Finding Your Way Through Therapy
Strategies for Trauma Recovery in First Responders With Hayden Duggan
What happens when the champions of our safety need rescuing? Join us for a profound discussion with Dr. Hayden Duggan, founder of OnSite, as we dissect the mental health challenges faced by first responders. This episode promises to illuminate the critical need for specialized therapy and trauma recovery tailored to those who risk their lives daily. Dr. Duggan shares compelling anecdotes and expert insights into why seeking mental health support is a courageous and necessary step, not a career-ending move.
We delve into the alarming rates of suicides among police officers and firefighters, emphasizing that traditional therapeutic approaches often fall short for these heroes. Dr. Duggan and I explore practical solutions like Critical Incident Stress Management (CISM) courses and the integration of mental health providers within first responder communities. This episode underscores the emotional toll of the job and the importance of peer support systems in managing stress and trauma.
Discover how wellness modalities like yoga, Pilates, and acupuncture play a vital role in the mental and physical recovery of first responders. We highlight impactful trauma recovery programs and stress the significance of timely mental health interventions. Finally, we express our heartfelt gratitude to military personnel and firefighters for their unwavering service.
What happens when the champions of our safety need rescuing? Join us for a profound discussion with Dr. Hayden Duggan, founder of OnSite, as we dissect the mental health challenges faced by first responders. This episode promises to illuminate the critical need for specialized therapy and trauma recovery tailored to those who risk their lives daily. Dr. Duggan shares compelling anecdotes and expert insights into why seeking mental health support is a courageous and necessary step, not a career-ending move.
We delve into the alarming rates of suicides among police officers and firefighters, emphasizing that traditional therapeutic approaches often fall short for these heroes. Dr. Duggan and I explore practical solutions like Critical Incident Stress Management (CISM) courses and the integration of mental health providers within first responder communities. This episode underscores the emotional toll of the job and the importance of peer support systems in managing stress and trauma.
Discover how wellness modalities like yoga, Pilates, and acupuncture play a vital role in the mental and physical recovery of first responders. We highlight impactful trauma recovery programs and stress the significance of timely mental health interventions. Finally, we express our heartfelt gratitude to military personnel and firefighters for their unwavering service.
Hi and welcome to Finding your Way Through Therapy. The goal of this podcast is to demystify therapy, what can happen in therapy and the wide array of conversations you can have in and about therapy Through personal experiences. Guests will talk about therapy, their experiences with it and how psychology and therapy are present in many places in their lives, with lots of authenticity and a touch of humor. Here is your host, steve Bisson.
Speaker 2:Merci beaucoup. Thank you and welcome to episode 134 of Finding your Way Through Therapy. I am Steve Bisson. If you haven't listened to episode 133, it's probably very important for you to listen to it, because this is the first part of two of an interview with Dr Hayden Duggan. Dr Hayden Duggan is the founder of OnSite, which is an academy which is for a residential trauma treatment and training program for public safety personnel police, fire EMTs, paramedics, sheriffs, DOC. He works with everyone. And fire EMTs, paramedics, sheriffs, uh, DOC. He works with everyone. Um, and he I.
Speaker 2:I hope you enjoyed the first part of the interview. We really talked about humbleness. We talked about his. He graduated uh from um Harvard and then we talked about a lot of different things. And then, you know, uh, part two. I think we're going to talk about a lot of different things, including, you know, the seven deadly sins uh for uh first responders. So I hope, uh, that's a good teaser for you. And here is the rest of the interview. I'm just gonna interrupt you because, you know, I thought that in 2023 and I know we're in 2024 when this is released um, a few weeks ago, I got a phone call from a uh police officer looking for therapy. And then he's the. I say hello. He's like uh, I'm john doe. I hear you work with first responders. I don't want you to take away my gun. And I'm like right, is there a reason why I should take away your gun? Yeah, and he's like no, why? And I'm like okay, so then there won't be any reasons for me to take your well, I don't understand.
Speaker 2:I said well, you're seeking help, so you're not that far off. You're like you're not far away, so that's a good sign, and my goal as a provider is to always keep you in the community, safe and taking care of the community, cause that's what you want, but it's in 2023, probably 2024. Now I still get people who are like oh, you're going to take my gun away or you're going to make me lose my job as a firefighter, paramedic, emt whatever the case may be or sheriff, or even the nurses and the ER docs, which we don't like.
Speaker 2:Let me not put those guys out of first responder.
Speaker 3:Because they are first responders, I agree, yep.
Speaker 2:They have all these fears and I'm like, no, you're calling me, that's a good sign. And we got to stop thinking that calling and getting help and this is something that you know, you don't need bars to give that information to your team is that that's not the goal. Is you go see a therapist? That means you're not that far off. You know you need the help. You don't go somewhere and you're doing screwed up shit. Now that's a problem. And that's where that becomes more of a problem.
