Paramedics and PTSD: Moving On After Trauma?

You know, I don’t like being triggered by images and memories of my former profession. One day I would like to take pride in what I once did without being brought down my traumatic memory and feeling ashamed, afraid and angry.  I relayed this once to my husband through hitching breaths and tear blinded eyes after a particularly harsh trigger event.

You see, we were sitting watching a movie and an ambulance siren started in the background of the scene getting louder and louder as the actors stood by an open window delivering their lines. I did my best to control my anxiety responses to it; I deepened my breathing, I consciously loosened muscles that I was aware were tensing up, I tried to focus on the dialogue as though it were a foreign language and I had to consciously analyze every single word (that kinda looks like this, “Are you angry with me?” In my head I am picturing I, the person, you, the other person, angry, I search for a mental representation of a mad face, With Me, I consciously focus on the two actors body positions, mannerisms, facial expressions etc). At the same time I was also touching the armrest of the couch, feeling it cool under my hand, flexing and relaxing my fingers while dragging them across the fabric, my brain analyzing to the nth degree the sensations, the texture. But part of being mindful is also paying attention to auditory input and when there is a growing siren sound that you cannot shut out and it is a direct reminder of a deeply ingrained traumatic injury you’ve been grappling with for years, being fully mindful is extremely difficult. I tried to replace the sound; humming, blocking my ears – which I have learned to do rather subtly in public lest people stare at me or if worse comes to worse, moving away from the sound and quickly – but I could not drown it out and it got the better of me.

Unfortunately, at times like that, my brain is interpreting the sound as a threat to my Self, my tactics for distraction and grounding don’t always work and I can feel once again that locus of control beginning to shift in favour of what was once my most favourite organ. My nervous system begins to disobey my commands and starts working of it’s own accord, my breathing shallows out, my heart rate spikes, my insides and my body begin to tremble and I experience a sensation like I am falling or being pulled out of my current reality, which in turn gives rise to extreme fear and severe anxiety that manifests as tears spilling down my face and sometimes gutteral groans emanating from my throat. At times it feels like my brain is split in two, with me screaming at it trying to get it back under control. When I lose control of the reaction my next conscious thought usually is, “It will pass.” Radical Acceptance Theory. It’s just PTSD, it’s not You.

**For those newly struggling this is an extremely important point. The trigger reaction is self limiting. It always passes. You will survive it. It’s disturbing and exhausting as all hell, but you will get through it and with time/practice the duration of each trigger event will decrease.**

Now back to my original thought, I triggered to the damned siren in the background of a movie we were watching on tv! I lost control and it wasn’t a mild trigger event, it was a knock-me-on-my-ass trigger where I was curled up, hyperventilating up a storm, eyes wide, groaning and crying. My husband helped to “talk me down” in that, he coached my breathing, he rubbed my arms and reminded me to feel the sensations, he reassured me that I was going to be okay, that I was safe and most importantly, he removed the insulting stimulus – he shut the movie off. When my body started to come up the other side of the trigger, I was fully aware of how ashamed I was in myself for not being able to handle such a small sound. I was disappointed in me. I was angry because I Should Not (thinking error) still be reacting this way to the sounds and reminders after all of the skills I’d gained and how much I’d fought over the years to get the upper hand on this “disorder”. I was angry that I could still lose myself because of one day, one call, and I was upset that it took away from me all of the pride I had in having been a paramedic because it relegated every reminder of my former career to a trigger.

So how do you move on from that? I want too. I really want to be able to stand with my comrades and be proud of who I was but everywhere my comrades are so are the ambulances and uniforms I have so much difficulty with. They have pride that I can’t have and it makes me jealous and resentful. I want to be one of them again….or must I simply accept that limitation and continue to accommodate my life in such a way as to protect my basic functioning? Who do we become after trauma takes away our strongest identity?

I was pretty good when my husband was alive. We practiced looking at him and seeing him when he’d get ready for work, my focus was on his smiling face not his uniform and eventually I could tolerate looking at him in uniform with only slight, controllable anxiety  –  but that was just a single person, not a sea of uniforms which is still a huge issue. 

The sirens were one we struggled with, you see, I hear it and my mind sees the grey asphalt on that day, I hear the crunch of gravel under my tires, I smell the moisture in the air just after a rain, I see the instrument panel and I see my hand reaching to turn on my siren and I hear it and it drowns everything out and I trigger.  It’s extremely difficult when I’m driving to drown out the sound with the radio, or hum, or talk loud, or if I’m taken by surprise, not move until I can breathe normally again. It’s a huge safety issue when operating a vehicle, and not an imagined safety issue either, the triggers affect my concentration and decision making ability so it is extremely important for me to try to mitigate the effects to actually keep me safe once I start to drive again. 

For me, every ambulance is a possible trigger and my mind sees them as a threat, a potential siren that is going to sweep me away into the past again. It makes my days pretty difficult. It limits my life in some ways but I no longer let it prevent me from leaving my house. 

I’ve come to realize that paramedic, ambulance and siren are actually different things, it sounds ridiculous but each has a grade of fear attached to it and the first two I can handle fairly well when I’m in a well rested, calm and more “normal” state of function. You toss them all into a pot and I’m reduced to a pile of crying, hysterical rubble. You toss them all into a pot when I’m already stressed or haven’t slept and my mind convinces me in a heartbeat that All Is Lost and I can swiftly become suicidal.

