energy out and f and focus that they've just naturally do that as a whether they've been taught to do it or not. You know who does it naturally? Dogs. Do you have a dog? I have had dogs, yes. Okay. So you have you ever seen a dog? I have one, she's sleeping next to me right now, get into like a little like talking altercation with another dog where they bark at each other. Immediately after that, they always shake. And it's not because they're wet and they're trying to dry their bodies, they shake off the energy. If animals do that naturally, I think as humans it's a a great thing. I actually have I typically tell my clients probably think I'm nuts. And that's totally okay with me. They usually come in very skeptical, you know, first responders, especially my crusty crunchy ones. Like, what in the world are you telling me to do, lady? I will tell them, get up and shake it off for a second. When you close this, like close your laptop, get up, shake it off, move your hands around, go walk around. Don't sit in the same spot we just did therapy in because you're gonna sulk in it, right? I want you to get up and move. It does move things around. So that goes with the breathing and kind of that like stale. air that we hold on to when we don't take a full breath allowing the everything to leave our body. It's so important. Sauna is great for that reason too. But yeah, movement is wonderful. Have you heard of trauma release or tension release exercises? I have, yes. Have you used them with clients or have clients use them and have benefit? I've found benefit from them. So that's why I'm asking. I've used them myself. I've also done EMDR therapy myself as a client. And so I've tried all the things that I make my clients do don't worry. Absolutely. Somatic work is beautiful work. I think it's necessary. And I believe that our brain and our body are connected. So if we're gonna treat one, we absolutely need to treat the body as it stores trauma as well. We've had enough data and science over years to know that our body does hold on to trauma. So we need to release it. And a lot of times that is a physical release. It's not always just a mental. Anything else you want touch on? I want to be mindful of your time. Thank you. I could go on and on. No, but if you ever, you know, want me to pop back on and talk more about relationships or deeper into I will say that there's a very big stigma around sexual addiction. And one of my specializations in my practice is sexual addiction with men. So pornography, infidelity, this is common for a reason. It's because of that dopamine that happens I've done episodes on them in the past, but if you ever want to venture in that direction, I'd be happy to hop back on with you again. I do want to say one thing I think is important for people to hear is, and we kind of mentioned it earlier, but I just want to say it even clearer for anybody listening at home that if you feel like what you're dealing with is too big or too much or too late, that is a lie. That is not true. In my line of work, I have sat with Gosh, there's not anything someone could tell me that would make me look at them any differently or any less. And when I worked in the psych ward, I sat with people who had had awful, awful crimes against children. And there is not anything that is too far gone, in my opinion, if you want to work on it and you have the ability to work on it to get to that place. So I just want everybody listening to know that that there's nothing that's too shameful or too big. Find a clinician that you can trust, right? We have confidentiality laws for a reason. I would lose my entire license that I went to school for 10 years if I peeped one word about a client. So it's very, very important to us as clinicians, not just because we respect our client, but because we've worked hard. It's very important that you don't feel isolated and alone. I think that's one of the leading causes of suicide, obviously, is people who feel trapped, that they have no options and that there's no one to talk about it with. Obviously I'm not licensed in every state or in Canada, but I am a resource and I have a lot of resources as far as licensed clinicians who are culturally competent in different states. So I just want your listeners to know that they can always reach out to me via DM or email and I'm happy to connect them with a clinician who would be a safe choice if they have things that they're struggling with. Awesome. I'm sure we're gonna touch back again. I appreciate your time. Yeah. Thank you for having me.