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Welcome

To the Breaking the Stigma Podcast with McNeal and Company. The mission of this podcast is to offer education and resources for first responders, wellness, mental health, and resiliency. The hosts of this podcast are not mental health professionals, but all information shared will be in conjunction with either a certified training or mental health expert. We are here to break the stigma around mental health discussion. That being said, some of our topics may be triggering or upsetting to our listeners. If at any time you are overwhelmed, we encourage you to pause the podcast or forward to the end where we will list the hotline. You can call for immediate help and conversation with a professional. Please be safe and gentle with yourself. We need you here, and we want to help

Everyone. Thank you for joining us for another episode of Breaking the Stigma podcast. I'm Jason Salazar, joined here with Lee Price, training manager for McNeil and Company. And today, our guest today is Dr. Andrew Berry. Uh, Dr. Berry , thank you so much for being on with us. Can you give us a little bit of your background?

I'm a psychologist and psychoanalyst . I specialize in working with , uh, veterans and first responders , uh, fighting with p post-traumatic stress disorder. I've got a grand total of one publication out there, yeehaw. But , uh, I'm, I'm more known for delivering a veterans presentation, which my discussant and I have done around the country now, a grand total of 14 times coast to coast over the past five or six years. That's kind of it in a nutshell for years , truly.

My first question for you would, how did you get into psychology with first responders and vet's? Um, how, how did that process look like? Um, how did that come about?

It started with veterans when I was a kid. I was largely surrounded by them. Okay, I'm gonna be 59 this year due to circumstances beyond my control. And our fathers and grandfathers were the ones who were running the country after service during World War ii. My father served stateside . He graduated in 45 when the war was winding down, but he still did a year and a half , uh, as an enlisted man. And my maternal grandfather was a combat officer who did his time as an army captain. Uh, he was decorated , uh, in South Bavaria . So many of the neighbors were veterans. And when they chose to speak about their service, which was rare, it was very, it was, it was captivating. It was compelling to listen to that sort of thing. And that's, that's what I was surrounded by. We even had a couple of guys in the little town where I grew up, who served during World War I much less World War ii . I don't like saying this 'cause it's, it's just something that I, I fell into, for whatever reason, veterans and first responders talk to me. They find me easy to talk to, even though they know I've never seen combat and my experience on the road as a first responder. I'm , uh, I'm a volunteer firefighter with the Nici unit district too , here in New York where I, where I practice and an E M T, they still talk to me anyway. I don't really have any formal training in working with either of these populations. But that being said, I have learned so much from them , uh, in my consulting room as well as in my personal life. They feel safe in speaking with me. And that's about it really.

I know this is kind of a basic question, but why , for you exactly, why is it important working with vets and first responders to you in your role , um, you know, dealing with treatment, dealing with counseling psychology? Why is it important to you? Exactly.

