Psychological Impact of Working as a Firefighter

Fire service personnel witness traumatic events everyday and traditionally, a stigma existed, leading many firefighters to keep their feelings about these events to themselves. Thankfully, things are now changing.

Not many people know about the day-to-day job of fire service personnel. Believe it or not, less than 5% of calls received by the fire department are fires. The vast majority of calls – 75% or more – are medical emergencies. This includes severe car accidents, natural disasters, substance overdoses, heart attacks, etc. This means members of the fire service witness horrifying, gruesome, and life-threatening events everyday. As the saying goes in many fire departments: “Your worst day is our everyday.” 

Traditionally, however, the fire department has been stoic about these experiences. Psychological suffering was seen as weak-mindedness and emotional turmoil was stigmatized. Those who struggled with cumulative tragedy were shunned and labeled as people who couldn’t cut it to be a firefighter.  

However, the culture in the fire service is changing thanks to recent research shedding light on the emotional toll of these experiences. Compared to the general population, fire service personnel have higher rates of Post-traumatic Stress Disorder (PTSD), depression, anxiety, and problems related to alcohol use. One gut-wrenching study in 2017 found more firefighters died by suicide than in the line of duty.

These findings led to important initiatives across the state of Florida. The Florida Firefighter Health and Safety Collaborative, for example, offers two-day workshops specific for behavioral health clinicians. These workshops aim to increase clinician awareness and competence in working with firefighters.

Although awareness is key to initiate change in firefighter psychological wellbeing, there is still much work to be done. If you or a loved one is a first responder struggling with stress, irritability, sadness, and difficulties connecting with those around them, know that there are clinicians out there who can help. It’s time to change the culture around the fire service. It’s okay to not be okay.

How to Be Kind to Yourself (+ Top 10 List)

In honor of Random Acts of Kindness Day, Dr. Isoma shares his own struggle with being kind to himself and shares a list of ways to treat yourself with more kindness.

This has been a rough first month of the New Year for me. My wife and I are expecting our first baby, we just opened our new practice, and we are still putting our new home together. I know this all sounds really exciting, and it is. But, at times, it can also be stressful and scary.

What if my practice fails? Am I going to be a good father? What if I can’t manage everything? These questions constantly bombard my mind. Then, my inner critic starts up: “You’re too disorganized,” “You’re in over your head,” “You don’t even know how to hold a baby – you’re going to be a terrible dad.” The underlying message tends to be the same: “You’re not good enough.”

Perhaps you can relate to some version of the “I’m not good enough” story. When it shows up, it can make us feel terrible about ourselves and bring us down. Most of the time, we work really hard to push this story away, argue with it, or distract ourselves from it. But it always comes back, typically when we feel at our worst.

Sometimes it can feel like our mind is our worst enemy – like a bully just looking to kick us while we’re down. But if you take a closer listen, you might notice that this so-called bully is actually trying to give you some important information. 

Our brains evolved to keep us safe from perceived dangers, connect with others, and help us grow. Being able to anticipate failures, avoid pitfalls, and drive our system into fight-or-flight mode increases our chances at continued survival. This means that even the most self-critical information is for the purpose of safety and advancement.

Think of it this way – It wouldn’t be all that helpful if our minds gave us only positive affirmations. What would happen if my mind only told me I’m going to be the best dad in the world? (Yes, that’s what my future mug will say.) What’s motivating me to learn how to properly hold a baby, take parenting classes, or even attend to my child’s needs? Without my inner critic, I would think I’m already awesome at everything, even if I’m really not.

In some ways, our “negative” mind is more like a close friend without a filter rather than a vindictive bully. Most of us want our friends to let us know when we mess up, so we can learn and grow. The problem with this friend is he has no idea how to say things in a “nice” way. Still, you know he has your best interest in mind.

So, how do we deal with this filter-less friend who really just wants the best for us? For starters, notice what isn’t working – telling your inner friend to shut up, arguing with him, ignoring him, or drowning him out with the fifth consecutive episode of your favorite show. Instead, I invite you to do something completely different – listen to him.

If you are willing, even for two minutes, listen from a different perspective. When your inner friend says, “I’m not good enough,” what do you think he/she is really trying to tell you? If it’s possible that their words are intended to keep you safe, would you want to treat him/her differently?

I’m not saying you have to like this inner friend all the time – I know I don’t. You don’t even HAVE to be kind to him/her. But see what it might be like to stop fighting with him/her all the time and invite them to join your journey. If you would like to learn specific ways to treat yourself with more kindness, here’s a list of my top 10 recommendations.


