Post Traumatic Stress Disorder Story Archives - West Virginia Public Broadcasting

Report On First Responders Mental Health Issues Sparks Crisis Reaction

Firefighters are more likely to take their own life than to die in the line of duty. First responder PTSD rates are triple the general population.

Firefighters are more likely to take their own life than to die in the line of duty.

First responder PTSD rates are triple the general population.

Those are just two of the many devastating statistics House Education Committee Chief Counsel Melissa White laid out in a Tuesday interim meeting of the Joint Committee on Volunteer Fire Departments and Emergency Medical Services.

“A journal of Emergency Medical Services reported that 37 percent of EMS first responders contemplated suicide and 6.6 percent attempted suicide, making them 10 times more likely than the CDC average,” White said.

White told lawmakers that combining EMS and firefighter duties made the individual six times more likely to report a suicide attempt than just firefighting duties alone.

“Here in West Virginia, in the month of September 2022 alone, four suicidal first responders were referred to inpatient treatment through the assistance of local non-profit organizations,” she said.

White spelled out research that showed “after experiencing a traumatic incident, just one of those, the CDC reports that first responders may experience the following system symptoms…chest pain and difficulty breathing, signs of shock, nausea, vomiting and dizziness, heightened or lowered alertness, poor concentration and memory, nightmares, anxiety and depression, guilt, grief, blaming others or self intense anger and outbursts, excessive alcohol drug consumption and inability to rest or pacing.”

White told the committee more than two thirds of EMS professionals never have enough time to recover between traumatic events.

“As a result of this repeated, often unprocessed trauma and working conditions inherent in the job,” she said. “Studies consistently report the first responder’s mental health suffers, resulting in increased risk of PTSD, substance use disorders, depression and other mental health conditions, all of which are associated with suicidality is the cumulative effect of the day to day hard to process moments shooting and stabbings, highway wrecks, children harmed, quiet deaths in quiet homes.”

She said in rural West Virginia, a first responder’s exposure to trauma is greater than in urban areas.

“In rural areas, substance use suicide and older adult populations needing EMS assistance is significantly higher,” White said. “Rural EMS take on higher call volumes, often with less resources and that call volume has increased over the last 20 years. Moreover, living in and responding to emergencies in small towns means that first responders may respond to a call of someone that they know or love, and that takes a huge toll on the first responder.”

White said there is a critical lack of training, support and education regarding first responders coping with overwhelming stress and trauma.

“The literature is clear that a majority of fire EMS departments do not provide education regarding mental health risks and symptoms,” White said. “They do not have behavioral health systems in place to help first responders cope.”

She said the long-standing mentality of what many have termed “suck it up” is still pervasive throughout the state and country.

“Even when first responders do realize they need help and do have support accessible,” White said. “They are discouraged from using it or even told what to say.”

She referred to Huntington’s Compass program that directly addresses first responder mental health issues.

“Therefore, a template to begin to support first responders as this exists locally. In addition, other cities have established similar programs and national organizations exist to provide assistance,” she said.

Committee Chair, Sen. Vince Deeds, R-Greenbrier, said White’s presentation demonstrates a crisis in first responder mental health.

“I challenge our Senators or Delegates and those that are hearing these words to do something,” Deeds said. “Because now is the time to do something.”

State EMS Director Jody Ratliff said in a May 2023 WVPB interview, that he is tackling mental health issues head-on.

Ratliff said EMT’s are now using the 988 suicide Crisis Lifeline. He said the “suck it up” mentality “is not what it was.”

“When I was brought up, it was that ‘suck it up’ mentality, we’ve got to move on to the next call,” Ratliff said in the interview. “Unfortunately, that’s still EMS, we still have another call that’s coming, we don’t know when it’s going to stop for the shift.”

Ratliff said, on Tuesday, that a network of first responder critical debriefing teams to deal with the trauma will soon be deployed throughout the state. His hope is “that the older medics out there have to be the leaders in mental health.”

New Mental Health Trauma Therapy Eliminates Anguish

The whole purpose is to reset the brain from traumatized to no longer living with those distressing images and sensations and emotions.

Imagine eliminating the anguish of experiencing a traumatic event – or dealing with dyslexia, anxiety or pain management – without speaking a word about the trauma, or the issue itself.

Randy Yohe spoke with Christie Eastman, manager at the Cabell Huntington Hospital Counseling Center, who is on a mission to train West Virginia mental health professionals in a technique to better treat trauma.

This interview has been lightly edited for clarity.

Yohe: You’re training West Virginia therapists and mental health providers in a better way to treat trauma. What is trauma?

