Emotional responses to potentially traumatic events: An interpretative qualitative analysis of high-risk professionals in relation to their social structures

Professionals in emergency-focused environments are taught to prioritize emergencies over their own emotions and trained to suppress their own emotional reactions. High-risk professionals in a vertical social structure, such as police officers, military personnel, career firefighters, and perioperative nurses, also tend to develop an us-versus-them mentality with emotional distance from patients or civilians. This study explores emotional reactions of police officers, military personnel, firefighters, paramedics, and specialized nurses (emergency room nurses, operating room nurses, and intensive care nurses) to past and present potentially traumatic events. We aim to understand how a social environment that reinforces suppression of emotional reactions and fosters emotional distance from patients and civilians influences their emotional responses. We analyzed fieldnotes from ethnographical research, encompassing 332 h of observations and 71 in-depth interviews with professionals from eight occupational groups. We identified meaning units that were interpreted through the lens of literature on etiology and treatment of trauma-related mental health problems. High-risk professionals in a vertical social structure experience unexpected moments of identification with victims or patients, which leads to personal distress and has lasting emotional impact. For those in horizontal social structures, such as paramedics and specialized nurses, we did not observe these sudden, intense emotional reactions. Instead, they seem to experience increased emotionality and exhaustion over the course of their careers. While emotional distancing may be functional during emergencies, it likely increases the risk of traumatization. This risk is amplified when ingrained during early socialization. Graphical abstract designed by Uros Pajic. • Police, military, firefighters, and surgery-teams have a vertical social structure. • One characteristic of a vertical social structure is an us-versus-them mentality. • Us-versus-them mentality reinforces emotional detachment from patients/civilians. • Moments of identification dissolve this distinction and lead to personal distress. • Early socialization shapes emotional responses and increases trauma vulnerability.