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There is a common understanding among the firefighter and EMT community that there are lives that can’t be saved or rescued. It’s a fact of life, and death. Usually those lives are lost due to circumstances beyond our perceived control, and most of us have come to grips with this certainty so we can focus on the next savable life. Understanding doesn’t make it easier, but it helps us live with the fact that as humans there’s only so much we can do to control the inevitable.

However, regardless of our experience, knowledge and training, we struggle to rationalize a loss of a brother or sister to suicide. We simply can’t wrap our mind around a concept where the injuries or rescue avenues are not visible - and we torment over the reality of not saving a life taken too soon. I have experienced this myself, and have seen this internal conflict in my friends all too often.

I have, in some ways, made peace with the knowledge that some friends who committed suicide were determined to do so, and no intervention nor conversation could have stopped it. I wish I could have tried, but deep down I know I would have failed. Unfortunately, the one thing that nags at my conscience more than missing their presence in my life, is that they were convinced that my life would be better without them. That by leaving us behind, our lives would be more rewarding. This eats at me - this angers me!

We all deal with personal demons - some annoying, some antagonizing, some insidious - but they are ours to resolve. So I can’t begin to point a sanctimonious finger and say “get help.” But I will say this, your life matters more than you know, and our lives are NOT better without you in it. Your life matters - you matter!

I could ramble on, but it would be ignorant gibberish about a subject that I am just now beginning to comprehend. So, as you know I like to do, I’ve asked someone with a deeper understanding and education to help disentangle what many of us are struggling to grasp.

You have been introduced to Sarah Gura before when we collaborated on a post about firefighter intervention and self-help (Sharks), but I thought it important to have her voice added to this illustration and topic as well. Sarah and I have been friends for years, and she was instrumental in helping me through the turbulence of losing my friend EJ Mascaro (more on this next month). Sarah is a master’s level, licensed clinical professional counselor in Illinois.  She specializes in treating firefighters and law enforcement. She also provides counseling and education services for first responders.

So without any further rambling from me, Sarah, you have the floor!

By Sarah A. Gura, M.A., L.C.P.C.

The undeniable facts are in; firefighters are more likely to die by suicide than a LODD.  Firefighters and their families continue to step forward reporting they had a friend die by their own hands.  We are left with the aftermath, and wondering what we could have done differently.

There is an unspoken set of rules in the first responders’ world: 1) Don’t cry about it, 2) Don’t talk about it, and 3) Don’t ask for help –or, something must be wrong with you.  Basically, firefighters fear that if they are human they will be viewed as not fit to do the job.  So many zip up their thoughts, feelings, and needs before they provide their talents and skills to the public. 

Externally everyone is looking tough, but it is a disguise.  Internally, firefighters respond to calls with empathy, compassion, and concern the same as anyone should.  When there is no peer support there is no listening, validating, and relating.  Compassion turns to burn out, and the powerful memories and feelings get stacked in the memory bank.  At first, it may be easy to brush off bad calls and the everyday politics in the fire service.  For many, one incident sticks and then it is difficult to “just get over” anything.

Firefighters are left alone with their self-critical thoughts, and they become their worst judge.  The inner critic often feels hopeless, angry, and/or like a burden.  They think they are doing everyone a solid by keeping their mouths shut; and they suffer in silence because of it.  Horribly, they may turn the blame on their self and wonder what is wrong or ask, “Why can’t I move on?”  They may present as moody, irritable, short-tempered, tired, sarcastic, and/or weathered.  One day they may say to themselves quietly, “This isn’t who I thought I’d become.”

First responder careers are supposed to be awesome. That’s why everyone applies and goes through the brutal application and testing processes, right?  It was all worth it at some point, one way or another.  However, whether your pain is personal or professional –the fire service has a history of never-minding its greatest asset: the firefighter.  Old schoolers and their supporters lead the ostracizing behaviors and get others thinking: Am I enough?  The jokesters hide behind the comedy, but I am certain they are just as human as everyone else.  We do not educate firefighters on psychology as it is relevant to their careers, let alone prepare a new first responder family for the truth of this profession’s job description, quite literally: human illness, human suffering, human death, human stupidity, and property destruction
Intimately knowing the dark side of humanity without training is insane.  As a mental health therapist, we train to cope with constant negatively-charged disclosures.  Sadly, most firefighters are operating with coping mechanisms that can lead to addictions, self-sabotage, and/or self-harm.   Coping skills are the positive alternative to coping mechanisms.  With a first responder career, this means providing down-to-earth relatable information.  We cannot keep googling “coping mechanisms” just to find: breathe, count to 10, or imagine unicorns.  The fire service needs real information that helps them transition and adjust to a philosophy of pro-psych-education, peer support, and personal growth.  Firefighters need to know how to use their pain as fuel for discovering the truth of who they are: Healers & Rescuers.