Okay. I learned about triage from a very pivotal show , television show in my life, namely mash. Um, and I grew up watching Mash. I I have everything on D V D and triage is spoken in terms of those who are most traumatized, those who are most damaged, those who are bleeding the most are the ones who were seen first. And because of the fact that we have 22 service members still every day committing suicide, as well as firefighters dying by their own hands faster than the fires that they fight. And same thing for police officers and, and emergency medical personnel. Houston, we have a problem here. We have a national epidemic that's a disgrace. And , uh, I don't think we're doing any anywhere near enough. Uh, for these men and women who give their lives , uh, the way they are , the way their lives are presented to us is it's a lifetime of service. It's a heroic thing. Well, I am here to tell you , a lifetime of service is tantamount to also a lifetime of trauma. Okay. Let's say, and I'm just making up, this could be anybody that I've known or worked with throughout the years. Let's say somebody grows up in a very dysfunctional, violent, or alcoholic household, and they join the military because they want to get the hell outta dodge and see something better and join a family that they believe will be better somehow than the family that they came from. And then that person in the military goes off and sees combat, okay? So they come from a traumatic background , they go into the service and experience more trauma. And when they get outta the service, they only really feel comfortable about being among their own kind. So that means becoming a first responder. And when you become a first responder and you fight fires and you save people's lives and you see death a hundred times over, you see violence, et cetera , et cetera, there is more trauma. So what I'm trying to get across here is the slogan, A lifetime of service really is a lifetime of trauma. Those who are the most traumatized, as I said before in my, in my idea about triage, they should be seen first. The reason why they are not is , uh, the stigma against speaking out. Because you have to consider how these guys and these gals are trained. They are trained to think of themselves absolutely. Last and everybody else, absolutely first. And the idea of asking for help is somehow seen as, as as weakness. All right ? And so what they do is they stuff it down. They drown themselves in work. They take multiple jobs, they lose sleep hand over fist. Their diets are not exactly the best in the world. Uh, perhaps they , uh, they pick up an alcohol problem along the way, and they are just burning themselves out. The relationships and their lives go sour. Divorces occur all because it's like, my favorite metaphor is the snowball starts rolling down the mountain. They didn't seek help soon enough. And so many by the time they get to my consulting room, are in real trouble because they've been so afraid to open their mouths and say something. Now, here's what we can do about this. If we can get these guys over the stigma of opening their mouths, that will make things so much better. The reason why so many suicides occur is because mental and emotional pressures build and build and build, and the person suffering from these suffers in silence because he doesn't want to talk to anybody, doesn't want to be thought of as that guy. And it builds and builds and builds until one day enough is enough, and they wind up ending it. And I'm here to tell you , for those who get to me in time, categorically, when they are finally able to spill their guts, the relief that they experience, okay, is palpable in my consulting room. And so many of them have said to me at the end of a particularly grueling session that they thought that talking about it would somehow make it worse. I ask them, how are you feeling right now? And they, they look at me rather quizzically, and they say, strangely relieved. The reason why they pick up, they pick up a gun and end it all, or do whatever it is they do to end it all, is because they are not opening their mouths to relieve that emotional pressure. How's that for a long-winded answer?

I think it's a great answer. And you know, doc, I, I just thought a comment that I , I've never heard it put so well and so poignant poignantly , uh, me speaking as , uh, the fire and e m s veteran Navy corpsman, I've, you know, served through the entirety of the war on terrorism and a lifetime of service is, is really, I think, very, very hitting the nail on the head in a way that I can tell you I've never heard before. And I think most people haven't. That that's where we begin. And, you know, in some ways we, sometimes the traumas start before that point. It's , uh, it's a really clear way to look at it. And I think about all of, all of my brothers and sisters that I've worked with or served with, and they're, they're exactly the same type of people. As, as we look at that and you bring up the stigma that goes along with that , uh, goes along with seeking for help, knowing when to ask for help. Uh , mm-hmm . <affirmative> , when I started in firing e m s, and, you know, as I served it was the, the cowboy attitude, I call it. Right? You know, you just pull up your britches and you go back to work. How do we, what are , what are some thoughts you have maybe, or, or ways that we can kinda work towards making, making it more acceptable for people to, to see that asking for help is sooner than later is the right path to go?

