International Critical Incident Stress Foundation, Inc.
International Critical Incident Stress Foundation, Inc.
By: Doug Kinnard
Walking into the station I get the feeling immediately that this is a very professionally run volunteer department. Being a 27-year career firefighter, I am always amazed and humbled by the dedication of the many volunteer departments I have been called on to assist. This night feels somewhat heavier than other nights when I’ve been asked to facilitate a debriefing. All I really know at this point is that a teenager has died in a car accident; deaths of young people are always more difficult. As I enter the debrief room, there are already several people present, varying in age, and likely, varying experience levels.
As we begin the debrief, my attention is immediately drawn to a young lady whose body language and facial expression indicate she is in immense pain. When the group begins to share, she is one of the first to open up, and she almost immediately begins crying. While she shares her experiences on scene, what catches my attention most is her description of her daily life. She shares about working at a local restaurant, where customers are more like acquaintances. Over the days following the incident, several of her regular customers have asked her where her usual smile and laughter have gone. She states that she is having some hard times but does not disclose further. In this group setting, she is different, though. She shares openly, with great detail and vulnerability.
After the debrief has ended another member of the group asks to speak with me, so we spend several minutes talking outside the debrief room. When I come down to the kitchen everyone has gathered to enjoy some pizza and snacks while continuing the informal part of the debrief. Once again, I notice the young firefighter who had shared about her struggles. Rather than her vulnerability or pain, what catches my eye this time is her infectious smile and laughter. She is fully engaged in the light chatter of the group. I walk over to her and quietly say, “Don’t tell anyone but I just saw you smiling.” The look on her face told me she understood that she had turned a corner in the way she was feeling, her smile was coming back.
Being in the fire service for over 27 years now I have experienced many changes. Trucks are adorned with more “bells and whistles” than ever. SCBA (Self Contained Breathing Apparatus) are so sophisticated that this old man sometimes struggles to keep up with just how to turn one on. We use TIC’s and peruse Tik Tok. (If you are not familiar with a Tik Tok, ask the rookies in the fire hall.) However, with all the changes, there has been one constant. We are still humans, doing one of the most demanding jobs in the world, a job that exposes us to some of the most horrific scenarios imaginable.
One of the most positive changes I’ve witnessed in the fire service and greater first responder world is the realization that we cannot continue to do our jobs and ignore the impact they have on our mental health. I am so thankful for the increased awareness and research into how important CISM is for helping our members to better cope with the horrendous things they must see. While my time in direct fire service will shortly come to an end, I plan to continue to serve our community through CISM facilitation/work.
I am currently facilitating debriefs with the Tennessee Mental Health Disaster Strike Team (TMHDST), a wonderful organization doing important work with first responders across the state. The Team was developed approximately 18 months ago as a joint effort of the Tennessee Federation of Fire Chaplains (TFFC) and the Tennessee Department of Health. It is composed of members of the TFFC, licensed mental health providers, and emergency service peer professionals. All team members must complete a rigorous application process, which includes the submission of two letters of recommendation, a report of good standing from their local emergency service or professional board and an interview with the organization’s board.
The TMHDST team was trained in the ICISF standards at a weeklong workshop at the Tennessee Fire and Codes Enforcement Training facility. This training was not your typical pencil-whipped fire service training but was intense, exhausting and experiential. All attendees actively and genuinely participated in the rigorous training sessions. As a result, our team is well prepared to meet the needs of emergency responders and civilians in a variety of crisis situations. We are prepared to deploy, at a moment’s notice, with several highly qualified personnel. We have conducted numerous debrief sessions for emergency responders, provided hours of one-on-one sessions with emergency responders, and responded to tornado-stricken areas of Tennessee to provide mental health first aid.
One lesson that I have learned through my experiences with training in ICISF courses and the implementation of ICISF protocols is that we are all humans with the capacity to hurt. If I were to articulate my goal when entering a crisis debrief, be it with a local fire department, police department, EMS crew, emergency communications center or a civilian group, it is to provide strategies and hold space that relieves emotional pain, if just to a small degree. Just as many of our teachers or parents taught us to leave each place cleaner than we found it, I hope to leave each debrief with participants feeling more capable of handling their responses than when I entered. When participants do not leave the first debrief in a more positive place, I use the tools I have acquired through training, my own life experiences and witnessing the suffering of others to leave them with a plan for coping as they move forward through the grieving/healing process.
Another important aspect of the healing process is the education of our peers and community; those supporting us need to understand what to expect following a critical incident. One important aspect of this process, and one I feel passionately about, is busting myths we hold about how first responders process traumatic experiences. One such myth is “real men don’t cry.” Many of us were taught from a very young age that showing emotions is a sign of weakness. This is untrue and harmful. Being able to recognize our feelings, acknowledge them and allow them to be seen is a sign of great strength and growth. The group process that we implement when using the ICISF guidelines creates a safe environment for those who have witnessed or been involved in tragic events to open up and express themselves in ways that have been stifled in the past.
Recently while dealing with a group of emergency responders who had lost a beloved peer in an off-duty accident one serviceperson came to me in obvious distress. He shared that he had lost his ability to stuff his feelings down, to which I replied, “good.” His problem was not feelings safe to express his feelings in front of others. This was partially due to many years in the service ingesting this old-school mentality. He had come to believe that his peers were not a safe group to share his pain. In order for us to develop safe environments for our peers to express and process their feelings in times of crisis and pain, we must continue to educate them on how the healing process works. The ICISF has been a great resource for learning how to help our peers grow into such a community, and I believe we are on the right path.
Doug Kinnard is a Captain with Columbia Fire and Rescue in Columbia TN and has been with them for over 27 years. Doug also holds a master’s degree in counseling from Trevecca University and has experience in working with alcohol and drug recovery as well as individual counseling experience. Doug has completed a number of ICISF courses and attended the 2019 World Congress. Doug is a member of the Tennessee Disaster Mental Health Strike Team and coordinator of the Columbia Fire and Rescue Peer Support Team. Doug welcomes any feedback or questions at [email protected].
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