Lisa King Smith, Ed.S, LPC
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Lisa King Smith, Ed.S., LPC, LLC

Psychotherapy
​​Integrative Health & Wellness Coaching
404-375-2036

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​Health and Wellness Tips for First Responders: Building Strength From the Inside Out

8/24/2025

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First responders—firefighters, police officers, paramedics, EMTs, and dispatchers—are often seen as unshakable pillars of strength. But behind the uniform, they are human beings carrying the weight of unpredictable schedules, high-stress situations, and exposure to trauma. The mental, physical, and emotional demands of the job can take a toll if health and wellness are not intentionally prioritized. As both a mental health professional and health coach, I believe wellness isn’t just about surviving—it’s about building resilience and thriving, even in the midst of a demanding career. Here are some practical strategies designed specifically for first responders.
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1. Prioritize Sleep as Recovery, Not Just Rest Shift work, long hours, and nighttime calls can disrupt natural sleep cycles. Poor sleep impacts reaction times, mood, decision-making, and long-term health. Tips for better rest: Keep your bedroom cool, dark, and quiet—even blackout curtains or a white noise machine can help. Create a “wind-down ritual” (stretching, reading, or mindfulness) to cue your body that it’s time to rest, even if it’s daytime. Limit caffeine to earlier in the shift to protect your ability to sleep later.

2. Fuel the Body With Energy-Sustaining Nutrition First responders often eat on the go—fast food, vending machines, or skipped meals. Over time, this depletes energy and increases stress on the body. Health coaching perspective: Think of food as fuel for performance and recovery. Pack quick, portable snacks like nuts, fruit, or protein bars to avoid relying on processed foods. Balance meals with lean protein, complex carbs, and healthy fats to keep blood sugar stable during long shifts. Hydrate consistently—dehydration increases fatigue, headaches, and irritability.

3. Movement as Stress Relief, Not Just Fitness Physical fitness is part of the job, but exercise doesn’t have to mean hours at the gym. Movement can be a powerful way to process stress and regulate mood. Tips for active wellness: Short bursts of movement (5–10 minutes of stretching, walking, or bodyweight exercises) during breaks can reset energy. Try restorative activities like yoga or mobility work to release tension. Pair movement with mindfulness—notice your breath, your body, and let it ground you after high-adrenaline calls.

4. Build Mental Fitness Alongside Physical Fitness The job requires quick thinking in crisis, but cumulative stress can overwhelm even the strongest minds. Mental health tools are just as important as physical training. Strategies for resilience: Practice mindful breathing or grounding exercises between calls to lower stress hormones. Journaling or talking with a trusted peer can help release emotions instead of storing them inside. Learn to recognize early signs of compassion fatigue, anxiety, or burnout—and seek support before it escalates.

5. Strengthen Support Systems First responders often carry a “strong face” at work, which can make it harder to lean on loved ones. But community and connection are key to wellness. Stay connected with family and friends outside of work for a sense of balance and perspective. Use peer-support programs or professional counseling designed specifically for first responders. Remember: reaching out for help isn’t a weakness—it’s an act of courage and strength.

6. Create Small, Sustainable Habits The unpredictability of first responder life makes big lifestyle overhauls unrealistic. Instead, focus on small, consistent changes. Drink one extra bottle of water during your shift. Spend five minutes stretching before bed. Take two minutes to pause and breathe deeply after a stressful call. Small habits, practiced daily, build resilience and protect long-term health.

Final Thoughts: Caring for the Caregivers First responders dedicate themselves to protecting others, but they also deserve to protect their own health. By blending health coaching strategies with mental health awareness, first responders can create a strong foundation for both physical vitality and emotional resilience. When wellness is treated as essential—not optional—first responders can continue to serve with strength, clarity, and compassion, while also sustaining their own well-being.

