First responders are learning about the surprising causes and unique therapies for challenges prevalent among their community thanks to workshops in Hilo and Kona that derive treatment strategies from a new book.
“They see things no one should see, and on a continual basis,” said Renee Godoy, a chaplain supporting members of the Hawaii Police Department for 18 years and the Hawaii Fire Department for eight years. “It affects their relationships and health.”
The book, “Operator Syndrome,” is being used to help first responders with the psychological struggles, sleep disorders and other health problems similarly experienced by military veterans.
The book by UH Hilo psychology professor Chris Frueh was released last year, and he is now working with Godoy to host informational workshops about how the responders can access support.
The first workshop took place in Hilo at the Connection Point Church on March 21 and focused primarily on police department personnel. A second workshop in Kona for firefighters is planned for Monday, Frueh said.
Prior to the book’s release, Frueh’s 30 years of experience treating military veterans was utilized in workshops for the FBI and the Drug Enforcement Agency. He also appeared on dozens of podcasts about the elevated number of suicides, sleep problems and behavioral issues among veterans.
His podcast appearances led to emergency responders connecting with him and recounting similar effects from their work, leading him to include police and fire officials in his speaking engagements.
Frueh said “Operator Syndrome” is “not an academic book. It’s intended to be a practical guide for operators and their families,” with quotes from operators with relatable experiences and expertise throughout the book help it feel more accessible to emergency personnel.
Godoy said she’d “recommend it to every first responder.”
“The framework really starts with traumatic brain injuries,” Frueh said of how problems begin at the physiological level, including work-related wounds and unbalanced hormones. “The two smart places to start are to get a sleep study and a blood panel of hormones. Both of those are a great way to look into issues and take away stigma of mental health.”
Frueh said low testosterone in male responders leading to sleep disorders and low sex drive often cause doctors to diagnose depression and prescribe medications for that condition. Early studies of female operatives indiciate “women special operators and firefighters are experiencing infertility, high rates of miscarriage and early menopause,” Frueh said.
Frueh said the constant engagement of first responders’ sympathetic nervous system — home of the “fight or flight” response — is responsible for hormonal imbalances. Frueh’s work introduces innovative treatment options like hyperbaric chambers and psychedelic medicine, as well as stellate ganglion block therapy.
“This treatment has been around for about 100 years and was used to treat headaches, but was also recently found to reduce anxiety,” Frueh said of stellate ganglion block therapy, a 45-minute outpatient procedure on the nerve collection in the spinal column that provides relief for six months or more. “It has an immediate effect of causing lowered physiological arousal, which leads to the patient suddenly feeling calm, their mind is not racing, and they sleep better.”
Godoy commended how Frueh “keeps up-to-date on current trends and therapies.” She also said that, “sleep deprivation and sleep deficit is not given the weight it deserves.”
“There’s no one-size-fits-all — there’s different treatments for different things,” Godoy said. “They may be dealing with sleep deficit, chronic pain, and, for critical incidents, it’s the memories.”
“The recollection of the event makes their brain run through the same pathways, (bringing up) the same feelings they felt during an event, and it may start to affect their life,” Fire Chief Kazuo Todd said of first responders dealing with traumatic memories or the loss of colleagues during response efforts. He said that three out of the four county fire departments throughout the state experienced fatalities in the past five years.
“For police, the most stressful incidents are obviously officer-involved shootings. That’s a very good example of a call when the stress level goes through the roof, and there is an impact to all our responders,” Todd said. “For fire, it’s cardiac events where people are needing CPR or being transported,” Todd said. “The younger the person is, the worse it gets. Fatalities of minors are pretty traumatic. It doesn’t ever really go away.”
Todd, a firefighter for 20 years and the department’s chief for four, said he doesn’t recall having the Peer Support and Critical Incident Stress Management support 20 years ago that benefit responders today. He said, “I know our old timers would solve problems in a bar … just drink it away,” which he said explains the higher incidence of alcoholism among first responders.
Todd, Godoy and Frueh all acknowledged the physical impacts of heat, explosions and exposure to toxins on the overall health of first responders, saying the physiological roots of these traumas that are shared by both first responders and military veterans must be addressed.
Godoy said one major difference between the sometimes similar trauma experienced by first responders and military personnel is the location of the occurrences.
“They see life and death and serious injury on a continual basis, but … a veteran is fighting on a field away from home. For first responders, their home is their field,” Godoy said. “A firefighter can pick up their mother, because it’s a small community.”
Frueh said the constant reminders of traumatic events that occurred in a first responder’s home community leads to hyper vigilance, again disrupting their hormonal response.
While veterans transition from the area of trauma to an area of safety at the end of a deployment, first responders make those brain-addling moves at the end of every shift, he said.
“It’s a very rapid transition,” Frueh said. “They could go from holding a dead child at a crime scene or a fire to holding their own child.”
Godoy said the police department is in the process of introducing an on-staff psychologist into their support system for officers, saying that, “Both Chief Todd and (HPD) Chief (Benjamin) Moszkowicz have been incredibly supportive and have made the health and wellness of their personnel a priority.”
Email Kyveli Diener at kdiener@hawaiitribune-herald.com.
