By Rachel Tuchman, LMHC

Dear Rachel,

My husband is a first-responder. He’s seen more than his fair share of tragedy during COVID but always seemed emotionally disconnected from the difficult scenes to which he responded. He would say that it’s just part of the job and that it doesn’t affect him. Recently, he responded to an accident and I could tell that something was different. He seems withdrawn though he insists he is OK. I saw pictures and videos from the accident and I can’t imagine what he’s going through. He puts on a brave face and repeats his old line about trauma being part of the job and it’s no big deal. It’s clear he’s hurting, even though he denies it. I’m a very spiritual person and know that everything that happens is G-d’s will. When I mentioned this to him, he shut down and quickly ended the conversation. I want to support my husband but I’m not sure what to do.

Feeling Lost

Dear Feeling Lost,

Thank you to your husband and to you (because it is a sacrifice for you as well) for doing this important work for our community. First-responders and their families are true heroes. We have all heard countless stories of the positive impact first-responders have made in intensely scary and precarious situations. Being a first-responder (medical, mental health, law enforcement, firefighter) can be both rewarding and challenging. It is estimated that about 30 percent of first-responders develop behavioral health conditions including, but not limited to, anxiety, depression, and post-traumatic stress disorder (PTSD). I have a feeling that this statistic is actually much higher, but due to underreporting of symptoms we don’t have the full picture.

Secondary trauma or “compassion fatigue” from repeated exposure to trauma can cause symptoms such as sleep disorders, avoidance behaviors, and feelings of helplessness that are often associated with PTSD. The research on trauma tells us that repeated exposure to distressing situations without proper support and intervention can impact the brain long-term, not only in children but in the fully formed brains of adults as well. Trauma can literally make someone a different person.

Neuroimaging has shown some hippocampal volume reduction (changes in the hippocampus), which would explain behaviors we see after distress or trauma, like being withdrawn, impulse-control issues, memory and concentration problems, and mood irregularities. 

First-responders are consistently exposed to death, injury, and high levels of stress all while also trying to manage their lives outside of this work. Challenging work schedules, extreme family–work demands, and stress caused by relationship demands can have a greater negative impact on the mental health of this worker group. 

Add to this that because of stigma men are less likely to seek mental-health support and are more likely to self-medicate through alcohol, drugs, or other self-harm or numbing behaviors. Men are often discouraged from emotional expression due to traditional gender roles, cultural norms, and/or learned behavior. Mental-health struggles are often missed in men because they are more likely to attribute emotional struggles to stress rather than sadness or feeling hopelessness. As a community and a society, we need to prioritize men’s mental health and encourage them to speak up rather than “man up.” Certainly, organizations and first-responder teams should be ensuring that their employees and volunteers are getting the mental-health support they need. Stigma is one of the main reasons first-responders don’t seek help, and this needs to be recognized and addressed from the top.

If you aren’t sure about the prevention and response measures of your husband’s team, ask him about it.

You mentioned seeing photos and videos from the accident that he responded to. I know that in times of tragedy it is common for people to feel very curious about the details of that specific incident. It’s common that people want to stop and look or see images of the scene of an accident. One of the reasons we are attracted to morbid things (aka, morbid curiosity) is that on some level, we have a desire to vicariously experience someone else’s suffering. Empathizing (while being physically safe from the situation) leads us to explore scenarios in which we could assess the dangers that threaten our survival. This leads to the sharing of feelings that we imagine the person we are looking at is experiencing, all while we are still “safe.” 

Other times, we can’t look away because we would rather deal with the unpleasant feelings of seeing the disaster rather than sit with the uncertainty of not knowing what happened. Other times we engage in a comparison game where we feel relieved that this bad thing didn’t happen to us. We feel glad that we are less harmed. While this may sound callous or cruel, it is actually a normal human reaction. Facing the mortality of others makes us feel (though only temporarily most times) more aware of our own fragility. 

All that being said, this is a good time to remind people that sharing these images is not without consequence. Care, sensitivity, and dignity for victims of these tragedies, their families, and those who have experienced similar trauma should be the top priority. Sometimes morbid curiosity can cloud judgment, resulting in impulsively sharing news and images that could be extremely exploitative and harmful to victims, their families, and many others. Let this serve as a PSA to think twice before forwarding a video from a crash scene, sharing that 911 call, or sharing news of a death without knowing whether or not it is confirmed or if the family has been informed.

If it were you, would you want images of you in an injured or vulnerable state floating around every WhatsApp chat? Please give the same consideration to others. 

I applaud your desire to be supportive of your husband; this is what loving partners do. Having solid support can help mitigate some of the harm of the difficult things your husband and you are dealing with. When you tell your husband that everything that happens is G-d’s will (which, as faith-oriented Jews, we are encouraged to believe) but he shuts down, it might mean that while that outlook is helpful for you it might not be the case for him. It’s really hard to see our loved ones in pain, but I encourage you to resist the urge to “fix” his feelings with positive thinking, mantras, or platitudes. In moments of distress and sadness it can feel really dismissive and invalidating to be told, “It’s all for the best,” “Everything happens for a reason,” or “G-d only gives you what you can handle.” Research has shown that accepting negative emotions helps us better defuse them and leads to fewer negative emotions over time, leading to better overall mental health. Chasing “good vibes only” can cause us to obsess over any unhappy feelings, bringing us more unhappiness overall. When we pressure ourselves to be happy, find meaning, or erase discomfort, we may start to see negative feelings or situations as personal failures. Feeling bad when bad things happen is part of the human experience. Welcome it. Happiness isn’t always the answer and it isn’t always a healthy response. We need to feel in order to heal. 

Some ways to support loved ones going through challenges:

Ask what they need. They may not find comfort in the same things you do. Don’t assume what would be helpful. “How can I best support you?” is a great question to start. 

Validate whatever they are feeling by allowing them to have those feelings. Often we try to make messy feelings go away and clean up grief, but sometimes it just needs to be there and it won’t disappear no matter what we do. 

Be specific with how you want to be there. Listening is a meaningful way to be supportive. Tell your partner or friends that you want to listen. Let them know that you would never judge and that their feelings are safe with you.

Presence alone can be so powerful. Physical presence, even if you are silent, can be extremely comforting. Let your loved ones know you will stay beside them and they can decide whether they want to talk or not. You can even offer to reach out to someone for them to talk to and take them to the appointment.

Remember that everyone processes differently. Give people time to feel their feelings. Don’t rush them to feel good. Optimism and hope are amazing, but there is a time and place for them. Read the room, think about what would be appropriate in that moment, and if you aren’t sure, silence is always great.

If you are struggling, please reach out to someone and ask for help. If you have access to therapy, make an appointment. Speak to a loved one. Realizing you need help takes great self-awareness and strength. Do not go through hard things alone.

Wishing you and your family healing and strength as you navigate this challenging time. 

For more on the topic of healthy support and healing in times of adversity, Elisheva Liss, LMFT, Rachel Hercman, LCSW, and I just recorded a discussion called “Toxic Positivity” for Amudim’s Unite to Heal campaign. You can find it at UniteToHeal.com.

Rachel Tuchman, LMHC, is a licensed therapist in private practice. She not only treats a variety of mental-health concerns but also shares psychoeducation via her social media platform, public speaking, and online courses. You can learn more about Rachel’s work at RachelTuchman.com and follow her on Instagram @rachel_tuchman_lmhc.

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