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In the Line of Fire:
Trauma in the
Emergency Services

CHERYL REGEHR
TED BOBER

OXFORD UNIVERSITY PRESS

IN THE LINE
OF FIRE
This page intentionally left blank
IN THE LINE
OF FIRE
TRAUMA IN THE
EMERGENCY SERVICES

cheryl regehr
ted bober

1
2005
1
Oxford New York
Auckland Bangkok Buenos Aires Cape Town Chennai
Dar es Salaam Delhi Hong Kong Istanbul Karachi Kolkata
Kuala Lumpur Madrid Melbourne Mexico City Mumbai Nairobi
São Paulo Shanghai Taipei Tokyo Toronto

Copyright © 2005 by Oxford University Press, Inc.

Published by Oxford University Press, Inc.
198 Madison Avenue, New York, New York 10016
www.oup.com
Oxford is a registered trademark of Oxford University Press
All rights reserved. No part of this publication may be reproduced,
stored in a retrieval system, or transmitted, in any form or by any means,
electronic, mechanical, photocopying, recording, or otherwise,
without the prior permission of Oxford University Press.

Library of Congress Cataloging-in-Publication Data

Regehr, Cheryl.
In the line of fire : trauma in the emergency services / Cheryl Regehr, Ted Bober.
p. cm.
Includes bibliographical references.
ISBN 0-19-516502-0
1. Emergency medical personnel — Job stress. 2. Fire fighters — Job stress. 3. Police — Job stress.
4. Emergency medical personnel — Mental health. 5. Fire fighters — Mental health. 6. Police — Mental
health. 7. Psychic trauma. 8. Post-traumatic stress disorder. I. Bober, Ted. II. Title.
RC451.4.E44R44 2005
616.02'5'019— dc22 2004006827

9 8 7 6 5 4 3 2 1
Printed in the United States of America
on acid-free paper
throughout the process of preparing this book, we have
experienced the fullness of life, including stresses and
challenges of clinical and research work, the SARS epi-
demic, concerns of West Nile virus, technological prob-
lems such as a blackout that left one-quarter of North
America in the dark, and, most importantly, the serious ill-
ness and death of family members. At the same time, ba-
bies were welcomed into lives of our extended family and
friends, one child left for university, and others entered
new and exciting stages of life. All the while, colleagues
and friends were supportive, brought tea and humor.

this book is about resilience and strength in the face of

adversity. It is dedicated to those important individuals in
our lives who have taught us about resilience, grace, and
gratitude. These are experiences that will continue to en-
rich our lives forever. To our families who have always pro-
vided the love and support and been our secure base —
thank you — always.
This page intentionally left blank
 Foreword

This book provides an objective, original, enlightening, and thought-pro-

voking analysis of the full range of emergency and trauma recovery services
practiced by social workers and emergency services personnel throughout
North America. Cheryl Regehr and Ted Bober have made a major and sig-
nificant contribution to the mental health and human services literature.
This is the most thoughtful, compassionate, inspiring, readable, insightful,
and original book I have ever read on emergency services, crisis manage-
ment, and trauma recovery. This book is so engaging and well-written that
I could not put it down until I read every page at one sitting.
Dr. Cheryl Regehr and Ted Bober have been on the front lines of com-
munity disaster intervention as co-directors of the Critical Incident Stress
Team at Toronto Pearson International Airport for over 15 years. In addition,
the authors’ two decades of clinical work, training workshops and seminars,
and research on trauma and emergency services are evidenced throughout
this timely book. I was also delighted to see an emphasis on evidence-based
individual and group interventions.
This gem of a book is a rare combination of outstanding writing, stimu-
lating case illustrations, and an integration of qualitative and quantitative
research. In sharp contrast to other academic trade books, the valuable in-
formation in this original volume is both superbly researched and emi-
nently readable. Catastrophic events, trauma and coping case exemplars,
emergency services and the continuum of early interventions and long-term
follow-up, and the everyday lifesaving and recovery work of police, para-
medics, firefighters, and emergency mental health practitioners are high-
lighted throughout this book. The figures, models, and graphs add an im-
portant conceptual and practical dimension to the book.
In summary, this book is essential reading for almost every mental health
practitioner because of the continued threat of community disasters, emer-
gencies, terrorist attacks, and trauma-precipitating events. Every informed
citizen, student, and practitioner interested in mental health and emer-
gency services should purchase this book. It is a pathfinding and seminal
viii foreword

contribution to the most challenging societal problems of the twenty-first

century.

Albert R. Roberts, Ph.D.

Professor of Social Work and Criminal Justice, Director of Faculty and Cur-
riculum Development, Faculty of Arts and Sciences, Livingston College
Campus, Rutgers, the State University of New Jersey, Piscataway, and edi-
tor in chief, Brief Treatment and Crisis Intervention journal (www.crisis
interventionnetwork.com).
 Preface

In the wake of disaster, emergency service workers including police officers,

firefighters, and paramedics are first on the scene and last to leave. They
are repeatedly exposed to violence and its aftermath and are expected to
cope with it. They put concern for the lives of others over concern for their
own lives, working tirelessly to recover the bodies of the missing. Their
heroic actions save lives, provide comfort to and care for the wounded, and
inspire onlookers, but at what cost to themselves? We now know that res-
cue workers who are exposed to mutilated bodies, mass destruction, mul-
tiple casualties, and life-threatening situations may become the hidden vic-
tims of disaster. The sequelae in terms of traumatic stress symptoms and
depressive symptoms have the potential to be highly disruptive and long-
standing both for the individual worker and their families and for the or-
ganizations in which they work.
Additionally, emergency workers are exposed to events involving human
pain and suffering on a daily basis. These events often do not make the
news or capture public attention. They do not result in an outpouring of
public support for emergency services. While for the most part emergency
workers are equipped to deal with these events, on occasion one particu-
lar event will have a lasting impact. Indeed, this one event may have a more
lasting effect than other more dramatic events involving the loss of many
lives. How do we understand such a process? How do we intervene to en-
sure that we do not lose these valuable resources for society?
This book is based on the authors’ combined experience of over 40 years
of clinical work in emergency departments and with emergency service or-
ganizations. This experience has included managing crisis intervention
teams in both health care and emergency service settings, interventions fol-
lowing critical events in the workplace and response to disasters. In addi-
tion, the book is based on research conducted with more than 350 police,
fire, and ambulance workers in two continents, 300 emergency mental
health practitioners, and qualitative research interviews with more than 50
emergency service workers.
This book provides an overview of the issue of trauma in the emergency
x preface

services. It is intended to serve as reference for social workers, psychologists,

and other mental health professionals who provide services to emergency
service organizations. It is also intended as a guideline for administrators
and peer support team members within emergency service organizations. Is-
sues addressed include the event-related, individual, organizational, and so-
cietal factors that influence trauma response. Various theoretical models for
understanding trauma response are reviewed. In addition, practical advice
is provided regarding planning intervention programs, developing trauma re-
sponse teams, training both emergency service professionals and mental
health professionals regarding providing mental health trauma response in
the emergency services, and evaluating the effectiveness of services provided.
Finally, the stories of emergency responders and the strategies for both self-
care and care of significant others will resound and make the book of inter-
est to both emergency services workers themselves and their families.
 Acknowledgments

Many people have been instrumental in the development of this work.

Members of the Pearson International Airport Critical Incident Stress
Team and the Ministry of Natural Resources (MNR) Team have been valu-
able colleagues over the years. In particular the energy and commitment of
Deane Johanis of the Greater Toronto Airports Authority, and the vision of
Doug Hyde of MNR, have been invaluable. John Hill of Mississauga Fire
and Emergency Services, Gerry Goldberg of Toronto Emergency Medical
Services, and Chuck Bartram of Peel Regional Police have been important
coinvestigators in the research projects. Other team members have shared
their wisdom over the years and have shaped our thinking significantly. Ron
Seymour of Toronto Fire and Emergency Services has inspired us with his
dedication to peer support. In addition, we wish to thank all the emergency
responders who have given us the privilege to share in their experiences
through our clinical work, training, and research. We have tremendous re-
spect for their resilience and ingenuity. Finally, thanks to Albert Roberts for
his encouragement, facilitation, and enthusiastic support of this project.
The research reported in this book was generously supported through the
Social Sciences and Humanities Research Council of Canada.
— Cheryl and Ted

Thanks to Graham, Kaitlyn, and Dylan for tolerance, support, and fabulous
senses of humor.—cr
I also wish to thank colleagues and mentors David Hoath, Keith Travis, Liz
White, Donna Little, Madeline Brynes, and Janina Bober. Thanks to Vicky
Lynham and Clare Pirie for their research support. And thanks to the love
and support of my partner Sue and daughter Jacqueline.—tb
This page intentionally left blank
 Contents
13 Foreword, Albert R. Roberts vii
1 Setting the Stage 3
2 All in a Day’s Work: Traumatic Events
in the Line of Duty 12
3 Building a Framework: Health, Stress,
Crisis, and Trauma 24
4 Disastrous Events: Mass Emergencies and
the Emergency Responder 47
5 The Right Stuff: Trauma and Coping 66
6 Help or Hindrance? Stress and the Emergency
Service Organization 82
7 Heroes or Villains? Public Inquiries 99
8 Are You Coming Home Tonight? The Impact
of Emergency Service Work on Families 113
9 The Continuum of Interventions I:
Doing the Right Job at the Right Time 126
10 The Continuum of Interventions II:
Interventions for Extreme Stress 151
11 Laying the Foundation: Developing Trauma
Response Teams 175
12 Keeping It Going: Team Maintenance 195
13 Does It Work? Evaluating the Efficacy
of Interventions 211

13 References 235
13 Index 259
This page intentionally left blank
IN THE LINE
OF FIRE
This page intentionally left blank
 1
SETTING THE STAGE

Following the crash of two subway trains during rush hour, ambulance, fire,
and police crews worked tirelessly in cramped and difficult conditions to
move ambulatory victims safely from the tunnel, to carry out the injured, and
to extricate those trapped in the debris. The response was time-consuming
and hot. Paramedics held the hands of trapped victims and reassured them.
In the end, however, three passengers died during the rescue attempts. As
indicated by the advertisement in figure 1.1, which ran in newspapers one
week later, the public response was overwhelmingly supportive towards
emergency responders. People brought food and drink and offered their
thanks. Emergency responders were called heroes. At the public inquiry
that followed, however, it was suggested that altered fire and ambulance
procedures during the course of extrications could have saved at least one
life. It seems that heroism isn’t necessarily forever.

On a hot August night, the crew on Engine 11 arrived at a blazing home.

A woman on the lawn screamed that her children were still in the building.
Firefighters immediately set about dousing the flames. Two firefighters en-
tered the building and managed to rescue the children. A newspaper pho-
tographer managed to get a picture of Joe Driscol (not his real name)
emerging from the flaming building with a three-year-old child in his arms.
The picture ran on the cover of every local newspaper declaring that
Driscol was a hero. Television and radio stations sought interviews and de-
scribed his brave actions. But Driscol did not want to be heralded as a hero.

3
4 in the line of fire

Figure 1.1. Toronto Transit Commission

He repeatedly stated that there is no one hero in such a situation; rather,

everyone works as a team to manage risk, preserve life, and protect prop-
erty. Other firefighters in the hall who also worked on that fire shared
Driscol’s sentiments, but expressed them by putting hero signs on Joe’s
locker and bunk and playing Tina Turner’s “We Need a Hero” over the loud
speaker.
 setting the stage 5

After another long day of body recovery on a handful of hours of sleep, a

firefighter heads home, passing the American flags, the mountains of food
and water, and the posters that say thanks and thanks, heroes. As he has
done every night, he arrives home, eats, and sits on the couch with his wife
for a moment. His wife briefly brings him up to speed on the neighborhood,
a new baby was born. Meanwhile, another firefighter’s family grieves. He’s
trying to listen, trying to win the battle, but he’s tired and loses. He is asleep,
she’s in midsentence. A few hours later he is up, sheepishly, when some
people drop by to say thanks and offer support to the neighborhood hero.
His wife asks, “Does the hero have time to take out the garbage tonight?”
He smiles, appreciating his wife’s sense of humor. It has been their way, her
way, to help him stay steady, as he juggles the work, the thoughts of Ground
Zero, and his role as a firefighter, as a neighbor, a father, and husband.

This book is about everyday heroism. It is about the work emergency re-
sponders do and the traumatic situations they face when serving the pub-
lic. It is about the impact of this work on them and their families. We look
at factors at multiple levels that make these jobs and the impact they have
on individuals more difficult or less difficult. Our purpose is to show that it
is not one event alone that causes trauma in people who work in the emer-
gency services. Rather, trauma is a result of the interplay between an event,
the person encountering the event, the public and media response to the
event, the organization in which responders work, and the supports and life
that they have outside the workplace. In the end, we attempt to provide
suggestions for intervention that take into account these multiple levels of
influence. The goal is to assist mental health workers, managers of emer-
gency service organizations, and peer support team members to realize that
there is no single, one-size-fits-all model for assistance. Interventions must
fall on two continuums: one that spans prevention, early intervention af-
ter a traumatic event, and long-term follow up, and one that spans the in-
dividual responders, their families, the organizations in which they work,
and the community as a whole.
The information contained in this book is derived from a series of research
projects conducted on two continents with more than 350 police officers,
paramedics, and firefighters, and with 300 emergency mental health prac-
titioners. These projects involved quantitative data gathering through the use
of questionnaires addressing various issues regarding exposure to traumatic
events, public response to the events, personal and organizational supports,
and levels of distress experienced by emergency service workers. In addition,
qualitative research interviews were conducted with over 50 emergency re-
sponders to more fully understand their experiences, what aspects of the job
they find most troublesome, and what forms of assistance are most useful.
6 in the line of fire

