The Psychological Effects of Rescue
May 8th - 14th 2017 was Mental Health Awareness Week (UK) and I figured that now would be the perfect opportunity to briefly talk about the mental aspects of vehicle extrication and rescue in general. In many of my blogs I have talked about the physical burden of what we do on an almost daily basis and how this can be reduced with lighter, smaller tools combined with correct techniques. What I have never covered however is the flip side of the coin; How does what we do affect us from a psychological perspective?
Let’s remember two things; Firstly, I am not an expert in this field and this is only a blog, so we won't cover much ground here. I do however feel that any experiences I can share may assist someone somewhere and at the very least, promote some discussion on a topic that is very seldom mentioned at all.
Vulnerable, because we care
Let me say right away that I have been psychologically affected by a small number of incidents I have attended in my career and feel very comfortable saying so. I have never seen myself as a ‘tough guy’ or a ‘hero’ and firmly believe that this public perception of the emergency services may actually delay some people seeking help for fear of appearing weak. There is no shame in being affected by some of the things you see, hear, feel and subsequently think. Being an emergency responder is a privilege and being able to help people in their hour of need is more than a job, it is a vocation and I guess our desire to help means that we are also sometimes emotionally vulnerable; because we care. Ultimately though our position means that we are exposed to things that the overwhelming majority of society will never see in their lifetime. So how do we prepare and deal with it?
Impact after the incident
Twenty five years ago my training prepared me with a vast array of knowledge and complex skills but it simply didn’t give me the mental capability to readily deal with the aftermath of traumatic situations. One thing my training did do however, was to condition me to work effectively under pressure. Adrenaline is an amazing thing. It acts as a dynamic filter allowing an incident to pass quickly and also provides a shield, seemingly preventing me from seeing what was around me to a point where i could just ‘get on with the job’. However when the incident is over and the adrenaline subsides, there were times when I have struggled to deal with what I have seen. Sometimes trouble sleeping or reliving the incident and my actions during it. I suppose being critical of your own performance is a natural reaction and asking yourself if you could have done more is understandable. I have to say however, that in my experience this has rarely (if ever) been the case and rationalising the fact that despite your best efforts, the outcome was never going to be favourable, is a huge step to recovery and reconciliation. That is not to say that you can not take learning points forward from such incidents.
Talk or get support
I consider myself very lucky that in every occasion I was able to deal with my feelings by simply talking; sometimes to colleagues and sometimes to lay people who were not affiliated with my job i.e. friends. I think the fact that talking worked for me is linked to my own personality traits and for that reason I accept that this will not work for everyone; I would always urge getting support from your employer.
Awareness is vital
A quarter of a century later I am not sure any organisation has found a way to adequately preparepeople for mentally dealing with traumatic incidents and I certainly cannot offer a silver bullet. I am happy to say that today, more than ever, we are aware of post traumatic stress disorder (PTSD) and most (if not all) organisations have a mechanism for providing post incident support. I do believe that there is a place that falls between being ‘OK’ and having PTSD, that affects a lot of people (including me in the past). Awareness is vital and the ability to notice behavioural changes in yourself and colleagues is the first step to recognition and intervention; we all have a responsibility to look out for our colleagues. Talk to them, ask them if they are ok and just simply be there for them.
Single incident versus whole career
Finally, I think that it is important to look at the role you perform as a whole and not on an incident by incident basis. My career has provided me with a great deal more high points than low ones. My training, knowledge and application has assisted with more positive outcomes than negatives and I know that applies to you too. It is a sad fact of life that sometimes, despite our very best efforts the end result is not what we wanted and it is sometimes difficult to deal with. My advice is talk to someone, anyone. Don't suffer alone.
As ever, I welcome your comments!
Ian Dunbar