Crises do not give a warning- and are treated right away with where there are firefighters, paramedics, police officers, and EMTs designed to handle that problem. These people see humanity at its worst, and it can be traumatizing. That is why it is important to address the psychological and emotional impact that comes with it with help like PTSD Treatment for First Responders to help those traumatized and fight the risk of suffering from addiction.
It is draining to deal with the physical exhaustion and long shifts. But the emotional cost and trauma of seeing and having to deal with the aftermath of death, injury, and chaos is a pain that is not easy to bear alone. Suffering in silence and having trauma in the background is debilitating and can lead to the desire to cope in self-destructive ways, such as abusing alcohol and using prescription and illegal drugs.
Trauma Within the First Responder Community
For first responders, trauma does not have to be the result of a single altercation. Instead, it is more frequently the result of a cumulative set of encounters. The trauma stacks as each call is taken, each scene visited, and each memory collected. The sharp and devastating encounters that leave a lasting impression, like the scene of a car accident with a child, a domestic violence scenario, or a failed resuscitation and burial with the memory, are emotionally sealing the landmines that will explode later, with devastating effects.
The trauma is unique to each responder and scene, but the symptoms will range from silence and suffering until the trauma adds up to full-blown PTSD. The first responder culture of stoicism and resilience almost always shames the person into suffering alone, with silence and suffering.
Disguised self-soothing followed by the hope that the next call, encounter, or shift will finally erase the emotional pain is a common way to cope in silence. The shame of weakness that is almost always associated with asking for help, and the institutional barriers that many face while trying to access mental health.
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Understanding the Link Between PTSD and Substance Use
The link between trauma and substance abuse can be hard to identify. At first, it can look like someone needs to blow off steam after a tough shift. Grabbing a few drinks after work or taking a few sleep aids to fall asleep seems harmless. But as the trauma symptoms start to worsen, people start to reach for these substances more often, and it becomes a necessity.
Using substances to suppress trauma is a growing trend. People use alcohol, benzodiazepines, opioids, and marijuana to numb the feelings of anxiety, sadness, or other intrusive memories. It can start with just a temporary escape and spiral into a full-blown addiction.
The link between PTSD and addiction is strong, and the research is clear. The link for first responders is even clearer. They are exposed to high-stress situations and are conditioned to suppress emotions. These conditions can create a dangerous cycle, where they can become one’s own and make the situation even more complicated to recover from.
The Importance of Integrated Treatment for PTSD and Addiction
It is not enough to just treat the trauma or the addiction. The two are deeply intertwined, and this is especially true for first responders. If one is not treated while the other is, it can cause a rapid relapse, worsen the other symptoms and cause a more severe emotional instability.
Not incorporating substance abuse within the context of PTSD treatment misses the individual’s primary mechanism of coping. Conversely, dealing with the primary trauma without addressing the substance abuse means the individual remains exposed to triggers, emotional instability, and possible dysregulation.
For this reason, optimizing the treatment of PTSD among first responders must utilize the dual-diagnosis treatment approach. This acknowledges the complexity of integrated co-occurring disorders and helps the individual transition into integrated living. This way, first responders suffering emotional trauma will learn to stay within the bounds of negative self-constructive behaviors.
The Role of Therapy in Trauma and Addiction Recovery
For first responders dealing with PTSD and substance abuse, trauma is immense, and therapy is essential in addressing these complex, intertwined issues. Therapy enables the individual to not only process traumatic experiences but also identify and challenge the beliefs and behaviors that contribute to their self-destructive patterns.
The first responders facing trauma and abuse issues will benefit from more evidence-based approaches, including Cognitive-Behavioral Therapy (CBT) and Eye Movement Desensitization and Reprocessing (EMDR) therapy. The first is based on the premise of changing negative thinking, while the latter targets trauma and assists the individual in their trauma reprocessing. Both approaches will work and maximize the benefit to the first responders, trauma, and abuse issues integrated approach if the therapist understands the primary stressors affecting the individual.
Alongside individual therapy, group therapy can also be powerful. Being with people who have had similar experiences can lessen shame, create bonds, and promote safety and truth. Many first responders feel talking with those who “get it” helps to relieve the isolation trauma and addiction create.
Addressing Shame and Guilt in Recovery
Shame is a hidden driver to both addiction and PTSD. For first responders, it is also the imposed expectation that they should always be strong, in control, and capable. During rescue, admitting to strong negative emotions may feel the same as admitting to a failure.
Shame, however, can be avoided. Through the act of naming and confronting it, people can start to disentangle trauma from their identity. Various forms of therapy can help to define these internal narratives better and provide a framework of self-compassion vs. self-judgment.
Healing requires grieving, accepting, and forgiving in order to move forward with service work. Without these emotional components, deep healing is not possible.
Safe Spaces for Recovering
First responders work best under pressure. First responders can become rejuvenated while still in treatment. It is most effective when the first responders have safe places that are calming, supportive, and emotionally safe.
Emotional safety is attained through trust, empathy, and respect. Knowing they are not going to be judged and that they can speak freely provides for safe places. First responders can disarm and stop the stressful situations that they have to deal with.
First responders in residential treatment may have trauma-informed treatment, mindfulness, care, and stress reduction, as well as peer support. All of these elements work together to increase individual self-esteem.
Peer Support
Isolation can be painful and suffer in pain. Relationships are the most effective way to cope with ease. First responders are reluctant to talk with therapists.
First responders in peer-led programs and support groups permit safe and open discussions with others of their kind. There is support and respect, which is often not available in clinical settings.
When someone says, “I’ve been there,” it can change how we view our challenges. It reminds those suffering that they’re not broken—they’re human. And that can, most importantly, restore hope.
The Importance of Culturally Competent Care
To treat first responders, we need to understand care culture. Without that, therapy can feel disconnected or impersonal. When it comes to treating PTSD in first responders, we need clinicians trained in trauma and addiction also to understand the everyday challenges of public safety professionals.
This might mean clinicians understand the challenges and trauma of shift work, the exposure to violence, survivor’s guilt, bureaucratic stress, and the pressure of life-or-death situations. Culturally competent care validates the individual’s experience and helps them feel that treatment is less of a diagnosis and more of a lifeline.
Long-Term Healing: Beyond the Crisis
Treatment doesn’t spell the end of the recovery process. To promote first responders’ long-term healing, they are going to need supportive structures to build upon. Aftercare planning helps clients avoid relapse and stay connected to therapists, support groups, and holistic healing resources.
Outpatient therapy, trauma-informed yoga, sober living communities, and peer mentorship programs offer continuing support. These people want to thrive, not just survive.
For those living with trauma and addiction, recovery is the start of rebuilding a connection with a sense of meaning and purpose. With the correct support, first responders can return to their jobs and their identities.
Final Thoughts
First responders carry trauma and addiction. Each day, these professionals encounter the unthinkable, and so much goes unprocessed. While it may be a workplace norm to “tough it out,” unaddressed PTSD can evolve into addiction, a deep emotional spiral, and loss of self.
The choice of active PTSD treatment for first responders is a way to reclaim a life and more. It is a path to restoring loss. Healing is possible and it is attainable, albeit difficult.
At First Responders of California, we recognize the importance of this work. It is a privilege to provide the recovery support these heroes deserve. We meet them on their path and help them become whole again.