Well, the first thing you can point out to people is that if we can introduce the idea of mental health, open discussions about mental health and trauma being the norm, what we are automatically doing, what we are immediately doing is starting to lengthen the shelf life of those who serve, really, because they are relieving that mental pressure at long last. They are getting a proper , uh, they're getting properly medicated and monitored. And, and, and , and what a lot of people , uh, a lot of people really don't understand, and I hope this makes it into the final cut of what we're doing here today, is that when a person is traumatized past a certain point, and hear me on this one, the central nervous system changes. Your brain is affected. And it doesn't have to be by a bullet going through your skull. It doesn't have to be by a concussion, okay? The adrenaline blasts, the , the incredible sleep loss, the crappy food, the irregular hours. You know, we have circadian rhythms for a reason, and I have heard of people who will work three days straight and then put themselves through the equivalent of swing shift . Meanwhile, the circadian rhythms on their, in their bodies are feeling incredibly violated. And that aggravates the living bejesus out of anxiety and depression. What you have to do is take the case right to the, the departments who have lost brothers and sisters to suicide. And I have absolutely no problem getting up in front of a , in front of a bunch of these guys and say , saying to them, this could have been prevented if this person had finally opened their mouth and said something. I cannot put it plainer than that, and I don't want to hear, I don't want it heard. Like I'm blaming them for not doing this. They have the reasons, but the end result is the same. You keep it inside long enough, guess what? You're gonna explode. And I remember a conversation I had that did not go well, not , this wasn't a patient, this was just somebody I met , uh, an old chief who had still that cowboy mentality and be , and the reason why he didn't want to get rid of it or try to alter it because it served him so well for so long, that was his official excuse. Okay? Um , kind of like firefighters. They like a certain type of halligan and they're not interested in changing. You can sort of understand it because they've had a certain amount of success with it, and they don't want to chance anything new out on a hot fire scene. But getting back to the sole chief said something along the lines of that asking for help is a sign of weakness, and if that's what they're doing, then they shouldn't be in the fire service, et cetera , et cetera. Meanwhile, I'm looking at my watch and trying to figure out if the year is somehow 1920 all over again, this ancient fungus encrusted old school mentality. And I looked this guy right in the face, and I said, oh, really, chief , uh, you know, he'd been married three times. I said, do you have any conversations with your ex-wives? Do you have any conversations with your kids? Or do they all hate you ? Because what happens is, in plain English, I, these guys, they go into an emotional deep freeze and they become obsessed with the job, and they neglect what's going on at home. Houston, we have a problem here. This is what leads these guys to the end. And this guy act , this old chief actually had a guy suicide under him. And he said, and I quote, he said, well, he must have been just plain weak. At which point I looked this guy square in the jugular. And I said, then you chief are part of the problem and you're not part of the solution. He didn't like hearing that too much, but tough. If somebody had gotten in his face and gotten this guy turned around, who knows? He might have been, he might not have been one less man on his fire medic roster.

Most definitely. You know, and I think that's the thing we see a lot in fire and emergency services in other places as well, is the asking for help is equated to weakness in some way. And acknowledging your own weakness is a sign of weakness, it seems to me. And , you know, it's , and I guess in what you're seeing, maybe you can comment one way or another. The more we can work, and it has to be department wide , kind of every member is part of this situation getting a broader sense or understanding of needs to be a cultural change of , uh, asking for help isn't weakness, not asking for help, or the weak people, the people who are taking easy way out, or the cowards, the ones who don't have the courage to ask for help and seek guidance and things like that. Is that kind of a , a , a good approach maybe to try to get all of our people to be thinking or , or , or to at least moving our minds in that direction?

Well, effective firehouses, effective police departments, effective emergency medical services are effective because of leadership and working from the top down. Now, I'm gonna use you as an example. How old are you, if you don't mind me asking?

54.

54. Okay. I don't, believe me. I'm gonna cut you in half and count your rings. I'm kidding. <laugh> . No . Anyway, we can have a few laughs when we're doing this. So getting back to answering your question, the young firefighters and the subordinate firefighters from the assistant chiefs on down to the captains, the lieutenants, to the black hats, to the sergeants, or whatever the rank structure might be, they are going to listen to men of respect. I'm gonna say that again and make sure it registered. Those, those guys are gonna listen to men they respect. Now, that means you, you 54 year old, lovely person, you, you stand up in front of them and say, listen, I, I , this was my background. I served in the Navy as a corpsman. I saw things that nobody should have seen out in a combat situation. We've all seen things on fire scenes, and we have to have a discussion about mental health. And you have to be, now listen very carefully. You have to be open to discussing your own trauma history . I don't know if you've ever been divorced or gone through any of that, those terrible things. Lost a home, lost a fight with alcoholism. But you have to be willing to discuss that openly. And, and you have to look at the, the young bucks who are young, dumb, and full of, and you have to say to them, look what the cowboy mentality did for me, the macho ethic. Look what that did for me. And what I'm telling you guys is men, don't let this happen to you. I've been through it, and you can say something. I've been with this department for 20 years, and I paid a terrible price because I didn't ask for help soon enough.