  1. Give yourself a hug. If it feels awkward and weird, you’re doing it right. Give it another 10 seconds and see what it was like to really hug yourself.
  2. Do the activity that makes you feel most connected to life. For me, going to the beach is when I feel whole, even if I’m also feeling hurt.
  3. Give yourself permission to feel whatever you feel, even if it’s unpleasant. There is a big difference between fighting against painful feelings and being willing to have them.
  4. Chances are you are doing the best you can with what you have. Gently remind yourself of that and see what happens when you can let your best be good enough.
  5. See if you can remember a time during your childhood when you felt hurt. Bring to mind what you looked like during that time. Then, imagine you were able to meet this childhood version of yourself. What do you think this small child needed back then? Are you willing to give that child what he or she needs in this moment, if only in your imagination?
  6. Re-introduce yourself to your inner voice. Spend 30 seconds allowing your mind to just chatter on and see if you can really listen to what the mind is saying, as if this is a close friend you haven’t seen in years.
  7. Try out some of the self-compassion exercises by Kristen Neff.
  8. Imagine someone you care deeply for in their most painful moments. How would you want to be there for that person? What are some things you might say or do when you are with that person? Now, see if you can replace that someone with yourself.
  9. When you notice your mind criticizing you, no need to try fighting with it. Believe it or not, this is your mind’s way of letting you know something important is happening. Picture this inner critic as an infant or toddler trying to get its needs met. How does this change your relationship with your self-critic?
  10. If you’re anything like me when trying these exercises, the mind still judges and criticizes, like a bully who just won’t give up. The secret about bullies – they’re usually the ones who need to be cared for the most. So, when you notice the bully show up, give them some love too.

Loneliness During the Holidays

The holidays can be a time of immense sadness, heartache and loneliness for some people – and that’s okay. How do you make it through the holidays when you don’t feel full of joy?

It’s December, which means the jingles are jingling, the carolers are caroling, and the “holiday spirit” is in the air. For some, this can be a time of joy, love and connection. For others, this can be a time of immense sadness, heartache and loneliness.

I know all too well both extreme ends of this spectrum. On one hand, this time of year brings me closer to a sense of deep connection with my family and friends, and pushes me to be more giving and kind to others. At the same time, I miss family who live out of town, I long for loved ones who passed away, and I experience nostalgia of a pastime that is no longer.

The holiday cheer that our culture puts on a pedestal doesn’t make these moments of loneliness any better. Joy, love and everlasting happiness are shoved down our throats so forcefully, it can feel like we’re broken if we don’t feel these emotions at every moment of the season. Happiness sells, and so it’s marketed as goods and services that we must buy and own.

Unfortunately, this marketing gives the impression that to be a normal, everyday human, we must act like a Who from Whoville – smiling, singing and dancing with overwhelming happiness. The problem is, as humans, sometimes we actually feel like the Grinch – castaway to the mountains, doomed to only watch as everyone else gets to experience love and connection but us.

My takeaway from the classic Dr. Seuss story is these two emotional experiences – joy (Whoville) and loneliness (The Grinch) – do not need to live separately. Eventually, rather than trying to fight off The Grinch, Whoville was willing to accept him as part of their holiday experience. Similarly, you can simultaneously love the holiday, take part in the festivities, and at the exact same time, feel sadness, grief, stress and loneliness.

It’s okay if you don’t “live up” to the holiday hype. You are allowed to feel exactly what you feel, without exception. If you are feeling lonely, rather than trying to make yourself feel better, try treating the feeling the same way Whoville treated The Grinch at the end of the story – open yourself up to loneliness and continue to do what matters most to you during the season.

Remember, feeling lonely and being alone is not the same thing. In fact, feeling lonely is an indicator that connecting with others is something that matters to you. If that’s the case, let loneliness be the kind reminder to reach out to friends, family, partners, or even strangers. Go to that holiday party, or create one of your own, and take loneliness with you like The Unwelcome Party Guest.

This holiday season, don’t buy into the myth that you must be happy to be normal. You also don’t have to banish yourself into reclusion if you feel down or lonely. When you feel joy, great! Do all of those things you love to do when you feel happy!

And, when you feel lonely – that’s okay too. Notice, you can still do all of the things you love to do, even when you feel lonely.

Surviving Being a Survivor of Suicide

I wish this wasn’t a topic to write about. Alleviating human suffering is at the core of my profession, and yet everyday there are people who can no longer bear their darkness and take their own lives. In their wake, are the close friends and family who did their very best to help. Unfortunately, these survivors of suicide could not control their loved one’s despair anymore than the person in despair could. And so they are left with loss.

If you are a survivor reading this, you should know that you are not alone in your pain, and the way that you are feeling is perfectly okay. There is no wrong way to feel – there is only feeling, itself.

