941-462-4807 meg@megyounglcsw.com

Hope Just like so many first responders, “Joanna” has been on several calls, some of which she believed she should have and could have done more for. The more calls you go on that you believe this about yourself, the more feelings of worthlessness and low self esteem come in. You start beating yourself up over all the “shoulda, coulda, woulda’s.”
The obvious problem with living life with shoulda, coulda, woulda is we cannot change the past. The maybe not so obvious problem with living life this way is the compounding emotional struggles we feel from it. It affects our belief in ourselves as well as in our work.
Some of the downsides include low self esteem, second guessing everything you do, and worthlessness. These are awful feelings that can get in the way of the good work you do.
Not only does living life with the shoulda, coulda, woulda affect our emotional state, but it also affects our behaviors and actions. When we second guess ourselves, we don’t act quickly. Emotion gets in the way of objectivity. When that emotion is due to our feelings about our own worth, it hugely impacts our actions at work, but also at home.
A recent client of mine, “Joanna,” went on a call to a housefire. In the house was an occupant who was asleep on the bed as well as a couple scared animals. This was not the first call she’d been on where her team had to get people and animals to safety. The occupant was not well off by the time the fire department got to the house.
At the time, Joanna and her team battled the blaze, got the animals and occupant out of the house, and sent the occupant on his way to the hospital. She continued to do what she needed at the scene. She did not allow herself to think about the occupant or animals, and just focused on the task at hand.
After the blaze was extinguished and she and her team left the scene, the image of the occupant came flooding back to her. She wondered how he was, whether the doctors would be able to do anything for him, what his family would be going through and felt very sad for him and his family.
She then started thinking about her own family. How did he get so burnt without realizing it? Was he intoxicated? What would happen if someone in her own family was not able to get out of the house, or didn’t realize that the house was on fire until it was too late. How would she get through that?
Then her mind went to is there anything I could have done differently? Unfortunately, as her mind was racing around all the things that happened, all the possibilities, all the what if’s, all the unanswered questions, and everything else, she started feeling worse and worse.
Eventually she wound up feeling very sad and wondering if this career really is for her. Every call she’d been on where someone’s life had been turned upside down (yup, that would be the vast majority), kept reverberating in her mind. She didn’t know who to talk to about it. Her self esteem dropped. Feelings of worthlessness set in. She ended up in a very depressed state of mind.
Joanna is not alone in this. It is completely normal for first responders to start to feel worthless, for your self esteem to drop, for you to keep replaying the calls you’ve been on and wonder if you are ok.
It is ok to feel this way. You are normal and you are not crazy. There are a good number of first responders who are starting to realize this and starting to seek out help from a therapist.
It is true that you are feeling worthless and your self esteem has dropped. However, when we see others overcome something similar, it can inspire us to make the changes we need to achieve a feeling of competence over ourselves and our lives. When we take similar steps, it is entirely possible to love your career as much as you did when you started and to not let the accumulation of stress from what you see and deal with on a daily basis impact your feelings about yourself, your career, or your life.
Keep reading to see how one firefighter started seeing herself as a competent member of her department again
Before scheduling a session, Joanna was starting to feel crazy. She knew she was good at her job, but was starting to second guess herself with everything. She started thinking she couldn’t do anything right anymore and even felt worthless at home.
She often found herself feeling down about herself, her career, and her life in general. The feelings of worthlessness and low self esteem seemed to worsen each day, no matter what she told herself.
Living this way impacted her ability to act rationally at times. It impacted her ability to act quickly on the job. It impacted her self-care routine at home. Her nutritional intake changed; time spent at the gym changed.
Joanna found herself not hanging out with those she cared about as much. She didn’t feel like she had anything to offer to the relationships anymore. She just didn’t feel like herself, which increased her feelings of worthlessness.
Right before scheduling a session, Joanna’s coworker shared with her that she has noticed the change in Joanna. She thought Joanna may need counseling. Joanna blew it off with her co-worker, but when she went home, she did some research online. She found that she was not alone in these feelings and decided maybe she could benefit from a few therapy sessions.
When her co-worker told her she thought Joanna needed therapy, Joanna was defensive and upset about this internally. She thought she was hiding it pretty well from others. She thought she acted normal at work.
Joanna decided to schedule a session because if her co-worker noticed how she was feeling, then others would as well. What would they think of her? Would they think she is not capable of doing her job? According to what she found online, therapy could help her feel better and get a sense of happiness and control back.
When Joanna presented to therapy, she expressed her mixed feelings about therapy. She wasn’t convinced therapy would help, but she was willing to give it a try. She needed to do something at this point.
Together in the first session, we explored Joanna’s fears and reservations about therapy. She shared her hopes, but also her skepticism that therapy would actually do what it claimed. She thought she was too far gone. She read a bunch on line, but part of her still thought that was just high claims, but not truth.