Speaker 2:And I tell guys like schism is great, scissors is great, going to one session with a therapist amazing, I'm all for that. I don't perform miracles in one session. I've never done. I tell people like you know, I'm waiting on that. Uh, that whole thing where you, I put up my hand and go all all right, you're good Next person and then maybe I'll change jobs when I can fix everyone like that.
Speaker 2:But the point, the point I want to make, is that when you talk about all this is, I find that our feel, like the first responders, feel they're like oh, it's gotta be fixed right away. And I always give this example also to. I gave this to one another guy. It was like when you break your arm, it's fixed Right after you go to the hospital. It's fixed, you can use your arm and they're like well, no, it's going to take six to eight weeks or whatever. Oh, so you think mental health is suddenly not a science because we're not curing you right away. It's the same exact thing. That's a great analogy. I give people let's work on that stuff, and you know, being trauma informed, I just I let you talk, but now I got like now my, my, my, uh, verbal diary is coming out, yeah my, my biggest pet peeve about trauma informed is people like, oh, I know about trauma, like that's not trauma informed.
Speaker 2:Oh yeah, but I know about trauma. No, that's not at all what that means. And we have too many people out there who like, oh yeah, I know about on-site, so I'm trauma informed. That's not even close to knowing about trauma. That's not even knowing anything about mental health. Passing the buck to on-site or hayden is not the uh answer. You're part of the problem because you don't want to look at it. But anyway, that's my two cents. And if you're a chief or someone in higher ranks that heard me say that and you feel attacked, good, I did my job.
Speaker 3:Well, thank you for letting me tell that story and to boil it down to its essence. I was a hair club client and I had a event that was very obviously upsetting to me. I had helped, making the connection to a failed rescue that you know that that fire, when we didn't save that child, related to my own feelings about not being able to save my sister. It wasn't rocket science, it's not psychoanalysis, it was a clear connection, a sense of failure. So anyway, I did get trained, I did get sober, tim and I decided to form a nonprofit many years ago. We didn't know what the F we were doing and we started as all volunteers. And then it grew and we went out to Oklahoma City after the Murrah building was bombed.
Speaker 3:We did go down, we decided to call it the on-site because we'll go. If you call us, we'll go. Then we went to 9-11, 27 days corner of West and Vesey. Then we happened to be at the Marathon 10A when the bombing occurred. We got there after the bombing occurred I don't want to misrepresent myself, but we're there until midnight and we were in the temporary morgue, et cetera, et cetera. But why do I say that? We started a place, we created a nonprofit. We got a board of directors Over the years. We did get contracts. God bless Boston Police, boston EMS, mass Department of Fire Services, worcester EMS, now Mass State Police, as well as Department of Corrections, all have agreements with the on-site where the people can come free no matter what.
Speaker 3:And then they also get our clinicians to come to them. And then this year, finally, the legislature voted to make all admissions free for Massachusetts first responders, including nurses, doctors, both pre-hospital and hospital-based services. So now everybody can come free, but the rest of the services still we get compensated for going to them. So that's 30 years later for going to them. So that's 30 years later. That's what happened to us as a result of the very early beginnings, with Tim who is the peer, and me the mental person, and to this day we're still best friends and he's the chairman of the board.
Speaker 3:But to get back to where this comes from, there are 24 CISM teams in the Commonwealth. I serve on one and we're all volunteer and we're all united somewhat loosely by the Mass Statewide Peer Assistance Network, which all follows the same standard of care, all have monthly meetings, all require a clinical director and a peer director of the team. All require that peers are GRIN certified. That's the three-day training course certified by the state, and if you are GRIN certified you can get on a team, clinicians included have to go through it and then you will get both I'm CISM trained so God bless you.
Speaker 3:You get confidentiality and you get privilege, meaning that you can't be forced to testify. As long as you are disclosing this to a GRIN certified peer and a clinician in a debriefing, you cannot be forced to testify. So there are many different systems out there. You know, gordon Alport said the surest way to lose truth is to pretend that one wholly possesses it. There are other methods of group crisis intervention, of course. As it is right now, though, the only method that can guarantee its volunteers both confidentiality and privilege is if you're GRIN trained and you're in the state network. So we strongly believe in the state network, and the onsite now has become really just a small if you look at all the services as the broad edge of a funnel. You've got peers out in the street, you've got people embedded in local departments police, fire, ems who are trained.
Speaker 2:God bless for those.
Speaker 3:You've got chaplains. Mass Corps fire. Chaplains are fabulous.
Speaker 3:They do excellent work, um, and you know that's the broad edge. Then you get through the debriefings and then the one-to-ones and then finally you get down to the stem. That's us low frequency, high intensity resource. If somebody is really in need of it, you better have it for for them, because you know very well, steve, there's that moment in time where they're willing and open to talk and if you miss it, they see a light over no, I'm good, no, I'm okay. You say damn, we should have taken that person in when we could. So the onsite's had 9,500 folks through over the last 30 years.