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First Responders and Compassion Fatigue: Caring for the Caregivers

8/24/2025

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First responders—police officers, firefighters, paramedics, emergency dispatchers, and others on the front lines—carry an extraordinary responsibility. Every day, they face crises most people can’t imagine: life-threatening emergencies, trauma, loss, and chaos. While their training equips them to act quickly and effectively, no amount of preparation can fully shield them from the emotional toll of witnessing suffering again and again. This repeated exposure can lead to compassion fatigue, sometimes referred to as the "cost of caring." Compassion fatigue is more than burnout. It’s the emotional, physical, and spiritual exhaustion that comes from prolonged exposure to others’ pain and trauma. For first responders, it can sneak in quietly—masking itself as irritability, numbness, or detachment—until it begins to affect both professional performance and personal well-being.

The Signs of Compassion Fatigue
Compassion fatigue may show up differently for each person, but some common signs include:
Emotional symptoms: Irritability, anger, sadness, emotional numbness, or feelings of hopelessness.
Physical symptoms: Fatigue, headaches, changes in appetite or sleep patterns.
Behavioral symptoms: Withdrawing from loved ones, increased use of alcohol or substances, difficulty concentrating.
Work-related symptoms: Reduced empathy toward those they serve, dread about going to work, or questioning one’s effectiveness and purpose. Because first responders are trained to remain composed and resilient, many ignore or suppress these symptoms—believing they simply have to "push through." But over time, unresolved compassion fatigue can escalate into burnout, depression, or even post-traumatic stress.

Why First Responders Are at Higher Risk
Unlike other professions, first responders often have little time to process one incident before the next call arrives. The constant exposure to high-stakes emergencies—combined with long shifts, lack of sleep, and the culture of "staying strong"—creates the perfect conditions for compassion fatigue. They are also uniquely impacted by the dual burden of responsibility: Protecting and saving lives in moments of crisis. Carrying the emotional weight of those they couldn’t save. This cycle of giving and carrying, without space for recovery, makes first responders especially vulnerable.

Pathways to Healing and Prevention
Compassion fatigue is not a sign of weakness—it’s a human response to extraordinary stress. Protecting mental health requires intentional strategies, both individually and organizationally:
Self-awareness and education: Learning to recognize the signs of compassion fatigue early can help prevent deeper exhaustion.
Peer and professional support: Talking with colleagues who understand the unique pressures of the job, as well as accessing counseling or peer-support programs, provides vital outlets for processing emotions.
Healthy coping strategies: Regular exercise, mindfulness, hobbies, journaling, and time with loved ones help restore balance.
​Workplace culture change: Leadership can play a major role by encouraging open conversations about mental health, reducing stigma, and providing access to mental health resources.
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A Call to Care for the Caregivers
First responders dedicate their lives to protecting and supporting others. But behind the uniform is a human being whose heart and mind carry invisible scars. Recognizing compassion fatigue—and addressing it with compassion, not judgment—is essential to sustaining their health and their ability to serve. Caring for the caregivers isn’t optional; it’s an act of community resilience. When we support first responders in tending to their own well-being, we ensure they can continue to show up strong, compassionate, and effective in moments when we need them most.

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How Psychotherapy Works: A Guide for New Clients

