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PODCAST: Effective Trauma Mitigating Strategies for Post-critical Incident Support with Tania Glenn

Updated: May 8

Clinical psychologist, trauma and PTSD treatment expert, Tania Glenn PsyD, LMHC, whose clinical practice focuses on critical incident support and trauma healing for first responders and veterans, discusses her work in supporting her clients in moving through the healing process and returning to normalcy and healthy functioning, both personally and professionally.

Understanding the physiology of stress and trauma... what exactly is trauma? Effective trauma mitigating strategies for post-critical incident support. Restoring resilience following traumatic experiences and the possibilities for post-traumatic growth.

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Effective Trauma Mitigating Strategies for Post-critical Incident Support Transcript

Fleet Maull: 

Hi! Welcome to another session on day three of the Global First Responder Resilient Summit. Our day today is focused on emotional fitness and resilience. I'm here today with Dr. Tania Glenn. Welcome, Tania. 

Tania Glenn: 

Thank you. It's great to be here. 

Fleet Maull: 

Well, it's really great to have you. Thank you so much for doing this and for the incredible work you do in support of first responders. I'd like to start off just by sharing a bit of your background for our audience. And so I'll do that, and then we'll jump right into the conversation. Sound good? 

Tania Glenn: 

Sounds great. 

Fleet Maull: 

Okay. Dr. Tania Glenn is president of Tania Glenn and Associates, a Clinical Practice in Central Texas that is focused on promoting resilience and providing critical care to first responders and veterans. 

As a leading national clinician in the treatment of post-traumatic stress disorder or PTSD, Dr. Glenn specializes in creating effective programs designed to mitigate traumatic stress and to assist patients with their return to normalcy as quickly as possible. 

Dr. Glenn is a noted author with numerous books dealing with mental health, PTSD, first responders, military, and family. Additionally, she has been involved in several documentaries dealing directly with mental health trauma. 

So again, welcome.

Tania Glenn: 

It's great to be here. 

Fleet Maull: 

As a mental health practitioner and trauma specialist, you really focused your practice on the needs of first responders, veterans, and their families. And you're married to a first responder. I'm curious as to whether you are already a clinician when you got married or whether this developed after you were married and maybe in response to being married to a first responder. I don't know. And how did you first get involved in focusing your practice around first responders, and veterans and their families? 

Tania Glenn: 

Actually, I was working in a level two trauma center in the emergency room. That was my second-year internship for my master's degree. I knew that I wanted to do crisis intervention and trauma work. I hadn't quite exactly found my niche yet. And so, I was kind of rolling along through my second-year internship, this is 1993. And suddenly, I go home on Sunday afternoon and I turned on the news and I watched the ATF raiding, the Branch Davidian's compound in Waco, and just the outcome of that and then of course the subsequent standoff and then the eventual sort of ending. But honestly, watching ATF raid that compound and seeing their trauma, I knew that day my calling was to work with police, fire, EMS to go to high-velocity events like Waco and help people like the ATF. 

I went to school the next day. I had one of my classes. I told my professors that I was going to do such. They told me I was crazy. So, here I am. I like to say 29 years later, just as crazy as the rest of us. And I love it. I just never looked back. I continued to work in the trauma center for 10 years and went full-time private practice in 2002. It was actually 9/11 that launched my practice out of a cannon, and I just went for it. 

As far as the marriage, yeah, he's a police officer. It was interesting. I, of course, spent pretty much my whole adult life around first responders. I fit well with that personality type. And so, I dated a few people. In my mid-20s, I attempted to date what I call normal people for probably about five or six weeks. It just didn't jive, right? I remember I was on a date with a normal person. 

Fleet Maull: 

Maybe we could call them civilians.

Tania Glenn: 

Yeah. Well, civilians. We'll call them civilians. And so, I was telling him just the good, funny stories from the emergency room. And he kind of turned white, and he's like, “I really don't like your stories.” And I'm like, “Oh, I’m telling you the bad stuff, right?” I just couldn't do it. 

And so, Mike came along eight years ago for me. He's such a great guy and he's such a great fit for me. And so, that just kind of ties it all together, being both the clinician and a spouse of a first responder. I've just really been able to kind of meld the two, and it just works really well. And it does help with credibility for a lot of folks, especially law enforcement. 

Fleet Maull: 

Sure. I'm sure it does. Yeah. Wow. That's a great story. It's really helpful to understand your background. It's amazing how one event in our life like you witnessing what happened to Waco can just be a turning point in our lives. 