Speaker 3:We don't advertise, we don't market. We do have a 90% return to duty rate because our people want to get back on duty. We are focusing a lot now on retirees my age and younger I'm truly old, but a lot of them retire much younger than me and families. That's our new focus and we want to build a new building for it.
Speaker 3:But right now yeah, that's where we are. We're just an extension of everything else the Mass Statewide Peer Assistance Network does out in the field the one-to-ones, the debriefings, the response to the crisis, to the shootings or whatever and then we're that last piece If you need it. Not many people do you better have it for them, because we lose piece If you need it not many people do you better have it for them, because we lose them.
Speaker 3:As you know, we lose a firefighter every 3.2 days in the United States. Despite all the training we have size up and RIC training and rescues we still lose a firefighter every 3.2 days, every 57 hours. We lose a cop shot in the line of duty, still in both emergency services. Heart attack, lung disease and cancer are the leading causes of death and they shorten the lifespan of the average firefighter by 12 years and police now it used to be 10 years. They've overtaken us.
Speaker 3:In this current era of everybody hates cops. They have a shorter lifespan than we do. So it's really important that the work you do in this current era of everybody hates cops they have a shorter lifespan than we do. So it's really important that the work you do every time we have a provider out there that understands what people are talking about and has the respect for them. Just listens to them. We don't want clinicians that have to be a cop or have to be a firefighter. That's not what it's about. We want the best clinician we can get, but they have to respect and understand what these people have been through.
Speaker 3:Just shut up and listen you can't go wrong by listening and thank God you work with cops. We've had cops who would come in, come into us and say I might as well stab myself in the eye with a pencil before I'll go back to that person. That person made me feel worse when I came out than I did when I went in. So yeah, you're right, it is a specialty. Not all of us in the clinical world are trained in it and we need training for it. But, that's the overview of the onsite, where it fits, et cetera.
Speaker 2:You forgot one important thing, though. I don't know what the stats are going to be for 2023, but there is a first responder I think it's every 20 hours that commits and completes suicide, and I am not I'm not looking over that, because this is something that's important for people to understand, that you know, you said it yourself. This is we hate cops mentality at this point, and but the stress that firefighters and police go through on a regular basis, daily basis, is something I can't even phantom, and I'm a I work in this field yeah and you need.
Speaker 2:I wanted to mention that too, because we're losing too many to suicide, and I want to mention that too no, you're absolutely right.
Speaker 3:We lose four or six times as many police officers by their own hands every year as we lose by perpetrators. The bottom line of all these activities is suicide prevention. You're 100% right.
Speaker 3:And now of course it's trauma and addictions, because 87% of completed suicides involve alcohol. So for old guys like me, aa becomes just as much of a cause, because we lose people if the only tool in their toolbox is booze or opiates or whatever, and I understand it. I'd only be looking in the mirror if I didn't, but it'll kill you. So we got lots of ways to die in this gig.
Speaker 2:What did people call it? Going to church is usually what happened after a shift.
Speaker 3:Yeah, that's right quiet practice quiet practice.
Speaker 2:Thank you, I couldn't remember the exact expression, but one of the things that I would say to you, that and again, maybe a more, uh, not trying to be provocative here, but one of the things that really is happening is you said, say it yourself they go to a therapist who is a first responder therapist and they go. I would never want to go. Like how many guys come to my couches and go? Okay, I was scared because a lot of people call themselves specialists and they are truly not.
Speaker 3:And I was afraid you're one of those guys.
Speaker 2:There's bucks in it now right, and I think that that's the problem is that people are looking at as a financial gain. For me, it's like, really, how do we, you know? One of the things that comes to mind is that I can fill out. There's a, an insurance company I mentioned this in the past podcast, but I'll mention it to you now because there's a insurance company that'll remain nameless, that took me off their first responder specialist because I wouldn't do their one hour training, which absolutely was horseshit. It wasn't even close to what I deal with.
Speaker 3:Yes, so I'm like you actually know what you're doing, as opposed to a one hour training course.
Speaker 2:Yeah. So for the frustrated people like me, how do we really help? Like? Therapists sometimes come to me and say gee, steve, I really want to help first responders, but I don't want to. And those are the best ones because they're like I know I'm not trained for it, I'm like perfect, let's work. I think that one of the things that I've mentioned to people and someone mentioned it in my podcast a few months ago one of the things is we got to let some therapists in on it, and when I mean we need to like, I don't mean like I gotta go live in the firehouse for 24 or I gotta go do like seven weeks of uh, mids or you know uh for for afternoon shifts or whatever with the police, but I think that we gotta let in a little more the mental health providers and the social workers of this world in order for them to understand. How do we get that message across to a whole lot of people?