More important, however, is our combined experience of over 40 years of

clinical work in emergency departments and with emergency service organ-
izations. This experience has included managing crisis intervention teams in
both health care and emergency service settings. For instance, for 15 years
we have shared the clinical director duties of an interagency, multidiscipli-
nary crisis response team at Toronto Pearson International Airport, and
through this experience we have had the honor of working with dedicated
professionals from many emergency service organizations. We have also
conducted interventions following critical events in the workplace and have
provided mental health services in disaster situations.
In chapter 2 we begin with an overview of the types of critical events to
which emergency responders are exposed. This chapter addresses human
tragedies encountered in the course of everyday duties. One type includes
dramatic events such as the death of a child, multiple casualties in a large
traffic accident, a line-of-duty death, or situations where the responder’s
own safety is at risk. These events are easy to identify as distressing and are
most likely to result in intervention services provided by peer support teams
and mental health professionals. A second category involves low profile, in-
dividual tragedies, such as the isolated death of an elderly person or the de-
spair of a suicide victim. These events may connect with a responder at a
highly personal level, causing hidden distress that is generally not ac-
knowledged or even identified by intervention programs.
The experiences of emergency responders and their subsequent reactions
to these experiences are placed in a theoretical context in chapter 3. Here we
review current theories for understanding response to adversity. Stress the-
ory attempts to explain the biological and psychological reactions experienced
by a person faced with excessive demands, often on an ongoing basis. From
this perspective, stress occurs when there is a significant imbalance between
one’s demands and the type and amount of internal and external resources
available to cope with those demands. Occupational stress theory further re-
fines this concept and applies it to stressors encountered in the workplace. It
suggests that when the requirements of the job do not match the capabilities,
resources, or needs of the worker, harmful physical and emotional conse-
quences can result. Thus, the ongoing demands of the job and the consistent
exposure to suffering and tragedy can gradually wear on the emergency re-
sponder and in the long run create physical, emotional, and social problems.
Crisis theory and trauma theory refer to more specific traumatic events. Cri-
sis theory describes the psychological disequilibrium experienced by individ-
uals as a result of a hazardous event or situation that disrupts normal patterns
of behavior and cannot be remedied by using customary coping strategies. A
crisis causes emotional distress and behavioral disruption but generally is re-
 setting the stage 7

solved within a few weeks, as the individual, with or without assistance from
others, develops new strategies for managing the event. Trauma theory, on the
other hand, refers to a set of physical, cognitive, and psychological responses
to a particular horrifying event. As a result of this exposure, individuals ex-
perience symptoms of intrusive thoughts and dreams, autonomic arousal,
and behavioral avoidance of stimuli that may trigger memories of the event.
Increasingly, however, trauma theorists are aware that people are highly in-
dividual in their responses to horrifying events, and that several individuals
encountering the same event will have great disparity in the severity and du-
ration of symptoms. Finally, secondary trauma or vicarious trauma refers to
overwhelming emotions and thoughts experienced by people who are exposed
to traumatic imagery through their work with others. From this perspective,
the process of empathically joining with others who are suffering allows for
the transfer or assimilation of traumatic symptoms in the worker. Thus,
merely witnessing the distress of another, such as a grieving parent, can lead
to distress on the part of workers.
Clearly all the theories discussed above—stress theory, occupational stress
theory, crisis theory, trauma theory, and secondary or vicarious trauma the-
ory — are highly relevant to understanding responses to stress and trau-
matic events in emergency workers. It is the premise of this book, however,
that each of these theories in isolation is inadequate in explaining the com-
plexity of the work exposures and subsequent reactions of emergency re-
sponders. Rather, we contend that individual responses to adverse events
are best understood within the broad context of an individual’s life experi-
ence. One approach to comprehending the complex interactions between
people and their environment is the ecological framework. This perspective
allows for multiple levels of influence in any one situation. For instance,
emotional distress is rarely predicted by any one event. Certainly, as we dis-
cuss in this book, emergency responders are exposed to events far beyond
the average person’s experience. It is not surprising that people will be af-
fected by such exposures. Yet reactions to even the most gruesome and dev-
astating of events are highly variable. Thus, we must consider the personal
history and concurrent struggles of the individual encountering the event.
We must consider the organizational environment in which they work. We
must consider the societal response to the event in terms of public attitude
and media attention. We must also consider the social supports an indi-
vidual has in terms of friends and family. From an ecological perspective,
the relationship between these levels of influence is the best way of un-
derstanding response to any adverse event.
In chapter 4, we review catastrophic incidents, which in and of them-
selves affect many of those responding. Disasters are events that occur
8 in the line of fire

rarely if ever in the work life of the average responder; yet when they do oc-
cur, they have lasting impacts. Disasters are unique in terms of the extent
of loss and devastation, the length of time and hours of work involved in the
rescue and recovery efforts, and the disruption to the daily and family life
routine of emergency service workers.
We continue our discussion of multiple levels of influence, which began
in the chapters on daily exposures to events and disasters, by considering
the individual encountering the event. Chapter 5, “The Right Stuff,” begins
by describing the types of reactions encountered by emergency responders
exposed to stressors. The symptoms experienced by responders range from
mild distress to symptoms that significantly influence functioning. Preex-
isting or concurrent vulnerabilities often contribute to the development of
more severe symptoms. Someone who is also dealing with other losses or
stressors may have reduced capacity to cope with additional traumas. In ad-
dition, coping strategies vary between individuals. Coping strategies dis-
cussed by emergency responders include the deliberate use of cognitive
strategies. For instance, during a traumatic event, emergency workers de-
scribe conscious attempts to shut out the emotional reactions of family
members of the victim and visualize the next technical step to be accom-
plished. They also discuss the need to shut down their own emotions. Fol-
lowing the event, an additional strategy involves reviewing the event from
a technical standpoint and identifying learning opportunities. Other types
of strategies involve having a positive personal life, talking to family, exer-
cising, and blowing off steam with colleagues.
All workplace traumas are experienced within the context of organiza-
tional culture and climate. Recent advances in workplace health research
have found that psychosocial factors in the workplace have a significant ef-
fect on work-related health problems. Occupational health research indi-
cates that a lack of control over work demands and a lack of resources to
work effectively seriously damage the health of workers. This is particularly
true in the instances of high psychological demand. Higher rates of heart
disease are evident in jobs that impose unpredictable and uncontrollable
demands, particularly when one’s skills and decision-making abilities are
underutilized. Clearly high demand and unpredictability are central factors
in the jobs of emergency responders. In addition, the organizational struc-
ture is frequently based on a hierarchical command model that demands
high levels of accountability and low levels of autonomy and input into poli-
cies and procedures. The degree to which distress is acknowledged, ac-
cepted, and supported varies considerably between organizations and be-
tween departments within any one organization.
In the aftermath of September 11, 2001, the North American public is
 setting the stage 9

aware as never before of the stresses, danger, and potential for fatalities
inherent in the work of emergency responders. While the initial public re-
sponse to tragic events may be an outpouring of support and admiration
for emergency workers, this support inevitably wanes and society begins
to consider what might have been done to facilitate a more positive out-
come to the disaster. Following the occurrence of a significant event such
as a mass casualty or death of an emergency responder in the line of duty,
frequently a postmortem inquiry is performed in the form of a coroner’s
inquest, an internal investigation, or a specially formed public commis-
sion. The experience of going through a postmortem review can be ex-
tremely stressful for workers. Emergency service workers are often faced
with life-threatening and uncontrollable situations where quick thinking
and reasoned action are required. Failure to deal with these acute situa-
tions optimally may result in professional condemnation, community sanc-
tions, and possible legal actions. Chapter 7, “Heroes or Villains?,” dis-
cusses inquiries into deaths that occur during a traumatic event and the
media and public response to emergency service workers during these re-
view processes.
A final level of influence that must be considered when discussing the
impact of traumatic events on emergency responders is their personal sup-
port network, in particular their families. There is considerable evidence
that family support is a key protective factor in managing the stresses of the
jobs of emergency responders. However, families of responders are also sig-
nificantly affected by their loved one’s choice of work. Daily stressors in-
clude coping with shift work and long and unpredictable hours that can in-
terfere with family activities and undermine a sense of support. Added to
this is the constant fear for the emergency responder’s safety. When criti-
cal events occur, these fears are heightened. Over time, the coping strate-
gies employed by emergency responders can cause additional stress on fam-
ilies. One result of exposure to trauma described by workers is that they at
times felt disengaged and emotionally distant from family members. An-
other issue is generalized anger and irritability, often vented on family. Fur-
ther, responders describe generalized fears for the safety of family members
and a tendency to become overprotective. In the chapter “Are You Coming
Home Tonight?” we discuss the strains that emergency work places on fam-
ilies and strategies for maintaining this central resource.
Using the ecological framework, in chapters 9 and 10 we suggest a con-
tinuum of interventions aimed at addressing the multiple levels of influence
that lead to trauma and stress reactions. Interventions for complex issues,
such as trauma in the emergency service, cannot be simple, one-size-fits-
all models. Rather, interventions must be offered at different times along
10 in the line of fire

the spectrum of prevention, before the event, during an event of massive

proportions, and after the event has occurred. Interventions must not fo-
cus only on the individual, suggesting that they alone are responsible for
their reactions. Rather, we must also address societal and organizational is-
sues that support or hinder healthy recovery from severe stress. In addition,
intervention must span from policy development and consultation, to train-
ing and establishment of support programs, to clinical interventions with
individuals and groups. We suggest that any intervention must incorporate
a thorough understanding of the situation, the organizational culture, the
organizational response to the individual experiences of stress and trauma,
and the level of stress and support individuals within the organization ex-
perience on a regular basis. One of the most effective ways of achieving this
is through developing programs and trauma response teams that draw upon
the experience and wisdom of members of the organization.
Next, in the chapters “Laying the Foundation” and “Keeping It Going,”
we discuss the development of trauma response teams within emergency
service organizations and within communities. Team structure and re-
sponsibilities and support for the team must be carefully considered. In
developing a credible program, team members must be chosen on the ba-
sis of their personal skills and abilities, the constituency they represent,
and their reputation with others. Training must follow the principles of
adult learning theory and focus on team building and ethics, as well as
skills such as listening, assessing, and group leadership. Once teams have
been established, continued work must focus on maintaining a strong ad-
ministrative structure, on continuously upgrading the skills of team mem-
bers, on maintaining the motivation and commitment of team members,
and on assessing the quality of services provided by each team member.
Finally strategies for self-care for team members must be developed and
monitored.
We end with a chapter titled “Does It Work?,” in which we review the ev-
idence related to workplace interventions following traumatic events. Con-
siderable controversy exists over the use of certain types of interventions,
in particular the critical incident stress-debriefing model. The research lit-
erature is somewhat contradictory, in large part because different types of
studies review different aspects of interventions. There has been a tendency
for groups and individuals to consider only one aspect of the literature and
conclude either that there is tremendous support for all aspects of the in-
tervention, or that the intervention is not only useless but also harmful and
must be abandoned. We attempt to find a middle ground in these discus-
sions and seek to determine which aspects of early interventions are useful
and have empirical support and which are potentially harmful. We believe
 setting the stage 11

that responsible practitioners in this area, both those with mental health
backgrounds and those with emergency service professional backgrounds,
wish to provide effective and responsible interventions. Therefore, in ad-
dition to reviewing research evidence currently available, we make sugges-
tions for evaluating the programs each of us provide.
 2
ALL IN A DAY’S WORK
Traumatic Events in the Line of Duty

Emergency workers are exposed to events involving human pain and suf-
fering on a daily basis. They work to rescue individuals trapped in crashed
vehicles, they extricate people from fires, they collect the remains of sui-
cide victims, they care for victims of assault. While for the most part emer-
gency workers are equipped to deal with these events, on occasion one par-
ticular event will have a lasting impact. In recent years, researchers
focusing on the potential impact of emergency work have recognized that
exposure to death and destruction can result in post-traumatic stress symp-
toms and depressive symptoms in emergency workers (Bryant and Harvey,
1996; Marmar et al., 1999; McFarlane, 1988; Regehr, Hill, and Glancy,
2000). Symptoms described include recurrent dreams, feelings of detach-
ment, dissociation, guilt about surviving, anger and irritability, depression,
memory or concentration impairment, somatic disturbances, alcohol and
substance use, and reexperiencing of symptoms when exposed to trauma
stimuli (Gersons, 1989; Solomon and Horn, 1986). These symptoms un-
doubtedly have an impact on the health and well-being of emergency work-
ers and their families.
While most of us can imagine that emergency workers will be affected by
an event involving mass casualty, it is frequently a smaller and less sensa-
tional event that triggers an emotional response. Such events as the lonely
death of an elderly person or the suicide of a desperate individual do not
make the news or capture public attention. They do not result in an out-
pouring of public support for emergency services. Yet these quieter events

12
 all in a day’s work 13

may have more lasting effects than other, more dramatic events involving
the loss of many lives. In this chapter, we discuss the types of traumatic
events emergency workers encounter and begin to consider the impact of
this exposure on them.

Dramatic Events

The research literature and the popular press have focused a great deal in
recent years on critical events that occur in the line of duty for emergency
workers and the impact that this may have on them as individuals. This fo-
cus generally involves mass casualties, including natural disasters (McFar-
lane, 1998); bus crashes killing children (Dyregrov, Kristoffersen, and Gjes-
tad, 1996); explosions on a naval ship (Ursano, Fullerton, Vance, and Kao,
1999); airplane crashes (Brooks and McKinlay, 1992); train wrecks
(Tehrani, Walpole, Berriman, and Reilly, 2001); and terrorist attacks (Galea
et al., 2002; Pfefferbaum, Doughty, et al., 2002). It is easy to see why such
large-scale events would draw the attention of researchers, the media, and
the public. While disasters of great magnitude are unlikely to happen often
in the career of an emergency responder, most emergency responders are
nevertheless exposed to many gruesome and dramatic events.
In the studies we have conducted with emergency responders, we pro-
vided a list of events that clinical experience and the literature have sug-
gested may cause distress in those exposed while on duty. These events in-
cluded the death of a patient in the responder’s care, the death of a child,
exposure to mass casualties, witnessing violence perpetrated against a
member of the public, being personally assaulted by a member of the pub-
lic, a responder feeling his or her life was threatened while on duty, and
having a coworker die in the line of duty. Figure 2.1, “Exposure to Critical
Events,” demonstrates the rates of this exposure in three groups: 103 Cana-
dian firefighters, 164 Australian firefighters (Regehr, Hill, and Glancy, 2000),
and 86 Canadian paramedics (Regehr, Goldberg, and Hughes, 2002). As
can be seen in this figure, paramedics, as a result of the nature of their
work, report significantly higher rates of exposure to death of patients, mul-
tiple casualties, deaths of children, and violence against others, with over
80% reporting exposure to each of these events. In addition, paramedics
were more likely to have been assaulted (almost 70%) and feel that they had
been in situations where their lives were at risk (56%). Nevertheless, over
40% of the firefighters in Canada report being exposed to violence against
others and witnessing multiple casualties; over 40% of firefighters in both
countries had been exposed to the death of a child, and approximately 30%
of firefighters report experiencing the death of a person in their care. These
14 in the line of fire

100

90
Percentage of workers exposed

80

70

60

50

40

30

20

10

0
Death of Line of duty Violence Violence Near death Death of child Multiple
patient death against self against other casualties

Australia firefighters Canadian firefighters Canadian paramedics

Figure 2.1. Exposure to Critical Events

findings are consistent with those of other studies. For instance, 56% of vol-
unteer firefighters in New South Wales reported that their safety had been
seriously threatened at some time, 26% in the last year (Marmar et al.,
1999). Similarly, 82% of ambulance personnel in Scotland reported expo-
sure to a particularly disturbing incident in the past 6 months (Alexander
and Klein, 2001).
In addition to asking emergency responders whether they had been ex-
posed to the events listed above, we were also interested in whether emer-
gency responders would identify that these events were distressing for
them. We therefore asked them to identify whether they had ever experi-
enced “significant emotional distress” as a result of events on the same list.
The results of this question appear in figure 2.2, “Workers Exposed Re-
porting Distress.” It is clear from this graph that the event causing distress
for the greatest number of people is the death of a child, followed by the
death of a colleague in the line of duty and the death of a patient for whom
the responder had responsibility. There is a fair bit of discrepancy between
groups regarding the distress experienced as a result of multiple casualties,
violence against themselves, and risk to their own safety. These findings
come to light when we examine interviews held with emergency responders
about their experiences and exposure.
The next sections report the results of 50 interviews conducted with
paramedics, firefighters, and police officers. The interviews were 1– 2 hours
in length and were conducted in a place most convenient to the respon-
 all in a day’s work 15

90

80
Percentage reporting distress

70

60

50

40

30

20

10

0
Death of Line of duty Violence Violence Near death Death of child Multiple
patient death against self against other casualties

Australia firefighters Canadian firefighters Canadian paramedics

Figure 2.2. Workers Exposed Reporting Distress

der, often an office or their home. Interviews followed a semistructured in-

terview guide that included questions about stressors encountered on the
job, the effects of the stress on participants, organizational supports, and
strategies for dealing with stress. The interviews were audiotaped and tran-
scribed to ensure accuracy of data. Data were analyzed for themes using
the Nvivo computer program. Throughout this research process, members
of emergency service organizations have acted as community partners,
working to develop the research questions and discussing data as portions
of the analysis were completed. This process has provided an opportunity
to confirm and expand upon the trends developed in the analysis, thereby
enhancing the trustworthiness of the data (Erlandson, Harris, Skipper, and
Allen, 1993).