Tania Glenn: 


Fleet Maull: 

Before addressing your work with first responders specifically, I wonder if you could say something, generally, about your understanding of what trauma is and how traumatic events or cumulative trauma exposure can lead to conditions like empathic distress, empathy fatigue, or burnout, all kinds of physical, mental, emotional health challenges, and ultimately the life altering and debilitating effects that we describe as a post-traumatic stress disorder. So, if you could just give us some general background about that and your understanding of that before we talk specifically about first responders. 

Tania Glenn: 

Sure. I do a lot of education with all of our customers. I think that education is really the first thing we should be doing with everybody, whether it's when they become a brand new customer or if it's their academy or their continuing education. 

What I like to do is I like to break down the physiology of stress. I take everything back to fight or flight. And that fight or flight response during trauma, your brain tells your body to launch into that fight or flight response, and you produce all the adrenaline, glucose, and cortisol. I talk about that activation, and I talk about the adrenaline dump. 

And then in terms of trauma, I really get into the effects of copious amounts of cortisol produced over time, basically crossing the blood-brain barrier and hitting the hippocampus and causing it to shrink and hijacking the amygdala. 

I get into all of that, the physiology of stress to link it through the types of stress. It really is no surprise based on continuous exposure to human suffering and pain and misery with horrible trauma sprinkled throughout somebody's career, how their chemistry changes and their personality changes, and their physiology changes. And when you tie all of that together, it's really no surprise that people are experiencing burnout or, ultimately, hopefully not, but ultimately post-traumatic stress disorder if it's bad enough. 

I talk about the importance of understanding everybody has a threshold beyond which they become overwhelmed. And what I like to explain to my customers is that when you're exposed to an event where you think you're going to lose your life or witness the loss of life of someone you care about or when you are exposed to mass carnage or the death or serious injury to children, your brain just doesn't process that like a normal ugly cause. Your brain really grapples with that. And when it hangs onto it and everything sticks in the frontal lobe when your brain's not able to process it and it hangs out there and continues to trigger you, over time, what that does is all of the damage, and you couple that with the cortisol. 

And so, I love to explain the physiology of trauma and stress. And basically, the bottom line is there's no surprise that burnout is happening and that people have been traumatized through the things that they've experienced. And so, we start with the physiology and then we get onto solutions. We get onto treatments and treatment modalities and all the things that we do, which I know we're going to talk about. But that's kind of my take on it is let's look at the science and the chemistry of the stress response and what happens to the brain during trauma, and then normalize all of that to help folks understand why they're experiencing what they're experiencing. 

Fleet Maull: 

Yeah. I think it is very clear, and it really kind of leads to my next question. Maybe you already answered my next question, we'll see. But I know a lot of your work is focused on post-critical care support for first responders, and that's really such an important thing. And some of the critical incidents are what can really lead to serious trauma. 

But before we go there, could you talk about the cumulative effect over someone's career of ongoing exposure to high stress that's insufficiently managed and becomes chronic stress as well as maybe primary trauma incidents, but also just secondary trauma where we hear about these incidents and we work around people with a lot of trauma in their nervous system and the cumulative impact of that over the course of someone's career. 

Tania Glenn: 

Yeah. Actually, in my book, Code Four, I outlined that the phases of the public safety career. It's the innocence, which is when everything is shiny and new and you just want to go help people, and you run a lot of calls. 

I was talking to a firefighter a couple of weeks, and he was so excited because they ran 14 calls in a 24-hour shift. He was like, "This is the best ever." And I'm like, "Uh-huh, enjoy this because that's the beauty of sort of the innocence." 

And then, I basically tell folks that there is the end of the innocence, which is burnout. And the burnout is because, over time, no one calls 911 because today's a good day. No one calls 911 because everything's fine. You see despair, you see chaos. You see grief, trauma, pain, sorrow, violence, and awful things happening to children. You see people on the worst days of their lives. 

I liken those to bricks. If you're marching through life and you have a rucksack on your back, you keep shoving those bricks in that rucksack and it just gets really heavy. So, when you are at the end of the innocence, that's burnout. I tell people all the time that you get to this point where you're cynical, you're jaded, you're negative, you hate the public, you hate people in general and you tend to view society as the despair and the trauma and the violence that you experience on calls. 

What I always remind first responders is every time they're running code three into whatever situation they're going into, they're passing hundreds, if not thousands of happy and healthy people who never need them. It's just that they don't interact with them, right? They don't beat their children or they don't overdose on heroin. 