Speaker 3:that's my question to you well, that's a very good question and we need to be inclusive and I think that, um, you know, our sort of basic vetting is if a clinician is willing to take the cism class, as you were, that speaks volumes. I mean, maybe they're doing it to enhance their private practice, but that's okay. If they do good treatment, that's fine, but they have to be willing. That class is brutal, as you know, and has role plays in it, and you, you really get to hear what our folks are feeling. So somebody who's willing to do that, that's basically all we ask, and then you know they can be on it. We do have a list of people who have expressed an interest in, or want to to do this kind of work.
Speaker 3:You asked me in the beginning, though, before the mics came on, which I didn't address at all. You know what other issues besides the trauma are these folks focusing with? I first should say Massachusetts does have that list of the seven deadly sins, based on that early survey by Mitchell, which was not he doesn't say it was good science, it was a paper pencil questionnaire, but he did run it through the computers and we got a good order. Exposure to line of duty, death, without doubt was the worst for any department, because we all have that fallacy of uniqueness it can happen to thee, it can happen to thee, it's not going to happen to our department.
Speaker 3:And that was the worst. And they also said it was the worst for their families, because their families get used to seeing them going out the door. They get a little bit inured to the danger and all of a sudden the worst happens and they realize, holy shit, what my loved one does for a living can really bite. We could lose them. The next interestingly thank you for my news ranked second was suicide of a working partner. And it's not like it is with civilian suicide where we often get a lot of warning.
Speaker 3:There's gestures, overtures, cross-cutting, giving away of cherished objects. We don't get any of that. They just quietly go down some country road and hang themselves. They go around the cellar and swallow the glock. They overdose with the opiates after wasting some drugs in the ambulance. It's so lethal. We have to move in so fast if we see signs and symptoms that we lose people, if we see signs and symptoms that we lose people.
Speaker 3:The third one was death of a child during the course of any emergency services operation. And why is that ranked right up there with the top three? Because we all have children, or, if we don't, we're close to our nieces and nephews, or we're close to our partners. We've been invited to Thanksgiving, maybe over, because we're young. Children aren't supposed to die, we're supposed to save them. We've been invited to Thanksgiving, maybe over, because they're young Children aren't supposed to die, we're supposed to save them. I was supposed to save little Kimberly Charlie. Instead I'm shoveling her into a body bag. So that's rank three Of those top three, steve. We say we're stripped of our usual mechanisms, which is gallows humor.
Speaker 3:We can make a joke out of anything and if we're not giving shit to each other, we don't like each other. You can't make line of duty death, suicide of a cherished partner or death of a child funny. And we have our class clowns. That are great. We love them in the station. They can blunt any trauma with a joke. Watch what happens if they try to make that funny. Next, I'll be brief because we want to get to the other issues, which are the marriages and the betrayal and the administrations. But to be very brief, the next is prolonged failed rescues.
Speaker 3:We have extended time on scene. You do everything. You know how you come back to your chief and say our shit didn't work. We did everything. We know how we couldn't save that person or whatever. The next, and it also has to do with length of exposure that prolonged. That PTSD taxi meter flag is down Sight, sound, smells. You're absorbing way too many. This is not what we call a scoop and screw or a load and go. This is way too much exposure.
Speaker 3:The next is multiple casualty incidents. Not that we can't handle those. It doesn't have to be the marathon. It could be any time the incident exceeds your department's ability to handle it, like lewiston, maine or whatever. But it's when you're first on the scene. It's okay if you arrive when incident command is set up. We got a command car. We got lifelike coming in. We got the fire department washing the blood off the highway. The vehicles have been separated. The ambulance has transported those that are viable.
Speaker 3:This is when you arrive on scene and you're first. You got an offset head on. You got a 13-year-old sitting in the medium still, as can be A little bit of cerebral spinal fluid coming down. She's gone. Then you got the mother bleeding out. Facial injuries bleed a lot. She's screaming but she's going to make it. The medics are calling on the radio. What do you got? We're just basics. They want to know how to set up the truck. It's raining, lifelike's not going to be able to land. There's not. You got nothing and you're. You're a little emt firefighter arriving first on scene. People remember multiple casualty incidents when they were first on the scene because it was a cluster. They had nothing except themselves and they're overwhelmed. They got through it but but they remember. The next is any time. You know the victim. I'm almost done the victim known to respondents.
Speaker 2:Small towns, small towns especially.
Speaker 3:Absolutely. You know the big cities. It might be your district. It's a brother police officer, firefighter. One of them is trapped in an MVA, but in the small towns you stop even referring to it. By streets, you know, you say, hey, doug, get the ambulance Go down to. We got a baby not breathing, call. I said, is it down by where? That in the cul-de-sac where the old guy was smoking and he's on oxygen, parts is parts he blew himself to soon.