8/16/2025

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Starting psychotherapy can feel both hopeful and uncertain. You might be wondering what to expect, how it works, and whether it can really help. This guide will walk you through the basics so you can begin your therapy journey with more clarity and confidence.
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What Is Psychotherapy?
Psychotherapy—also called talk therapy—is a collaborative process between you and a trained mental health professional. It provides a safe, confidential space to explore your thoughts, feelings, and behaviors, and to work toward personal growth, healing, and improved well-being.
It’s not about “fixing” you—because you are not broken. It’s about understanding yourself better, developing healthier ways to cope, and making meaningful changes in your life.
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The Therapeutic Relationship
One of the most important parts of therapy is the relationship between you and your therapist. Research consistently shows that the quality of this connection—built on trust, respect, and openness—is a key factor in whether therapy is effective.
Your therapist’s role is to listen without judgment, ask thoughtful questions, and guide you toward your own insights and solutions. Your role is to be as open and honest as you can, even if that feels uncomfortable at times.
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How the Process Works
While every therapist has their own style and approach, here’s what you can generally expect:   
 1.    The First Sessions – You’ll discuss your reasons for seeking therapy, your personal history, and your goals. This is also your chance to ask questions and see if the therapist feels like the right fit for you.   
 2.    Setting Goals – Together, you’ll identify what you want to work on—whether it’s reducing anxiety, processing trauma, improving relationships, or finding greater life satisfaction.     
3.    Exploring and Learning – Over time, you’ll talk through challenges, explore patterns, learn coping strategies, and gain new perspectives. Your therapist may use specific techniques, such as cognitive-behavioral therapy (CBT), mindfulness practices, or trauma-informed approaches.     
4.    Practicing Outside of Sessions – Therapy often involves “homework” between sessions—trying out new behaviors, journaling, or reflecting on insights.     
5.    Reviewing Progress – Periodically, you and your therapist will check in on your progress and make adjustments to keep you moving toward your goals.
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Common Myths About Therapy     
•    “Therapy is only for people in crisis.” Many people come to therapy for personal growth, self-discovery, or preventative care—not just during emergencies.   
 •    “The therapist will tell me what to do.” A therapist won’t hand you all the answers. Instead, they’ll help you find solutions that fit your unique needs.     
•    “If therapy works, I’ll feel better right away.” Some changes take time. It’s normal to have ups and downs as you work through deeper issues.
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How to Get the Most Out of Therapy     
•    Be honest—even about your doubts or frustrations.   
 •    Keep an open mind to new perspectives and ideas.     
•    Commit to regular attendance, especially in the beginning.     
•    Practice what you learn between sessions.     
​•    Give yourself permission to grow at your own pace.
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The Bottom Line
Psychotherapy is a powerful tool for healing, self-understanding, and personal growth. It works best when it’s a partnership—where both you and your therapist are invested in the process. If you’re willing to show up, be curious, and do the work, therapy can help you create meaningful and lasting change in your life.

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C-PTSD vs. Borderline Personality Disorder: Understanding the Differences

8/9/2025

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​Both Complex Post-Traumatic Stress Disorder (C-PTSD) and Borderline Personality Disorder (BPD) can involve intense emotions, difficulties in relationships, and struggles with self-image. Because of their similarities, they are sometimes confused—by the public, and even by professionals who aren’t trauma specialists. However, these are distinct conditions with different causes, patterns, and treatment approaches. Let’s break down the differences.
1. Origins and Causes C-PTSD
C-PTSD develops in response to chronic, long-term trauma, often occurring in childhood. This might include repeated abuse, neglect, domestic violence, captivity, or living in a war zone. The key factor is ongoing trauma where the person feels trapped and powerless to escape. BPD
BPD is considered a personality disorder, often linked to a combination of genetic vulnerability, early life experiences, and environmental stressors. Many people with BPD also experienced trauma, but trauma is not the sole cause—there are also differences in temperament, brain function, and emotional regulation that contribute.
2. Core Features C-PTSD Symptoms
In addition to the symptoms of PTSD (flashbacks, nightmares, hypervigilance), C-PTSD often includes: Persistent feelings of shame or guilt Emotional numbness or difficulty feeling positive emotions Chronic sense of worthlessness Avoidance of reminders of trauma Difficulties with trust and feeling safe Problems regulating emotions, often triggered by reminders of the trauma
BPD Symptoms
The hallmark features of BPD are: Intense fear of abandonment (real or perceived) Rapid changes in self-image or sense of identity Unstable, intense relationships (idealizing someone one moment, devaluing them the next) Impulsive or risky behaviors (spending, substance use, reckless driving) Chronic feelings of emptiness Intense, inappropriate anger or difficulty controlling anger Stress-related paranoia or feeling “out of touch” with reality
3. Relationship Patterns C-PTSD
People with C-PTSD may avoid close relationships out of fear of being hurt again. They often keep emotional distance, even from loved ones, as a protective strategy.
BPD
People with BPD often desperately want close relationships but struggle to maintain them due to rapid shifts between closeness and conflict. Their intense fear of abandonment can drive both clinging and pushing people away.
4. Emotional Regulation C-PTSD
Emotional triggers are often tied directly to trauma memories or situations that feel unsafe. Emotional dysregulation may be more predictable and linked to specific reminders.
BPD
Emotional changes can be extreme, fast, and not always linked to a specific trauma trigger—sometimes even small perceived slights or changes in relationships can cause intense emotional reactions.
5. Treatment Approaches C-PTSD
Trauma-focused therapies such as EMDR (Eye Movement Desensitization and Reprocessing), TF-CBT (Trauma-Focused Cognitive Behavioral Therapy), and Somatic Experiencing are often used. Treatment typically emphasizes safety, processing traumatic memories, and building self-compassion.
BPD
Dialectical Behavior Therapy (DBT) is considered the gold standard for BPD. It focuses on emotion regulation, distress tolerance, mindfulness, and interpersonal effectiveness. While trauma work may also be part of treatment, the primary focus is on learning skills to stabilize emotions and relationships.
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Key Takeaway While C-PTSD and BPD can look similar on the surface—especially when emotional dysregulation and relationship struggles are present—their root causes, patterns, and treatments are different. A skilled mental health professional can help clarify the diagnosis and create a tailored treatment plan.