The Death of a Child

In our clinical experience and in the research interviews that we con-
ducted, the events emergency responders most commonly cite as causing
traumatic reactions involve violence against children. In cases of child
abuse and neglect in particular, responders are able to recall in specific de-
tail aspects of the victim and of the environment in which he or she was
found. One paramedic described a 10-year-old child whose throat had been
slit by his father. Another described a dirty, neglected baby who was sleep-
ing on a mattress on the floor with his parents in a basement squat and was
smothered when the parents rolled over on the child as they slept. A third
16 in the line of fire

described a baby who had been burned to death in an oven. A police offi-
cer described a child that had been viciously bitten and scalded to death
with boiling water. He explained that despite the fact that he had many
years of experience on the force and had seen many gruesome things by
that point, this particular event caused nightmares and distress. Another
officer described the sense of helplessness that he experienced when a baby
died. As he held the three-month-old in his arms, he states that was the
only time in his life that he felt overwhelmed by helplessness.
Emergency responders indicated that the impact of child deaths and se-
vere abuse of children was due to the fact that they were unable to under-
stand why something like this might have occurred. One recalled, “I
thought it was the child’s father that had done this and I sat, just outside
the building for the longest time just trying to make sense of it and of
course that’s the biggest trap in any of these things, trying to make sense
out of what are by definition nonsensical things.”
Dealing with the grief of others adds to the trauma of child deaths. Re-
sponders described situations where parents were screaming and beating
on the backs of firefighters and paramedics as they were attempting to as-
sist an injured child or a baby who died suddenly in the crib. One para-
medic described his feelings toward the mother of a dead child. “It was just
heart-wrenching; I didn’t want to talk to her, I didn’t want anything to do
with her at all. I couldn’t even look at her.”
A firefighter described working on a child, although he knew it was dead.
“The parents are just looking at each other and looking at you to do some-
thing, but not saying anything. You put the baby in your hand and the kid’s
head just fits in the palm of your hand. You look at it, and you look at the
parents, and you know that you’re doing something just to pacify them, just
to show them that there’s something you’re doing. You’re ventilating and
also doing compressions. The baby is dead but you’re going through the
motions and you’re just pumping away and everybody is looking at you and
the other crew members are just looking at you looking at them, because
they understand what you’re going through. And they’re going, ‘Holy shit,
there’s nothing you can do.’ They know it’s over.”

Violence toward Others

While television shows such as Law and Order and Third Watch make it
appear that rape and murder are common-place occurrences in emergency
work, exposure to violence and inhumanities is described by responders as
highly distressing. One aspect of this is the shock associated with the first
exposure to the scene. In our studies, one firefighter described an incident
where his truck responded to a call in which they were told that someone
was having difficulty breathing. When they arrived on the scene, they dis-
 all in a day’s work 17

covered a female real estate agent whose throat had been cut when show-
ing a property to a client. “Surprise! . . . She wasn’t having difficulty breath-
ing, she was bleeding to death.” He then described his reaction. “Suddenly
you kick into a high gear, you go into an adrenaline rush, basically, and
you’re trying to keep a handle on everything, and it’s around 2 hours, at the
end of it you just try to breathe.” A police officer and a firefighter both de-
scribed their attendance at a murder-suicide. At first when they entered the
property, they were confronted with a woman who had cut her throat and
abdomen but was still alive. Upon further investigation, they discovered the
dismembered body of her husband. “I saw in the bedroom this guy’s leg
leaning up in the corner. That’s all I saw was a human leg.”
Sewell (1994) adds that the impact of homicide investigations on police
officers involves not only exposure to the sights and smells of the scene, but
also the responsibility for dealing with surviving family members. This in-
volvement can last for years as family members seek information on aspects
of the investigation, arrest, and trial.

Multiple Casualties and Patients

Dying in Care
As can be seen in figure 2.1, which depicts exposure to critical events, ex-
posure to multiple casualties within the work environment is an experi-
ence shared by almost every paramedic and a substantial minority of fire-
fighters. Those that have the greatest impact involve some aspect that is
emotionally memorable. One paramedic described a multivehicle collision
involving automobiles and a transport truck. As emergency workers re-
moved the deceased man and woman from one vehicle, they discovered a
dead baby in the back seat. Another described working to extricate a se-
verely injured man who explained to the responders that it was the wed-
ding anniversary of himself and his dead wife, who was trapped beside
him. A firefighter described watching two severely injured teenagers die
before his eyes. He discussed how this memory plagued him as he inter-
acted with his own teenagers.
Multiple casualties occurring in the context of disasters have an even
greater impact. This will be discussed in more detail in chapter 4. Briefly,
however, responders in the Toronto area, where we conducted many of our
studies, remember with vivid detail the crash of a DC-9 that occurred in
1972. One paramedic described the scene. “We were the third unit on the
scene and we got to view the crater where the nose had gone down. It was
about a 15-foot crater, and there were body parts all over the place. There
was all kinds of debris flying around. It was a total scene of chaos. There
were little children there, parts of them, and half bodies strapped into the
seat. I still have dreams of that [30 years later].”
18 in the line of fire

Line-of-Duty Death
A line-of-duty death has a profound impact on emergency service organi-
zations and those who work in the organizations. We speculate that the lev-
els of distress identified in the graph above displaying subjective reports of
distress are in fact low, as many people responding to that question in our
study may have had a death occur in their organization, but not of some-
one with whom they were closely associated. Other researchers have un-
derscored the traumatic impact of a death on duty on other members of the
organization (Violanti, 1999). A study of police officers suggested that the
death of a partner, the line-of-duty death of another officer, or the suicide
of a colleague were among the top 6 of 144 possibly stressful events on the
job. Of other items in the top six, two related to the shooting or killing of
another person by a police officer in the line of duty (Sewell, 1983). Vi-
olanti and Aron (1994) found that killing someone in the line of duty and
having a fellow officer killed ranked first and second on a list of stressors
for 103 police officers.
One responder recalled a situation occurring 23 years earlier in which
three firefighters with whom he was acquainted died in a warehouse fire. A
police officer discussed the loss of a colleague and friend when his vehicle
was hit by a drunk driver who had a suspended license. Friends continue to
carry a plaque commemorating him to annual police events. A paramedic
described in detail the shooting death of a police officer.
It happened so close to the police station that there was hundreds of
police officers, or what seemed to be hundreds of police officers, there.
All of them stressed to the maximum, because they could see them-
selves lying on the ground instead of him. We had everybody from the
apartment complex standing out on their balconies yelling and scream-
ing. We had a six-foot fence that we had to get around, which means
our response was delayed. The officers were getting angry and yelling
and screaming and trying to pull our stretcher over a six-foot fence. So
we’re trying to gain control of the officers, we’re trying to gain control
of the scene, we’re trying to work on a patient with people screaming
and throwing things above us.
When we got to the hospital the media became a big issue. Every-
body was there from every news station you could think of — that
heightened the stress. The hospital trauma team is now part of the sce-
nario, and they’re interested in trying to figure out what’s just gone on.
So we’re trying to update them, update the police chief, who was on
the scene, the Internal Investigations Unit of the department. All of
those things now add further stress on us. It sort of just kept piling and
piling and piling throughout the entire call, it never let off once. It just
kept getting worse in terms of stress.
Then at the hospital was the time that the officers could finally just
 all in a day’s work 19

break down completely. That impacts on you to see adult police offi-
cers, male and female, all over the hallways crying.
He was only 20 something years old, so that added further impact.
Ultimately, by the time we left the hospital, his fiancée had arrived. I
felt like I gave his spouse a chance to see him when he was still alive.
If it hadn’t been for our revival, he would have been dead at the scene
and therefore she wouldn’t have had a chance to see him, and nor
would any of his family. Sometimes it’s not the patient we impact, it’s
the family, and that kind of makes it all worthwhile at the end of the
day.
Risk of Personal Injury
In general, emergency responders do not describe violence directed toward
themselves as traumatic unless it threatens their lives. Responders indicate
that they have been assaulted, particularly on domestic violence calls, sur-
rounded by dangerous characters on the street, and threatened by people
on drugs. However, these events do not stay with them as traumatic expe-
riences. For the most part, emergency responders are physically fit individ-
uals well trained in defending themselves. One paramedic described feel-
ing fearful and carrying a flashlight for use as a club in the early part of his
career. He indicates that he was “set straight” by a more senior paramedic
and has now learned to talk his way out of situations. Another stated, “You
have to be able to talk your way out of some fairly serious altercations, be-
cause drunks and junkies are not necessarily known for their demeanor.”
Understandably, responders did experience distress when confronted
with severe risk to life and limb. One paramedic described feeling “shaken
up” when he and his partner were attacked by a man experiencing diabetic
shock. He recalls the man’s wife standing in the home holding her infant as
the man punched out a window and destroyed furniture. In the end it took
six men to subdue the patient. A police officer described how he and his
partner were attacked. The officer was thrown over a balcony and believed
his back was broken because he was unable to move. He watched helplessly
as his partner was beaten until help arrived. While his back was not bro-
ken, the injuries caused him to be off duty for a period of time. Another
officer was shot during an episode where a gunman was being contained in
a building. The bullet did not penetrate his Kevlar vest, so he continued
working to the end of his shift. Later, in retrospect, as he looked at the se-
vere bruising, he realized the risk to his life. Firefighters described being in
situations where their air supply was running low or a fire was burning too
hot for them to safely remain in the building.
Another officer was involved in an incident where a civilian was shot and
killed by an armed robber. He was off duty at the time and was an unarmed
customer in the business where the shooting occurred. He described being
20 in the line of fire

in such close proximity that the bullet actually bounced off him after pen-
etrating the victim.
This thing started happening with the sound of a shot. When that hap-
pens, you hear one thing at a time, you don’t hear everything. I don’t
know how else to describe it. In this particular case, one person was
the major speaker, but there were other noises happening that I wasn’t
hearing, which were the employees screaming and the yelling that they
were doing as they were told. I pretty much focused in because I
wanted to know what he was saying. I had been lying on the floor at
this point, and I had been watching everything step by step. When the
shot went off, and I heard the shot ring, and I knew what it was, the
best way I can describe it is my vision shut down to the carpet within
about a foot around me, and I couldn’t see anything else. I know a
shot, and I’ve heard shots, and I’ve shot guns. I know what a gun
sounds like, and the sound sounded very soft in comparison, even
though it was in an enclosed area. It should be loud, like so loud it
should ring your ears, but it wasn’t. It was muffled, in a big way. And
then the adrenaline or fear or whatever it is that runs through your
body when that happens, shut everything down to the point where I
could only see in the immediate area of me. And then again I began
doing some conscious things because I’m a policeman. I started look-
ing for what had hit me. And after that, the field of vision became open
again.
One officer emphasized the feeling of helplessness in a shooting incident
in which he and several police officers were “just basically trying to get
cover, and not knowing where this guy was, and he fired over the twenty
minutes about six rounds, and that one shook me up a little bit because it
was kind of tense, not knowing where this guy was going to pop up . . . what
are we going to do, how do we find this guy, how do we get out of here, and
stop this guy from doing it.”

Responses and Interventions in Traumatic Events

There is no question that emergency responders describing these events are
profoundly affected. In our studies, 64% of police, firefighters, and para-
medics indicated that they had experienced significant emotional distress
as a result of an incident that occurred on the job. Firefighters were least
likely to indicate that they had ever experienced significant distress as a re-
sult of an event encountered at work such as the death of a child, multiple
casualties, or risk to themselves (45.6%); paramedics were most likely
(83.7%). This is not surprising when one takes into account that only
67.1% of firefighters reported encountering events and 100% of both police
and paramedics in our studies had encountered one of the events listed. Po-
lice and paramedics were also far more likely to have encountered multiple
 all in a day’s work 21

tragic events. The effects of these exposures are described in detail in chap-
ter 5, “The Right Stuff.”
As a result of the exposure that traumatic events get within emergency
service organizations and in the popular press, it is not surprising that many
of the intervention efforts have been directed at these types of events. The
most well known of these approaches is the crisis debriefing group model,
an early-intervention strategy designed to mitigate post-traumatic stress re-
actions (Bell, 1995; Dyregrov, 1989; Mitchell, 1982; Raphael, 1986). This
model offers a brief group treatment approach, usually limited to a single
session. It is based on the premise that emergency service professionals
possess the internal resources to deal with most work-related events but
can benefit from limited extra assistance in extreme circumstances. Other
aspects generally included in intervention programs include preventative
education, informal group opportunities to discuss the event (defusings),
family outreach, and follow-up counseling.