Speaker 1:Yeah, that's where it is.
Speaker 3:We don't even refer to the street number. Yeah, we do it by the incidents, because when you've been on long enough and I know you've treated some people who have there's not a street in the town you haven't been to for something. It might be a well-being check or it could be an ambulance call, it could be a chimney fire, but that's how you remember the calls. And the last one which is why I'm grateful you put up with this long list, steve ranked last by first responders as the least important was any incident where their personal safety was unusually jeopardized. That's what they share with combat vets Achieve the goal, not the glory. They're mission oriented. They don't like medals. They don't like to be called heroes. If another police officer says you did a great job, that's good. If a shrink like me says it, it doesn't mean anything because I don't do his job.
Speaker 3:I don't carry a gun, so we can help. I don't mean that we can't help, but you know that peer support is fabulous. Now that was the list. That is the list of Massachusetts that we use for the 24 teams as a oh kind of if that happened, we better keep an eye on it. We have three kids murdered in Duxbury. Oh no, just let's, let's keep an eye on that. We don't ambulance chase, we don't chase after it, but it's perfect that we have a cism trained police officer embedded in that department.
Speaker 3:that's great right that as you says, ain't what's happening predominantly now? It's cumulative stress, it's marital issues, it's relationships bombing out. We roughly have a 68 to 72 percent divorce rate, I should say rate of relationship breakup, not necessarily divorce in first relationship. The first marriage is in first. Second marriages tend to go much better, especially if both are in the field, because they just understand it. But it's a killer. It's a killer on the kids. It's a killer on the kids, it's a killer on the family and self-medication goes right with that.
Speaker 3:And then, on top of that, why don't we have a chief? You come in, you just lost the kid, and he says yeah, I want you to take a few minutes and get back out there. I got another call for you. Excuse me, this gal is toast. This guy's got the thousand mile stare, he's someplace else. You don't want him answering that call. He's not emotionally fit. So, yeah, what we call administrative betrayal. Unfortunately and I'm not saying I think I made it clear definitely not all chiefs or all deputies or all captains. We have some that are stars. They never forgot where they came from, and I could give you names, which I I can't but. But then we have a lot that, um, when they get up where the air is sitting. They got stars and bars and stripes. They forgot where they came from. They become instant assholes and they do harm. They hurt people and it's not. It's not hard to hurt our people if you tell them that they're not doing a good job or they didn't do enough.
Speaker 3:If you tell them they fucked up operations or they need to go back for retraining and this or that. Yeah, okay, I got that. You tell them you didn't care enough, you're not doing enough, you're not doing your job. That kills us, because that's all we have is our identity as a first responder. The rescue personality rescues. It doesn't lose people. So, yeah, that that's a bit. You're absolutely right. Relationship problems, addiction problems, administrative betrayal are just as serious as any critical instance. In fact, they are critical instances.
Speaker 2:You know, you know this is a, you know we we had a private conversation prior to this and it's something that I I tell people. I said you know, if you really want to know how great your department is and name police or fire and I'm not naming names and I'm not pointing out any departments the chief that's going to go. Hey, you know what, got a few phone numbers you want to call them. Call them, but that would be helpful. That's trauma-informed. That's like hey, look, we thought about it. We see that you're disturbed or someone is like I.
Speaker 2:My personal favorite is the best departments that I've ever seen. Are the chiefs what I? There's a small town where my kids go to school, in holtdale here, um, and I love once in a while the chief of police and the chief of fire are right in the community maybe doing the directions or just talking at the school or like just doing those little things, and I'm like that's the chiefs that I want. And I'm pointing out hey, mark tom, you don't need to thank me for anything. I'm not fucking doing this for that.
Speaker 2:I'm doing this because I truly believe it is that for me, that's what embodies, what's missing when you're in a town like Worcester, you're in Lawrence, you're in Boston. I get that the chief may not be able to be as Anzahan because it's such a big district, but if you're, like I say, like under 25,000, you got to catch the chief at the school once in a while and catch the chief or the deputy or the sergeants or captains for those who have them Just doing little things in the community. And to me what that says is I haven't forgotten where I got these bars and that's when I start on the bottom. But that's my two cents.
Speaker 3:I'm just a mental health counselor and I'm not just no. You save lives and careers when you intervene like that.
Speaker 1:And they'll tell you that.
Speaker 3:The guy that worked with me absolutely saved my life, and he's part of why I got sober. I was in the toilet, marriage down the tubes, living by myself in a one-room apartment. Sober, though, at least. I got sober, I had to start over, and that strength absolutely saved me. No question about it, along with cism too, and I think that what?
