Cumulative Trauma: The Unseen Weight

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What is Cumulative Trauma

Our worst moments and greatest emergencies in life are another day on the job for first responders. If those events are traumatic for the person it’s happening to, how then must they affect the first responders responding to the emergency. The number of personal traumas across the population are small. A single person may experience one to a few traumatic events in their lives. A first responder responds to many in a given day on the job. They respond to fires, car accidents, gun fights, and other emergencies. It’s their job to respond to your emergency.

The truth is, it’s not nothing just because it’s ‘someone else’s emergency.’ Those traumatic events bear a weight and, though most responders shove that small weight aside or push the experiences down, it builds and builds over time. It’s hard to forget a face, dead or alive, in the moment of trauma. It’s hard to forget the fear when your life, or your partner’s, is in mortal danger. This is cumulative trauma and many first responders carry it, many unknowingly.

Cumulative trauma during the course of one’s work refers to the psychological, emotional and physical distress associated with repeated exposure to potentially traumatic events, either directly or indirectly. While frontline emergency services personnel such as police, fire services and paramedics are known to experience direct and repeated exposure to trauma in their working day, other occupational groups also experience distress related to repeated exposure to traumatic incidents or the traumatic experiences of others. For example, nurses are frequently exposed to trauma in the course of their work, both directly (e.g. violent or aggressive patients) and indirectly (e.g. suffering of others).

Bywood & McMillan, Institution for Safety, Compensation and Recovery Research, Cumulative Exposure to Trauma at Work: Phase II, 2019, pg. 7

How Does Cumulative Trauma Affect First Responders?

A study published in October of 2020 by BMC Public Health illustrates that increasing trauma load, even if the trauma did not directly affect a person, leads to a lower life-satisfaction level and difficulty functioning. So if you see more trauma, even if it’s not your emergency, that trauma builds up and stays with you, bringing its effects with it. Over time, as more traumatic events pile up in your experience bank, the weight of it all increases. Soon, the effects can no longer be pushed down and things will start to overflow.

Another study published in 2014 by the National Library of Medicine concurs that “the cumulative impact of exposure to traumatic events throughout the life course contributes significantly to post-traumatic stress in older adulthood above and beyond other known predictors of PTSD.” Many things cause PTSD, but sometimes it’s difficult to find the cause. If the trauma is cumulative, it’s going to be more difficult to pinpoint as the individual has not one major event but many events culminating. There’s only so much the human psyche can handle.

What can be done to Help?

First, we must acknowledge that it’s okay to not be okay. It’s okay to admit that something has stuck with you. It’s okay to feel uncomfortable going to similar emergencies as those which were worse for you. So, first responders must acknowledge that this is an issue that needs addressing. Departments as a whole must do this because bringing this into normalcy starts with it becoming part of workplace policy. Yearly OSHA and HIPAA requirements exist everywhere. Health insurance is required to be offered. Why shouldn’t we have standard mental health resources?

Second, we need regular check-ins. Check on your coworkers, check on your friends, and check on your family members. We get annual physicals; why not get annual mental health checks? This way, we can see if a change is happening. We need to pay attention to each other so we can see if a deeper hurt is rising.

Third, we need to normalize help, normalize therapy and coaching. We need to normalize whatever needs to be done for a person to be fully whole inside and out, physically and mentally. Resources need to be present at departments and workplaces. Even medical doctors should have access to more mental health resources aside from just a few psychology or psychiatry locations. This needs to expand and it needs to happen yesterday.

One Experience

Chad Lizardo shares with FRC (from post comments on April 3,2022). “I will speak from a police stand-point, from which I myself did not even realize the traumas, until I began getting asked specific questions about my entire career. We store trauma. For me, I had stored trauma all the way back to the beginning of my career. One of the main traumas I had stored was as a detective where I had handled a two year old little girl’s homicide, who was drowned in a pool, and I myself had a two year old, and a pool. While my shooting was 6 years later, where I took a life that set off PTSD, I was dealing with cumulative trauma from my entire career. The rationalization is because we cannot put a finger on one event that caused the emotions. It’s not until specific questions are asked that the trauma makes sense.” Chad’s experience is just one example of many in the first responder world.

Are You at Risk?

At First Responder Coaching, we look out for one another and for all first responders. Coaching can help first responders see their baseline and when they get off course. Coaches and coaching partners navigate the first responder road, experiencing the weight of trauma, seeing the twists and turns in one’s life, and finding the right path to better living together. Coaches help coaching partners recognize when more, possibly clinical, help is needed. They hold them accountable for seeking and obtaining that help to help lead the first responder to a more whole and healthy life.

Are you a first responder or family member? Are you checking on yourself and those you love? It’s not nothing. It’s the trauma that hides in small pockets because it’s not just one event. It accumulates and builds and will drown a person if unchecked. We need to keep checking on each other. We need to watch for burnout and PTSD symptoms. Departments need to be aware and have resources ready. Society needs first responders to be whole and healthy. You deserve that.