By the time Joanna left the session, she felt more confident and willing to give it a full try. She reported her skepticism was still there, but she would put in all the effort needed because if this really would work, she realized she would need to do some work on her own.
As we continued therapy, Joanna came to realize the feelings of low self esteem and worthlessness she felt were due to the accumulated experiences from work. We created a treatment plan to address the daily stress and allowing the brain to let go of instead of hold onto the calls she went on.
By the time she left session, she felt a sense of hope. She wasn’t yet sure whether it would work, but she felt a sense of hope and encouragement. She was ready to start the process.
When Joanna and I sat down to work together, she wasn’t sure what therapy would be like. She wasn’t sure what she needed to do, or how much she would need to share. She wasn’t too keen on sharing the details of her experiences, either.
We often discussed the bodily mechanics of what was happening in her brain and body due to her work experiences. We discussed the effects this has on her and how normal it all is. There was a lot of education on the role of the stress response and how to settle the stress response.
Joanna attended therapy weekly and started to feel more trust in the therapeutic relationship and more confidence that I understood what she was going through. As she started to feel this increased trust, she started to feel more confident that therapy may actually help her.
Joanna and I came up with a treatment plan to address her concerns and what she wanted by the end of treatment. We outlined a way to measure improvement and identified how she would know she is feeling better. We discussed how we would work through the details of the experiences she did not want to share and still help her move past those experiences.
When I practice with clients like Joanna, I often use a technique called EMDR. EMDR, also known as Eye Movement Desensitization and Reprocessing, has been studied and is shown effective in many studies. The VA and several other national organizations use EMDR as a modality of treatment to help their clients with PTSD.
I like EMDR with my clients who suffer from racing thoughts, intrusive memories, and other symptoms due to trauma, including seeing other people’s trauma, because it gets to all aspects of the memories including smell, which is one of our strongest memory recall senses, and body sensations. Because it gets to all aspects of the trauma, it tends to have quicker results.
Furthermore, with EMDR, you do not have to share anything you do not want to. Traditional trauma therapy requires you to share the details of the event(s) with the therapist so you and the therapist can work through the thoughts. However, with EMDR, your brain will do the healing and you do not need to share with me anything you do not want to. This is a huge benefit to my first responders who often cannot outwardly say some of the things they’ve been witness to.
Another benefit of EMDR is you do not need to go through each and every incident. Each call you go on are slightly different (and sometimes very different) and traditional therapy modalities will only work on one incident at a time. With EMDR, you start with the worst part of what is bothering you and we work on that until there is something else which is the “worst part,” then we work on that. In other words, we work on all incidences together.
After several weeks of therapy, it was obvious Joanna was feeling better. She reported feeling stronger and more in control. Her appearance in session changed. I was able to see the confidence in her grow and she also noticed this. She reported improved sleep and less racing thoughts. When we dug into it, she identified a few examples of not second guessing herself, which was a huge improvement and made her feel more confident in herself.
Joanna reported her humor had returned and noticed a change in her attitude with her co-workers. She reported a couple of her co-workers mentioned the change to her and she told them about EMDR. She informed me that she believed this therapy was a life saver for her and she had only attended 6 sessions thus far.
Joanna knew she was ready to end therapy because she was no longer second guessing herself. She felt confident and worthwhile in her career. Her friends and family enjoyed being around her and she enjoyed being around them.
We completed EMDR therapy with focusing on the future. We identified a couple what if situations and worked through them. We completed a treatment plan for her continued self-care upon termination.
By our final session, Joanna couldn’t rave enough about EMDR. She stated this therapy was a life saver and was so happy that she decided to go through with it. She recalled how skeptical she was about therapy before beginning, how afraid she was that she’d have to share things she didn’t want to or know how to, and how unsure she was about the treatment modality as it seemed too good to be true prior to beginning.
Although you struggle with anxiety and feelings of hopelessness and worthlessness, you have the potential to feel the excitement and passion you felt prior to the accumulation of horrific experiences you’ve dealt with on the job.
Now that you’ve seen what is possible for other clients, there is a possibility for you to also turn off the stress response so it does not continue to set the alarm off so many times per day. You have the potential to feel better quickly.
Achieving this freedom from the emotional roller coaster can be both exciting and scary. However, when you know more about what to expect, the unknowns won’t be as scary. You can read more about EMDR at my ultimate guide to EMDR.
You absolutely can enjoy your life and career as much as you did when you first started. It is also not going to take years of therapy. Meg Young, LCSW specializes in the unique culture of first responders and will help you reach your goals quicker than attending therapy with just anyone, similarly to going to a specialist versus a general surgeon for hand surgery.
Choose strength and call me today to start feeling results quickly! I look forward to hearing from you. 941-462-4807.