And so, what happens is as you're shoving these bricks in the rucksack, it gets real heavy. I tell people that a lot of times, it feels like if we all have an internal fuel tank inside of us that when you're at the end of the innocence, the burnout, you're reporting for your shift half empty or you're empty. And that makes for a very long shift. The tones drop or the first call drops, and you're already mad. 

It's no surprise that this is coming because of the work that first responders do. When you are at the end of innocence, you have some choices. You can stay where you are, it can get worse or it can get better. And how it gets better is we go to wisdom. 

Wisdom is hard-earned and it causes gray hair. But wisdom is the paramedic who says things like, ‘You know what, I know it's 2:00 AM and this call is for toping but we know that this is really about psychological pain, so let's go help our community.’ You stop taking things personally. 

The best way you reach wisdom is you restore your resilience. With our patients, what we do to restore resilience. We start simple. Hydration, nutrition, rest, and exercise. Small changes in those really start to pay off big. It's not that you have to do an overhaul of your life. It's that we just start to make minor adjustments. 

And then, we get into your family, your faith, your friends, and your hobbies, your life outside the job. And what we do is we work with folks to regain that balance so that when they go to work, their internal fuel tank is full. It's your off-duty time that refuels it, right? 

This is very, very, very important also for what you mentioned, which is the secondary traumatic stress or vicarious trauma because you hear of a lot of things or this event doesn't happen directly to you, but you take it on. When we connect with some of our patients and the public, we take it on. And the best example I can give is Murphy's law. 

Unfortunately, your first responder and the first year that they've had a child, their first child, they're going to have all the bad pediatric trauma ever. And so, when you run a pediatric trauma and you have little ones at home, you take it on, right? This is important for the family members too because they hear the stories, and they walk through it with their first responders. 

So, all of this is important for direct trauma, for the indirect, and for the family members as well. All of this matters. And really working on and making resilience part of your daily mantra and your goal of the sort of continual self-improvement throughout your career, it's what really restores the balance. And so, so important for all of our first responders to be taught that.

Fleet Maull: 

I think what I'm hearing you describe, one term you're describing is growth mindset versus a fixed mindset and the possibility of post-traumatic growth, not just recovery, but growth that actually having a challenging job like this, if we embrace the fact that we don't take it personally, this is the career I chose and I'm going to do all the things I need to do to stay resilient, get the support I need, this can actually leverage a lot of growth and wisdom. 

Tania Glenn: 

Absolutely. Those folks that reach that post-traumatic growth, that mind growth, they are the best employees agency has because they see it in others and they know how to look out for others, right? They join support teams because they want to pay it forward now and help others so that maybe they don't have to go through maybe the extremes that they did. 

Fleet Maull: 

I think what a lot of us don't understand is with this idea of vicarious trauma, when we hear about terrible things happening in the world, this impacts all of us because we all hear about every terrible thing that happens in the world anymore with 24/7 cable news. I'm not sure we’re designed to hold that much, right? But certainly, first responders, when they hear about events, somewhere in the back of their brain, the brain's going, ‘That could have been me.’ Right? 

Tania Glenn: 


Fleet Maull: 

And they're having the same neurochemical experience of the person that's in the primary, not to the same extent, but as cumulative over time. I mean, it affects all of us. I mean, I'm sure every time there's one of these tragic school shootings, parents are all going, that could have been my children, right? And they start to have that same neurochemical reaction, and it is cumulative over time. 

Tania Glenn: 

Absolutely. Yeah. We are bombarded. I mean, social media, it can do a lot of great things, but it does a lot of damage too, that 24 cycles. It's a constant, right? And first responders look at other incidents across the country. And every time, I know it registers that could have been me. And that puts them in that hypervigilant state constantly.

Fleet Maull: 

Absolutely. There was that recent, well, it's been a couple of months now, I guess, but there was a terrible mass shooting at a King Soopers in Boulder, Colorado. I lived there for 20 years. I used to shop in that King Soopers all the time. And when I saw that on the news, I could tell I was having a physiological response to that. Yeah. 

Tania Glenn: 

Yeah, absolutely. Yeah. 

Fleet Maull: 

Let's focus on critical incidents and strategies for mitigating the very serious health risks associated with going through or experiencing a critical incident and then perhaps not getting the support one needs. 

I mean, unfortunately, the culture previously among many first responders and first responder agencies would just kind of tough it up and move on, right? In corrections, they've got this terrible expression. Something like, ‘buck up buttercup’ or something like that. This kind of expression, right? 

And so, what is your approach to supporting first responders and their families following a critical incident? And is it similar to the critical incident stress management approach, the CISM, which I know is kind of a national standard? 