Quiet Losses and Despair

Emergency responders experience many of the traumatic events discussed

above throughout the course of their careers. In interviews we have con-
ducted with police, fire, and ambulance workers, we began by asking them
to describe events in which they have been involved that they believed oth-
ers would classify as traumatic. Most responders discussed horrific events
that contained much blood and gore, but many were quick to add that these
were not the events that “have left me sleepless.” Frequently, the events that
do lead to distress are quiet events that connect in some way with the emer-
gency responder on an emotional level. As mentioned above, often this re-
lates to the pain experienced by parents who lose a child. One firefighter
talked about his realization that this loss will change the lives of these par-
ents — that a part of their life was over because their child had died. An-
other firefighter vividly recalls the looks of two children whose mother had
died in a car crash. “The kids are looking at me. Like, ‘Do something.’ Who
else can they look to for help? But that’s the kicker, I can’t do anything.”
Others talked about worrying about family members who had lost a
loved one close to Christmas. One paramedic in particular recalled an eld-
erly Eastern European man dying in the emergency room and his son, a
tough-looking construction worker, was crying and saying “Daddy, Daddy,
Daddy” in his own language. The responder’s parents were from the same
country and he spoke the language. “That one still chokes me up a bit.” A
firefighter described attending to a dead alcoholic who was still clutching
a bottle in his hand. The man had been found by his daughter. The fire-
22 in the line of fire

fighter recalled, “That was in the days when I was trying to get my father
to stop drinking.”
The death of a patient in care can also have a lasting effect. One para-
medic described working with a cardiac patient. The man said to him, “I’m
going to die.” And the paramedic responded that everything was under con-
trol and that he was fine. “Then his last words to me were ‘goodbye,’ and
that was it. That really struck me.” Another recalled the routine transfer of
a woman with a chronic lung condition who was on a ventilator. En route
she went into distress and died. “She was looking at me, like she was plead-
ing for me to save her. That was early in my career before we had our cur-
rent equipment. It really bothered me.”
Another type of event recounted by some respondents was that of people
dying alone. “Loneliness, people being alone and very ill, that bothers me.”
One paramedic described taking an elderly man who lived alone away from
his apartment for the last time and transporting him to a palliative care
unit. Other workers described the despair they felt when discovering a sui-
cide victim and wondering what had happened that might have lead to this
solution. “You’re wondering why would [he commit suicide]— look at this,
he’s got everything, why would he do this? . . . there was no indication . . .
that was like, wow, life is really frail.”

Summary

The descriptions above make it clear that emergency responders are ex-
posed to tragic events far beyond the experiences of most people. In addi-
tion, they are not simply exposed to one tragic event in the course of their
careers; rather, a career involves a string of horrifying exposures outside the
average person’s experience. These events involve various types of human
tragedy, including the abuse and death of innocent children, severe vio-
lence perpetrated by one individual against another, accidents caused by
negligence, suicide, and lonely deaths. One police officer summarized his
experiences by stating that he had probably dealt with 100 sudden deaths;
he has seen people decapitated, severed limbs, and shootings and that no
one had ever asked him to talk about it before. While each of these events
in and of themselves has the capacity to cause reactions, it is frequently the
accumulation of events that continues to wear on an individual, until one
event is the final straw. A firefighter described how his chief left the job af-
ter the death of a child — he had stated that he had seen just too many chil-
dren die.
While those individuals who select a career in the emergency services are
in many ways prepared for the types of events they will encounter and over
 all in a day’s work 23

the course of their careers develop strategies for managing the impact of
these events, they are still human and are unlikely to be unaffected. In this
book we attempt to shed some light on the following questions:
What is the impact of exposure to tragic events in the lives of others
on emergency responders?
What individual, institutional, and community factors influence re-
sponse to traumatic events?
How can mental health professionals assist emergency responders,
their organizations, and their families to manage responses to tragic
events?
 3
BUILDING A FRAMEWORK
Health, Stress, Crisis, and Trauma

As anyone who has undertaken a major home renovation knows, there is

more to the work than starting off with a couple of hammers, a carton of
nails, a load of wood, and the goodwill of friends and family. With re-
sourcefulness and ingenuity, a few people may “reconstruct” a house under
these circumstances. Usually, however, it is helpful to have a drawing of the
existing structure and the plans for changes and additions. A useful plan
provides a framework to understand the overall structure and gives a sense
of how things may come together. And as any “do-it-yourself” enthusiast
knows, a framework is not the same as having the right tools and skills to
be in the trenches pouring a foundation or, later, framing a roof. The best-
made plans may not anticipate the changes and adjustments required in
marrying old and new structures, nor do plans consider how a couple or
family will adapt to the stresses of a major renovation. Theories, like good
framework and plans, can help us to understand how things work the way
they do. A useful framework can make sense of the complex process of how
people and their environment interact, adjust, and adapt over time.
This chapter provides the foundation for our discussions of trauma in the
emergency services during the remainder of this book. We begin by looking
at the theories that have been advanced for understanding stress. These
theories consider the cumulative impact of working and living in stressful
environments. Next we review models for understanding the influence of
acute events, including crisis theory, trauma theory, and secondary or vi-
carious trauma theory. Since emergency responders work in complex or-

24
 building a framework 25

Stress
theory

Occupational Crisis
stress theory
theory

Vicarious/ Trauma
secondary theory
trauma theory

Figure 3.1. Theories for Understanding Responses to Adversity

ganizations that have rules, norms, and cultures that also influence re-
sponse to adverse events, we then review occupational stress theory. While
each of these theories adds to our appreciation of the experiences of emer-
gency service workers, we suggest that they are too limited in providing a
comprehensive understanding of the multiple forces that influence their
response to events that occur on the job. As a result, we offer the ecologi-
cal and population health frameworks to put trauma responses in the broad
context of people’s lived experiences and to use this broader understanding
to direct our efforts at intervention.

Theories for Understanding Responses to Adversity

Stress Theory
To survive and prosper, our ancestors collected and hunted food, crafted
tools, and gathered in small groups to take advantage of environmental re-
sources and overcome environmental challenges. When acute threats were
encountered, biological adaptations served as protective mechanisms. Res-
piration and blood pressure increased; oxygen and energy shifted to large
muscles from the immune, digestive, and reproductive systems, less es-
sential for immediate survival (see Bremner, 2002). Today, the biological
mechanisms that have evolved to confront danger are remarkably similar to
those of earlier times (Dubos, 1980) and are often summarized by the con-
cept “flight or fight” (Cannon, 1932). Academic focus on these biological
26 in the line of fire

responses led to the development of the theory of General Adaption Syn-

drome (Selye, 1936), a three-stage model for stress adaptation involving (1)
alarm and mobilization, when the body prepared for action, (2) resistance,
in which the body’s stress response diminished and returned to normal
functioning, and (3) exhaustion, which occurred if stress was unrelenting
or repetitive.
More recent work has substantiated the view of our biological ability to
cope with adversity but has noted that earlier research focused on short-
term biological responses that did not adequately account for ongoing
stress and adversity, often caused by psychosocial factors, not only acute
physical risk. The ongoing strain that leads to ‘wear and tear’ on a person
has been called the allostatic load (McEwen, 2000; Sterling and Eyer,
1988). Earlier stress theories also failed to account for the buffering effects
of social relationships in the experience of such stress (Repetti, Taylor, and
Seeman, 2002; Ryff, Singer, and Seltzer, 2002). Further, earlier research
ignored differences between male and female responses to stress, as most
studies on stress were conducted on men. Although women and men may
begin with a similar alarm reaction to stress, Taylor, Kemeny, Reed, Bower,
and Gruenewald (2000) identified biobehavioral differences between men
and women in how they continue to respond to stress. These researchers
found that men often do react to stress with a “fight-or-flight” response, but
women are more likely to manage their stress with a “tend-and-befriend”
response. That is, females respond to threat by tending to or, in other words,
protecting and nurturing children and by befriending or affiliating with oth-
ers, particularly women, for social contact and support (Taylor, 2002). Fight
and flight was necessary for our survival for thousands of years, and tend-
ing and befriending behaviors were equally protective of the well-being of
children and families in danger. Taylor suggests that these differences are
influenced by our biology and the behavior modeled in our society, and that
these gender patterns are not permanent; they can be learned and devel-
oped in both men and women.
While early work on stress considered the biobehavioral aspects of stress,
Lazarus and Folkman (1984) shifted attention to the cognitive aspects of
stress response by defining stress as a relationship between the person and
the environment that is appraised by the person to taxing or exceeding his
or her resources and endangering his or her well-being. They observed that
stress was an interaction and people assessed their circumstances by ask-
ing ‘what’s at risk and what can I do about it?’
Lazarus and Folkman identified two appraisal processes that lead to ex-
periencing stress: a primary and a secondary appraisal process.
The primary appraisal considers whether an event is perceived as irrele-
vant, benign, positive, or stressful and considers whether the stress is a
 building a framework 27

harm/loss, a threat, and/ or a challenge. Harm/loss appraisals include both

physical and emotional features, such as diminished esteem or loss of a sig-
nificant relationship. Threat appraisals involve the anticipation of contin-
uing social, emotional, or economic losses, such as those related to a
chronic illness or harmful exposure to a toxic substance. Challenge appraisals
involve the potential of positive events to result in a risk of a negative out-
come, such as accepting a job promotion in an unfamiliar city.
Through secondary appraisals, a person estimates his or her ability to deal
with harm/loss by identifying the coping options available and the potential
to successfully implement the preferred coping response (Lazarus and Folk-
man, 1984).

Stress occurs when there is a significant imbalance between one’s de-

mands and the type and amount of internal and external resources avail-
able to cope with those demands.

Lazarus and Folkman (1984) viewed stress as the balancing act between
demands and resources. This addition of the cognitive process of appraisal
to the theoretical formulation of stress recognizes that people are not
merely on a physiological autopilot at times of stress but rather have the
ability to alter their responses. Bandura’s work (1997) recognized the power
of a person’s belief in his or her own ability to cope effectively as important
to coping successfully. Belief in one’s own competence, also referred to as
self-efficacy, is associated with lower levels of distress following an expo-
sure to a threat or extreme stress (Benight, Ironson, Klebe, Carver, Wyn-
ings, et al., 1999; Regehr, Cadell, and Jansen, 1999). Self-efficacy has re-
cently been expanded to include the importance of communal efficacy in
responding to large-scale stress events.
Hobfoll’s (1989, 2002) Conservation of Resources (COR) theory enriched
the appraisal model by introducing the importance of resources, community,
and culture. In COR theory the loss and gain of personal, social, and mate-
rial resources are key determinants in the experience of stress. COR’s cen-
tral premise is that people strive to obtain, retain, protect, and foster re-
sources — that is, the things that they value. Resources are generally defined
as objects such as property or other belongings, conditions such as a good
job, personal attributes such as self-acceptance, or social skills and energies
such as time or knowledge. Stress occurs when there is a threat of resource
loss, actual resource loss, or the failure to regain resources after a significant
loss (Hobfoll, 1989).
Research has demonstrated that after the initial exposure to extreme
stress, resource losses predicted ongoing distress among disaster victims,
combat veterans, rape victims, and the general population (Ironson, Wyn-
28 in the line of fire

ings, Schneiderman, Baum, Rodrigues, et al., 1997; Holahan, 1999; King,

King, Foy, Keane, and Fairbank, 1999; Norris and Kaniasty, 1996; Monnier,
Resnick, Kilpatrick, and Seals, 2002). Individual losses, like dominoes, may
quickly cascade down into a series of losses without the timely injection of
resources. For instance, in a police shooting where an officer is injured,
there will be multiple losses and disruptions (Travis, 1993). The injured offi-
cer’s personal and work roles are disrupted, and there are risks to self-esteem
and confidence as a number of investigations into the event proceed. Mean-
while the other officers have temporarily lost a colleague, perhaps a support
person or mentor, and the organization has one less officer. Without sup-
ports including medical intervention, physiotherapy, or post shooting peer
support, the recovery of the officer may be delayed or seriously disrupted.
One of the aspects distinguishing COR from an appraisal model is that
a loss of something such as reputation, self-esteem, health, security, or home,
is perceived as meaningful to both the individual and the workplace com-
munity. The community to which we belong influences what resources we
value and aim to protect or “hang onto.” In some workplace contexts being
independent and self reliant are seen as a valued qualities, whereas in other
workplaces, relationship skills and getting along with the team may be most
valued (Hobfoll, Jackson, Hobfoll, Pierce, and Young, 2002). Adaptation by
an individual, group, or organization is seen as the ability to use resources
effectively and in a culturally appropriate manner. Workplace culture will
influence people’s perceptions of which resources are significant and, when
these resources are lost, what the idioms of distress are. The loss of a fire-
fighter in the line of duty will be expressed differently than a loss due to re-
tirement. The unanticipated death of a police services dog will be experi-
enced differently by the handler than an administrative office staff.
Culture, in the broad sense of race, ethnicity, age, nationality, spiritual ori-
entation, gender, or socioeconomic power, is an aspect of the workplace
that influences which skills, abilities, characteristics, tools, or equipment
are valued in a workplace community (Cohen, Deblinger, Mannarino, and
de Avellano, 2001).

Crisis Theory
Crisis theory has had an interesting history in that it has been an integral
part of the work of social work, psychiatry, psychology, and the community
volunteer movement. One of the pioneers in the development of crisis the-
ory was Erich Lindemann (1944), who worked with the survivors of a 1942
fire in the Coconut Grove nightclub in Boston, in which close to 500 peo-
ple died. Lindemann observed and documented the reactions of the sur-
vivors, which included somatic responses, behavioral changes, and emo-
tional responses such as grief and guilt. In describing the process of their
 building a framework 29

recovery, he noted the importance of grieving, adapting to the loss, and de-
veloping new relationships. Lindemann’s work contributed greatly to our
understanding of crisis as the response to external, unpredicted challenges
to the individual. Gerald Caplan (1964) built on the work of Lindemann
and expanded crisis theory to include both developmental crises such as
birth and adolescence and accidental crises. Caplan’s work was based in
preventative psychiatry and gave prominence to the community’s role in
supporting health and recovery.
Roberts (2000) defines a crisis as “a period of psychological disequilib-
rium, experienced as a result of a hazardous event or situation that consti-
tutes a significant problem that cannot be remedied by using familiar cop-
ing strategies. A crisis occurs when a person faces an obstacle to important
life goals that generally seems insurmountable through the use of custom-
ary habits and coping patterns” (p. 7). In the workplace, a crisis may result
from an event that is sudden and unexpected such as an accident, or from
the accumulation of multiple events such as an employee going through a
company restructuring, and job redesign followed by a job loss. As a result
of exposure to crisis-producing events, people may feel a sense of disor-
ganization, confusion, anxiety, shock, disbelief or helplessness, which may
increase as usual ways of coping appear ineffective. Pearlin and Schooler
(1978) describe observable consequences of ineffective coping: (1) emo-
tional distress, (2) impaired sense of personal self-worth, (3) inability to en-
joy interpersonal contacts, and (4) impaired task performance.