Speaker 2:what I tell people too is they ask me what's the best client like? Why are the clients you mentioned something earlier which is extremely key and for my co, my colleagues in my field, whether it's social workers, psychiatrists, psychologists, mental LMHCs, whatever you want to call me, I can't forget about my buddies at the KDAC, the Certified Alcohol and Drug Council. Absolutely Can't forget my buddies there too. But they ask me what's the most effective thing? I said, whenever you get a call from a first responder, return the phone call within a 48-hour period. That's true, and if responder, return the phone call within a 48 hour period.
Speaker 3:That's true, and if you don't, you have fucking lost them.
Speaker 2:Yeah, that's true. And they say how do you know that? I said, yeah, I'll 20 something years of working with this stuff. I, you know the guy, the guy who I call right back, like most of them, like they go oh, I didn't think you'd call back, I'm sorry to disappoint you guys. And you always laugh because they're like, oh, no, it's just. And then they cut the end.
Speaker 2:At the end of the day, it's not you using the vernacular, but you need to know what they go through.
Speaker 2:If you don't know what roll call is, then don't say you're an expert. If you don't know what it is to be around the table after a hard call at a as a station, get informed, ask some guys, but don't like oh, yeah, I know what that means. I'm like no, that means a little more than what you think. Yeah, and and knowing that that's there in that thousand mile, stare, people like, oh, that's typically trauma and I'm like it could be trauma, but your intervention may keep it as a stress versus just a dot of trauma and it may not even be about. I tell people, it's not about the dead dog on the side of the road, it's about blankety blank from the past. That's not even dead. It was just a loss of a relationship as a as a first responder, you go through so many things that you start melting these dots together and you go. I don't know how they get there, but I say, if you logically listen to them, you'll know exactly how they get there, exactly.
Speaker 3:And that's. You know, when you mentioned LADACs, we have four at the onsite and they're absolutely fabulous. I mean, I'm in AA and they're more up to date on substance abuse and alcohol abuse than I am. So we're looking for that next wave, you know, the next generation that's coming along. Like you said, we want both peers and clinicians to get involved in this, get intrigued by it, to want to do it. Our place, absolutely our goal, is our staff. Without our staff we wouldn't have any program. They are fabulous, most of them not all, but most have lived through it and trauma work with us.
Speaker 3:But it's a powerful program. It's not for everybody. It is a hardcore trauma approach and when they come in on Monday, you know they get a meet and greet, they meet each other a little bit of urinary Olympics. You know who's done what and where have you been, and then they get right away. They get a great class on trauma in the brain by Kalina, who's our clinical coordinator, um, and she's an air force brat, so she grew up in the military and she connects with them instantly and it's in layman's turf. They understand the impact of trauma and why it affected them. Then in the afternoon they Charlie Popp, who's head of the whole CISM network across the state, along with Jimmy Leary. Charlie's the fire side, jimmy's the police side. Charlie goes through the seven deadly sins. We did Like, okay, just you and me. I know you think this shit doesn't bother you and I realize you don't think that's why you're here. You're here because of the marriage. But if I can just ask, have you been exposed to you?
Speaker 3:see, the head start to nod and then we ask them just to write down just a little bit and by the time they finish that they're toast and that's just the first day. Second day, right out of the box, got a look in the eye of the tiger, you pick your index incident. Whatever you want to talk about, that's up to you, and as a the staff debriefs them. They usually have a different incident In the morning. They get yoga to burn off some of that stress from a yoga instructor who only works with first responders. So she's great First responders, military.
Speaker 1:But the rest of the day.
Speaker 3:Just tell the story. We're not going to psychobabble it, we're not going to interpret it, Just get it out like oil to the surface of water and you don't have to talk about it if you don't want to, but we kind of encourage you to. We don't re-traumatize people, but usually by the third day we got them because everybody else is doing it. You get that peer pressure.
Speaker 2:I'm just going to stop you. I've got to share this with you because I thought I think you would appreciate this more than anybody else. There's a fellow therapist of mine who says you can lead a horse to water, but you can't make him drink. That's true, but you can make him fucking thirsty to drink that goddamn water. That's exactly right, and that's what you're doing. Sorry, go ahead. I just said no, you exactly right, and that's what you're doing, so go ahead.
Speaker 3:I just said that You're right. We try to make them thirsty to get at the trough for sure. Right, and everybody else is sharing the worst shit you can imagine.
Speaker 3:And then we get to in the afternoon on Wednesday. The old man is here and after they've done the emotional bloodletting, then it's my job on Wednesday and I have three people helping me who are fabulous and they're all experienced trauma counselors and some are ex-first responders, ex-cops who've been through their own issued incidents, whatever Time to talk about. Okay, so what did this do to you? You got it out, did a great job yesterday, oiled to the surface of the water, beginning, middle end, what this thing was like to you. We got it. What did it do for you?