I just wonder if you could talk about this. What are some of the key elements of really helping prevent the worst of or even maybe prevent altogether a traumatic injury resulting from going through a critical incident? 

Tania Glenn: 

This is my forte. This is the thing I do, right? I love right bringing the calm and the solutions to crises. Actually, my company uses a peer support model. What we do is, number one, we have a plan in place before the incident happens, ideally. And what we do then is after we have our plan and our policies, we build our peer support program. 

The peer support training I do is three days. It's very intense. This is after policies are written and a strong recruitment process happens. So, we have our peer support program in place. And what happens initially is that peer support will activate, and our focus is on Maslow's hierarchy of needs. So in a crisis, we all go to the base of the hierarchy of needs, which is food, water, clothing, shelter, and safety. 

And so, what we do quickly is we stabilize the situation, all of the individuals involved. Usually, it's a one-on-one type of peer support situation or it may be one peer to two personnel. That sort of ratio. A very, very strong safety net to make sure that people are getting home safely, that they're hydrated, that they're eating right, that they're not staring at four walls drinking 27 beers and freaking out. 

And so, in the first few days, we're heavy on Maslow's hierarchy of needs. And then, as a person stabilizes and they start to move up the hierarchy of needs to the more emotional, then the peer support team is there to talk with them about the event to listen, to validate, normalize and educate. And then, when a person is ready, then my team and I will obviously jump in. Every situation is different. There's really no cookie-cutter sort of timeframe. 

Usually, peer support is strongly encouraging folks to come in and to deal with whatever has happened. As folks come in, we're treating their trauma very quickly. My team and I, we all do EMDR, the Eye Movement Desensitization and Reprocessing. We're actually doing that very quickly to mitigate trauma, to prevent PTSD from occurring. 

Sometimes it's four days post-incident. Sometimes it's a couple of weeks. Sometimes it may be a month, depending on the logistics and the circumstances. I have done EMDR on people at hospitals before they've been discharged because they were injured. And so, we get in and we do as much preventative work as we can to start to mitigate the trauma. 

It's a very fast, effective way we have found to do it. And I actually just developed a presentation that talks all about how we are doing this with our customers. I'll tell you, we've seen people just heal and recover and move through the trauma so quickly. It's amazing to watch. 

Fleet Maull: 

For a first responder who, let's say perhaps, that these resources aren't in place in their agency and they go through a critical incident of some kind. They've got to do what they do, right? 

They respond as best they can. But at that point when they're actually able to step out of the incident appropriately, what can they do in the immediate aftermath themselves, even if they don't have support from others at that moment? I mean, ultimately, yes, go seek support. But at the moment, are there things they can do immediately to help themselves not go full blown into that kind of trauma response? 

Tania Glenn: 

Yeah. I would say, absolutely. First thing’s first is to have your support system in place, whether it's your spouse, your partner, other folks from the department, or outlying agencies. Count on and lean on your buddies to be there for you and with you. 

And then, what I always tell first responders is I call it the devil's playground or the trifecta of self-destruction. And that is that when you have a bad call and you go to all the negatives, and so those things are like not getting enough sleep, drinking copious amounts of alcohol, and skipping the gym. 

So, what I would tell any first responder is to stay with your physical routine as much as well as you can. Get rest when you can. You're not going to sleep well the first few nights, but maybe schedule some naps in there and eat right and stay hydrated and really, really minimize the alcohol. 

What I want people to do is get back to their baseline as quickly as they can and avoid the pitfalls because if you're not sleeping and you're drinking copious amounts of alcohol, that is just gas on the fire. It's those healthy choices, those things that you sort of adhere to for the most day-to-day, and then counting on the support system that you have in place that you trust that you can talk to. 

And then from there, I'd say start to find someone that you can go see and talk to. Someone who really primarily works with trauma is what I prefer if that's available. And someone who can kind of stick out with you through this healing process. 

Fleet Maull: 

Absolutely. And so, you mentioned sticking with your physical care, your workout. I know a lot of first responders work out and so forth. I think that just brings up the importance of the body that, as quickly as we can get back in our body, right, I mean, you mentioned EMDR and there's some related kind of things like grounding exercises. I mean, just even feeling your body, squeezing the muscles, some sense just to get back in the body so that you're not up in that fight or flight. So, I'm just curious if you used any kind of physical grounding exercises like that or something.

Tania Glenn: 

Oh, absolutely. Yeah. So whether it's as simple as you said, you sit on your couch and you feel the carpet under your feet and you feel the couch sort of under you and behind your back and taking big, deep breaths and slowing your heart rate, slowing your breathing and good, good, deep breathing, good tactical breathing and just being present in the moment, right? 