Dr. Berry , do you think, Lee, and you also touched on this, but do you think talking about leaders, do you feel like that is also a problem? Like , first responders don't seek help because there's not that leadership where they can go, like you said, going in front of your crew and saying, look, this, this is a thing that we need to talk about. That whether it's a round table , whether it's say , look, if having an open door policy per se, you know, a lot of departments may say, well, you know, it's an , we have an open door policy here, but doesn't always necessarily mean that they actually fulfill it. Do you feel that also starts with the leaders too, of trying to get kind of that next generation of firefighters? Would you say that's a huge percentage of people, why they also don't go seek help?

Well, an open door policy <laugh> , that can mean so many things, and it can be also a gust of hot air. Okay, let me tell you how I would do this. An open door policy means to me , uh, an effective one that you, you feel free and safe to go and talk to the chief or whomever the chief opens the door says, come on in and sit down. And the chief says, I'm glad you brought this to me, because now I want you guys to listen very carefully to this next part, because I went through this too . I'm not saying the chief makes it all about him, but I'm saying, I didn't ask for help, and bad things happened to me. Bad things happened to me. I want you to learn from my example of what not to do. Whereas the open , the open door policy, you can smell the sarcasm in my voice, is, the way I think of it, is you're free to go in and tell your chief what's going on. And the chief should be able to say, well, it sounds like you need to go to counseling, and that's okay. Which is a completely, a completely different message from, I went through counseling myself because I almost blew up my life several times over. See, the first message is, you're getting the firefighter who comes to you to ask for help. You're getting them to work for you. Whereas when you, as the chief, as you open up and discuss and say, go get, let's, let's get you some help, that that's a different message, that's a message of working with the firefighters.

I think along with that, in my experience in the firehouses, and I'm sure you know, you doctors as well have ha have seen this where it has to be a, a group sort of effort or, or you're not working against each other. I think early on I've been in that position exactly what you described, and actually you were pretty close in, in describing me as the 54 year old old guy who said, don't be me , uh, at one point, and it's, it's a good sell that you try to encourage people. The trouble, of course, is trying to bring along those other leaders who maybe haven't had those experiences, haven't recognized those things in themselves, or have not accepted the fact that , uh, the old school attitude is killing people. And so they continue to perpetrate, I guess, that attitude while you're working against them . And, and I , I realize this , there may be no silver , silver bullet here, but is there any way short of

Yes, there is , uh,

Absolutely violent violence <laugh> to convince those people to that, hey, you know, we're, we're trying to take care of people here. We're trying to save lives. We're trying to, we're trying to keep people on the job, right? As you said, yeah. When people walk away, how many volunteers walk away, never say a word, and it's because they're suffering from a trauma. We think they just lost interest. And, you know, those are people we wanna retrain, right ? Retain, correct.

Yeah. Those are the people we wanna retain. So what you say to the leadership who have not had those kinds of terrible experiences is, okay, you gotta , you gotta play in their ballpark and say, listen, okay, the reason why you wanna change your mind about this, the way I'm hearing this is what's in it for you? Okay? I'm gonna tell you what's in it for you. We got good guys at this station, let's keep them here longer. What's in it for you is if you promote this and we all start working together and be open and honest about the suffering that goes on around here, is we will be extending the shelf life of shelf lives of good men and women in this department. Whereas if we keep doing business as we have been , as we have been, they're gonna be dying off by their own hand. And then we're gonna sit around and wonder what the hell happened, ladies and gentlemen. And you look, these guys right in the jugular with this next sentence, ladies and gentlemen, we have met the enemy and it is us.

I have no words. I can't help but agree.

Part of the thing, Dr. Barry , one of my questions I have, when you meet, whether it's a vet, a firefighter, or police officer, e n t who comes and sees you, what are your methods of approach? How do you talk to them? How do you deal with them? Um, it's definitely a different group of people who maybe are a little bit more , um, I don't wanna say the word, harder to crack, but trying to get through.

