​The Silent Killer – Cumulative and Vicarious PTSD

By Kenneth Koon
Some folks may relish the idea of making the front page of the local paper, I’m not one of them. In October of 2009 I was sitting at my computer in the sunroom when I heard the explosion; I turned to see Chad running through the woods. The front page story that day read, “A 14 year old boy was airlifted to Grady Burn Center as a result of a BLEVE (boiling liquid expanding vapor explosion).” Chad had thrown an aerosol can in a brush fire that exploded; burning him over 90% of his arms and half his face.  That was a tough day.  Thankfully, the local Shriners heard about the incident and sent us to the Children’s Hospital in Cincinnati. Miraculously, Chad’s injuries were not permanent.
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Until three years ago I never considered that I had Post-Traumatic Stress. But with help I have learned better. PTSD is not the exclusive domain of soldiers in war; it can happen to anyone. Mine was cumulative in nature.  It began with fire and culminated with fire; with many emotional and financial fires in between. The first incident with fire occurred April 28, 1993 at 12:55. Sherry and I were eating lunch at McDonald’s while our two little boys were playing. Suddenly, a woman screamed “FIRE!” I looked up and saw that a car had collided with a gas tanker at the station next door. I told Sherry to get the boys, get in the van and GO. I ran to the scene, but the vehicle was already completely engulfed in flames and there was nothing I could do. Every store and office within a block was evacuated and we watched for several hours as each cell of the tanker exploded in a massive ball of fire.

Cumulative PTSD results from the accumulation of several events which alone are often benign, but overtime wear away at mental, emotional and spiritual resilience.  As an Army Chaplain I am trained in Mass Casualty Triage, as are first responders, emergency rooms and various organizations. The community quickly rallies around those impacted by such events or the personal events of loss.  But somehow we have misunderstood the impact of cumulative events overtime.  Then we are bewildered when a friend ‘snaps’ over what we perceive to be rather insignificant. 

Vicarious trauma can also have significant impact on individuals, especially care givers. Commonly referred to as compassion fatigue; vicarious trauma is typically cumulative in nature from the day in day out hearing of the stories of others. Vicarious trauma goes beyond “burnout” which can often be resolved by a week at the beach or some other get away.  Vicarious trauma can have the same impact on the care giver as the one for whom they are caring. At the end of 2015, after an intense year that included 151 suicide interventions, hundreds of counseling sessions and the suicide of five soldiers I was completely exhausted. It was little wonder that one night on my way home from an intervention in Fayetteville, I had to pullover to the side of the road to figure out where I was. What was normally an easy drive home became an unnerving event.   

Cumulative and vicarious trauma, as with PTSD in general, impacts upon the mental wellbeing; but it can impact the physical being as well.  Left unaddressed it can be the silent killer. In the military we have annual physical and mental health assessments.  All care givers do well to have other care givers in their lives that help with periodic check ups, be it a therapist, pastor, or MD. In the military it is often our battle buddy; someone whose got your back.  
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I am thankful to have an entire team that keeps me in check. If you are a care giver or you are in a highly stressful job such as law enforcement, the military, mental or physical health, who takes care of you? For that matter, regardless of your field, who do you have in your life that helps you take care of you? If the answer is “I don’t have anyone” then do something about it. Don’t assume that others will care when you are in pain. It’s not that others don’t care; it may simply be that they don’t know. The first person on your list of who takes care of you is YOU.  Lead the way in seeking help for you and you will find the help you need. As the good book says, “Knock and the door will be opened. Seek and you will find.”

Much thanks to Fayetteville Fireman, Keith Harris for providing the photos  ​