And so, we do a lot of that. A great grounding technique is just to go for a walk or walk your dog or sit on your carpet and just hug your dog and pet your dog. Anything physical that brings you to here and now and gets you grounded is fantastic. It's basically whatever soothes that person is really recommended. Absolutely. 

Fleet Maull: 

And ideally, perhaps even in the squad room or wherever, I mean, even like not waiting, right. As soon as they're free of the incident to be able to do something, to get back in the body, reorient to the here and now. 

Tania Glenn: 

Yeah, absolutely. 

Fleet Maull: 

Right. Thank you. So, you mentioned peer support and the importance of peer support. And so, I'd like to talk about that a little bit. One of the books you wrote is I've Got Your 6. I did a little research on that. I realized the expression comes from World War I, actually, where pilots would say I’ve got your 6, which means I got your back, because six o'clock is the position behind you, right? 

And so, what creates really effective peer support program? I know from my experience and a lot of my work has been in the corrections field, a lot of peer support programs are underutilized because of issues of trust, anonymity, confidentiality, and so forth. So, what do you think are some of the key elements of an agency creating a really effective peer support program? 

Tania Glenn: 

I agree. It is underutilized in some areas, but it has to be done properly, and that's actually why I wrote the book. It starts with good policies. You always have to have your policies. And then what we do is we typically push out an application and request a letter of recommendation. 

If someone is serious about joining the peer support team, they're going to fill out the application thoughtfully. There are some pretty deep questions on the sample application that I put in the book. And then, if they go seek a letter of recommendation that shows the commitment. Then, we do an interview, right, where we really get into what are your motivations for being on this team? 

We do have to be cautious because not everybody who is fit for that team is really capable of doing peer support. Like, if they have way too much going on in their lives, if they're disgruntled with the agency, if they tend to gossip a lot. So those are folks that we would eliminate. 

And what we do is we start from ground zero. Like day one of training, we want the strongest candidates in every seat in the classroom. I typically try to get 10% of the population. So, if a fire department has 80 employees, I would like to start with eight. But if we only have five that we really want on that team that are going to be good quality peer support team members, we'll start lower. 

And then, I do three days of training. I hammer home the confidentiality. I mean, I really do. We go through every possible scenario. One of my customers, before they became a customer, they had attempted peer support. It was like sort of a gossip chain. And so, it died for 10 years until we could redo it. It was just basically turnover and time and distance from that awful experience. But we started it up again, and that is actually one of my strongest teams. 

And so, I talk all about the role, the function, the purpose, the confidentiality. We work really hard on skills, on empathy. Everyone comes out of training, they're nervous because they're about to go do peer support, but they're ready. 

The training is also very important because the best compliment I get as an instructor is my students will say, "Tania, it's exactly the way you said it would be. It went exactly the way you said it would go." And so, once we got going, it's like, it just flowed, right? And it worked. 

And so, having good policies, having the right people, and having excellent training, to me, it's a win because what happens then is, especially the first year that that team rolls out, they start to show themselves and prove themselves that they're really there for the people. And what happens is they start to gain a lot of trust and respect, and then your team just really grows. It's amazing. 

I've seen it in law enforcement when peer support starts, the tough guys, the SWAT guys are like, "Nah, whatever. I don't need that." And then a well-run team within a few years, we'll have SWAT team members on it. I love it. And it's just such a win. 

And so, when it's run properly, part of it is also I clinically guide and oversee their activities. So they have me as their backup. If they're stuck or if they're floundering a little bit or if they can't figure something out, I'm there for them. So good quality service and trusted people is the way to go. 

Fleet Maull: 

You've written a number of really important books related to this kind of work with first responders. Your book called First Responder Resilience: Code Four, which you mentioned before. I've Got Your 6, which I just mentioned. First Responder Families, which I want to address before we finish today. And Smashing the Stigma: Changing the Culture in Emergency Services

I'd like to focus on that one for a moment because the stigma in our general society around mental health issues, around mental illness is still something we're dealing with as a society altogether. And then with the first responder communities and agencies, there can be even a greater stigma. And there can be the concern of not being considered fit for duty and so forth and so on. 

There's all kinds of reasons why people don't seek the support they need. And so, maybe you could talk a little bit about that, about what we need to do to change the culture to remove the stigma around mental health and mental fitness and even mental illness that this is just part of our human experience and something we need to work with. 

