The Cumulative Effects of Trauma Over a Career as a First Responder

First responders are trained to expect the unexpected. Whether it’s a fire crew arriving at a blaze, a paramedic rushing to a crash scene, or law enforcement responding to a call, their work places them face-to-face with danger, tragedy, and human suffering on a daily basis. While the public often associates trauma with a single catastrophic incident — the “one bad call” — the reality is that most responders are carrying far more than one story.

During a recent After Action First Responder Workshop, our facilitators discussed what’s known as cumulative trauma: the layered psychological impact of experiencing repeated stressors, tragedies, and high-stakes situations over an entire career. As one speaker explained, “Very rarely do we come across somebody that is just dealing with one incident. More often, it’s experiences throughout a career that roll into what manifests after a single event”. – Chris Scallon – Retired Police Lieutenant, U.S. Navy veteran, and internationally recognized trainer on officer wellness, trauma, and peer support.

This blog explores the cumulative effects of trauma, how it develops, the toll it takes, and — most importantly — how first responders can protect their mental health and seek support.

What is Cumulative Trauma?

Cumulative trauma in first responders is the gradual build-up of stress and traumatic exposure over time. Unlike post-traumatic stress disorder (PTSD), which is often associated with a single, life-threatening event, cumulative trauma refers to the “stacking effect” of repeated exposure.

The Workshop emphasized that one incident can often feel like the “trigger” — but in reality, it’s the straw that breaks the camel’s back. “People might get confused that this one event is what’s bothering me,” one facilitator noted. “The interesting side note is that we may not know that past experiences have led us to this spot, where one incident is kind of bothering us”. Raul Rivas – Retired Law Enforcement Officer and First Responder Liaison at After Action, dedicated to peer support and breaking the stigma around mental health.

For first responders, that one moment may not actually be the source — it’s the years of stress layered underneath that rise to the surface.

The Threshold of Exposure

One of the most powerful insights from the Workshop was about the “threshold” of what responders can endure. Over time, many develop a kind of tolerance for disturbing situations.

“For first responders and veterans specifically, we have a really high threshold of what we can be exposed to… but when we surpass that threshold, everything comes down. It’s an avalanche of emotions“. –Doug Monda – Retired Law Enforcement Officer, suicide survivor, and Director of First Responder Relations at After Action.

When responders begin their careers, their senses are in overdrive. “You’re almost hypersensitive to everything. You’re working in overdrive,” Chris recalled. With time, though, there’s a shift. Responders begin to normalize what once would have left them shaken.

A homicide detective described how officers could stand over a body and casually discuss lunch plans. “Earlier on, I would’ve thought, well, there goes my appetite. But over the years, there’s a shift that kind of goes on,” Chris said. This ability to adapt allows responders to function on the job — but it also reflects how deeply cumulative trauma embeds itself in their psyche.

Signs and Symptoms of Cumulative Trauma in First Responders

Experts note that cumulative trauma in first responders often goes unnoticed until symptoms become overwhelming. Often, it reveals itself in subtle ways first, before escalating. Common signs include:

• Emotional numbness or detachment – Joking about tragedy or feeling “nothing” at disturbing scenes.
• Burnout and fatigue – Chronic exhaustion, lack of motivation, and difficulty finding joy outside of work.
• Hypervigilance – Being “always on,” easily startled, or unable to relax off duty.
• Sleep disruptions – Insomnia, nightmares, or restless sleep.
• Relationship strain – Irritability, withdrawal, or emotional unavailability with loved ones.
• Substance use – Drinking or using other substances to cope with stress.

As Chris put it, “We see all these horrible things… exposed to stressful situations time and time again, and we start to become almost inoculated to them. The problem is, when we finally do surpass that tolerance, it all comes down”.

Real Stories from the Field

The Workshop provided raw examples of how trauma builds across careers.