Crisis = the event + the individual’s crisis meeting resources + the indi-
vidual’s perception of the event + other concurrent stressors.

Crisis theories suggest that crises have the following characteristics:

• They are perceived as sudden. Even if one anticipates a particular de-
velopmental event, when it arrives, the changes that accompany it are
perceived as sudden. For instance, although one may be forewarned
about the risk of a child’s death at an accident scene, as a paramedic
the impact and the feelings upon encountering the child’s death may
be sudden and unexpected.
• The individual is not adequately prepared to handle the event and
normal coping methods fail. An event does not become a crisis if the
individual has coping strategies that match the situation. Early re-
tirement can be a crisis for some and an opportunity for others who
had been planning to start a small business for some time.
• Crises are limited in time, lasting from 1 day to 4 – 6 weeks. In gen-
eral, it is thought that people cannot function at a heightened level of
arousal for prolonged periods of time. Individuals, particularly emer-
30 in the line of fire

gency responders, are resilient, work hard to cope and seek social sup-
port from others such as co-workers and family. Those who are un-
able to adapt may develop other more serious mental health or emo-
tional problems.
• Crises have the potential to produce dangerous, self-destructive or so-
cially unacceptable behavior. In times of disequilibrium, people may
be so distressed that they feel suicidal. Some may express their dis-
tress by lashing out at others and undermining social support net-
works.
• Crises lead to a feeling of psychological vulnerability which can be an
opportunity for growth. Crises are said to offer both danger and op-
portunity. Frequently people emerge from a crisis situation with a
greater confidence in their own strengths and abilities and new strate-
gies for life.
At times there is confusion over crisis as a concept, since it may appear
as an umbrella term encompassing hazardous events such as traumatic
events, workplace critical incidents, or traumatic crisis (Hendricks and By-
ers, 2002; Flannery and Everly, 2000). Nevertheless, crisis theory and cri-
sis intervention models have been useful in understanding and supporting
people in the process of learning new adaptive skills. However, the short-
term nature of response implied by this theory does not fully account for
the responses people have to life-threatening and horrifying events.

Trauma Theory
The experience of psychological trauma in response to exposure to horrific
events is a theme that can be found in the earliest of literature. Achilles in
Homer’s Iliad and Hotspur in Shakespeare’s Henry IV, Part 1 are frequently
cited as excellent portrayals of what we now understand to be traumatic
stress reactions secondary to involvement in combat. Psychiatrist Pierre
Janet wrote in 1919, “All famous moralists of olden days drew attention to
the ways in which certain happenings would leave indelible and distressing
memories — memories to which the sufferer was continually returning, and
by which he was tormented by day and by night” (quoted in van der Kolk
and van der Hart, 1989, p. 1530). In the late eighteenth and early nine-
teenth centuries, many physicians began describing reactions to traumatic
events including both physical responses such as “irritable heart” (Da-
Costa, 1871; Oppenheimer and Rothschild, 1918), post-traumatic spinal
cord injuries due to nervous shock and without apparent lesions (Page,
1885), and “neuraesthenia,” a physical disorder associated with fear (Mott,
1918), and psychological reactions such as “war neurosis” (MacKenzie,
1916) and “shell shock” (Southward, 1919).
 building a framework 31

Two main theories emerged out of this literature. The first was proposed
by Freud who suggested the concept of “anxiety neurosis” or “hysteria” in
which a horrific psychological event leads to physical consequences (Turn-
bull, 1998). The second suggested that the impact of physical forces on the
central nervous system experienced during a traumatic event such as a rail
disaster or combat resulted in a temporary neurological dysfunction which
in turn lead to symptoms (Turnbull, 1998). However, this interest in the ef-
fects of psychological trauma on individuals subsided after the end of the
First World War and did not resurface again until the Second World War
and again in the mid-1970s. At that time both interest in the effects of war
on Vietnam veterans emerged resulting in the concept of “post-traumatic
stress” and interest in the effects of rape on victims emerged resulting in
the concept of “rape trauma syndrome” (Burgess and Holstrum, 1974). To-
gether, the pressures arising from the needs of these two highly divergent
groups of sufferers resulted in official recognition of post-traumatic stress
disorder in the third edition of the Diagnostic and Statistical Manual (DSM-
III) of the American Psychiatric Association in 1980.

When an individual is exposed to an event that involves actual or threat-

ened death or serious harm to themselves or others during which they ex-
perience fear, helplessness or horror, they may subsequently experience
traumatic stress.

One aspect of trauma response is viewed as neurophysiological. As a re-

sult of exposure to an experience of fear or danger, individuals undergo neu-
rophysiological changes that enhance the capability for fight, flight or freez-
ing. These biological responses generally return to normal levels within a
period of hours. In individuals suffering from post-traumatic stress, however,
several biological alterations remain including an enhanced startle response
that does not habituate, increased activation of the amygdala, alterations
in the hypothalamus, and decreased cortisol levels (van der Kolk, 1997;
Yehuda, 1998; Yehuda, 2002). Thus, autonomic hyperarousal mechanisms
related to the event continually recur and are exacerbated by traumatic
memories and images. Sufferers thus find themselves alternating between
states of relative calm and states of intense anxiety, agitation, anger and hy-
pervigilance (Roberts, 2002). In part the neurophysiological influence is ev-
idenced by the disorganization in trauma memory and the difficulty in pro-
ducing a coherent narrative (Brewin, 2001). As individuals attempt to
reconstruct events they discover gaps and experience spontaneous flash-
backs. These flashbacks can be controlled, primarily through attempts to
manipulate the probability of their being triggered by stimuli (Brewin,
2001). Thus, in order to cope with the symptoms, an individual frequently
32 in the line of fire

attempts to avoid exposure to stimuli that are reminiscent of the event or

tries to shut out memories of the event. From this perspective, reactions to
traumatic events are expected and viewed as normal.
What is problematic about this formulation, however, is that there is con-
siderable evidence that not all people will have traumatic stress reactions
to a catastrophic event. Several studies have shown that 50 – 80% of men
and women experience potential traumatic events, but that the majority does
not develop post-traumatic stress disorder (PTSD), which requires that the
symptoms continue for more than 1 month (Kessler, Sonnega, Bromet,
Hughes, and Nelson, 1995; Resick, 2000). For instance, a nationally rep-
resentative study of 512 Israelis who had been directly exposed to a terror-
ist attack and 191 who had family members exposed demonstrated that
while 76.7% had at least one symptom of traumatic stress, only 9.4% met
the criteria for PTSD (Bleich, Gelkopf, and Solomon, 2003). In this study,
the majority of people expressed optimism and self-efficacy regarding their
ability to function in a terrorist attack. Similarly, a study of Latino primary
care patients in the United States revealed that of those who had experi-
enced political violence in their homeland, 18% met the criteria for PTSD
(Eisenman, Gelberg, Liu and Shapiro, 2003). The reported lifetime preva-
lence of PTSD in the general population of the United States is reported to
be 5% for men and 10% for women (Kessler et al., 1995). This is not to say
that individuals are unaffected by the events, but rather that they have symp-
toms of distress that for the most part subside within a relatively short pe-
riod of time. These findings led researchers (Litz, Gray, Bryant and Adler,
2002; Shalev, 2002) to suggest that “traumatic events” may be more appro-
priately called “potentially traumatizing events.” Thus, the evidence is that
most people are resilient and adaptive following a traumatizing event. Those
who continue to have difficulty with symptoms frequently also experience
other problems. It is reported that approximately 80% of men and women
with post-traumatic stress disorder have co-occurring problems including
depression, anxiety, significant health problems, and/or substance abuse
(Schnurr and Jankowski, 1999).
It has been suggested that the ability to contain disruption caused by
trauma within reasonable boundaries is associated with a cluster of per-
sonal attributes including mastery, control and flexibility, and optimism.
This understanding of trauma response is primarily cognitive in nature.
That is, a traumatic event violates assumptions that individuals hold about
the world, such as “If I drive safely, I will not get into a horrific accident.”
As a result of this disjuncture between an individual’s view of the world and
the event that has occurred, his or her normal adaptive mechanisms fail to
be activated. Sensory images of the event are stored in active memory,
where they are repeatedly experienced. These intrusive thoughts and im-
 building a framework 33

ages give rise to feelings of anxiety, guilt, and fear (Horowitz, 1976). From
this perspective an individual attempts to cope with the traumatic imagery
in one of three ways:
1. Failing to be sensitive to the discrepant information (“It did not really
happen,” or “It wasn’t so bad”)
2. Interpreting the meaning of the information in a way consistent with
current beliefs (“I brought this on myself” and “I will be more care-
ful next time”)
3. Altering existing beliefs to match the experience (“The world is really a
bad place” or “Bad things happen to good people”) (McCann, Sakheim,
and Abrahamson, 1988)
Those individuals who are able to maintain a sense of control and opti-
mism regarding the outcome of the event are thus expected to fare better.
However, this formulation ignores other factors that influence the individ-
ual and his or her response to trauma. For instance, there is an important
difference in the development of trauma symptoms when the event is at-
tributable to human rather than natural causes. Most people believe it is
profoundly different to be hit by a rock thrown by a volcano than one
thrown by another human being (Briere, 2000). Secondary losses or stres-
sors, in particular the loss of resources and the failure to replenish lost re-
sources, are another crucial factor in trauma response (Brewin, Andrews,
and Valentine, 2000; Hobfoll, 2001). For instance, people surviving a tor-
nado may have lost loved ones, their possessions, and their community,
losses that continue to influence their ability to recover. In addition, the de-
gree of support in the environment regarding the event is important. This
support includes the individual’s personal network, the workplace, if it is a
job-related traumatic event, and the community response to the event.

Secondary Traumatic Stress, Vicarious Traumatization,

and Critical Incident Stress
Trauma theory was advanced to understand the experience of people who
encountered tragic and horrifying events in their lives. In the past 20 years,
the focus has broadened from considering only the victims of an event to
include those who were on the scene attempting to help. A variety of con-
cepts have arisen in the literature in recent years aimed at identifying oc-
cupational mental health issues related to trauma exposure in health care
and emergency services workers. These concepts include critical incident
stress, secondary traumatic stress, compassion fatigue, and vicarious
traumatization. At the front lines, these terms often have been used inter-
changeably. At the research level, there is lack of consensus about these
terms and the factors that contribute to these work-related problems.
34 in the line of fire

Secondary or vicarious trauma refers to the overwhelming emotions,

thoughts, and reactions of individuals who, through their work, relate
empathetically to traumatic events and survivors.

Saakvitne (2001) suggested that it is useful to distinguish direct, sec-

ondary, and vicarious traumatization in the following manner:

• Direct traumatization refers to the effects of direct exposure to trau-

matic events or its consequences.
• Secondary traumatization refers to the effects of loving or feeling re-
sponsible for someone who is directly traumatized and consequently
experiencing their symptoms (Saakvitne, 2001; Figley, 1999). This
term is sometimes applied only to those who have a personal rela-
tionship with the victim and sometimes also includes emergency re-
sponders.
• Vicarious traumatization refers to the transformation of a worker’s in-
ner self as a result of empathic engagement with a traumatized client
or patient (McCann and Pearlman, 1990b; Pearlman and Saakvitne,
1995; and Saakvitne, 2001).
• Compassion fatigue is a term used to describe the results of caring for
traumatized individuals over a period of time (Figley, 1995).

Vicarious traumatization is based on theories related to trauma and con-

structivist self-development theory (McCann and Pearlman, 1990b; Pearl-
man and Saakvitne, 1995). This concept was originally used to describe the
experience of mental health workers who develop symptoms of traumatic
stress as a consequence of working with traumatized individuals. That is,
through the process of hearing the graphic details of other people’s horri-
fying experiences, the worker can begin to experience symptoms that in-
clude intrusive imagery, generalized fears, sleep disturbances, a changed
worldview, and affective arousal (Chrestman, 1995; Regehr and Cadell,
1999). Over time vicarious traumatization leads to a diminished sense of
hope. Similar to burnout, vicarious trauma may also lead to pervasive cyn-
icism and pessimism. More recently, the term has been applied to emer-
gency service workers who not only hear of traumatic material described by
others but also witness gruesome events and experience personal risk on
the job.
Critical incident stress theory applies directly to responses experienced
by emergency service and health care workers encountering critical events
on the job. A critical incident is defined as a “stressor event (crisis event)
which appears to cause, or be most associated with, a crisis response; an
event which overwhelms a person’s usual coping mechanisms. The most se-
Other documents randomly have
different content
nugæ sunt. Boni igitur omnes amant, cui nihil nisi boni et honesti
cordi est. Colunt et prædicant uno consensu, uno concentu
Leucotetii, Unelli, Ergosiavi, et Alpini Ariobriges. Humaniorem
hactenus non viderant, nec commodis suis opportuniorem. Hunc ad
se missum esse virum, quem a vera honoris via nulla averterit
unquam lucri fames, nulla pravi affectus insania, gaudent, sed puro,
sed sincero gaudio.
»Gratuleris et tibi, Aule Persi: obvolvisti ipse te cæca nocte:
videri nolebas. Altam versibus et versuum sensibus superfudisti
caliginem. Nolebas intelligi, forte et tu non intelligebas. Non fecerunt
venientem at te nox et caligo, ut exerraret. Venit: discussit noctem
et caliginem. Te proxime videt. Perspectum id omne habet, ut tute
loqueris,

»Quod latet arcana non enarrabile fibra.

