Three secrets about post-traumatic stress

June 14, 2021

by Dr. Anna Courie - Director, Responder Wellness, FirstNet Program at AT&T

Post-traumatic stress is common in first responders. In fact, first responders experience PTS at statistically significant higher rates than the general population.1 Post-traumatic stress is something that, left unattended, can lead to post-traumatic stress disorder. Unfortunately, post-traumatic stress disorder is also positively correlated with suicide.2 This month, we unpack some secrets about post-traumatic stress, as we mark Post Traumatic Stress Disorder Month.

Secret 1: Post traumatic stress is not the same as post-traumatic stress disorder.

Stress is a normal response. In fact, the stress response can be a protective factor in the face of life-threatening events. When you, as a first responder, run towards the fire, the bullets, the fight, the distress, the damaged, and the grieving, that’s going to create stress. Period. That would happen to anyone. Post-traumatic stress disorder occurs when individuals begin exhibiting negative behavior patterns because of multiple factors. Often, individuals suffering from post-traumatic stress disorder have experienced traumatic events prior to becoming a first responder.

The individual with post-traumatic stress disorder can exhibit irritability, poor sleep, guarding behaviors, unreasonable anger, flashbacks and disrupted thought patterns. These symptoms can lead to poor coping behaviors, such as increased alcohol and drug abuse, isolation, aggression, loss of work productivity, and poor decision making. Post-traumatic stress disorder results when the traumatic events are buried and not addressed as a normal part of the experience of being a first responder.

Your goals should include being aware of the stress you deal with as a part of your job and developing positive coping mechanisms in which to address them. Dr. Sara Metz of Code 4 Counseling, says, “the first step is being willing to show up for yourself with curiosity and compassion.

“When folks show up in my office for the first time with trauma stress injuries nine times out of ten the deepest wound that needs to be addressed is caused by the inner critic – the shame that responders experience can be intense,” she says. “Responders can absolutely thrive when they:

1.     Develop a true understanding of their injuries;

2.     And show up for themselves with the same compassion they offer to others.

Easier said than done, but I’ve seen it happen enough times to know that with the right supports in place, these responders can absolutely heal.”

Secret 2: You can grow from post-traumatic stress.

Just because you experience a terrible event doesn’t mean you are broken for life.  Will you carry the scars of having to experience events that many of us cannot even comprehend? Likely. But there is an opportunity for growth. That’s the magic of the resiliency movement.  All the chatter about mindfulness, gratitude, self-reflection, journaling, tactical breathing and other habits are driving you to reflect on the events you experience. And that’s encouraging you to seek ways of reconnecting with the things that bring you joy, meaning, and hope in your life. The threads of joy, meaning, and hope provide the foundation to support you when the next thing happens and you aren’t sure how you’ll pull yourself out of it.

Ken Falke, Chairman, Boulder Crest Retreat, and Josh Goldberg, executive director of the Boulder Crest Foundation, are leading an effort to facilitate post-traumatic growth in the first responder population. In “Struggle Well,” Falke and Goldberg provide a roadmap for transforming struggle into strength and post-traumatic growth so that first responders can find meaning in their struggle. Post-traumatic growth speaks to the ways in which trauma can catalyze growth in five areas: new possibilities, deeper relationships, personal strength, appreciation for life, and spiritual and existential change.

 “No one deserves a great life more than our first responders, who sacrifice so much in their service,” Goldberg says. “A key part of that is ensuring they can do more than just survive the lifestyle – and learn to thrive and grow during stress and struggle. Our programs and work are designed to ensure that first responders can do precisely that – and we see no community better poised to grow through trauma than they are.”

Secret 3: You are a hero, but you are human.

Everyone is talking about reducing the stigma surrounding post-traumatic stress, but the secret starts with you. When we repeat behaviors that put diagnosis in a corner and shroud them in mystery and suspicion, we perpetuate that stigma. Stigma happens when we whisper about the problems we face, instead of admitting them, or put on a face of false bravado. Stigma happens when we know there’s a problem, but we consistently avoid addressing the issue.

We know you are a hero. We want to celebrate that and support that, because the world needs first responders. First responders are a unique and wonderful breed of individuals that are the heartbeat of our communities being vital and thriving places for people to come together and live. We also need to recognize that you are human; and it is critical you take the time to take care of you and to recognize that human beings need connection.

Every time you acknowledge, “hey, that was hard,” “hey that hit me harder than I realized,” or “hey, I haven’t been coping from that event well,” you are busting down the stigma doors. You’re serving as a beacon for others that it’s okay to not be okay and that they are not alone in the dark. Because peers watch each other, listen to each other, and grow from each other, acknowledging suffering out loud is an essential part of trauma healing and growth. If we share our experiences and struggles, then we help someone else who’s also struggling, and we offer them the healing power of hope.


Dr. Anna Fitch Courie, Director of Responder Wellness, FirstNet Program at AT&T is a nurse, Army wife, former university faculty, and author.  Dr. Courie has worked for over 20 years in the health care profession including Bone Marrow Transplant, Intensive Care, Public Health, and Health Promotion practice.  Dr. Courie holds a Bachelor’s in Nursing from Clemson University; a Master’s in Nursing Education from the University of Wyoming; and a Doctor of Nursing Practice degree from Ohio State University.  Dr. Courie’s area of expertise is integration of public health strategy across disparate organizations to achieve health improvement goals.

Dr. Sara Metz received her Doctorate in Clinical Psychology from the University of Denver Graduate School of Professional Psychology and is a licensed psychologist in the state of Colorado.  For the past 12 years, Dr. Metz has specialized in public safety psychology and has provided psychological support services to emergency responders (police, fire, EMS, dispatch, healthcare workers, etc.) and their families. 

Josh Goldberg is the Executive Director of the Boulder Crest Foundation that provides post traumatic growth programs and training for first responders and veterans nationwide. Josh is responsible for leading the development and delivery of training, technology, research and evaluation, and social and policy changes solutions based on the science of Posttraumatic Growth.


1 Heyman, M., Dill, J.; & Douglas, R. (2018).  The Ruderman White Paper on Mental Health and Suicide of First Responders. Ruderman Family Foundation.

2 Police Executive Research Forum. 2019.An Occupational Risk: What every police agency should do to prevent suicide among its officers.