Eastman: Trauma is not what happens to a person from the outside. It’s the way that the brain encodes the experience. And so something that is experienced as a trauma changes the brain and makes an imprint on the part of the brain that is always scanning to differentiate between what is safe and what is unsafe. The data that the brain encodes from that experience is encoded as data that the brain scans as unsafe into the future.

Yohe: How prevalent is this trauma, and who are you targeting? What issues can you deal with to help?

Eastman: To some extent, if we live long enough, all of us have experienced something that has resulted in trauma in the brain. Therefore all of us can benefit from therapy. When we talk about trauma and the treatment of trauma, we’re talking about things that significantly impact a person’s life, such as a traumatic incident that we would all recognize – a terrible car accident or witnessing a shooting or sexual trauma, like a rape, or combat trauma. It could be another experience in which a person felt very threatened or where someone else was potentially at great harm to themselves, or even death where the person witnessing the experience or that event, felt helpless and unable to, to prevent that from happening.

Yohe: We hear that “talking it out” offers trauma relief. Your approach is called Accelerated Resolution Therapy, or ART. What’s the difference between the two?

Eastman: There are other therapies, talk therapies where people rehash, either verbally or sometimes in writing, the incidences that led to their traumatic experience. Ours is different in that the person recalls the event in their mind silently under eye movements, that the therapist directs with their hand or with a light bar or some other instrument. The eye movements help the brain process very rapidly. They’re also very calming, and the person is recalling the events in their mind, not verbally, so that’s a big difference. And what people report and what we experienced as therapists, is that the individual doesn’t have to be re-traumatized, or get tremendously upset or have to verbally recall those difficult moments in their life. And the therapist doesn’t have to witness all of those details. Usually, that part of the therapy process only takes between in one session, you know, 30 seconds to maybe 10 minutes, and then that phase of the therapy session is already completed without the person having to speak about, or write about the event.

Yohe: That special aspect of ART is when clients replace negative images with positive ones, then they don’t need to talk about the details of the trauma. Explain why.

Eastman: Because all of the psychological processing and change is happening in the brain. As I said earlier, a trauma is how the brain encodes an experience. Any of these therapies that are developed to heal trauma are about rewiring the brain from that unsafe state, to a safe state. The brain doesn’t get reset to not any longer have vigilance over things that we need vigilance for. We just remove the hyper vigilance, which is that constant sense of being on alert or responding in an exaggerated way to a neutral stimulus.

How it works is as the person early in the ART session visualizes the defect difficult memory, the eye movements are used so that they’re silently recalling that and we break it up so that the person is alternately recalling the difficult experience and then calming their body and then going back in to seeing the difficult experience and then calming the body and all this is guided by the therapist. Once they’ve seen that difficult memory one time, then the memory begins to change as the therapist continues to guide the individual through the protocol. Then we come to a point where the individual is voluntarily choosing what they want to replace the images with.

Although this may sound kind of strange and unlikely, research has demonstrated for quite a long time that every time we recall a memory, it becomes malleable. Even though we’re not really aware of it, we’re kind of changing our memories every time we recall them. That neural network in the brain that’s now open, that person gets to put in that neural network what they would rather have there. So often it’s replaced with a really happy memory, or instead of being a victim, they weren’t a victim, and they were powerful, and they were able to do the things that they wish could have happened, so that the whole thing could have been prevented. Or if it’s something that they can’t, and don’t really want to erase like the death of a loved one, or, or maybe a buddy in combat, they may just simply replace that memory with with one of the happiest moments that they had with that person, or just another really good memory from their life.

Even though the person is very alert and awake and sometimes extremely alert, they say at the end of the session, “I feel a lot of mental clarity.” While they’re under the eye movements, their brains are in a kind of a theta wave state, so that it becomes a little bit of a dreamlike experience. And the brain loves metaphors, and as people we dream in metaphors. So replacing those images can be with anything, including something that’s not even reality based. The whole purpose is to reset the brain from traumatized to no longer living with those distressing images and sensations and emotions.

Yohe: There seems to be a myriad of issues that ART can help relieve, right?

Eastman: There’s a lot. Anxiety, depression, phobias. ART can help people resolve panic attacks, obsessive compulsive disorder, post traumatic stress. It’s used for addictions, for performance anxiety. For athletes or people that are preparing for a very significant test, family issues, victimization of many kinds, poor self image, relationship issues, grief, job related issues, pain management, memory enhancement, and even dyslexia anxiety.

People whose dyslexia for instance, is really based from what was going on during that period of time when they were learning to read and something was going on in their life, maybe in their family life, where they were held back or where they were teased or bullied by their peers, therefore their ability to learn to read was disrupted. There are people that have lived with dyslexia for a long time who can be cured. People come for therapy and can be cured in as quick as one to five sessions, which is absolutely remarkable.