Healers & Rescuers often attract and are surrounded in life-threatening situations (mentally, physically, and spiritually).  If you do not know how to cope with this, the pain becomes self-destructive.  There is another way: learning to cope so that you can become powerful in your potential as a firefighter.  This is what everyone is hoping for and it is possible.  However, it becomes impossible if you are disconnected from yourself.  This disconnect appears to be the “right way” to many firefighters.  What sense does that make though?  If you disconnect from yourself to help others, you will always be one straw away from breaking the camel’s back.  Your life bucket will be overflowing, and when the crap hits the fan you’ll feel too exhausted to clean it up.

If you are already there, please ask for help.  Your silence can become so isolating if you don’t.  Do not become the firefighter who starts to find relief in the thought of suicide.  We are not better without you. To think that is a cognitive distortion, or thinking error.  It is driven by your ego and it gets rationalized in the loneliness.  Your higher mind knows better.  Stop thinking your thoughts for one moment, and try observing your thoughts.  That observer or watcher of your thoughts is you –it is called your Self.  Your Self is the most knowledgeable and nurturing part of who you are.  Your Self loves you so much.  That sounds cheesy until you experience it –then, you would never want to live without it.  Self-compassion is the driving force behind being aware, authentic, and assertive.  In this state of being you can approach happiness and be at peace no matter what is happening to you or around you.  If you want to do life so it doesn’t do you, you need to accept and embrace self-love and appreciation.

I know that firefighters are expected to be 9-1-1, and we forget to be their 9-1-2.  If you are reading this, and you need help, check out “Psychology Today” on the internet.  Click on “Find a Therapist.”  Type in your zip code.  On the next screen on the righthand side, filter your search: insurance/payment accepted, male/female therapist, and specialty area.  A list of therapist profiles near you will pop-up.  You will be able to see their picture, descriptions, and links to their webpages/contact information. 

If you are reading this and you want to know what you can do to make it safe for firefighters to ask for help, see my suggestions for your department below.

Make it Safe by encouraging:
(1) every firefighter to self-monitor, and to take personal responsibility for his or her mental wellness.  
(2) every firefighter to seek psychological support when confronting potentially overwhelming difficulties. 
(3) every firefighter to be a peer supporter by reaching out to other firefighters known to be facing difficult circumstances. 
(4) every firefighter to avoid the use of pejorative terms to describe firefighters seeking or engaging psychological support services.
(5) every ranking firefighter to use their status to help provide others with psycho-education opportunities about firefighter behavioral health issues, and to help provide appropriate firefighter behavioral health policies.
(6) fire service leaders and administrators to better educate themselves about the nature of firefighter behavioral health issues, and to take the lead in responding more appropriately, effectively, and competently to those firefighters in need.  
(7) fire service leaders and administrators to initiate incident-specific protocols to support firefighters and their families when firefighters are involved in potentially traumatic events. 
(8) basic training in psychology topics as it is relevant to the firefighter career, including: potentially traumatic events, vicarious traumas, compassion fatigue, burn out, stress management, depression, anxiety, post-traumatic stress disorder, drug/alcohol abuse, and responding to high risk ideations (i.e. suicide/homicide). 
(9) the development of programs that engage pre-emptive, early-warning, and periodic department-wide firefighter support interventions (i.e., proactive annual check in, renewal/updating of firefighter behavioral health policy, firefighter behavioral health wellness events, prevention programing/education, and significant other/spouse support programs). 
(10) every fire service entity to engage an appropriately structured, properly trained, and clinically supervised peer support team.  
(11) every fire service entity to provide easy and confidential access to counseling and specialized firefighter psychological support services. 
(12) every firefighter, at all levels of the organization, to enhance the fire service climate so that others are encouraged to ask for help (and not hide/isolate) when experiencing psychological difficulties.
(13) the fire service to embrace Life Safety Initiative #13 of the 16 Life Safety Initiatives: Firefighters and their family members must have access to counseling and psychological support services by doing more than just offering an EAP Service.

Respectfully Submitted,
Sarah A. Gura, M.A., L.C.P.C.

"Firefighter Behavioral Health Alliance (FBHA), since its inception in 2011, has been presenting workshops on suicide awareness and prevention across N. America. We believe the fire service is aware of the problem yet so many departments are searching for the next step. FBHA believes creating a successful behavioral health program is the next giant step for the fire service. FBHA will be concentrating our focus in this area for 2018 as we begin consulting with departments on how to create these programs.  There are twelve points departments need to focus on, which include but not limited to are behavioral health, resources, families, retirement, PTSD and so much more." Jeff Dill

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