Speaker 3:And they give their thoughts about it afterwards, some of the worst images, and then we say, okay, does this relate to anything? Just the theme, not the the details of the incident, you know. But when my strength did that, for me the theme was failed rescue and kimberly jolly, related to something that I didn't succeed in doing when I was eight years old. We're not trying to do psychoanalysis, it just I can't tell you the relief it was to me to say, okay, I'm not nuts there's well, I'm not any less, no more nuts than anybody else doing this stuff. But there's a reason why that child incident and the loss of that child in that building fucked me up to a fairly well. So that's Wednesday. We got a great AA meeting in the evening. Only for those who wish it's pretty raucous, it's a badge meeting All people who you know are in the on the job. Not that we're some special brand of alcoholics, steve who has to go through just badge meetings.
Speaker 3:Sometimes you can go to a civilian meeting and there's a 19-year-old kid next to you who's newly sober, just kicked heroin and he says something that just blows your socks off. It's got so much genuineness to it. But this is a meeting just for people with a badge, because they don't always want to be sitting next to somebody. They just cuffed and stuffed the night before or they intubated on the way to the hospital right, and then thursday almost done is all one-to-one, where we do the rapid eye movement stuff, as you know, and some other eye movement, desensitization, reprocessing, which is a great tool for trauma thank you sir, and we also do.
Speaker 3:We also do TFT, thought field therapy. Oh yes, I have been training it, but I don't. I'm not the best at it. No, we have Larry Brown, who's an ex-Boston cop.
Speaker 2:Oh, you got Larry. I hate to say that, yeah, he's fabulous. I heard great things about Larry too.
Speaker 3:He's unbelievable, but he's one of the best substance abuse counselors we have. He connects with people, have ifs, internal family systems, valerie, my wife, who's the boss of the agency um, she does that. She's trained in all three, so she's pretty unbeatable. And that's thursday, really hard work. In the afternoon you get acupuncture and you get chair massage if you so wish wish from a paramedic who's fabulous at it. And then Friday we just can't open up anything new. I've made that mistake. It's a disaster.
Speaker 3:There's a reason why it's a slow. It is five days and it's a phased process and not everybody can do that. I get that, but if you are willing to really clean out the wound, friday we've got to put it back together. Friday's the road back, and you write yourself a letter which we mail to you six weeks later. Dear Hayden, this is what I learned at Happy Camp. The guys from Oklahoma City called us Happy Camp.
Speaker 2:Happy Camp. I love it.
Speaker 3:Y'all, riding is hard, but you don't put us away wet. That's a farming expression.
Speaker 2:I know, I love it, I love it, I love it, I love it.
Speaker 3:And six weeks later is about the length of, you know, a New Year's resolution. You got this letter that says oh, I promise to go to the gym three times a week, I promise to do a date night with my wife, I promise I spend more time with my kids. Huh, what happened to all that? Anyway, that's, that's it, my friend. We have a discharge plan that is kind of detailed. That was is better than anything I did at any other agency. It covers eight major areas. They all do it together and by that time you can't a. They've all gotten to know each other. They give each. They won't let each other get away with anything. Um, but you know Brian, our director of the residential services, who's a retired Hull firefighter and Navy vet. All week long he's making sure that the environment is conducive to their feeling of privacy and safety. He cooks kick-ass meals. He does do anger management with them and he's a great a counselor. So brian's kind of the rock of the place in terms of the life space, what they, where they live.
Speaker 3:A lot of people joke with us and tell us you know, the real program starts when all you staff get the hell out of here after dinner, when we're with each other. And lastly, the thing they all fill out an evaluation of us. When they leave, it's anonymous, but some of them like to put their names to it. What do you think they rank as the best feature? This is over 30 years, over and over, because we do research on our own program. They rank one thing as the most powerful thing for the whole program.
Speaker 3:We all looked at the first set of data. You know look, was it EMDR? Was it the debriefings? Was it AA? Was it the health and wellness stuff? Was it the food? No, it was peer support. Now that's humbling. I don't understand why other group or other agencies that work with first responders don't get that joke. Of course what you do is important. Of course what I do is important. We're not bumps on a log, but it's a peer clinical alliance. You don't have trained peers doing that, you're going to get minimal impact. And most of the other programs and I respect them duly we work a lot together. We cross-refer. You know some of them. Some of them are hospital-based, some are in Vermont. If they're not peer-based and clinically guided, it just doesn't have the same impact.
Speaker 2:Well, I'll tell you, hayden, what I've said in this podcast. And when people ask me, I've been asked, as a therapist, what's the best therapy out there. And I always respond with the same exact thing the therapeutic alliance. If you get along with your therapist or the person who's talking to you, they can do CBT, ifs, they can do DBT, they can do psychoanalytic, it don't matter what they do, but if you have that therapeutic alliance, it will work out great right. And without that you got nothing, as they say.