Something that is a bit new, that I’m discovering and working with here at Mountain Health Network and with the neurology department of Marshall Health, is working with people with neuromuscular disorders to help with pain, and with some of the other symptoms that come from living with chronic, traumatizing effects of living with such illnesses as ALS.

Yohe: You want to put out a hue and cry for West Virginia therapists to learn to use ART. Well, here’s your opportunity.

Eastman: My fellow therapists that are in the trenches with people who suffer so much, this is a therapy that will help you do what you’re in the field to do, which is actually heal. To heal the terrible experiences that people live with that affects their lives so much. These people that you care so much about, and that you go to work to help every day. We’re in a crisis right now, as you know, there are so few of us out there.

One of the reasons that our training will be so important for you and your practice is that rather than turning people away, because you’re not able to accommodate all the needs, you can help people rapidly so that you can continue to accommodate new people who are in need of therapy. Instead of feeling heavily laden by how long it takes and how hard it is for your clients, you can experience, session after session, the buoyancy of the joy of this model and seeing the remarkable delight and excitement in the lives of your clients as they see their lives change right before you.

To those that live with trauma and other things that change their lives, I encourage you to keep the faith, know that your life is worth living, and that you can be healed from things that perhaps you wonder if you will be living with for life. Although there are not a lot of ART trained therapists in West Virginia right now, there are some of them, and it’s growing. Because this works so rapidly, it’s worth looking on the ART website for ART therapists, even if you need to travel, because you may be able to resolve something in as quickly as one session. But there is absolutely hope.

I meet with folks every day, that’s what I wake up in the morning to do. And I know that there are people like me all over the state, who are eager to be a support to you and all over the country. Don’t live with your suffering. Find help for it now.

To get information on ART training and treatment, contact Christie Eastman at Cabell Huntington Hospital’s Counseling Center; Christie.Eastman@chhi.org; CabellCounselingCenter@chhi.org (304-526-2634), or go to artworksnow.com.

Emotional Healing From Floods Can Take Just as Long as Rebuilding

Rachel Taylor stands on the front porch of her little yellow house in White Sulphur Springs. The front door is pasted with paw prints where her dog tried to get in during the flood.

Across the street, nestled between two battered houses, is an empty lot marked by a cross with an array of flowers and photos. It’s a memorial for a family washed away by the flood.

The dog? He survived the flood and is now with family in Kentucky. Taylor’s across-the-street neighbors, the Nicelys, did not.

“When I start feeling overwhelmed with this, I just look across the street at that memorial and I think, there’s nothing that we have lost that can’t be replaced or mended,” she said.

Taylor gestured at her gutted living room. She and her husband spent seven years renovating this 1930s Craftsman house, room by room. They were just about done with renovations when their house was flooded a few weeks ago.

“You know, the first couple of days it was very intense. It was kind of crisis mode. Maybe that’s the way I would describe it, because you didn’t really have time to think about it and process it,” said Taylor.

Once the full extent of the damage set in, Taylor said she developed severe nausea and carsickness to the point of not being able to drive.

A memorial for the Nicely’s sits across the street from Rachel Taylor’s White Sulphur Springs home.

“Talking to different people, they said, ‘That’s probably your nerves – you know, the stress level.’ You don’t realize your body is just having a response to this, [which] isn’t normal for you,” she said.

Taylor has flood insurance that will allow her to rebuild, but she said her family will likely move out of the neighborhood once the home is restored or ready for sale.

“I think the words we use when we talk about it are ‘I don’t know if I have it in me,’ ‘I’m not sure if I can do it again,’ things like that. And then we just say, ‘Well, we’ll take it one day at a time.’”

Experts say this kind of response is normal following natural disasters.

“It’s a physical aspect of the stress response – it will affect the body’s ability to concentrate, to rest and to be able to function,” said Marcie Vaughn, leader of the state-funded West Virginia Crisis Response Team. “Cognition is slowed and impaired,” she added.

In addition to Vaughn’s team, church disaster-assistance teams and the organization Hope Animal Assisted Crisis Response offered material and emotional support to victims, trying to be “a meaningful presence.”

“From the behavioral health perspective, we find we are more in need after the 10^th^, 12^th day, just because immediate needs of food, clothing and shelter take precedence,” said Vaughn.

In the first few days following the flood, Vaughn said her team split their time between helping people replace lost psychiatric medications and looking for signs of mental distress in people at shelters or feeding stations.

“We see fatigue, problems with cognition,” said Vaughn. “You have individuals who walk into a supply center and they have no idea what they need.”

A 2012 study published in the journal of Social Psychiatry and Psychiatric Epidemiology found that while most people bounce back a few months after a disaster, if you don’t address ongoing stressors – such as lack of a home, financial challenges and repeated exposure to the trauma – people will continue to struggle.