Tania Glenn: 

I think that people's perception of mental health was based on like in the 1950s, the state hospitals with that broad iron gates and the big narrow oak trees wrapped around the gates, like haunted houses basically, that we did frontal lobotomies and that we used all these horrible medications. That is true. 

Then over time, of course, mental health really started to shift and change and really good progressive treatments came out, and much better medications came out. Hospitalization took on a whole different tone. I think for the most part of the general population, the civilians, they see that. I think, overall, although there's a lot of stigma still, but overall the general population has accepted it. 

The problem with public safety is that while all that was changing, there were very few resources for police, fire, and EMS. So they would go see a therapist, and they would just talk about the normal day of a paramedic and the therapist's jaw would drop and they would cry. And it's like, ‘Well, this doesn't work. So, there's no resource for us.’ And so, the stigma has really continued in public safety because of the lack of competent clinicians that could treat their traumas. 

I wrote this book last year because I think last year was like the ground zero for mental health for first responders, with everything that happened in 2020. And so, that motivated me to get this book out because I just want chiefs and directors and leaders to understand that the tone that you set and the resources that you set up and the things that you bring in really, really do matter. 

I think it starts at the top. I think when directors and chiefs and leaders say ‘I got help. I struggled.’ your crews are way more likely to go get help, right? And it is really about normalizing and validating what happens to the brain in the body during stress that first responders are human beings, that they are not sociopaths, they're not immune to this trauma, and that they are going to be impacted and that's called normal and good options and solutions for healing and recovery. When you have all of those, then the stigma starts to come down. The more first responders that get good help that tell other first responders, the more it reduces the stigma. 

Fleet Maull: 

Yeah. I think that's a really important angle on the conversation is the competency of the providers that provide these services to first responders because they really have to understand that world, which obviously you're someone who does understand that world and can understand what's an appropriate way to provide services and so forth. 

So yeah, it just seems like the stigma is so critical. I have a friend and colleague who's also on the summit here, Rich Goerling, a retired Police Lieutenant from Hillsboro, Oregon, and 

also a long career in the coast guard. He talks about the importance of this and a lot about growth mindset. 

He says, "As a first responder, I just know what I need to do to take care of myself. I work out. I go to the gym regularly. I have my mental health coach.” It’s what he calls it, basically a therapist. He calls it my mental health coach. And I see them on a regular basis because I know this is just what I knew to do to keep myself tuned up and resilient and in good shape. 

The more we can begin to see these kinds of services as just normal things, all of us as human beings do to stay resilient and stay healthy and be at our best. I think that's where we need to go. And several things you're pointing to really here are really the reason for this summit, right? 

This past couple of years, I mean what we've been going through with the pandemic and the pressures on all of our frontline healthcare workers and all of our first responders, and then what we went through with the protests around the tragic killings and so forth. I mean, first responders. I mean, they have tough jobs anyway, but it has really been quite a time. 

We have a weekly call we do with first responders in Indiana, and it's been going on for about 14 months. We've been with them for 14 months week in and week out as they went through riots and protests and the pandemic, and all of it. We really get to see what their lives are like and how it impacts their lives. So, I really appreciate you pointing to that.


Tania Glenn: 

Thank you. Thanks. It's so important. 

Fleet Maull: 

Yeah. I'd like to talk about families. We mentioned vicarious trauma before. My understanding of it is that there are two types. One is when we hear about other incidents happening, and there is actually a neurochemical reaction we're having. 

On some level, our brain is having the same experience as the person involved in the instance, just to a lesser degree. And over time, that's cumulative. But the other kind is that we actually absorb trauma from people around us. We think we're just these skin encapsulated beings, and I'm not talking about anything, woo woo, this is actual science. 

We know we're all empathic beings. We couldn't have any kind of relationship without being empathic to one degree or another, and we take on from the world around us. And when we work around a lot of people who have a lot of trauma in their nervous system and we absorb it. We carry trauma in our nervous system. 

So, through your career as a first responder, you're absorbing whatever you absorb and then you're working around other first responders who have been absorbing what they've been absorbing. And then, when you go home to your family, guess what you bring with you? 

And if you don't know how to kind of unmirror from that world you're in, it really shift your neurophysiology from being in that world and how to shift into a neutral zone. Otherwise, you bring that home to your family. There's no wonder there's so many among first responder communities and, of course, mostly I really know the data in corrections, but the incidents of family problems and divorce and just all kinds of family issues and problems are really high among, I know correctional officers, and I'm sure other first responders because of this. 

So, I'm wondering if you could talk about your experience as a family member and your work with families because, certainly, the primary focus is the first responders, but also their families. You could think of families as part of our first response. They're the backup to our first response, right? 