Bottom line: Both conditions are real, valid, and treatable. With the right support, healing and healthy relationships are possible.

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Understanding Complex PTSD: Symptoms and How It Manifests

8/9/2025

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Most people are familiar with post-traumatic stress disorder (PTSD), often associated with a single traumatic event such as a natural disaster, assault, or accident. But there’s another form of trauma response called Complex PTSD (C-PTSD)—and it deserves just as much understanding and attention.

What Is Complex PTSD?
Complex PTSD develops as a result of long-term, repeated trauma, often in situations where escape feels impossible. This might include: Childhood abuse or neglect Domestic violence Prolonged captivity or trafficking Living in a war zone over many years Chronic emotional abuse or coercive control Whereas PTSD often stems from a single incident, C-PTSD is shaped by ongoing, cumulative harm—especially when it occurs in formative years or within close relationships.

Core Symptoms of C-PTSD
While C-PTSD includes many of the symptoms of standard PTSD—such as intrusive memories, hypervigilance, and avoidance—it also involves additional layers of difficulty.

1. Emotional dysregulation
People with C-PTSD may experience intense emotions that shift rapidly—anger, sadness, shame—often triggered by seemingly small events.

2. Persistent negative self-beliefs
Survivors may internalize the belief that they are unworthy, “damaged,” or to blame for what happened.

3. Relationship difficulties
C-PTSD can lead to challenges in trusting others, feeling safe in relationships, or setting healthy boundaries.

4. Chronic feelings of emptiness or hopelessness
There may be a lingering sense that life lacks meaning or that happiness is out of reach.

5. Dissociation
A feeling of being “disconnected” from one’s body or surroundings, which can occur during stress or without warning.

How It Manifests in Daily Life C-PTSD is not always visible from the outside, but it can influence nearly every aspect of life.

Work and school: Concentration problems, perfectionism, or fear of criticism
Social interactions: Avoidance of closeness, conflict, or intimacy
Physical health: Chronic pain, fatigue, headaches, or gastrointestinal issues Self-perception: Constant self-criticism or difficulty celebrating accomplishments

The Path Toward Healing Recovery from C-PTSD is possible, but it often requires time, safety, and specialized support. Effective treatments can include:
Trauma-focused therapy (e.g., EMDR, somatic experiencing, cognitive processing therapy)
Psychoeducation about trauma and its effects
Mindfulness and grounding techniques to regulate emotions
Supportive relationships that model trust and respect
Self-care practices that restore a sense of safety in the body Healing from C-PTSD is rarely linear. There may be setbacks, but each step forward—no matter how small—is progress.
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Final Thoughts
Complex PTSD is not a sign of weakness; it is a natural human response to prolonged harm. By understanding its symptoms and recognizing how it manifests, we can reduce stigma, increase empathy, and support the resilience of survivors.

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    Lisa King Smith

    is a Licensed Psychotherapist in private practice and a health & wellness coach specializing in integrative & holistic approaches to mental health & wellbeing. She lives and practices in the West Georgia area near Atlanta. 

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Lisa King Smith, Ed.S., LPC LLC
309 Tanner Street
​Carrollton, GA
Phone: 404.375.2036
​Fax: 470-231-1732
[email protected]
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