First of all, I try to be myself in the session, which is to say, what? You see me on screen here? I'm in my consulting room. I got jeans, I got a Carhartt shirt, and I got sneakers on. I am not a suit and tie shrink. I am being myself. These guys, that's the very first thing they are looking for is any sense of pretentiousness. Okay? And if there is any that's gonna turn 'em off. So they come into my consulting room, which maybe you can see in on your camera. There's fire helmets all over the place. It's warm. It's like somebody's living room. And they're, they're thinking to themself , I , this guy, this guy's a fricking nut job, or he really is being himself and maybe he can help. All right ? And the other thing is, I will tell people when I don't do this a hundred percent of the time, but when it's appropriate, I will tell them, and this is one of the reasons why I am a very proud psychoanalyst, is to, in order to become a psychoanalyst, you have to go through what's known as a training analysis, okay? I trained at , at a place called the William Allenson White Institute in New York City. And I was on an analytic couch on my back three times a week, all the way through four plus years of analytic training. And my analyst and I continued to work together via telephone for about another two years and change after that, she and I worked together for about seven years. Now, the reason why I'm boring you to death with this seemingly unrelated bus bit of business here is when you tell that to these guys, that gives them a message of leading from the front. In other words, I didn't just learn about therapy by reading it out of a book. I've been through it.

That's a great approach. I think, like you said, I think people may feel a little bit more comfortable seeing that, you know, you're human also, not someone who, yep , like you said, it , some sterile environment that you walk in and there's bright lights everywhere or there , you know, you , you know, you feel like you're talking to a robot that you know you're a person and you're also a first responder. So you can understand what they're going through. Maybe not the exact situation, but you can understand the circumstances behind it. With going through the counseling process with family members, how can they be supportive during , uh, let's say there's a vet, a first responder going in to the , um, going into counseling, going to see you. How is it , um, how can they be supportive of that person? Is there any things , any tips or any advice to people out there who are considering going to counseling and that maybe they are family members of how they can support their loved ones for that?

Absolutely. But first of all, you have to educate them about what they are supporting. Exactly. Which means you have to show them what post-traumatic stress disorder is. Now, I don't mean get yourself a copy of the DSM five or Wikipedia or Googling, 'cause that only gives you a sliver of what it's all about. What I will tell people, I will have them sit through the, and provided they're old enough, and I warn 'em as, as, as best I can ahead of time about what they're about to see. I have them sit for , for the veterans I have, I have families who can handle it. Sit through the opening beach scene of a movie that came out a number of years ago called Saving Private Ryan. That opening beach scene, I'm here to tell you is the most realistic depiction of combat according to the combat vets themselves. Many who actually go , uh, went to see it and had to go into treatment because of what it brought up from them. And that tells you that , uh, the filmmakers did a very good job. And then what I'll tell people is that is what Dad has as a soundtrack going through his mind, and he can't turn it off. That's for the veterans. Now, as far as firefighters go, TV series, there was an interesting one called Rescue Me that came out a number of years ago with the one and only Dennis Leary. There's a lot of truth in that, as in that series, as well as a lot of satire. But there is a scene on YouTube, and you can find it on YouTube. It's a famous scene where firefighters are responding to a motor vehicle accident and there is a dead baby. Now, the baby is never shown in this scene. The only thing you see is Dennis Leary's character taking on the responsibility of getting a blanket and picking up the remains of the dead baby and carrying it away. Again, you don't see the baby, your imagination takes over. But that scene is incredibly powerful to families. And I'll say, this is the kind of thing that Dad has seen and that he has seen, or she has seen way too much of. That's what I mean. You have to educate them about what Post-Traumatic stress disorder is.

And once we get 'em , me , you know , once we have them educated, I guess is a better way to put it, is, or giving them a little understanding of the challenge. And , uh, how can, are there any any other things that we can, you know, get the family involved with, engaged with? Or is , is , uh, Jason's question was , uh, the ways that they can help be supportive , uh, during that therapeutic process for the person who is receiving the therapy or re or receiving treatment for these post-traumatic stress? Alright ,

To an , to answer the question , the person who is suffering from the P T SS D half has to be able to tell the family members what P T S D means to them. So that means when, let's say Christmas rolls around, they get especially moody. What are they thinking about around Christmas? They're thinking about all the guys who never came home. Unfinished business. The person suffering from P T S D can talk about triggers. Okay? Certain odors are very triggering. Worked with one guy who told me what it's like to smell burning flesh as an example. And the guy said to me, he says, doc, even though it's not the same smell, I can't go to barbecues anymore. 'cause when I smell hamburger, I, my mind goes back to that accident. That for me is a trigger. And another guy who , uh, fought in Vietnam , uh, I asked him, you know, we, we were out at a restaurant. I said, do you need to, you know, have your back to the wall? Where do you wanna sit to to be most comfortable? Because that's another trigger. When their backs are not to the wall and they can't see everything, their anxiety goes through the roof. And he says, doc, I'm fine. You can put me wherever. That's, that doesn't bother me. He says, but when I, when I catch an odor of rotting vegetation, I'm back in the jungle and I gotta flea the scene . You have to get an open discussion about the particular symptoms of P T S D that the family member is suffering from. So the kids and the wife can understand what's going on.

