Volunteer View: Taking Trauma Home: Resiliency as a Core Skill

During my first year as a volunteer firefighter with a mostly rural department in southern Ontario, Canada, our station was called to the scene of a plane crash. When we jumped the curb into the field that a single pilot had nosed into, I took a deep breath before being handed a pry bar and a medical trauma bag. I remember having a difficult time getting gloves on. I remember making contact with the patient.

There simultaneously were flashes of action and periods of calm to the scene.

When we returned to the station, the county Critical Incident Stress Management team had been activated, and our district chief helped to guide us through a formal debriefing. Thirty minutes after that, I was reading a Harry Potter book to my eight-year-old son.

Mental conditioning: an afterthought

The transition from parent to firefighter and back again is something learned from experience. Furthermore, we can stage correctly for those lessons by applying new information to the way that we prepare to respond. After all, it isn’t only the “bad” calls that can harbor a negative effect. For the vast majority of volunteers, debriefing isn’t conducted for the “average” tone. Here, our training toward being personally resilient can help to fortify us against the years of stress to which our beloved service can expose us.

Traumatic experiences aren’t filtered for full-timers only. From all-volunteer departments, the pull for equipment, training and personnel makes budgetary decisions toward resiliency training a tough sell. At least informally, when proper training isn’t provided for responses to trauma, volunteers are asked to step in front of their community’s crises with the hope that they’ll harden by virtue of time that’s spent in the field.

Hope, however, isn’t a good plan. New recruits ought to be developed with a sense of urgency where resilience is concerned. Whereas fireground skills, such as hose advancement and ladder deployment, are scrutinized carefully, with iterative checklists and the watchful eye of the cadre, mental conditioning can be an afterthought or neglected completely. Actionable ideas can be harnessed to change the latter, and, unlike the common response to changing the way that we do things, everybody who is involved will see immediate benefit.

The physiological sigh

A regular response that I receive when I start the conversation about training for mental well-being is members folding their lips into a straight-lined crease of disapproval. This reaction is rooted in insecurity. It can be uncomfortable for members to face the idea that we retain some of those emotionally taxing experiences that we encountered on the fireground.

When members are faced with the hard facts of trauma-informed training, the truth is, we all check some of the boxes. That’s not a major problem, though. It’s an opportunity. When running the newest recruits through their standard evolutions, there are places to break apart some of the fireground skills to explore how focusing on resiliency can play a role when they make it out to real calls.

Before my department’s recruits get through the door to our shipping-container training tower to conduct a search, we talk about using box breathing to steady their focus toward the job at hand. In the same conversation, we bring another breathing technique to the toolbox, too: Teaching about the “physiological sigh” is a highly transferable skill toward conditioning them toward being exposed to traumatic scenes.

The physiological sigh is a breathing technique that you can use to emulate the way that people breathe when they cry or fall asleep. It helps a person to actually transition into a calmer state of mind. Data suggest that this method can help to reduce a stress response before, during and after exposure to a traumatic scene. Recruits should take in two full inhales through their nose, completely expanding their lungs, before exhaling fully with their mouth. Doing so for two or three repetitions, any firefighter would be better prepared to respond.

When the volunteer finally pulls into the driveway at home, the physiological sigh can serve as a boundary between the call and the couch. Particularly in circumstances in which debriefings are few and far between, this technique is helpful to decompress from the inherent stress of an emergency. If this is brought to recruits as a strategy for career longevity, as a method to reinforce and build their mindset, the buy-in is built in.

Three more tools

Tactical breathing techniques are one of the tools of a four-pronged approach to building mental resilience. These tools were developed in the military but have been adopted widely in first-responder circles. Mental rehearsal, goal-setting and positive self-talk are the other three tools. Adaptations of these tools are publicized widely, they are free, and they are easily assignable to station-level practice nights as a means to readily incorporate resiliency training into regular training.

The process of mental rehearsal includes visualizing what might take place on a call. For my department’s recruits, we urge them to imagine what tools that they’ll hold and the sights that they’ll see on the call. For some, this also might include thinking about what their response might look like, so they can plan in comfort and safety.

Goal-setting can be as simple as finishing a tough evolution. A more formal sit-down to consider is the well-studied SMART (Specific, Measurable, Attainable, Relevant and Timely) system, which can be used to help members to execute on objectives.

Positive self-talk is a force multiplier in high-stress situations. From a study of U.S. Navy Seals wading through their Hell Week recruitment process, those candidates who took on a stress-is-good-for-me mindset had better times in obstacle courses, more positive reviews from peers and instructors and, overall, more perseverance through difficult tasks than those who didn’t adopt that mindset. Offering our fellow firefighters a simple form of repeatable training in encouraging them to say words—in their head or out loud—that reinforce their actions in periods of high stress is a functional improvement on hoping we’ll just pull through when the going gets tough.

A reflection of strength

Resilience training is a core skill in the fire service. Unfortunately, too often, resiliency training is offered with a backdrop of sympathy toward firefighters, a focus on our members being victims of their experience. Instead, we should bring mindset development to departments as the bedrock of clear-headed operations in the field. It should be a reflection of our strength and capacity; it shouldn’t be some byproduct of fragility.

Our fire family is well-trained to help to win the day for our community, but the people who are in bunker gear need more than clean equipment and a few repetitions on the training grounds. The heritage of our service’s sacrifice puts forward the simplest argument of all: Our people deserve the best information that’s available for getting the job done correctly. In today’s fire service, that means making our mind as forged as are the irons that we pull off of the truck.