• The smells and sounds that linger – Chris described scenes where a body had been in an apartment for weeks, the heat left on, creating conditions that haunt responders long after they leave.
• The casual conversations at crime scenes – Forensics teams and detectives joked about food at gruesome scenes, not out of callousness, but as a coping mechanism. “There’s a shift that goes on. You start normalizing things that aren’t normal,” Chris said.
• The avalanche moment – After years of “holding it together,” responders can suddenly hit a breaking point, where one incident unleashes years of suppressed stress and grief.

These stories illustrate how cumulative trauma in first responders is not always obvious in the moment, but it leaves lasting marks on first responders’ minds, bodies, and relationships.

Why Acknowledging Cumulative Trauma in First Responders Matters

Failing to address cumulative trauma can have devastating consequences. Research shows that first responders experience higher rates of depression, anxiety, PTSD, and suicidal ideation compared to the general population.

In fact, according to the U.S. Department of Health and Human Services, first responders are more likely to die by suicide than in the line of duty. Recognizing the cumulative nature of trauma is vital for early intervention.

As the Workshop highlighted: “When we surpass that threshold, everything comes down… an avalanche of emotions”. Without acknowledging the build-up, responders may believe they’re only reacting to “one bad call” and miss the bigger picture.

Healing and Support

The good news is that cumulative trauma can be addressed — but it requires intentional effort, support, and cultural change.

Doug noted: “When we reach out to friends, counselors, clinicians — the conversation often goes back to what happened leading up to that point.” In other words, healing means looking at the full picture, not just the most recent incident.

Effective supports include:

• Peer support teams – Trained fellow responders who “get it.”
• Counseling and therapy – Trauma-informed clinicians who understand first responder culture.
• Resilience training – Tools for stress management, mindfulness, and coping skills.
• Family education – Helping loved ones understand the signs of trauma and how to support their responder.

After Action is dedicated to providing these culturally competent, trauma-informed supports — from residential treatment to workshops that bring first responders together in shared understanding.

After Action: A Dedicated Program for First Responders

At After Action, we understand that first responders face unique challenges that can’t be met by generic treatment programs. Firefighters, law enforcement officers, paramedics, dispatchers, correctional officers, and border patrol personnel all experience trauma differently — and require specialized care that respects their culture.

Our program offers:

• Gender-specific treatment facilities – separate men’s and women’s environments to foster safety and openness.
• Trauma-informed, culturally competent care – clinicians trained in first responder culture, language, and values.
• Peer support integration – retired and active responders on staff, who bridge the gap between clinical work and real-world experience.
• Innovative therapies – including Sensory Modulation Therapy, EMDR, and resilience training tailored to the high-intensity demands of public safety work.
• Flexible stays – options like a two-week Mental Health Tune-Up, a 30-Day Reset, and longer residential treatment depending on need.

As Chris put it during the Workshop: “Very rarely do we see someone just dealing with one incident. More often, it’s the build-up over time. That’s why programs like After Action are so important — to unpack years of service, not just one call.”

Watch the Full Workshop

If you’d like to dive deeper into this discussion and hear firsthand from retired and active first responders, you can watch the full workshop episode here:

This conversation brings raw, unfiltered insights that resonate deeply with anyone who has served, or who loves someone who has.

Conclusion

Cumulative trauma is a silent burden carried by countless first responders. It doesn’t happen overnight — it builds slowly, quietly, until one day it feels unmanageable. But healing is possible.

At After Action, we’ve built a program designed specifically for those who run toward danger when others run away. Here, first responders find the understanding, tools, and community they need to heal.

👉 If you’re ready to take the next step, contact After Action today. Your service has always been about protecting others. Now it’s time to protect yourself.

About the Speakers

This blog draws from insights shared during the After Action First Responder Workshop, led by experts with decades of service and lived experience.

• Chris Scallon – Retired Police Lieutenant, U.S. Navy veteran, and internationally recognized trainer on officer wellness, trauma, and peer support. Read Chris’s bio →
• Doug Monda – Retired Law Enforcement Officer, suicide survivor, and Director of First Responder Relations at After Action. Read Doug’s bio →
• Raul Rivas – Retired Law Enforcement Officer and First Responder Liaison at After Action, dedicated to peer support and breaking the stigma around mental health. Read Raul’s bio →