Wounded Warriors
by Women’s Brain Health Initiative:
EMOTIONAL TOLL ON PUBLIC SAFETY PERSONNEL EXTENDS TO THE FAMILY.
There are times when Lorraine Downey comes home after work that she just does not want to talk to her husband. It is nothing against him. It has to do with what she has seen in her work as an Ottawa paramedic. Such as the day when she concluded a long shift that involved two intense hours on a ledge trying to convince someone from jumping. A police negotiator took over and brought the incident to a safe end, but it was a draining experience.
“It was very intense. And then I had an hour-long drive home and I was exhausted, and the last thing I wanted to do is talk when I arrived home. I just wanted to sleep and eat. At some point, I knew I would tell him why,” said Downey.
She counts herself lucky that her husband is a volunteer firefighter and has had his own experience of being a witness to troubling events.
“We’ve been married almost 30 years and we have a good understanding how each other ticks. He’ll ask me what I need. Sometimes it’s just a bath or a walk. I just don’t want to be around anybody and he understands.”
While our awareness of post-traumatic stress disorder (PTSD) has grown, less thought has been given to the spouses and partners of people at risk of PTSD. But in their own way, they are on the front lines as well, struggling to support a loved one who may see awful things on the job. As the Peer Support Coordinator for the Ottawa Paramedic Service, Downey hears about these challenges all the time.
“They know something is different, wrong. But they don’t know where to turn and might think they’re the only ones,” she told Mind Over Matter®.
IT’S NOT JUST THE PEOPLE WHO SHOW UP WITH LIGHTS AND SIRENS. FAMILIES CARRY THE WEIGHT WITH THIS, TOO. IT IMPACTS THE CHILDREN, RELATIONSHIPS. AND THEY NEED THE HELP BEFORE THEIR LOVED ONE IS NO LONGER ABLE TO WORK. THEY NEED UPSTREAM SUPPORT.
Downey is participating in a variety of new initiatives to bring help to the families and friends of public safety personnel (PSP). PSP is a relatively new term, which includes not only police, paramedics, and firefighters but other sectors like correctional officers.
A new resource hub, PSPNET Families, is a place for loved ones to learn more about what it means to be in this line of work. Funded by the Public Health Agency of Canada, researchers from Queen’s University and the University of Regina have joined forces to build something unique in the space and fill an important gap in resources within the PSP community.
“We’ve been working to give voice to the experiences of families and create resources that resonate with their unique challenges,” said Dr. Heidi Cramm, one of the leaders of the project and a PSP spouse herself.
“We’re bringing together state-of-the art evidence around what it means to be a PSP family and to build out resources to deal with what goes with it,” added Cramm, who is an Associate Professor in the School of Rehabilitation Therapy at Queen’s University. She’s collaborating with Dr. Heather Hadjistavropoulos and Dr. Nathalie Reid of the University of Regina.
Cramm says they are proactively preparing families with strategies for identifying the ways in which the job creates additional challenges for the family, before someone shows signs of PTSD. It means understanding that a spouse may need some space and time alone after a tough day and perhaps recognizing that sudden irritability may be work-related.
WITHOUT UNDERSTANDING HOW PSP MIGHT REACT TO WHAT THEY SEE AND DO AT WORK, FAMILY MEMBERS MAY TAKE BEHAVIOURS LIKE DISENGAGEMENT PERSONALLY, LEADING TO RELATIONSHIP CONFLICT.
Cramm says the families are a diverse group, but their needs are secondary to those serving as PSP. Depending on the nature of the PSP’s job, families may have to move frequently, with spouses balancing their own careers and child care demands, all while supporting someone who might be dealing with the effects of trauma exposure.
“It takes a lot of bandwidth for people to anticipate and manage the dynamic demands of the job. There’s a constant need for adaptation and logistical management that’s very complicated and creates concerns about the mental health of families,” she said. Traditional gender norms around household management may be amplified in PSP families where most spouses may be women.
PSP families need a variety of supports. While PSPNET Families offers upstream resources and a well-being course for spouses experiencing their own mental health issues, organizations like Wounded Warriors Canada have developed a number of programs for those families affected by PTSD in trauma-exposed professions.
“Living with PTSD is hard. Families also need support,” said Tim Black, National Clinical Co-Advisor to Wounded Warriors. When Wounded Warriors started providing programs for spouses and families, the demand was huge, with a wait list that was five years long. In response, they have scaled up, allowing people to access services more quickly.
Black, an Associate Professor of Counselling Psychology at the University of Victoria, says a person with PTSD is constantly reliving trauma, constantly feeling at risk of danger, with symptoms that can include emotional volatility, insomnia, and fear of certain spaces (some cannot stand going into Costco), for instance. All of which is not only bad for long-term brain health, but hard on the spouse and family.
“You can imagine what that’s like, walking on eggshells, never sure what will set them off. Because of how the brain is affected by trauma, even a well-meaning comment by a loved one can be seen as an almost life or death level of threat to the person. It’s a terrible, vicious circle,” Black told Mind Over Matter®.
Wounded Warriors offers retreats for couples, where they encounter other people facing similar challenges. They start by teaching participants how their brains work and what trauma is all about so they can understand that it is not their fault, while sending the message that they are not alone.
“I believe that bringing them together for five days is one of the biggest healing factors. It’s understanding that I’m not a total screwup because I see others are going through the same thing. It’s healing the shame,” said Black.
The core program teaches couples skills that help them work together as a team to manage PTSD with strategies such as deep-breathing exercises to assist in calming down when experiencing a flashback.
“There are tons of self-regulation exercises that you must practice before starting to work through the past. It’s very pragmatic. You have to do it and you have to practice it,” said Black.
Based on his observations, Black believes that PSP who are the best at their jobs may be the most at risk for PTSD as they continue to be exposed to trauma for longer periods of time in their careers. They may show signs of trauma at home, but people at work might not notice because they continue to do their work proficiently in front of their colleagues. He believes that the PSPNET Families project can do a huge amount of good.
Exposure is inevitable, but traumatization isn’t. With an ounce of protection, we could change things in Canada a lot for the better.
Along with PSPNET Families, Dr. Heidi Cramm and her colleagues are building more knowledge about the families of PSP through the Families Matter Research Group and the Families Matter Network, moving research into the community of PSP families and those who study, serve, and support them.
They are responding to an urgent need to create a coordinated hub of research that focuses on families that can effectively and efficiently identify and respond to gaps in the system, she explained. “Developing the evidence is essential, but the relationships with the community are critical if the evidence is to be impactful,” she added.
As a paramedic who is also the daughter, sister, and wife of firefighters, Lorraine Downey could not agree more.
“All of Heidi’s research is going to help me, both as a PSP and the spouse of a firefighter, as well as my peers. And keeping us well benefits society as a whole.”