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The personal toll of responding to a terror attack

There will be short and long-term effects that are physical, emotional and psychological


We must not forget to protect our first responders in any way we can.


Preparing America’s Cops For Terrorism: Expert columnists address prevention, preparedness, training, mitigation, response, recovery and lessons learned from incidents on U.S. soil. Check out all of our coverage here.


September 11, 2001, marked the deadliest terrorist attack on American soil. Since this date, attacks like the Boston Marathon bombing, the Orlando nightclub shooting, and the San Bernardino attack were so horrific we remember them like yesterday.

These domestic terror attacks are fresh in our minds because of the continual reporting of stories, sharing of graphic images, and because we are still seeking to learn from these horrific attacks to prevent future occurrences. Images capturing desperate people jumping from the Twin Towers to escape immense heat and flames to lifeless children carried from the rubble of the Murrah Federal Building in the arms of first responders can never be forgotten. They are permanently etched in our minds.

Side effects of exposure

Despite how disturbing these incidents are to those who observe from afar, these graphic images do not affect the casual viewer the same way they do those who viewed these incidents on the front lines. A once peaceful world is quickly brought into focus once an officer graduates the academy and hits the street. This reality was seen during the Boston Marathon bombing on April 15, 2013 and during the subsequent shootout with the attackers on April 19, 2013. This reality was seen when the Boston Marathon bombing (April 15, 2013) and when Watertown, Massachusetts officers were involved in a shootout with the two bombing suspects on April 19, 2013. MBTA Transit Police Officer Dic Donohue responded as backup and upon arrival, he was shot and critically wounded.

It is impossible to predict how the aftermath of this type of attack will affect first responders on an individual level – everyone reacts to trauma differently – but there are both short and long-term effects that can occur. These effects are physical, emotional and psychological. In fact, 20 years after the Oklahoma City Bombing, survivors are still coming forward for mental health assistance and “…nearly one in four survivors has markers for PTSD.”

The critical incident

Critical incidents are major stressors for law enforcement, according to a 2002 study on “Routine Occupational Stress and Psychological Distress in Police.”.

Yet, many officers believe they are fully prepared for whatever the streets throw at them. The truth, however, remains that there is no amount of training, education or life experience that can fully prepare an officer for critical incidents which are, according to Kulbarsh, those “… abrupt, powerful events that fall outside the range of ordinary human experiences.” These incidents have such a dynamic impact that regular coping skills no longer suffice, leaving an officer in a downward tailspin. This can seem like a dark, lonely place and can lead some to believe they are losing it or that they may never get better. Often, the officer tries desperately to fix him or herself, often believing they are suffering alone.

First responders are required to deal with death, destruction and human misery. However, there is a difference between dealing with natural versus manmade events, even if both have life-changing outcomes. Terrorists hide behind false narratives, anti-terroristic slogans and deceptive rhetoric. They believe taking the lives of the innocent is justified because of social, religious and/or political injustice. Officers, like many first responders and survivors of these attacks, are left to pick up the pieces. Sadly, many of our heroes are unaware at that moment that their own lives have been shattered in some way. Officer Donohue, like many first responders and survivors of these attacks, are left to pick up the pieces. Sadly, many of our heroes are unaware, at that moment, their own lives have been shattered in some way.

The aftermath

According to the Occupational Safety and Health Administration, the aftermath of the critical incident can present in numerous ways and in varying degrees and severities. This chart below is a compilation of common signs and symptoms associated with critical incident stress. However, this is not an exhaustive list.








Inability to rest





Unusual thirst



Antisocial behavior

Chest pain

Poor attention and decision making ability

Intense anger

Increased alcohol consumption


Poor concentration, memory

Apprehension and depression

Change in communications


Poor problem solving ability

Chronic anxiety

Loss/increase appetite

The majority of first responders exposed to a critical incident experience signs and symptoms within the first 24 hours. However, about half will not experience immediate symptomology. Rather, these officers may see noticeable changes days or even weeks after the incident. Some will even experience symptoms years after the initiating event. The lack of immediacy in symptomology can leave many confused as to what is happening or perplexed by the actual cause of the signs being presented.

The sad reality remains that even one event, like that of 9/11, leaves thousands to suffer. The aftermath still reverberates today. According to the Officer Down Memorial Page, in the 15 years since the 9/11 attacks, 181 officers have lost their lives. Of these, 72 were killed at Ground Zero and 109 have passed away due to 9/11 related illnesses. The number of deaths due to 9/11 related health issues is expected to rise.

Combating terrorism is a huge undertaking and a fight that will continue for many years. However, we must not forget to protect our first responders in any way we can. Harmful exposure to these attacks can be limited by sound mental health prior to events, training in disaster preparedness, limiting on-scene exposure, maintaining adequate sleep and limiting work shifts, providing critical incident stress debriefings, and most importantly providing adequate availability to mental health practitioners and resources.

Dr. Olivia Johnson holds a master’s in Criminology and Criminal Justice from the University of Missouri, St. Louis and a doctorate in Organizational Leadership Management from the University of Phoenix, School of Advanced Studies. Dr. Johnson is a veteran of the United States Air Force, a former police officer, and published author. As the founder of the Blue Wall Institute she trains first responders on wellness issues, suicide awareness and prevention, peer support, stress and anger management, and leadership issues. Dr. Johnson writes for several publications and is an Adjunct Professor at Lindenwood University - Belleville, Illinois.

Contact Olivia Johnson