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First RespondersMental HealthSuicide Prevention

Thwarted Belongingness, Perceived Burdensomeness, Hopelessness, and Cognitive Distortions for First Responders

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For all first responders whether law enforcement, emergency medical personnel or paramedics, or firefighters, there is a connection or link between thwarted belongingness, perceived burdensomeness, hopelessness, and cognitive distortions.

Thwarted Belongingness

According to Thomas Joiner’s interpersonal psychological theory of suicide, feeling like you don’t belong and that you are a burden can trigger suicidal thoughts. When a person lacks deep relationships with those around them, they are lonely and socially disconnected. If they feel that others are not reciprocating their feelings, they experience a sense of thwarted belongingness.

Furthermore, after retirement, a first responder no longer has many of the stable interpersonal relationships that they had while they were working. They can experience loneliness due to having fewer social connections. Although those individuals still working do care, the retiree may feel as though no one cares about them anymore. Being that thwarted belongingness is a risk factor for suicide ideation, it is important to talk about.

Perceived Burdensomeness

It’s possible that my father, a retired police officer, may have killed himself because he felt that his health issues made him a burden to his wife and children. Because I was due to give birth to triplets, he may have felt that his medical issues would be too much of a burden to his family.

When someone perceives themselves as being useless or a burden to others because of the work involved in taking care of them, that is perceived burdensomeness. They may also think that they make no contribution to the lives of those around them, making them more of a liability than an asset to the total well-being of the group. Research demonstrates that perceived burdensomeness is one factor in determining suicidality in Veterans.


first responder stressGradus and Associates discovered in 2010 that individuals who have depression and PTSD have a much higher suicide mortality rate. Many first responder departments put most of their focus on PTSD, but they should also be concentrating on depression, insomnia, hopelessness, and stress caused by trauma. They must be cognizant of how a first responder’s personal accomplishments outside of work act as a protectant, and they can help increase self-confidence and belief in themselves in the face of challenges at work by offering specialized psychological care to reduce feelings of hopelessness and educational support to lower stress. This can easily be done through classes on wellness. Also, departments should focus on the importance of getting check-ups.

Hopelessness is strongly predicted by burnout and depression. Financial difficulties, health issues, and negative life events that have lowered one’s self-esteem can all contribute to feelings of hopelessness. Hopelessness can cause one to be unable to think about the future, and to feel a sense of desperation and loss of hope. When working with a first responder dealing with hopelessness, it is just as important to hear what they are not saying, as much as what they are saying.

Cognitive Distortions

Suicidal thoughts can be triggered by different things, but a first responder who is thinking about killing themself may be experiencing cognitive distortions. These are incorrect, irrational, or excessive ways of thinking, and it is believed that they play a significant role in the development and persistence of a number of mental disorders.

Finding some middle ground can be challenging for first responders who suffer from cognitive distortions. They could isolate themselves because they believe they are a bad person, a failure, that they don’t belong, or that they are a burden to others.

Questions to Ask First Responders

If a first responder is thinking things that are not necessarily true, they need support.  Here are 10 questions to pose to a first responder on the judgments they make about themselves as a result of cognitive mistakes:

  1. Are they putting unnecessary blame on themself?
  2. Are they assuming the worst of the situation?
  3. Are they thinking in an extreme way about what happened?
  4. Do they focus more on what they perceive to be their failures instead of their successes?
  5. Do they describe themself with negative language?
  6. Are they personalizing what happened, even though it wasn’t their fault?
  7. Do they focus more on negative thoughts rather than positive thoughts?
  8. Are they drawing conclusions without any evidence to back them up?
  9. Are the conclusions that they draw from what happened not telling the whole story?
  10. Have they told anyone what they are thinking or are they too embarrassed?

These questions are meant to make a first responder aware of the possibility that occasionally their perceptions may not be accurate. Cognitive distortions are flawed thought patterns that can adversely affect behavior.  Whether they jump to conclusions, over-generalize, or blame themselves, they are not alone. If you are a peer, help them or get them the professional help that they need. Don’t allow shame, stigma, or first responder culture to get in the way of their wellness.

Barbara is a leading authority and best-selling author on managing burnout, secondary traumatic stress, compassion fatigue, and vicarious trauma. As a nationally recognized keynote speaker, she motivates audiences to build their resilience and create work-life balance. Her programs help leaders and teams manage workplace chronic stressors and get over burnout at work.

Barbara's newest book, "But I Didn't Say Goodbye: Helping Families After a Suicide", is available now on Amazon -

• Three weeks prior to giving birth to triplets, her father died by suicide. Her story was featured in the Emmy award winning documentary, Fatal Mistakes, Families Shattered by Suicide narrated by Mariette Hartley. Many employees are grieving personal loss. She offers programs for leaders on lost productivity and performance while managing grief at work.

• As a sought-after keynote speaker who has presented to over 500 groups since 1991, including corporations, state and national associations and non-profit organizations, Barbara offers work-life balance strategies for leaders to implement right away. With clarity and humor, her speaking engagements are designed to give audiences powerful and practical strategies of work-life balance, wellbeing, and self-care that can be implemented immediately.

• Barbara is a Board-Certified Expert in Traumatic Stress and Diplomate with the American Academy of Experts in Traumatic Stress. She received a Bachelor of Science in psychology and a Master of Arts degree in community health, with a concentration in thanatology, both from Brooklyn College.


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