I can tell you , and again, you know, one of my experiences for a while until I received treatment was there was a certain favorite food of mine that I had. I , I couldn't go near anymore for a while 'cause of an experience I had while I was working on , uh, at the time I was working , I was a paramedic on the ambulance. And , uh, we had a back call , uh, trauma call that, nope , not going near it . And for, until once I completed treatment, it got to be a heck of a lot easier, and I could enjoy it again. But there was definitely, it was definitely , uh, one of those triggers as we refer to , uh, for me for quite a while. And my family, who was very supportive, my wife was , she's the one actually got me to care when she recognized the science before I could. And , uh, I don't know, is there maybe something that, if I'm a worried family member listening to this, is, is there some stuff or some strategies you might be able to quickly offer for us to maybe guide our, our loved one to treatment

In a way? You're, you're , you're already doing it because you're talking about it. What, what trips you up your favorite food? That helps. Okay. Getting any sort of a dialogue going about it helps instead of just keeping it inside and feeling ashamed of it, et cetera, et cetera. Getting discussions going with other families who have a first responder who is , was of fighting with it. Somebody who is further along in their treatment, get a discussion going with them too. You notice there's a running pattern here, my man getting discussions going, talking about getting discussions going. 'cause the more you talk about this stuff, the big white elephant in the room gets smaller and smaller and smaller. The fear is taken out of the thing that we must never speak of. My , my belief is if there is something that we should not be speaking of, that's our first clue to begin speaking about it. Because it takes over our lives and we wind up giving it way too much power.

I think, I think, like you said, it's, it's, it's having that open conversation. I , you know, my wife used to talk to me when I used to be in law enforcement, and , uh, it , it used to be kind of, it , it was something that , uh, I never really liked talking about. And she's the , you know, whether it was at dinner , um, or when we were just going out, it was just having that small conversation that it finally got me that I was like, okay, if she's bringing this up this much, there also has to be a , there's gotta be some kind of problem out there that I'm just not looking at. Because we see it through such a tunnel vision. You know, you see it through tunnel vision. You see, you know, just your job mm-hmm . <affirmative> . Um , but you don't see in the darkness of that tunnel, your family, your friends, you know, your mental health, your physical health. So yeah. I, I, I think that's a great way to put it.

Yeah. And you, you have to tell the , you have to tell her what it's like to be a cop, what it's like to be a firefighter, the things that you're looking for constantly. Okay. When you go, I'm gonna use you as an example , uh, since you brought it up, and I thank you for bringing it up. When you're a cop for a certain amount of time, and it's different for everybody. You find yourself not really like being around crowds too much because there's too much to keep an eye on. That's why you , you want to have your back to the wall where you can see everything because there is a huge amount of sensory overload that's taking place. And you , you explain to the misses , that's a survival mechanism that the street taught us. I'm still alive because I did that, but even though I, I hung up the badge, I still do it because it's been programmed into me. I'm aware of it, but I can't program it out. All I can do really is talk about it. Maybe someday I will feel comfortable with sitting at a table in the middle of the room, but not today.