Tania Glenn: 

Yeah. Chapter three of that book is on vicarious trauma. I also address shift work and the adrenaline dump at the end of shift work and how first responders have no energy at the end of the shift and why and all that and to work through that. 

Honestly, that chapter on vicarious trauma is one of my favorites I've written. I really get into the impact on family members. Your loved one, first responder walks through the door and you see kind of that look and the energy. Sometimes you hear the story and sometimes it's on the news. What happens over time is if the first responder has an upset stomach and a headache and they're really irritable from this event, by day three, the spouse or significant other does too. They have the same headache, stomachache. All of the above. So, I talk about the importance. 

I always say the mantra of vicarious trauma is this didn't happen to me. I shouldn't need help or I shouldn't be impacted, but it did. It is. You're absorbing it. You care about someone. As you said, we're all empathic creatures to some extent. A lot of times what we're doing at our practice, as we're treating the trauma of the first responder, we're really encouraging the loved ones to come in too. It's the spouse. It's the significant other. It's sometimes the kids because they're going through it too. And a lot of times, they'll say, "Well, you know what, if you could just treat my spouse, that'd be okay." No, let's get you in too because it's important. 

I had really bad vicarious trauma after Oklahoma city after I went up to the Murrah bombing. I couldn't figure out what it was until I guess when I jumped on the couch and figured my stuff out, right? I talk in that book about just how significant it is. And even to this day, Mike had a traffic stop and it turned out to be a bunch of sovereign citizens. He was telling me about it. And unfortunately, I had viewed a video in hostage negotiation training of sovereign citizens killing a deputy. 

And so, of course, that night when I went to bed, I had horrible nightmares. Did I tell him about it? No, because I want him to keep talking to me. But even this many years in, he came home and he's telling me about this traffic stop and all the issues they're having with these folks and what they were saying and the way they were behaving. And I know enough to know enough. And sure enough, I mean, I had a nightmare. I think with both the COVID and, and the riots and just the distress of the country, it has come home to all of the family members. No doubt about it. No doubt. 

Fleet Maull: 

Yeah, absolutely. There may be things that first responders can share with their families or sometimes it's in the news. Especially in law enforcement and fire and things like that. I know in corrections, it's more of a hidden world. But often, first responders see stuff that they just don't want to share with their families, right? They deal with some really horrific stuff, and they just don't want their families even to have those images in their brain, right? 

And so how do they navigate that, understanding what's appropriate to share, what's not appropriate to share? And if they can't share, then obviously they got to have somebody else they can communicate with, right? And not just the kind of, unfortunately, black humor that sometimes happens among peers at work or something to deal with it, but a more healthy way of sharing their experiences? 

Tania Glenn: 

Yeah. I think every couple is different. Some are in a relationship with someone who wants to hear everything and can tolerate hearing it. Others are like don't talk to me about certain things. And others are like, I don't want to hear any of this, right? And so, each relationship, you have to gauge how much you're going to share with your spouse. And sometimes it's much later. In Code Four, I wrote about how sometimes after certain shifts or certain events, it's like the snake is following you into your house. So you cut the head of the snake off and you walk into your house and you see your spouse. And they say, “How is your shift?” And you go, “Good.” And then you get in the shower and wash it off. And then six months later, it's easier to talk about because you've got some space and some time. 

Each couple kind of has to navigate how much they share, how much they bring home. A lot of couples have kind of their code words like, “Hey, it was one of those shifts.” And the spouse knows, hey, today's going to be at like a super chill day, or my significant other needs to just like go take a shower and go play with the kids for 40 minutes or walk the dog or play solitaire or play a video game or whatever to reset. 

Each couple kind of figures out their rhythm and their MO. There are certain words for certain types of shifts. And over time, they have those good code words that let their significant other knows. Like, “Yeah, this was not one I want to talk about just yet or that I will ever talk about.” 

But you're right. If there's not a lot of sharing at home, there should be hopefully sharing with peers. Even if it's just as simple as something in passing or if it's sitting down and talking to someone to hash something out, whatever it is, the ability to offload that stuff and to seek validation and comfort is really important. 

Fleet Maull: 

Absolutely. And how about children? Of course, it really depends on the age. Obviously, we would want to protect children from all of that to whatever extent we can, but children are so intuitive and smart. They know what's going on. They pick up on stuff. And maybe pretending that they're not picking up on it is not so healthy either. 

So, I'm just curious if you have experience in terms of counseling, either parent, whichever is a first responder. There are some first responder families who are both the spouses are first responders. Any counseling with them around how they work with that and their children?