“As the fatigue sets in and the frustration, we see an increased need for behavioral health intervention,” said Vaughn.

But their work becomes hardest, she said, when national organizations and media have lost interest and real, tough problems persist, but only the local folks remain to extend helping hands.

Appalachia Health News is a project of West Virginia Public Broadcasting, with support from the Benedum Foundation.

Researchers Want to Know If Service Dogs Can Help Veterans Return to Civilian Work

Can service dogs help veterans living with post-traumatic stress disorder function in a civilian work environment? Researchers at West Virginia University are trying to find out.

Sometimes it’s hard to get interviewees to open up when you first meet them.

“Bella, speak. Oh, inside voices. That’s very good.”

Meet Bella, a 2-year-old yellow Labrador retriever, and her trainer, Morgan Syring.

I caught up with them last week while Bella was showing off her skills to a group of kindergarten students touring the WVU service dog training center at the university’s research farm.

WVU Service Dog Program

The service dog program began 10 years ago as a class to give pre-veterinary students the chance to learn about animal behavior. But it now trains dogs for veterans who have both PTSD and mobility issues.

Bella retrieves a bottle of water for Morgan Syring at WVU’s dog training center at the WVU Research Farm.

The training center has all the things you would find in a typical house, from a living room and a set of stairs to a row of fridges that the dogs can practice opening.

Bella trots over to fridge, pulls open the door and grabs a bottle. She hands it to Syring and closes the door.

Customized Skills

Syring says Bella has also been trained to provide a buffer for her person when he’s out in public.

“Her person also likes a lot of space, so she’ll walk around her person to keep like an imaginary bubble around them. So she’ll just circle around her person if he gets uncomfortable,” Syring said.

Bella is nearing the end of her training. Dr. Jean Meade runs the service dog training program. She says Bella’s skills will be customized to fit her person’s particular needs.

“When he gets stressed, he strokes his beard,” Meade said. “So he wanted us to teach the dog [that] when he started to stroke his beard, to come and put her head in his lap as a calming thing.”

Meade said having a service dog can be a transformative experience for a veteran with PTSD.

“We have another veteran that could no longer stay in the same bedroom with his wife at night because he would have severe night terrors.”

So the veteran wears a heart rate monitor, Meade said.

“So that at night when he’s sleeping and his heart rate starts to accelerate, the dog awakens him before he goes into a nightmare, which has really changed his life.”

The service dog training center at WVU’s research farm off Stewartstown Road in Morgantown.

Empirical Evidence

Many veterans say that a therapy dog can help alleviate the effects of post-traumatic stress disorder. Now researchers at WVU are studying whether service dogs might help control the symptoms of PTSD in the workplace.

Dr. Meade says, “There’s a tremendous amount of anecdotal evidence that service dogs are really helping these folks, but there’s not a lot empirical evidence to support it. And so the VA is waiting for that empirical evidence to make their decision of whether they will fund benefits for psychological service dogs.”

“We’re trying to generate that empirical evidence as to whether or not service dogs could help veterans get back into employment and society,” professor Matt Wilson said.

Working with psychology specialists at WVU, Wilson designed a scientific study to examine how dogs in the workplace affect veterans with PTSD.

So would a therapy dog in a workplace provide stress release to someone that wasn't their dog … or do you really have to have that bond with the dog to get that kind of a response and benefit.

How the Study Works

During the study, veterans will be monitored in a simulated work environment while they perform mildly stressful tasks. Dr. Meade is also involved in the study.

“We have a computer-simulated task that is intended to induce stress. The veterans are hooked up to heart-rate monitors and eye-blink monitors and are asked to do this demanding task and then these physiological parameters are measured,” she said.

Two types of tasks will be used. One task is much like a hearing test, where participants are asked to respond to flashing lights on a screen. The other involves completing math problems.

Because it can cost up to $25,000 to train a service dog, Meade says one of the study’s goals is to find out whether a therapy dog can provide that same benefit. She explained that a therapy dog doesn’t require the same intensive training that a service dog needs.

“So would a therapy dog in a workplace provide stress release to someone that wasn’t their dog, it’s just wandering around through the office setting, or do you really have to have that bond with the dog to get that kind of a response and benefit,” Meade said.

Project ROVER

The research is part of a WVU project called “ROVER.” ROVER stands for Returning Our Veterans to Employment and Reintegration.

Wilson said he is recruiting veterans with and without service dogs for the ROVER study. Wilson also encourages veterans across the nation to complete a survey on the Project ROVER website. Among other things, information gathered through the survey will aid in the design of more studies that focus on the barriers veterans with PTSD face in reintegrating back into civilian life.