So , uh, yeah, that makes perfect sense. Uh, we've sort of so far talked about, you know, the , the importance here and how you , how , you know, how important it's to you. And by the way, I, I can tell in conversations you and I have had, sir, is that , uh, I think your approach , uh, is highly compatible with , uh, the veterans of course, and, and law enforcement, fire and emergency medical services personnel, because we're the no BSS people, right? Uh , sometimes we need somebody like you to sit there and tell us in words that we can understand, if is , is that the polite way of saying it? We're , uh, communicating the therapy, you just call it like it is. And , uh, you know, that is , uh, something I think it'd be appreciated about your delivery and be extra helpful, as opposed to when we walk into that room, we aren't sure what to think, what to expect. One, we don't see the tie, right? That's good. Uh, two, you start talking to us, you know, again, like, like our people. If, if that's the way to put it. I don't know if that is or not, but , uh, you know, you, you speak, it speak directly to us and I , instead of beating around the bush. And I think that's a fantastic approach. We've talked about sort of getting to therapy, how to get everybody thinking in the right way with respect to asking for help for these traumatic experiences and critical incident and , and traumatic stress. Something I want to sort , sort of start to pivot towards now, if you allow us to, is this concept of resiliency. There's been a lot of talk about, it feels like a buzzword a little bit, but I think it's an important thing that , uh, if you could just sort of give us an idea what, what is meant with respect to this, the , the , you know, post, post-traumatic and, and critical stress, what resiliency and developing resiliency can do for us and what it is , I guess.

Okay, you're tapping into just about the oldest question we get asked, and it goes back to philosophy, which by the way is where psychology and psychoanalysis came from, was philosophy and the classics. And the question is , uh, was he born this way or was he taught to be this way, nature versus nurture, and I've never cared for the middle word versus nurture it because it implies one or the other. And it's actually a combination of the two. Now let me fatten that idea out a little bit here for you . You can have somebody who grows up in a hornet's nest of pathology, and they come through it fairly unscathed. And likewise, you can have somebody who grows up in a fairly, quote unquote , normal, decent loving home, and they, they, they act as though they've been brought up in a snakes den. It's the wonderful world of individual differences. And that's my, that is my verbally flatulent, psychobabble way of saying we don't know. But what I can tell you is, I'm gonna use you as an example, since you talked about combat, I would imagine, now I've never seen combat, but I've heard so much , I've heard so much about it, <laugh>, I would imagine if you're out in the bush and you get the sensation that you guys and your crew are about to, about to get your <inaudible> kicked, that if you know there's going to be backup and your leaders are gonna back you up to the best of their ability, that that goes a long way toward being able to be resilient. Whereas if you're out in the bush and you're about to get kicked and you feel like you're all alone and nobody's watching you six, resilience, what resilience does that help?

I , I think it does. You know, I think you're expressing that feeling of I can take what's coming because I mm-hmm . <affirmative> , I either, I've , either I've been prepared for it, or I know I've got , uh, I've got the cavalry on the way mm-hmm. <affirmative> , um, or you know, and again, you know, or it's the para paratrooper recon mentality of this is what I do <laugh>, you know, but , uh, you know, so is is there a way we can translate that to, to the fire and emergency medical services and, and sure, you know, what resilience means for them.

Okay, I'm gonna use combat and, and you can take what I'm about to suggest here and use it in the medical situation, or a law enforcement situ or a fire situation. One of my combat guys who saw a ton of combat , uh, in the desert, yet another one of my many marines, he told me so many years ago, he , he was having the devil's own job, opening his mouth , saying, well , doc, you know , um, I don't like to ask for help. And I said, oh, really ? Okay, let's say you're out in the middle of the M desert someplace. Let's say your weapon is either jammed or you're completely out of ordinance, but you got a working radio and you know, for a fact gonna come over the hill in the next two minutes. What are you gonna do? And he says, well, I'm gonna grab a hold of that radio. And then, and then he looked at me and I said, you're gonna ask for help. Is that what you're telling me here? And he goes, yeah, you made your point. There is no difference between asking for help out in the bush and asking for help back here. None

<laugh>. Well , well put. And again, I think if we put that in a, in a situation with a fire, you know, a firefighter, you know, again, I'm, I'm doing a search, but I know that the hose company is operating, so I know they've got me covered. If things get hot and uncomfortable and I'm out there when I'm not on a job and I'm feeling uncomfortable or have seen or experienced something uncomfortable and I can't get it, get it off of me , uh, can't get it off my mind, what's, what's stopping me from talking to somebody, you know, one of the people who were there with me for a start. Right?