Tania Glenn: 

Yeah. Actually, I wrote two kids' books, Protected But Scared. I wrote after Ferguson. And it was written for the children of police officers. We had a pretty significant uptick of kids at our practice during Ferguson. And so, I wrote that book. 

Christopher's the main character. His mom's a nurse and his dad is a police officer, which happens a lot. It's kind of an inside joke. He talks about how proud he is of his parents and his life and all that. And then he starts to get into, but lately, things have changed. And so, he basically is on this journey of talking to his parents of going to like a safety day at the police department, where the kids get to see all the best and the all the things that keep their officer, mother, father safe, which is kind of a suggestion to have like a family day for kids to come in and learn about police work and to play with the things that they can play with and get in the cars and all that stuff. 

He does go to therapy. So, it addresses therapy and it addresses the ability to offload worries, thoughts, feelings, why your stomach hurts, and the fact that a lot of kids think that if they verbalize it, they'll make it worse or it'll become something true when they worry about things. So, it gives parents tangible ideas to address that. 

And then from that book, a lot of their first responder parents were asking me for another book for other kids. So that book is called, This is Our Normal. And so, Christopher kind of rolls into healing and recovering. And then, he meets some other first responder children at school and also active duty military members kiddo. And it's like they form this informal peer support group. That's their normal is to having parents who serve. 

It gently, gently addresses a firefighter being injured and also an air medical crash. And so, I wrote a letter to the parents at the end of that book, just really encouraging them with ideas and tools to use to help their kids through this because the kids are part of it too. 

Fleet Maull: 

Wow. That's so important. The resources that you've made available to your writing are just really incredible. And I really encourage people to check out all of Tania's books. That was really amazing. 

We're about at the end of our time. The last thing I want to ask you about is for first responders in our audience here who are watching this and their family members because we really hope family members are going to be watching this as well. What are some of the signs to look out for that maybe you need to suggest your spouse to get some support or maybe you need support for yourself? 

One thing I like to always say is that the first symptom is exposure. So in some ways, all first responders should be seeking support from the get-go, right, because just exposure and everybody's exposed. But beyond that, what are some of the signs that people might want to be aware of to where they should really think about getting some support? 

Tania Glenn: 

What I always say is the changes in your baseline are the biggest things. Like, your sleeping is worse. You're less motivated. You have less energy. You are more quick to anger. You have abandoned your hobbies. Your humor is not just are dark humor but really off the charts, super dark humor. You are going to shift and you're irritated. You're going to shift and you're already in a fight or flight response. Those kinds of baseline changes. And you feel worse. 

And a lot of times for all of us, it's our spouse or significant other that points it out first or our partner who points it out first, like, “Hey, this has changed.” And so, your attitude, your drive, your desire, your compassion, your empathy, when those start to change, and then physiologically, you feel worse, get help. Get help. I cannot stress this enough. 

I mentioned coming back from Oklahoma City. I came back on a Thursday night, and I just wanted to get back to normal as we all do. I went to work on Friday night in the emergency room. My first patient was a 19-year-old who took 10 amoxicillin as an overdose because her boyfriend was giving another girl attention. 

I lost my stuff. I was yelling at the doctor about how this is BS, and I'm not doing this. I'll show you a real crisis, and it's up here in Oklahoma City. And six months later, I was no better. And you know what I was doing? I was running further. I was lifting heavier. I was avoiding alcohol. I was staying hydrated. I was doing all the things. 

One night, one of the nurses in the emergency room told me that she basically, as she walked past me, just out of arm's length and she never stopped, by the way, she kept going. She told me that I had been a complete asshole ever since I got back from Oklahoma City and that I needed help. 

And it was like this hit upside the head. She's right. She's right. So, when people are like, “Hey, that's different. That's changing.” It's not offensive. They're just wanting you back, right? And I will tell you, as soon as I jumped on the couch, it's like the relief was instant. I just realigned my life. I addressed all of the things that I had dealt with in Oklahoma City. There was one specific incident that I talked about in the family book. And then, I was back. 

So, listen to your colleagues when they're like, “Hey, are you sure you're okay? Because I see this change or I see this difference?” Or you notice it inside of you. Mostly you're going to notice your physiological manifestations more than anything else. But listen to all of the signs. 

Fleet Maull: 

Wow. Well, thank you so much, Tania. This has just been incredibly valuable. I'm sure it's going to be incredibly impactful and valuable for the audience. And thank you so much for the work that you do in support of our heroic first responders and their families. 

Tania Glenn: 

Thank you so much. Thank you for having me.


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