Speaker 2:And then at the end of the day, I tell people like we're all humans who want to connect to each other, right? So if you get a good therapeutic alliance, the next best thing is to have a community of like people. They don't have to be perfectly like you, they just have to be like you. And having that like um, you know I I joke around that the reason why that my type of therapy that I do gets along well with a buddy of mine who is a police officer is that we think we think kind of the same, like get off your fucking ass and do shit, and and we don't always say it in those words- I got it.
Speaker 2:And I think that that's what makes there's days where I got to look at myself in the mirror and I'm like, am I doing this? No, this is what works for me and that's that alliance with a friend, and maybe that's why I work well with first responders in general, because for me it's like you're right, all this is bad shit, and I agree with you. What are we going to do to get out of this shit? I'm not going to let you sit exactly, and I think that for me, at the end of the day, learning to teach people about the community, the therapeutic alliance I like that.
Speaker 2:You have acupuncture, yoga, and one of the things that I've told people is that it doesn't matter what you do as activity and if you don't like yoga, that's fine, then don't do breathing exercise. You don't like yoga, that's fine, then don't do breathing exercise. You don't like that, go do Pilates. You don't like that, go do a spin class. I don't give a crap what you do, but you got to move. You're not going to get better mentally by not moving.
Speaker 1:But anyway, I feel like I took over but I'm looking at the time, you didn't take over at all.
Speaker 3:No, that's a great point. Just to add to it, we didn't used to have that Right, because we work with combat vets, we have a weekend every six weeks of folks that are in emergency services, but they also went through the military. That's another duly diagnosed group and so one of the earlier groups. We started this in 2005, the tip of the spear, one of the early groups around 2009, 2010,. They came to us and said so you guys, this is a great weekend, we've enjoyed it. You guys doing the yoga? Oh, no, we don't do that shit, oh.
Speaker 1:Did you have?
Speaker 3:any acupuncture? No, we didn't do that. Do you do any like chair massage or something like that? Because the body tenses? Up during combat and all this stuff. No, we don't do that. This is a Marine. He looked at me. He said well, I got to tell you something. We have that at the VA and somehow I think if it's good enough for the U S Marines, it probably should be good enough for the onsite academy. Oh, oh shit. So now we have all those modalities because they're important, they're part of wellness.
Speaker 2:So yeah, and and my we can talk about like we're running out of time.
Speaker 1:I just realized that we've been talking all this time no, no, why are you sorry?
Speaker 2:this is great, um, but you know I want to thank you and if you want to go talk about the military, I'd have another hour in me of just military stuff. Because, even though, it's similar to the first responders.
Speaker 3:There are differences um but that would be an honor. Be very happy to do that on behalf of those folks.
Speaker 2:Well, you know, we went over an hour, almost an hour and a half, and I'm going to split this up in two interviews because I think that people will absorb it significantly better. But, as you know, I'm not going to say it's an honor, because I know that makes you blush. I want to thank you for everything you've done. I thank you for your service. That makes you blush. I want to thank you for everything you've done. I thank you for your service. I thank you for you know, as a Canadian, thank you for being there for the firefighters who went through hell and back in the last six months to a year which we tend to forget.
Speaker 2:They complain about their, their, their clouds here and I go like, yeah, that's, you don't understand how big these things are. You have no, you can't phantom it. But anyway, thank you for everything you've done and I appreciate that you thank me for what I do. One day, hayden, not only am I going to we're going to probably try to do this on the military a little bit at least I'd love to go to on-site and see I'd be an honor. But I'll never impose myself because I know some guys want their privacy and I respect that a hundred percent.
Speaker 3:We love to have you. Friday afternoons is when we generally do the visits. So, as they say, soyez le bienvenu, mon ami.
Speaker 2:Ah, je serai le mon ami. Yes, I will take you up on that offer, but I just want to thank you so much and we'll definitely get back together soon.
Speaker 3:No, thank you for the opportunity, very important. I appreciate it. Have a great day, steve. Thank you.
Speaker 2:Well, this concludes episode 134 of Finding your Way Through Therapy. Dr Hayden Duggan, thank you, thank you, thank you Probably one of the most honest goodness supportive, and we talked about mental health, we talked about first responders my two of my greatest passions through for the last two episodes and I hope you guys enjoyed it. But episode 135 is also going to be very interesting because it will be with Malka Shaw. Malka Shaw is going to talk a little bit about her experience, also on 9-11, which I know that Dr Hayden Duggan talked about, but we're also going to talk about the Kesher Shalom projects and a little bit of anti-Semitism stuff, and I hope you join me then.
Speaker 1:Please like, subscribe and follow this podcast on your favorite platform. A glowing review is always helpful and, as a reminder, this podcast is for informational, educational and entertainment purposes only. If you're struggling with a mental health or substance abuse issue, please reach out to a professional counselor for consultation. If you are in a mental health crisis, call 988 for assistance. This number is available in the United States.