Breaking the Stigma - Part 5

When we left off last time, we said that we were going to be addressing the three things that first responders need to manage stress, especially in the immediate aftermath of a critical incident.  Those three things are ventilation, validation, and education.

Ventilation is the process through which we encourage and allow individuals to express themselves freely – to “tell their story.”  Quite simply, research tells us that traumatic memories often get trapped in the mind, and the longer we avoid talking about the trauma the more likely we are to develop PTSD.  Talking about the event will often lead us to sources of support, help us make sense of what happened, and to realize that our identity is not limited to that traumatic event, even if it was a defining moment in our lives.  It can help us view ourselves as victors, not victims.

Clinicians, family members, and peers must be able to listen without seeming shocked and without passing judgment.  They need to be able to listen without expectations or judgments. As a helper, you can make it clear that you’re interested and that you care, but don’t worry about giving advice. It’s the act of listening attentively that is helpful, not what you have to say in response.

As you give that person the opportunity for ventilation, some of the things he or she tells you might be very hard to listen to, but it’s important to respect their feelings and reactions. If you come across as disapproving or judgmental, they are unlikely to open up to you again.

The next thing is validation.  Validation is the process through which we acknowledge the event(s) and the individual’s reaction(s), and then “normalize.”  One of the most refreshing things a person who is struggling with symptoms of stress can hear is that they are not “crazy.”  As we say in teaching critical incident stress management, people who have experienced a traumatic event are having a normal reaction to a very abnormal event or unusual set of circumstances.

Individuals will also benefit from hearing that others have experienced similar reactions or have had similar thoughts.  One of the benefits of group-based crisis interventions is that the idea that there is a set of reactions that is common to people who have experienced the same or similar types of situations.  This helps legitimize rather than stigmatize the symptoms that people are experiencing.  Research done for Call for Backup shows that over 90% of first responders agree that the things they see affect them emotionally.  People need to know that they are not alone.

Finally, there is a need for education.  Education is the process through which we help identify existing coping skills and suggest additional coping skills to manage stress reactions.  Individuals suffering from the effects of a critical incident and/or chronic stress need instruction on the right kinds of coping skills that will help improve their chances of feeling better sooner rather than later.

The idea is to promote healing from past events and to build resilience against potential future events.  Research done through Johns Hopkins University on early psychological intervention demonstrates that a person who receives good stress management education and learns effective coping skills will often show a higher level of adaptive function than was shown prior to the traumatic event.  Not only have we promoted recovery, but we have also helped that individual develop resistance against the impact of stress and resilience that will help them “bounce back” more quickly in the future.

In our next article, we will put this all together as we talk about the ABCs of dealing with the problem of the stigma for first responders associated with reaching out for help.  If you have issues that you are struggling with and know you need to seek some help, you can contact us confidentially at

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