Okay, well, there's absolutely nothing stopping you other than pride or fear or whatnot. But what you have to remember and look me in the eye when I'm telling you this, is that those guys you serve with, most of them have fought with exactly the same feelings when they're off duty . So they're not gonna judge you. And if they do, then look 'em square in the jugular and say, Chuck, you Farley, insist on you pistol . You're not so bucking fch. Go back off in your own Jacky yard .

<laugh> <laugh> , well said, and well executed <laugh> , well sit in , we'll execute . Yeah. And I think that's the, you know, are there ways we can prepare ourselves , uh, before , uh, the bell rings before we make that response? Other than the , I think the point we're , you're really, you're really making here with, with , with me and Jason, I think, is that the fact that it , it is just okay, right? It's just, okay, Uhhuh <affirmative> and to talk to somebody about it, because that's okay too. That's the best preparation is knowing that you should, there should be nothing stopping you, right? Mm-hmm . <affirmative> , is that mm-hmm . <affirmative> is that kind of it, but is there any other things we can do maybe to , uh, somehow prepare ourselves for that Trump that traumatic run we're about to go on or, or may go on later this year that , uh, will help us be in a better position to, to , it's a dis

That stress, it's a discussion you have to have more than once. Okay. Okay. You don't know when it's gonna hit. And that's part of the traumatic aspect of it, is the abruptness of it, and the , and the complete surprise. So you, you say, on more than one occasion, on more than one occasion, using words of one syllable or less <laugh>, that there's a good chance we're gonna see something out there that we can't unsee and we gotta be open to monitoring the effect that has on us and get a discussion going. And then the older guys who has a lot of stripes on and a lot of stars and a lot of whatever, and that , and a lot of respect has gotta be able to jump right in and say, yeah, I've seen it out there too. We're all about to step into it. They're gonna listen to that guy with all the stripes and all the service. Remember that the organization leads from the top down.

It starts with leaders. A , a good leader being able to , uh, lead by example, by, you know, accepting the faults that they've made, but also is , is having that success and , uh, you know, and also normalizing saying, look, it's okay not to be okay. You know, I think mm-hmm . <affirmative> , I think every first responder thinks , well, if I'm not, okay, that's a big issue. Which, you know, everyone's gonna go through that , uh, no matter what you do. But I think it's, like you said, it's having that conversation, getting out there and saying , look, this is something that's normal that you're gonna go through, but it's, it's getting is normalizing it.

Yep . And remember again, folks, listen up. You're gonna have to have that conversation more than once to break down the wall. You have to, in order to break down the wall, you have to normalize it. And that takes a great deal of rehearsal.

Yeah. Well, well said that , that is absolutely right. Lee , do you have anything else right now?

No. And you know, Dr. Barry , I really appreciate it. You know, again, the insight, the experience, the voice, the tone, <laugh> definitely , uh, gave us a lot to think about here, and I think in , in a way that we all can understand it. And, you know, the continuous conversation is the thing that is the , is one of the major takeaways here is that it's okay not to be okay. Mm-hmm . <affirmative> . And it has to be, you know, the top down every that we , that's, that's the way we, we shift our culture and accept the fact that we are losing people every day , whether it be the extreme , uh, suicide rate, the ridiculous suicide rate we have amongst responders, or simply as I mentioned before, that volunteer or that new recruit who decides one day, you know what, this isn't for me. I can't. And then they just fade away.

And , and there is, and we have to remove the shame. No shame as a, as a dear friend of mine who's on a mental health crusade himself, a retired navy corpsman, I know there is no shame in asking for help. And if anybody shamess you, then that's not a leader you wanna follow? There you go. You here, that's ,

Yep . That's, that's great. Dr. Barry , we can't thank you enough. I, I love your honesty, love. I love your approach. And that's why , uh, we thought of you with this because it's, we need more people that can be honest like that. And , uh, you know, be open, honest, blunt, because that's what a lot of first responders respond to best . So can't thank you enough for your time. Thank

You, sir.

This concludes this episode of breaking the Stigma with McNeil and Company. If you or someone you love needs to speak to someone immediately, please reach out to the National Suicide Prevention Lifeline at 1-800-662-FOUR 3 5 7. We look forward to you joining us for future episodes of breaking the Stigma, be well and go safely.