»Eripuit tibi te neganti conspectum. Latebas intra te, ne te curiosa et

erudita inveniret sagacitas. Eras ipse involucrum tibi. Quis vero fuit
furor ille tuus?—Nulla,» exclamo ego, «deleat unquam Mæcenatis
mei memoriam oblivio! Supremus sit illi dies qui soli erit et cœlis!—
Vivat tanti viri nomen,» subjicit Persius, «in ea luce quam fugi!
Effundat id in caput suos omnes gloria immortalis radios! Obsolescat
nunquam celsæ virtutis honos! Favet virtuti: faveant et illi virtutes!
referant laudantes et plaudentes gratias quas habent!» Subridet
Mercurius et caduceum movet.—«Audite, pii Manes,» inquit.
«Diuturnior est vita quæ suis cuique venit a benefactis: nam et
verior est. Non ita diuturna quæ venit a parentibus. Jupiter rerum
arbiter, cujus
 »Pondus adest verbis, et vocem fata sequuntur,

»duris hanc statuit Parcarum legibus legem: corpora [pg XXVIII]

quidem dedant neci; gloriam et laudem letho eximant. Instabili non
subest rerum mutationi virtus, nec virtutis merces.»
Cum diceret, perculit aures dissipatus longe rumor, et confusæ
convenientium voces. «Ecce, ecce,» pergit dicere Mercurius, «venit
ad vos humanitate clarus in Musas, ortu clarissimus, Furbinus
Oppedius. Eruditionem, florens dum manebat vita, maximum duxit
esse mortalium bonum Oppedius. Principem debet inter vos locum
tenere. Ingenuis favit disciplinis, ex animo favit, apud leves et
turbidos Salyes togæ princeps. Sed enim et acceptissima fuisti
Oppedio, Aloisia.» Audiit ille:—«Libros bono numero collegi,»
reponit. «Et in tuis, Aloisia, scriptis magna cum voluptate
conquiescebam. Eruditos, quotquot voluere, in clientelam et fidem
meam suscepi: suscipite et vos, pii Manes, in fidem vestram me. Sed
te, Aloisia, commendarat mihi tum adprobantis testimonium famæ,
quum hominum ingeniosorum et doctorum de te judicium. Eras mihi
amœnum et florens diverticulum a politicis curis.—Raros esse,»
respondeo, «altero sub cœlo, Barclajus et Boccalinus conqueruntur,
qui sui putent esse pensi in lucentibus dignitatum positi gradibus,
litteris et litteratis fera subigere invidiæ odia. Lætor igitur
vehementer, nove hospes, meum tibi quicquam dulce et gratum
tanto viro fuisse.»
—«Et jure conquerimur,» refert Barclajus. «Enimvero mihi multa
intercedebat cum Peyreskio amoris necessitudo. Meis delectabatur
commentationibus et moribus. At plurimum Argenidis oblectabatur
historia. Commendavi regiam virginem longe commendatissimo in
litterarum Republica viro. Edit ille in lucem, vult vivere nobilem
ingenii mei partum. Vide temporum iniquitatem, summe Furbine;
hominum malignam [pg XXIX] vide stoliditatem. Non placuit varicosis
Magnatum ingeniis liberalis Argenidis forma: non placebat stola
Romana. Non amarunt in Latio natam pulchritudinem. Bibliopola
magno, quod sumptus quos fecerat in ornanda et comenda, nullus
inveniretur emptor qui refunderet, succensebat pudore offusæ. Piper
et thus minabatur. Erat Argenis toga cordyllis et pænula olivis futura,
ni Marcassi opem obtestaretur, non magni viri, non ingenio sublimis,
non doctrina locupletis. Commendavit litteratorum plebi plebeius,
nec nobilis scriptor. Rem ridiculam! Principibus viris placuit Argenis,
postquam ineptis et fatuis placuisset. Quos graves putant et summos
esse viros, interdum noxæ sunt viles et stulti. Si nudos, detracta
opinionis larva, contempleris, homines non credes; aut nihili homines
credes.»
—«Melius tecum, Aloisia,» inquit Oppedius, «fatui actum
benevolentia fati. Nam inepti et ignavi illaudatam reliquerunt:
magnæ et excellentes mentes laudarunt, foverunt. Sunt immo qui ex
animo amant, et tamen obloquuntur. Secum ipse laudat Tubero:
vafer, vappa, in perniciem famæ suæ et bonorum ingeniosus, qui et
fruitur Dis iratis, Tubero. Coram et palam illaudatam temnit. Bene
sensit et male dicit, simulator improbus. Sed non tulit impune.—Feriit
indignans æther sacro fulgure vanum et perfidiosum caput,» inquit
Mercurius. «Ignominia merserunt nequam nebulonem ulciscentes
Musæ. Adfui nascenti Tuberoni,» adjicit, «cum Laverna et Cotytto; et
cum pœnas dedit, adfui exsultabundus: colaphos ipse impegi.—
Magni sane viri, sublimes animæ,» refert Oppedius, «ut viderunt,
laudibus cumularunt: deperiere.—Jure fit,» reponit Mercurius, «ut qui
auro, non meritis, emerunt dignitates, id solum plurimi faciant quod
auro venit, [pg XXX] non quod ingenio. Ne quidem, paucos si
exceperis magno e numero, primora labra Pegaseio latici
admoverunt. Igitur probro sibi verti putant, quæ laudes conferuntur
in litteratos. Velles amarent Parnassum, e cujus vident arce cudi tela,
quibus petantur ut feræ bestiæ?»
—«Erant in Neapolitano Prætorio, meo tempore,» reponit
Boccacius, «tres excetræ: Romulus, Elpinus, Valens, vaferrimi
conflandis fraudibus et calumniis triumviri. Romulus cohortem
duxerat, lepusculo timidior, cerva fugacior. Elpinus sacerdotem
induerat: pessimum nebulonem non exuerat. At Valens, ætate
provectior, in re augenda per fas et nefas totus erat. Astutam vapido
sub pectore servabat vulpeculam; dulce de labris loquebatur, corde
vivebat noxio. Accidit, volentibus Diis, calumniatorem insurgere in
me nescio quem de lutulenta plebecula, egenum, mente captum,
effrontem, Satyrum. Me insimulat criminis, me rerum repetundarum,
Mercuri! me peculatus, o Musæ! me! Indignabantur boni,
gratulabantur sibi tres hi laverniones. Exsultabant prurienti amentia.
Celebritatem nominis sperabant sibi, qualem qui Ephesinum Dianæ
templum subjectis flammis corrupit, qualem qui Vestalem vivam
defodit insontem. Boni concupiscunt sibi gloriam, mali famam. Dire
minitabantur. Dicebant sancti et probi cognitores e re sua esse me
male haberi, et ignominia Boccacium mergi vel immerentem.
Urgebant calumniatorem adhiberet accusationi acta, ut loquuntur,
produceret testimonia, subornaret testes, acta confingeret. Volebant
non veritati opem adesse, sed innocentiæ deesse, veritatem opprimi,
obrui innocentem.—Abeat hic in malam crucem nugator! dicebat
Romulus. Ausus est, quem voluit nostrum, pediculosis illis fabulis,
quas misit in lucem, contaminare. Mihi [pg XXXI] quidem librorum hi
scriptores odio sunt. Nam pilum mittere, ferro pugnare, hostem
ferire didici, non legere; fortiter facere, non sapienter loqui. Omnia
non emerim Musarum dona teruncio.—Nam qui doctrina vigent,
grunniebat Elpinus, nos flocci non faciunt: nimirum pretium in nobis
nostrum inveniri debere contendunt. Auro nos perduxerunt Regis
diplomata, qui plumbei eramus, aut ahenei. Aureos ideo stulti e
plebe credunt: eruditi, malum! aheneos vident esse aut plumbeos; et
irrident. Simulata pietate, affecto ire ad gloriam. Fallaci vultum larva
improbum tegi. Stupet et veneratur jejuna plebecula, ac si jam
viverem cum Jove. Pestes hominum, eruditi perspectam habent in
intimis fibris mentem; contaminatam sceleratis cupiditatibus vident
et oderunt. Pereant hi lynces sua cum perspicacitate! Malo noctuam
Minervæ mihi, quam Minervam.—Erumpebat Valens in cachinnos.—
Non ita odi litteras ac tu, dicebat. Nam fuit mihi non ineruditus pater.
Qua valebat gratia, derivavit in domum meam quicquid habet
ornamenti et decoris. Sed supina superbiunt interdum contumacia
viri docti. Quod velis nolunt; quod nolis volunt. Cui non doleat? Haud
libenter ego tulerim. Audivi qui, orando causas, captiosis dictorum
præstigiis me in curuli sedentem impeteret; qui sordes ultro objiceret
insultans. Sed ea malignitatem arte effutiebat, ut ne quidem hiscere
auderem. Impune oblatrabat furi, quia ingeniose. Pereant ingenio
suo liberius evagante, et nostro severius ulciscente! Et Rempublicam
persuasum habeo, plurimum a litteris capere detrimenti. Nec sunt
utiles sibi litterati, nec rei apti faciendæ. Legunt, commentantur,
scribunt: quid id est præ nummis? Non emerim tribus assibus
trecentos Aristoteles, nec teruncio mille Petrarchas. Malim mihi auro
plenam esse [pg XXXII] crumenam, quam doctrina cerebri sinus.
Philosophis et Oratoribus, mea sententia, antestant longe sartores,
cerdones, pistores. Deturbaverim libens e civitate mea id genus
otiosorum, si legislator fiam, et in tres classes distinxerim cives.
Primas tenebunt sedes Magistratus, ut nos sumus; secundas
Sacerdotes, ut tu es, Elpine; inferiorem locum agricolæ et opifices.—
Ineptum istud, respondebat Elpinus. Ineptum te legislatorem! Nam
primo sunt in loco Sacerdotes. Quis dubitet, nisi amens et impius?—
Accepi, reponebat Valens, jureconsultum, nescio quem, magni
nominis, nam nimis curiosus nunquam fui, dicere Magistratus omnes
Themidis esse Sacerdotes. Ergo qui sunt et Magistratus et
Sacerdotes, ut tu es, Elpine, præstant Sacerdotibus. Sed oriatur nulla
inter nos rixa, nulla contentio, nulla animi læsio. De Boccacio fieri
quicquid jusseris, et id ego fieri jubeo. Innocens scilicet erit quem
oderimus? Meo damnare calculo, vel frugi, vel innocentem, vel
sanctum certum est. Et blandiens nummi refulget spes?

»Tros Rutulusve fuat, nullo discrimine habebo,

»ut quidam inquit poeta magnus, puto, Donatus. Nam alium non
memini me legere. Dein id erit quod judicaverimus, non quod vere
est. Res judicata facit de albo nigrum, de nigro album. O cœleste,
per Ditem et Plutum, numina mea, prudentiæ juris effatum! Nam
quid commodius et opportunius? O utile nobis, non ita sapientibus,
ex arcana sapientia oraculum!—
»Quid plura, sancti Manes? Regi Roberto (cui non dictus
Robertus Rex?) re intellecta, non potuit continere se placidissimus
Princeps, quin sacro conciperet [pg XXXIII] iram pectore dignam se
optimo, maximo, dignam Deo optimo maximo. Nec mora: verbis
castigat amaris excitos ad se. Dein sublimi e sede, quam
dehonestabant, agit fulminatrici manu præcipites: abdicat
magistratu, quem incestabant. Romulum Thrasonem, ne fabulæ quid
deesset ridiculi, et tamen duri, lixis exercitus, quem coegerat in
Insubres, præfecit moderatorem, et calonibus. Nosocomio
incurabilium abdit Elpinum; Valentem vero avarum et prædæ
inhiantem Judæo Manassi, Portorii apud Calabros redemptori,
sufficit.—O infelicitatem temporum meorum! ingemebat cœlo dignus
Princeps. Boni et honesti vocabantur ad Judices: in lupos incidebant
et leones. Discant hoc reliqui exemplo justitiam! Suos discant mores
in sacraria Justitiæ non inducere. Dignum quidem fortitudine, qua se
jactat amens Romulus, munus cepit. Lixis et calonibus ducem
præfeci. In impedimentis exercitus, impedimentum ipse, Martem
aget; insultabit Alexandro. Elpinum detrusi in Nosocomium
incurabilium: nam quis ægrum ira, avaritia, superbia curarit unquam
belluæ animum vel homo vel Deus? Nulla mansuescunt arte his in
verbis animarum morbi. Sed mortuo suffeci Judæo Valentem.
Conquerentur, scio, Calabri Judæum decessisse Judæo, forte et
Arabem e Mahometis secta missum conquerentur: videbimus.—Sic
acta est fabula, quibus ferocire, nocere, pessumdare ludus erat.»
—«Belle, belle!» exclamat Oppedius. «Nam is non fui de quo
quicquam litterati queri possint agitasse unquam animo consilii, quod
Musis injuriosum videretur.—Nomen igitur tuum et decus,» infit
Mercurius, «commendabunt litteratæ immortalitati. Sempiternum per
ævum volitabis vivus, ut gloriabatur de se moriens Ennius, per ora
virum. Sed me vocant jussa Jovis. [pg XXXIV] Valete, cari Manes.
Fruimini læti et securo in otio, Elysii campi deliciis, et vobis fruimini
alter altero. Vetant quæ habeo in mandatis esse vobiscum diutius.»
Tunc celeri raptus alarum remigio evolavit.
Superest vero mihi, VIR SUMME, ut paucis de me dicam, quo
sim notior tibi, quam esse possum, si non dixerim. Vivebam ante
annos centum in Hispania, Toleti nata. Ingenio, eruditione, forma
præstiti, et omnibus excellui virtutum dotibus, quæ ingenuas decent.
Non in abjecta animi demissione, non in sordida rei familiaris cura,
non in vili nugarum studio virtutem mihi positam habebam:
liberalibus navare operam disciplinis, scriptis pulchram mihi et
æternam parere famam, ad summam sapientiam niti, non ad
summas contendere opes, id demum optimum putabam, laudabile
prædicabam: quod tamen fœminæ pleræque omnes per ignaviam
negligunt; homines multi, per socordiam stultam et furentem,
contemnunt. Quamobrem veri amans libere malos insectabar; quæ
sentirem de flagitiosis et impuratis ultro intonabam. Velut quadam in
curuli sedens sella, morum Censuram exercebam, plaudente e cœlo
Pudicitia. Me suspiciebant omnes, et ob os ora obvertebant sua.
Nobilium imprimis fœminarum spurcis infensa libidinibus
infremebam: quo injecto saltem pudore ad meliorem revocarem
frugem, nihil non agebam: pati non poteram specie prælucentes,
nobilitate commendabiles, brevis gaudii aut spe aut gustu, velut
emotas mente, ipsas in ludibria se vertere. Dicebam, ut Virtuti
honestum et gloriosum est nudam sisti ob oculos mortalium, sic Vitiis
esse ignominiosum. Quæ meretricie viverent, ideo volui e fornicibus
suis, in quibus latebant, in scenam humanæ vitæ nudas educere,
quæ essent documento impune non peccari, mulieres quasdam
superbi nominis et oris, et alto cretas sanguine. Nam, quas Tulliam,
Octaviam, [pg XXXV] Semproniam, Eleonoram, Isabellam voco, eæ
fuerunt Ducum, Marchionum, Comitum aut uxores aut sorores. De
his enarro nihil quod vere non factum sit, et ut eram a mendacio et
ab omni dissimulationis et simulationis specie alienissima, liberiori
omnia sermone exsecuta sum, qui solus conveniebat.
Satyram Sotadicam inscripsi opus, quod Colloquiis sex complexa
sum, et infra mensem absolvi. De Sotade nihil est quod dicam.
Rerum amatoriarum scriptorem fuisse liberrimum, neminem fugit.
Sed puellam ad scribendum his de rebus animum appulisse, post
Elephantidem et Philænim, nihil mirum videri debet. Fuerunt et aliæ
hoc scriptionis genere celebres. Et sane aptiores sunt fœminæ his
rebus depingendis, si quæ sint cordatæ, si quæ non fatuæ
procacitatis. Libidinum ipsæ sunt campus in quo nascuntur omnes,
in quo efflorescunt, in quo vigent, oriuntur et occidunt. Hispanice
scripsi: vir doctus Joannes Meursius, Lugdunensis apud Batavos
Academiæ clarissimum lumen, Latinitate donavit adolescens; etiam
adjecit, quæ mihi sane non venerant in mentem. Sed liber periit
meus Hispanice scriptus, Meursii superest commentatio, non infelicis
ingenii, non proletariæ eruditionis partus, quæ nec fastidium legenti
creet, nec stomachum moveat Sapienti. Attico sale condita omnia.
Invideri tam salsa, tam lepida, tam etiam utilia bene vivendi
præcepta huic ætati tuæ bonis litteris amicæ turpe esset, et
studiosis arduæ sapientiæ ingeniis durum. Quis ægre molesteque
non ferret? Bonos utique mores laudet Tullius; Philosophus doceat
Plato: melius sane suadebunt Publius Syrus, Laberiusque Mimi. Ferit
mentem et movet qui miscet utile dulci; a qua plerumque aberrat
laude verbosus Orator, strigosus Philosophus. Medicamentis vires
addit, dum horrorem et odium adimit, qui in bellaria format solers
Medicus. [pg XXXVI] Hæc mea fuit cogitatio. Omne mihi visa sum
punctum tulisse, quæ ingeniose, quæ facete utile dulci miscuissem.
Dura tamen amori silex fui: pectus nullo fixi telo. Inaccessa libidini
malæ, sanctam constanter duxi vitam. Severiori virtuti assidua hæsi
comes. Mores laudarunt boni, reveriti sunt mali. Et his et illis eram
acceptissima. Ut Regibus, et principibus in Republica viris, sic et plebi
placui miranti. Me et litterati coluerunt, litterarum, ut dicebant, bono
natam. Cave de pura et proba, VIR BONE ET SANCTE, hac judices ex
libertate loquendi quæ sentirem. Fœdas depinxi rerum species, non
amavi. Depinxi, quia odio habebam. Inique feceris, si velis has,
adversus Aloisiam tuam, pictas tabulas testimonia esse, et Tulliam,
Octaviam, testes. Humanius age. Famam consule; gloriam consule
nominis mei, quæ nulla obsolevit annorum injuria. Uni judicium
accommoda. Vale.

