International Critical Incident Stress Foundation, Inc.
International Critical Incident Stress Foundation, Inc.
By: Glenn R. Schiraldi, PhD., Lt. Colonel USAR (Ret.)
Emergency responders are remarkably resilient, daring to go where others won’t, carrying and bravely coping with years of traumatic scenes held in memory. Yet none of us is invincible. Traumatic wounding can strike even the strongest among us. In fact, it is unusual for career emergency responders to have no post-traumatic stress symptoms. Resilience involves strengthening individuals to prevent disturbing stress conditions and be at our best tactically, emotionally, physically, socially, and spiritually. Resilience also involves healing so we can be 100% there again for our selves, our families, and our buddies. I wish to briefly overview the nature of traumatic wounding and then describe two recent developments in its effective recovery.
How do I know if traumatic wounding is a problem for me?
Post-traumatic stress disorder (PTSD) is a condition that can develop after exposure to overwhelming (sometimes cumulative) distress that we were not sufficiently prepared to handle. However, many whose symptoms do not rise to the level of a formal PTSD diagnosis still suffer needlessly for years from treatable symptoms. Post-traumatic stress symptoms can include.
PTSD is highly likely to co-occur with other psychological problems (such as depression, anxiety, panic attacks, or drugs abuse) as well as with a broad range of medical problems. In fact, many will seek relief from physicians for pain, gut, skin, autoimmune, or cardiovascular problems (including high blood pressure or elevated cholesterol). When the traumatic wounds are treated, the medical symptoms often improve.
Are traumatic wounds treatable?
Yes. PTSD and its subclinical forms are highly treatable if you find a therapist who is well trained in treating trauma. The sooner traumatic wounding is resolved the better, but research shows that even treating traumatic wounding years later is remarkably effective.
If time has not healed traumatic wounding (it usually doesn’t), and if your are still suffering and struggling, a skilled trauma therapist can be very helpful, just like a coach can help a proficient athlete to be even more effective. Be prepared to shop until you find one you are comfortable with regarding his or her treatment approach, experience,, personality, and values.
Many avoid seeking professional help, thinking that it shows weakness or fearing loss of control. It is helpful to realize that it shows wisdom to recognize where additional coping skills can be helpful. This is why an athlete has a coach and a student has a teacher. In bringing painful emotions to the surface, we learn that we can experience them, express them (like draining a bullet wound), and then return to improved functioning. This is why military generals and senior enlisted personnel have acknowledged that getting treatment made them better, more empathic leaders, spouses, and parents.
Operational stress and adverse childhood experiences
Traumatic wounding is linked to more than job stress. More than two decades of research have firmly established that adverse childhood experiences (ACEs) predict an almost unending array of medical and psychological conditions. ACEs include emotionally toxic events that occurs between birth (and even in-utero) to eighteen years of age. ACEs include physical, sexual, or emotional abuse; emotional or physical neglect; absence of a parent; witnessing domestic violence; or having a household member who is addicted to alcohol or drugs, or who is suicidal, mentally ill, or in jail. The more ACEs one experienced in childhood, the more likely one is to experience conditions in adulthood like PTSD, depression, anxiety, suicidality, ADHD, occupational and relationship dysfunction, and nearly every medical condition physicians see. Emergency responders typically have experienced more ACEs than their civilian peers. So it is shortsighted to just treat job-related traumatic wounding without resolving hidden wounds from childhood. Fortunately, the hidden wounds from childhood also respond to appropriate healing approaches.
Effective approaches to healing
When we are relatively calm, our brains are hard-wired such that we can think, speak, and behave effectively. However, in overwhelming stress the brain kicks into survival mode: Regions of the brain concerned with logical thought and speaking go “offline,” while regions of the brain concerned with survival—regions that govern strong physical and emotional arousal and tendencies to move—become over-activated. For this reason, among others, treatments that ask a survivor to talk about traumatic memories that are stuck in survival mode are often ineffective, at least at first. Newer treatments first focus on: (1) calming the body and areas of the brain that regulate the non-verbal survival instinct; and (2) reworking disturbing images that are stuck without words in memory. Eventually disturbing memories can be thought about and talked about without undue distress. I’d like to describe two of the impressive newer treatments, which are effective, quick, and grounded in new understanding of the brain and trauma. Both can treat traumatic wounds from the recent or distant past.
Accelerated Resolution Therapy (ART)
Derived from the well-regarded treatment known as eye movement desensitization and reprocessing (EMDR), ART adds many innovative strategies that appear to make it even more effective. Research indicates that this treatment resolves issues like PTSD, guilt, depression, and pain, often in one to five hourly sessions.
ART starts by calming disturbing bodily sensations and emotions associated with a traumatic memory, using eye movements, breathing, and tools such as imagining a vacuum cleaner taking away lingering distress. As stress arousal comes down, one is able to tap into the creative healing capacity of the brain. When ready, the survivor processes the disturbing scene held in memory, viewing the scene like a movie while moving the eyes. The survivor often notices that the scene and the body’s response begin to shift in favorable ways. Next, the survivor is guided to erase the disturbing scene and replace it with a new positive scene. The survivor is prepared to handle triggers and the resurfacing of troubling images. Then the survivor imagines bridging to a normal, happier future without negative memories or images.
Intensive Trauma Resolution (IRT)
ITR gently, quickly, and effectively eliminates or greatly reduces disturbing trauma symptoms. Like ART, this treatment is especially useful for emergency responders and for processing traumatic memories from the earliest years.
ITR shows how the brain and body are instinctually hard-wired to survive during a traumatic event: Trauma memories get stuck—frozen in the non-verbal/emotional brain where there are no words and no sense of time—causing a person to relive the event over and over. ITR guides the recoding of memory fragments so that the verbal/logical brain sees that the event is finally over and in the past. ITR includes two major tasks:
IRT treatment is flexible. It can be done virtually or in person. It can usually be completed in 20-30 hours, 2-6 hours per day, over a period of a week or two.
Conclusion
Traumatic wounding is not a life sentence; relief and recovery are possible. Consider finding a trauma treatment specialist in your area, and start a reading program to help you better understand the nature and treatment of trauma.
About the Author
Glenn R. Schiraldi, Ph.D., Lt. Col. USAR (Ret) has served on the stress management faculties at the Pentagon, the University of Maryland, and ICISF. He is the author of The Resilience Workbook; The Post-Traumatic Stress Disorder Source Boo;, and The Adverse Childhood Experiences Recovery Workbook (due out January 2, 2021).
Resources
Find trauma treatment specialists in your area at:
Copyright © 2025 International Critical Incident Stress Foundation, Inc
International Critical Incident Stress Foundation, Inc is a 501(c)3 Non Profit