I used to ask my husband for help when I’d get that way. It took a lot of courage just to let him know how quickly it could happen to me. He knew how quickly it could take you over. Since his death, I’m learning to be brave in those moments and ask for help from others, whether that means picking up the phone and calling a hotline or calling someone, it’s what I have to do to protect me.  I don’t want to die over a simple glitch in my ability to reason.  And please know this, it is just a glitch in your thinking, it is momentary, it is an inability to grasp true reasoning and all you have to do is, like a trigger event, allow it to pass. Suicidal crises are self limiting. The pain you feel overwhelmed by will pass. The exhaustion you are experiencing will pass if you are allowed some time to just rest and breathe. I cannot stress this enough. I’ve been through this repeatedly over the years struggling with PTSD and I am still here.  I have come to accept that with chronic PTSD comes depression, yet another monster to wage battle against but neither of these has to kill me.

But it does limit my life in some ways. And it has taken my pride in who I used to be. I now cringe when people ask me about being a medic, or show me pictures of medics happy, smiling, doing good for their community, because I still want to be there, leaving was not a choice I made. I’m still grieving that loss of self and I don’t know when I will move on, or move forward fully healed from that particular loss.

In dealing with the grief of my husband I am repeatedly inundated with the idea that I am still alive and I need to keep moving forward, finding life’s energy and reconnecting with it; re-engaging with it. In that way, it is similar to recovering from PTSD. I may never Get Over It but I can accommodate it in my life and gently accept it when it intrudes. I will try not to stay past-focussed and continue to work toward finding my place in this world, as a civilian and as a widow. I will also ask for help when I need it because, sometimes the helpers need to be helped too.

There is no manual for moving on after trauma, you fight to make your life your own again and as a wise teacher recently said to me, in whatever path that life takes, that will be perfect.

In Solidarity.

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The Importance of FACES

I was recently able to attend a unique retreat experience for spouses and families of first responders lost as a result of their profession. The five day experience called Camp FACES (Families And Children of Emergency Services), put on by the Canadian Critical Incident Stress Foundation (C.C.I.S.F), was held over a five day period at the beautiful Fern Resort in Orillia, Ontario. It brought together spouses (caregivers) from across Canada with their children, for a retreat designed to not only provide experiences of shared joy and laughter, but grief support as well. 

For the most part, the central focus of the camp is on the children and parenting of children after the loss of a first responder parent, however, there is also recognition of the adult as an individual and attention is also given to the specific grief of the remaining spouse or caregiver. 

In my particular case of navigating life after the still fairly recent suicide loss of my first responder spouse, the “camp” gave me the ability to look into the eyes of fellow survivors of suicide loss and see reflected back at me the same human impact; witness the sheer complexity of the emotional residue that permeates every aspect of our lives as we move forward in the afterloss. The only true difference between us was that others were struggling to parent through their grief. 

I was in awe of the strength of these people but just the same, I felt outside of their circle because I am not a parent. Eventually what I did observe in their narratives was that being a parent in the aftermath of suicide loss has a tendency to negate the adult individual and their needs in favor of the child/ren. I found it fascinating how directed questioning of individual coping was often buried under an instinctive parental perspective and hearing “I” or “me” was pretty rare. As surviving parents the concern becomes the integrity of the family unit, often to the detriment of the remaining adult individual, who, is also a person like me, struggling to come to terms with what is in essence a wholly illogical act; suicide. 

(Please note, the types of losses experienced by all attendees do differ and run the gamut from work related illness to LODD. In this particular essay, I am speaking to my specific group.)

I had opportunity to witness unimaginable strength. I saw spouses mere months from their suicide loss and, remembering how painful, how difficult it was for me at that stage of my grief, for them to have been there was nothing short of bravery. If I had a medal to pin on their chest, they each would have received one. I’m sure they’re screamingly tired of hearing how strong they are, because Lord knows I was at that stage, but if they ever read this, with every breath, every step and every tear, your strength is growing. We only accept our strength in retrospect; looking back on the last year and a half of my life, I see what it took to get through.

As a result of the coping skills I learned and the connections I had developed over the years of treatment of my post traumatic stress disorder, I came into the afterloss of my husband equipped better than most for psychological survival. Not only was I granted pro-bono crisis and grief counseling, I sought out assistance online and was able to connect with others like me, spouses dealing with suicide loss (SOLOS on Facebook). I had a virtual sounding board. I had people (mostly women) to help me normalize my grief reactions. I gained coping assistance and self care advice. I survived my first year but soon realized that online supports can only take you so far and through a family member became aware of this unique “camp”.  

You see, my house went deathly silent after my husbands suicide. I was the only person who required caring for when the tides of caring gestures eventually receded and society expected me to pull myself up by my boot strings and get on with my life. It had already been over a year. It wasn’t acceptable to mention him, it wasn’t acceptable to be so sensitive to guns or suicide anymore, it was time to just get over it. But it’s not that easy. For me the struggle was loneliness, we were private people, my social supports were not readily accessible anymore if I got into trouble psychologically. (And it can happen so quickly with me it’s frightening.) I began struggling with a new monster, depression. Pro-bono services only go so far and ongoing treatment requires financial ability. I came into this camp hoping to gain some sort of support system and find it I did amongst my peers. Despite the triggers I encountered that set off pre-existing post traumatic reactions, the pay back, the access to understanding faces made the experience worthwhile. 

I now have real people I can turn to in this life who know what I’ve gone through, who understand where I’m standing right now and just get me when I say, “I hurt so badly.” 

I now have FACES to turn to when the world turns away.

(Camp F.A.C.E.S)

– Dedicated to my husband, Martin Wood, 36378

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