[pg 1]
ALOISIÆ SIGEÆ

TOLETANÆ

SATYRA SOTADICA

De arcanis Amoris et Veneris

 COLLOQUIUM PRIMUM

VELITATIO

Tullia, Octavia.

ullia. Dulce est, cognata mihi luce dulcior, tuas

tandem cum Caviceo pactas esse nuptias: ejus enim in amplexibus,
crede mihi, quæ te nox mulierem faciet, omnium longe maximam
voluptatem tibi allatura est; te modo, ut digna est hæc forma tua
cœlestis, fortunet Venus.
Octavia. Dixit hodie mane mihi mater, postridie [pg 2] hujus diei
nupturam me Caviceo. Et domi video, quæ ad ejus rei pompam
pertinent, magna apparari cura: lectum, cubilum, et cetera alia. Hæc
vero plane in mentem meam gaudii minus quam timoris injiciunt;
nam, quæ tandem illa, de qua loqueris, possit esse voluptas,
cognata omni mihi voluptate gratior, nec scio, nec etiam opinione
concipio.
Tullia. Te ejus ætatis, et tam teneram (nam annum vix decimum
quintum attigisti), mirum minime videri debet id nescire, quod ego
ætate provectior cum nupsi, penitus ignorabam quid esset, quod
pollicebatur Pomponia delicii, jam per tres annos experta, ac
tantopere prædicabat.
 Octavia. Sed, te de ea re prorsus scivisse nihil (patere me
liberius loqui in hoc plenæ libertatis confinio, in quo nunc sum), id
profecto vehementer miror. Nam si non usus, quem certe nullum
habebas, tamen multa tua eruditio adyta hæc tibi aperuisse debuit.
Te sæpe audio summis laudibus tolli in cœlum, quod litteris Latinis
Græcisque, ac liberalibus fere omnibus disciplinis ingenium ita
imbueris, ut superesse nihil videatur quod nescias.
Tullia. Multus in hoc fuit pater meus, ut, quo studio formosarum
et venustarum aliæ pleræque omnes famam ambiunt, ego eruditæ
virginis laudem persuasum haberem esse mihi comparandam. Et
aiunt qui adulari quam vera dicere satius habent, non omnino
operam lusisse.
Octavia. Aiunt etiam qui nolunt adulari, vix pudicitiæ laudem, vix
honestos mores retinuisse, quæ [pg 3] ex nostris eruditiores habitæ
sunt, cum id decus ceperunt.
Tullia. Pudicam negarent me, quam fatentur eruditam?
Octavia. Nec ullam potius ob rem admirationem omnium es
consecuta, quam quod bonis castisque moribus tuis eruditio non
obfuerit; magnam avem contra lucem attulerit. Qui vero fieri potuit,
ut, quæ virgines ducuntur, Musæ virginum laudi infestæ
crederentur? Ut, quæ animorum sunt velut quædam faces, quibus
ad magna et laudabilia omnes similiter fœminæ hominesque
accendimur, eædem contaminare animos dicerentur? Sane dum
nobis homines, per malignitatem quamdam arrogantem et stultam,
eas opes invident quibus ipsi superbiunt, maledicta invidiæ miscuere.
Aconita ac venena omnia non minus homines fugiunt, quam nos
fugimus, quas vocant sequiorem sexum, quia quæ nobis adimere
pestis animam potest, et illis etiam potest. Si nobis eruditio est pro
veneno et pro peste, ut obtrectant, quomodo rem tam malam, ut
hominibus prosit (nam sibi prodesse non negant) naturam continget
momento mutare? Suo si ingenio nobis est eruditio velut fons
quidam omnium malorum et flagitiorum, quomodo ex eodem fonte
bibent illi nectareos latices ad immortalem gloriam: nos vero infelices
et miseræ Stygia quasi fluenta, quæ pectori sulphurea sint incentiva
eas ad libidines, ad quas ipsi nos rapiunt imperio, aut ducunt
exemplo? Nam, te sic loqui memini, cum de ea re sermonem ante
hos dies cum Caviceo meo haberes. Decorum sane [pg 4] tibi est
hanc ad usque diem servasse illæsam honestatis famam, cum ea
pulchritudine, qua accendis etiam frigidiores, cum ea eruditione, qua
etiam capis quos pulchritudo non tangeret.
Tullia. Quæ sic loqueris, quæ scis amore inflammari hominum
corda, non ita profecto rudis es ut putabam.
Octavia. Nesciam ego penitus quod Cavicei oculi, frons, vultus
denique totus, toties dixere mihi, ut etiam ipse taceret? Enimvero,
dum ante octo dies liberius mecum agit, ad oscula mea ferri insueto
impetu certe mirata sum; nec quid sibi vellet hic impetus, hic æstus,
satis noveram.
Tullia. Aberat mater? sola eras? ab eo tibi timebatur nihil?
Octavia. Aberat mater; quid autem ab eo timeretur? ego certe
nihil timebam.
Tullia. Nihil ultra basia rogavit?
Octavia. At ea quidem ab invita sumpsit, linguam micantem
intra labia mea primora vibrans vesanus.
Tullia. Quis tibi tunc sensus erat?
Octavia. Fatebor: me nescio quis æstus invasit hactenus
inexpertus: totis artubus concepi ignem. Credidit mihi vultum esse
pudore suffusum; sustinuit aliquantisper amentiam, et petulantem
manum.
Tullia. Perge.
Octavia. Manus eas furaces oderim semper, ita me demum
excruciatam, fatigatamque incendio impleverunt!
Tullia. Rem bellam!
Octavia. Quid hoc est? alteram alteramve papillam, [pg 5]
demissa in sinum manu, prehendit, et cum duriusculam alteram,
alteramve attrectaret, impressis digitis, reluctantem ecce me
prostravit resupinam.
Tullia. Erubescis; res peracta est.
Octavia. Admota ad pectus læva manu (ut gesta res est refero),
conatus facile meos omnes frangebat: dextram vero sub stolam
misit. Pudet, pudet dicere.
Tullia. Excute pudorem illum deridiculum, cogita tibi dicere quæ
mihi loqueris.
Octavia. Mox evoluta supra genua stola, attrectavit femina. O!
vidisses oculos scintillantes!
Tullia. Te hoc temporis momento utcunque beatam!
Octavia. Inducta altius manu, locum eum invasit, qui nos, ut
loquuntur, ab altero sexu distinguit, et e quo equidem mihi, uno
abhinc anno, copia sanguinis, unoquoque mense, manare solet per
dies aliquot.
Tullia. Euge, Cavici, ah, ah, ah!
Octavia. O scelus hominis! «Hæc pars,» inquit, «me mox
summo beabit gaudio. Patere, Octavia mea.» Ego ad eos sermones
parum a deliquio abfui.
Tullia. Tum, quid ille?
 Octavia. Illa mihi pars, vix crederes, minima rima patet.....
Tullia. Sed ignea, sed micanti.
Octavia. In eam digitum immittit, quem cum locus ille ægerrime
caperet, non carui aliquo sensu urentis [pg 6] doloris. Ille vero:
«Habeo virginem,» inquit, et dicto citius apertis mihi per vim
femoribus quæ ut poteram obstringebam enixissime, in me
resupinam se projicit.
Tullia. Siles? nihil præter digitum in eam partem induxit?
Octavia. Sensi... sed quæ mea est impudentia, quæ dicere
pergo!
Tullia. Et eadem ego, quam tanti facis, passa sum, quæ tu. Nihil
audentius sponso, quem mora omnis lacerat mirum in modum,
donec sponsæ eum florem discerpserit.
Octavia. Sensi mea mox inter femora pondus aliquod obdurum
et fervidum. Ille me vi petere; vehementi impulsu eam rem in corpus
meum et in eam rimam adigere. Sed ego, collectis viribus, in alterum
me latus conjeci, et læva inter utrumque corpus insinuata, eam
appuli illum in locum, in quo pugna tam sæva pugnabatur.
Tullia. Potuisti una manu tam validam catapultam evertere?
Octavia. Potui. «O nequam hominem!» dicebam, «quid me tam
dire vexas? Ignosce, si me amas: quo delicto id supplicii merui?» Et
lacrymæ manabant ex oculis: sed enim ea erat mens mea in
perturbatione, ut nequidem hiscere auderem, aut opem clamore
misso obtestari.
Tullia. Nec ideo tamen sua te hasta transfixit Caviceus,
vallumque tuum istud subiit?
Octavia. Injeci manum, arreptamque averti; sed rem miseram!
sensi protinus me velut imbre ad [pg 7] ignem temperato perflui,
nudamque, ut eram ad usque umbilicum, irrigari. Admovi iterum
manum; sed cum in eum liquorem, quo ille me furor insperserat,
incidissem, quasi viscatum, refugit manus metu et horrore.
Tullia. Igitur nec ille victor, nec tu victrix, quum parum abfuerit,
quin vera sit potitus victoria.
Octavia. Ab eo die multo acceptior Caviceus. Et cupidine
impotenti nescio qua furit animus. Quid cupiam nescio, nec dicere
possim. Illud tantum scio mihi omnium mortalium Caviceum esse
longe gratissimum; ab eo uno exspecto voluptatem summam, quam
non intelligo, quæ qualisve futura sit nescio. Cupio nihil et cupio
tamen.
Tullia. Nacta me es quæ in his cogitationum tuarum ambagibus
tibi sim pro Œdipo. De Biblide quæ scripsit Amoris magister et
interpres Naso, belle tibi utique conveniunt:

Illa quidem primo nullos intelligit ignes,

Nec peccare putat, quod sæpius oscula jungat...
Sed nondum manifesta, sibi nullumque sub illo
Igne facit votum; veruntamen æstuat intus.
Spes tamen obscœnas animo dimittere non est
Ausa suo vigilans: placida resoluta quiete
Sæpe videt quod amat, visa est quoque jungere
fratri
Corpus, et erubuit quamvis sopita jacebat.
Somnus abit, silet illa diu, repetitque quietis
Ipsa suæ speciem, dubiaque ita mente profatur:
«Me miseram! tacitæ quid vult sibi noctis imago?
»Quam nolim rata sit! Cur hæc ego somnia vidi?»
Pudet somni: amatur tamen; et dum in imagine [pg 8] voluptatis
ludit animus, gaudio colliquescunt summo sensus. Erubescis? Habeo
confitentem, viderisque mihi dicere:

Dummodo tale nihil vigilans committere tentem,

Sæpe licet simili redeat sub imagine somnus!
Testis abest somno; nec abest imitata voluptas.
Proh Venus, et tenera volucer cum matre Cupido!
Gaudia quanta tuli! quam me manifesta libido
Contigit! Ut jacui totis resoluta medullis!
Ut meminisse juvat! quamvis brevis illa voluptas,
Noxque fuit præceps, et cœptis invida nostris.

Octavia. Haud inficias ibo: obversatur mihi ob oculos, diu noctuque,

Caviceus, mentemque totam spes occupat incredibilis voluptatis. Et
sane similem optavi sæpe Caviceo opportunitatem, ab ea die, quam
rudis et imprudens misere perdidi.
Tullia. Quid tum factura esses?
Octavia. Ipsa tibi potes dicere. Jam ego doctior essem, et ille
beatior. Nondum me composueram, vestem vix deduxeram ad
pedes: ille indusium condiderat, quod de femoralibus excesserat;
ecce intervenit mater.
Tullia. Væ tibi! nam novi mulieris mores, et severitatem.
Octavia. Nihil tamen molestius locuta est vel Caviceo, vel mihi.
Petiit subridens quos inter nos sereremus sermones? uter amantior
esset? «Nam amari quis sit dignior, id non quæro,» inquit; «tu es,
Cavici, nec tu, Octavia, puto, contra contenderis. Velim tamen,
quandoquidem vos brevi [pg 9] junget Hymenæus (quod precor
faustis avibus fiat), tu Cavici, Octaviam meam, et tuam, non pro
merito, quod in ea est permediocre, ames, sed pro generosa tua
indole. Annos uterque felicissimos in ea conjunctione animorum
agitabitis.»
Tullia. Sed post, postquam Caviceus abiit?
Octavia. Cœpit interrogare quid id esset, quod suis ipsa oculis
de utroque viderat. Ego excusare culpam; urgere mater verum
faterer. Queror ab eo me fere oppressam; quid vellet, quid quæreret
me nescire; me quidem non peccasse, quod scirem. Pergit quærere,
et sciscitari an corporis mei integritatem violarit: nego. Monet in
posterum ab eo caveam, minas addit ni fecero. «Nam,» inquit, «ante
multos dies illi jungenda es, nata; sed pro certo habe, si de te, ante
id tempus, solidam voluptatem ceperit, aut penitus discessurum: aut
si constantiæ laudem maluerit, te tamen contemptui habiturum.
Quarum rerum infelicior utraque plane est, quam ut puella generosa
æquo animo ferat, mortem ipsam æquiori ferat.» Ab eoque die
solerti cura mater invigilavit, me ut Caviceus nunquam inveniret
solam. Nec cum sola est collocutus.
Tullia. Sane, cui in prima adolescentia (at adolescens valde est
Caviceus), frui contigit usura amati corporis, re patrata, quod
Stagyritem non fugit, eam plerumque odio habet quam insano
antehac amore deperibat. At vero, Octavia, ingenuitatem tuam
admodum laudo, et quam ego tecum etiam [pg 10] ingenue agam,
faciam ne dubites. Petiit a me ipsa mater tua, ut arcana hæc
reconditiora nuptiarum ostendam tibi omnia, doceamque qualis esse
debeas marito tuo, qualis maritus circa res hujusmodi, ob quas
homines inflammantur, futurus sit. Hac nocte, quo liberiori omnia
condoceam sermone, una meo in lecto decumbemus, quem
dulcissimum mihi Veneris stadium vocare apte possim. Postera
concubinum experieris jucundiorem, quam ego fuerim concubina.
Octavia. Rides, Tullia; apage ab his dictis, quæ amori in te meo
injuriam faciunt, quam tuus non ferat, si ex animo me amas.