Emotions are not dictated by logic or reason. Don’t pay attention to the myth that grief follows strict, fixated, rigid, or linear stages. It’s okay to feel whatever you feel, however it feels, and whenever you feel it. It’s okay not to be okay.

Surviving the Holidays

Holidays can be really tough times for survivors, especially if their loved one died in these months. It doesn’t help that our culture forces cheer and joy down our throats, even when we feel at our darkest. It can make the shame, guilt and loneliness even worse.

Below are some tips for how to get through the holidays, or any other really difficult time. Keep in mind, these tips may or may not make you feel better. My goal is not necessarily to change the way you feel – remember, it’s okay not to be okay – rather, my hope in providing these tips is for survivors to find meaning in life, even where there is pain.     

  • You have the freedom to do whatever you choose to do around the holidays – Whether it’s time with friends and family or time to yourself
    • If you would like to be spending more time with family/friends but find it hard to reach out, try this:
      • Can you remember a time, between the times of darkness, when your loved one lived their life to the fullest? What did they stand for in those moments?
      • With this version of your loved one in mind, what do you think they would say to in your time of sadness?
      • What would they say about your struggle to be with family?
  • Self-care and self-compassion
    • If you choose to stay away from family for self-care, that’s okay too. There is no wrong way to react. In this case, a little self-care can go a long way. Here are some ways to find self-care:
      • Do your favorite activity, even if it’s a guilty pleasure. It’s okay not to be okay and it’s okay to be okay, even if it’s just for a little while.
      • Go to that one place you and your loved one always went. It might make you cry, but it might make you smile at the exact same time.
      • Call your favorite person: Friend, family, partner, that one person you really care about but who you haven’t talked to in forever. Talk, laugh, and be heard.
      • Reach out to support groups. They understand the pain, even if they can’t understand your pain. You can find a group in the Tampa Bay area here.
      • View our list of resources here.
      • Exercise: Walk, bike, swim, run, jump, pull, push, whatever exercise you love to do.
    • Let yourself cry. Maybe you have been crying already, but have you just let yourself cry? No holding back, no pushing down, and no need to be strong. Let yourself go and hold yourself tight.
  • These tips are in no way exhaustive. Find what works for you and do that thing.

The takeaway message here is this: Be kind to yourself in your grief, when you cry, when you smile, and when you remember. If you find self-kindness too difficult, bring to mind your loved one lost. If they were right there, next to you, would they shame you? Would they scold you? Or would they hug you? Would they offer kind, gentle, and loving words? Treat yourself as your loved one would treat you when they were at their absolute best. And remember, it’s okay not to be okay.

If you or someone you know is considering suicide, please call 211, text HOME to 741741, or start a chat with someone online.

Don’t Talk About It

When you’re a man dealing with emotional pain, you know the rules: Keep it to yourself, don’t bother anyone with it, and ride it out. The “it” I’m talking about is stress, anxiety, depression, loneliness, fear of rejection, or a deep sense of emptiness. If you were raised to “be a man” in western culture, you are very familiar with the message: Don’t talk about it. 

The “Don’t talk about it” message might be the clearest for most men struggling with emotional pain but there are a few other messages underlying this one. For example, many men believe expressions of stoicism (which is really just lack of emotional expression), anger, frustration, and irritation are signs of a strong and powerful man, whereas expressions of sadness, loneliness, fear, anxiety, or any other painful emotion is a sign of weakness.

Another underlying message that might sit in the dark corners of a man’s mind include, “If I am weak, I will not be seen as good enough.” The kicker is, even acknowledging these messages can be viewed as a sign of weakness. So, they get buried but not forgotten. They tunnel so deep within the inner workings of men’s minds that they become entangled around his sense of identity.

However, the tiring attempts to suppress “weak” emotions come at a high cost. Men who are reluctant to express a wider range of emotions tend to have higher rates of behavioral health problems compared to men who are more expressive. This means men who do their best to not feel painful emotions are at higher risk of feeling painful emotions. This ironic twist can (and often does) turn into a vicious cycle, eventually leading to substance use, depression, and suicide. One study found that adolescents who restricted their emotions were eleven times more likely to show symptoms of depression, three times more likely to have serious suicidal thoughts, and twice as likely to attempt suicide. 

So, if you are a man, I challenge you to take a moment to explore the worth of emotional restriction. When you don’t talk about the things that bother you, notice if it brings you closer or further away from the people you care about. If you shove away the inner voice begging for warmth and compassion, does it make you feel better or worse? The message to be a strong and capable man is enticing and ever-present. It promises you will be worthy, accepted, and adored. But what if this narrative isn’t working the way it’s supposed to, and your very attempts at being strong is breaking you down? In those moments, can you find strength in the willingness to be weak?