Why firefighters avoid therapy - and why it helps anyway.
Firefighters, like many first responders, are skeptical of outsiders. The firehouse is a family. Meals are taken together around a large table, members bicker like brothers and sisters, and pranks fill the slow moments between calls, all the dynamics you would expect in a close-knit family. Fostering the idea of family in the firehouse is important especially when on the fireground. Firefighters have to trust each other when lives are at stake.
An outsider, like a psychotherapist, is not immediately granted access to that trust. Sometimes there is a good reason for the mistrust of therapists.
Like all friend groups and families, firefighters talk amongst themselves. If one person had a terrible experience with a particular counselor, everyone will hear about the experience. I often hear firefighters tell me:
They made their therapist cry
Their therapist told them to get a new job
The therapist could not handle the trauma the firefighter talked about
Counselors don’t understand ‘us’
Word gets to their firehouse family that therapy (and therapists) don’t understand the culture and are not able to help. Since the firefighters already believe this the experience only reinforces the belief that they cannot be helped by therapy.
If you see an orthopedic surgeon who doesn’t sound like they are willing to help you, are you going to swear off all physical help from medical doctors? I hope the answer is no. You will ask your firehouse family if they have any recommendations for orthopedic surgeons (if you haven’t already asked them).
Finding a therapist is much like finding a doctor who will take your concerns seriously and make every effort to assist you in healing. Don’t fall into the trap of believing you are unhelpable. Ask around to see who other firefighters have trusted with their mental well-being. Use online directories to help find therapists. The National Volunteer Fire Council has a directory of therapists who have been vetted. The University of Central Florida has RedLineRescue for firefighters, BlueLineRescue for law enforcement officers, and GoldLineRescue for 911 dispatchers.
Some calls are difficult not because they were frightening, but because they raise deeper questions about responsibility, fairness, or what could have been done differently. These experiences are sometimes referred to as moral injury. Talking through these moments with a therapist who understands emergency work can help people make sense of them and reconnect with the values that led them into the profession.
Sometimes the hardest calls are not the ones that are the most chaotic, but the ones that leave unanswered questions.
Over the course of a career, most firefighters and paramedics will encounter calls that remain vivid long after the shift is over. Those experiences do not have to be carried alone. Working with a culturally competent therapist can help you process those memories and learn ways to regulate the emotions that accompany them.