[pg 11]
 COLLOQUIUM SECUNDUM

TRIBADICON

——

ctavia. Habet nunc idem nos lectus tuus, in quo

voluisti me sæpe, non solummodo tecum, sed etiam in amplexibus
tuis noctes ducere, cum Callias abfuit maritus tuus.
Tullia. Duxi interdum insomnes, quod, tuo amore per omnes
venas misso, quo me macerabam, velut incendio urerer.
Octavia. Me amabas? nec etiam amas?
Tullia. Amo, cognata, et misere pereo.
Octavia. Peris tu vero, quam vita mea servari malim incolumem?
Quæ hæc est ægritudo animi? Nam te corpore bene quidem valere,
omnia faciunt ne dubitem.
Tullia. Ut tu Caviceum, sic te ego.
Octavia. Aperte loquere: quæ est ista verborum caligo?
 Tullia. Sed primum a te tam venusta, tam formosa, [pg 12] tam
tenera, abige etiam procul a te quicquid id est pudoris.
Octavia. Cum nudam me voluisti ingredi lectum tuum (et
obsequuta sum), ut ingressuram me dixisti cum dabor Caviceo
fruenda, nunquid satis pudorem procul a me omnem abegi?
Tullia. Nam Lydorum dixit olim Regina: «Exui tunicam simul et
deponi pudorem.»
Octavia. Te hortante vici timiditatem meam, te duce vici me.
Tullia. Da mihi suavium, suavissima virgo.
Octavia. Quidni? quot voles et quod voles.
Tullia. O speciem oris divinam! O luce lucidiores oculos! O
formam Veneream!
Octavia. Et operimenta dejicis? jam nescio quid timerem, quod
tibi imprecor, si Tullia non esses. Ecce me nudam habes, quid
præterea?
Tullia. O Dii! personam agere Cavicei, dedissetis ut vellem,
posse!
Octavia. Quid istud est? Ambas papillas meas, ut tu nunc,
prehendet Caviceus? Oscula osculis tam frequentia miscebit? Labia,
collum, mammas morsibus his petet?
Tullia. Isthæc, corculum, præludia erant ad pugnam, et
promulsidaria ad plenas Dionæas epulas.
Octavia. Apage, corpus totum manu pererras; inferius demittis
manum. Quid femora attrectas mea? Ah! ah! ah! Tullia. Quid eam,
amabo, partem vellicas? Nec oculorum ab eo loco dimoves aciem.
Tullia. Cum voluptate conspicio curiosa istum Veneris campum,
non latum, non spatiosum quidem, [pg 13] sed amœnissimis deliciis
plenum, in quo Martis tui vires hauriet inexhausta Venus.
 Octavia. Sana non es, Tullia. O si Caviceus esses, jam ego in
tuto non essem: nam sedens quid jacentem per omnia membra
adversam aversamque oculis lustras? Est nihil in me quod
pulchritudinem tuam superet: ipsa te tuere, si quid tueri velis, quod
et possis amare et debeas laudare.
Tullia. Fatua sim, non modesta, si me negem pulchritudine
aliqua præditam; nam et floret ætas, sextum supra vicesimum vix
complevi annum. Partu uno a me Callias pater est. Si quæ in tuos
sensus ex me voluptas dilabi potest, fruere, Octavia, nihil moror.
Octavia. Nec etiam ego. De me gaudii, quicquid capere poteris,
id capias, per me licet. Sed scio tibi a virgine, ut sum, nullam venire
posse voluptatem, nec etiam a te mihi, quamquam vere sis velut
leporum et venustatum omnium mirabilis hortus.
Tullia. Hortum quidem habes, in quo Caviceus suavissimis
fructibus libidinem suam libidinosam pascet.
Octavia. Hortum non habeo, quem etiam non habeas iisdem
fructibus uberem. Hortum vero quid vocas? ubi situs? qui sunt hi
fructus?
Tullia. Percipio nequitias tuas: hortum certe tuum, quæ de meo
objicis, tam nosti, quam ego meum.
Octavia. Eo forte vocas vocabulo partem eam quam dextra tua
expansa occludis, quam digitis [pg 14] vexas, quam summis
unguiculis sollicitas mihi ad pruritum?
Tullia. Ista est, cognata, cujus usum inepta nescis; sed faxo
scias.
Octavia. Si scirem extra nuptias, nec proba essem, nec amore
tuo digna, tam dissimilis tibi. Verum, quis futurus sit usus ille, edoce.
At enim repone te in lectum: nam sedendo, ut facis, et tibi et mihi
creas molestiam.
Tullia. Faciam tibi satis. Nunc arrige aures: tam sane arrexerit
Caviceus facile et frequenter, ut tu aures ad hunc sermonem arriges.
Faxit Venus! omen cape, Octavia.
Octavia. Capio omen. Cachinnos edis? Quid latet, sub his verbis,
nequitiæ, sane non video.
Tullia. At senties quid hoc sub omine deliciarum optetur horto
tuo.
Octavia. Surdæ loqueris.
Tullia. Faxit Venus audias atque intelligas! Hortus ille tuus, quem
nec verna nec hiberna tempestate flores fructusque Venerei
deficiant, velim, locus is est, cognata, quem sub inferioris ventris
tumore lanugo obnubit, tibi quidem mollior; pubem vocant. Hæc
documento est esse viro aptam et Veneri maturam virginitatem, in
ea puella in qua exorta primum efflorescit. Cymbam, navim,
concham, saltum, clitorium, portam, ostium, porcum, interfemineum,
lanuvium, virginal, vaginam, facandrum, vomerem, agrum, sulcum,
larvam, annulum Latini dixere; Græcis vero est αἰδοῖον et δέλτα et
χοῖρος et ἐσχάρα. Julia Augusti filia dicebat, ideo se Agrippæ [pg 15]
marito parere quam simillimos liberos, quod nunquam nisi plena navi
vectores tolleret. Ἐσχάρα focus et caminus est; χοῖρος porcus; δέλτα
littera apud Græcos est hoc nomine, sed ejus litteræ figura ab horti
nostri forma oppido differt. Volo te, cognata, evadere ex amplexibus
meis hac nocte doctiorem, quam si somniaveris in Parnasso, ut etiam
possis Græce concumbere: audivisti de Juvenale.
Octavia. Malim esse docta, ut tu es, cognata, quam satiari
voluptatibus. Cum te video tam juvenem et tam doctam, opto te fieri
Caviceum. Quam læto tibi animo omnes corporis dotes
prosternerem!
Tullia. Amplexare me, cara virgo, amore tuo furentem. Qua licet,
oculis et amplexibus, meas patere nequitias. Nihil inde Caviceo
deperibit, nec tibi. O vanos conatus meos, quicquid aggrediar
misera! Quam efflictim te depereo!
Octavia. Solare amorem tuum, et illam mentis impotentiam
sequere. Quæ voles, maxime volo.
Tullia. Ergo hortum tuum istum dono da mihi, ut ejus sim
domina: non utilis tamen, quæ nec clavim habeo qua fores aperiam,
nec malleum quo pulsem, nec pedem quo subintrem.
Octavia. Dono do profecto, quæ tota sum tua. Habeam aliquid
quod juris tui non sit? Obvertis te in me: quid hoc est rei?
Tullia. Nec refuge, amabo, aperi femora.
Octavia. En. Totam me jam occupas: os ore premis, pectus
pectore, uterum utero: amplectar etiam te, cum me amplecteris.
[pg 16] Tullia. Tolle altius crura, superinjice femoribus meis
femora. Artifex tibi sum ego Veneris novæ, quæ nova es. Quam
excellenter pares! Non ita egregie possim imperare, ut tu obsequeris.
Octavia. Ah! ah! Tullia mea, hera mea, domina mea, ut me
pulsas, ut te agitas! Velim extinctos cereos illos, pudet lucem testem
habere patientiæ meæ.
Tullia. Age intente quod agis. Ut ego adsilio, tu subsili; exagita
crissantes nates, ut agito, et in aera mitte, ut poteris altius. Times te
anima deficiat?
Octavia. Sane me rapidis his fatigas concussionibus; opprimis
me; vim tam efferatam ab alia paterer?
 Tullia. Tene, amplectere, Octavia, excipe... En, en fluit; furit
pectus, ah! ah! ah!
Octavia. Hortus mihi tuus hortum meum incendit; abscede.
Tullia. Agedum, Dea mea, tibi ego vir fui, mea sponsa! mea
conjux!
Octavia. O utinam mihi vir esses! quam amantem haberes
uxorem! quam amatum haberem virum! Enimvero, etiam tu hortum
meum imbre proluisti, quo me sentio perfusam: quam ignominiam
depluisti in me, Tullia?
Tullia. Nempe perfeci opus; et Venereum virus ex cæca navis
meæ sentina projecit in cymbam virgineam tuam amor cæco
impetu. At in imis præcordiis, major unquam permovit sensus tuos
voluptas?
Octavia. Nullam fere, ita me Venus amet! ex ea [pg 17] re quam
fecisti, animadverti me percepisse voluptatem. Commotior paululum
fui, cum te commotissimam sensi, et ex ardore tuo scintillæ aliquot
in eam partem, quam obruebas tuis crebris subsultibus, inciderunt.
Sed de incendio potius monuerunt, quam incenderunt. Verum, dic
mihi, Tullia, iste etiam morbus tuus aliarum fœminarum mentem
invadit, ut puellas ament et petant?
Tullia. Amant et petunt, nisi quæ sunt stolidæ et saxeæ. Nam
quid gratius puella nitida et polita, ut tu nitida et polita es? Sic Iphim
nondum puerum Ianthe urebat:

Iphis amat, qua posse frui desperat, et auget

Hoc ipsum flammas, ardetque in virgine virgo.
Vixque tenens lachrymas: «Quis me manet exitus?»
inquit,
 «Cognita quam nulli, quam prodigiosa, novæque
»Cura tenet Veneris? Si Di mihi parcere vellent,
»Perdere debuerant; si non et perdere vellent,
»Naturale malum saltem de more dedissent.
»Non patris asperitas, non se negat ipsa roganti,
»Nec tamen est potiunda tibi: nec ut omnia fiant,
»Esse potes felix, ut Dique hominesque laborent.
»Nunc quoque votorum pars nulla est vana meorum.
»Dique mihi faciles, quidquid valuere, dederunt.
»Quodque ego, vult genitor, vult ipsa, socerque
futurus;
»At non vult natura potentior omnibus istis,
»Quæ mihi sola nocet. Venit ecce optabile tempus,
»Luxque jugalis adest; et jam mea fiet Ianthe:
»Nec mihi continget; mediis sistemus in undis.
»Pronuba quid Juno, quid ad hæc, Hymenæe, venitis
»Sacra, quibus qui ducat abest, ubi nubimus
ambæ?»

[pg 18] Fatendum utique est, Octavia mea, libidinosissimæ sumus

pleræque omnes. Audis Quartillam Petronianam? «Junonem meam
iratam habeam, si unquam meminerim virginem fuisse: nam et
infans cum paribus inquinata sum, et subinde prodeuntibus annis
majoribus me pueris applicui, donec ad hanc ætatem pervenerim.»
Octavia. Hactenus, Tullia, et probe nosti, non corporis tantum,
sed et puræ mentis agito. Stolidam voces et fatuam. Sentio tamen
jam jam me libidine tangi, et Veneris cupiditate. Nuptiarum prope
adesse mihi diem, etiam ultro æstui meo gratulor Venereo; nam,
opinor equidem, si cubent nobiscum viri, solidam nos et veram
tantum in eorum amplexibus nancisci posse voluptatem.
Tullia. Recte judicas et senties postera nocte: fortunet te
Lampsacenum ferculum! Sed tumor ventris, imprægnatio, partus,
consequi solent hominum liberiores nobiscum lusus, et «turgentis
verbera caudæ.» Extra nuptias periculis et infortuniis infesta, quæ
puellas ad plenum coitum vocat et impellit Venus. Sub Hymenæo
libera et læta; e contrario omnia. Quo flammeo obnubunt novæ
nuptæ caput, obnubunt et omnia libidinis suæ facinora; hoc velo
perspicaces legum et vulgi oculos feliciter fallunt. Igitur, Octavia, alia
via virginibus, et cœlibem ducentibus vitam, eundum fuit ad
voluptatem, ad quam vides omnia animantum sæcla, ut Lucretius
loquitur, impetu ferri, quem nulla nisi ipsa vis Veneris emolliat.
Itaque virginem amari a virgine nihil mirum: quandoquidem [pg 19]
et maximi Heroum invenerunt olim suo in sexu incentiva libidinis
suæ.
Octavia. Etenim virgo non es, quæ virum experta es; plena tibi
liberum est voluptate potiri. Qui fieri potest ut me ames? ut ea via
Venerem quæras, qua Venus aberrat semper a Venere?
Tullia. Primum, Pomponia mea (nihil enim ex rebus meis volo te
lateat), cum familiariores altera alteri a crepundiis essemus, ante hos
annos, sic cœpit mecum colluctari ingeniosa, sed procax; libidinosa,
ut nulla magis, sed cauta ut etiam nulla magis. Abhorrebat a
principio ab ea re animus meus: paulatim assuevi huic, ut loquebar,
molestiæ; et exemplo præibat Pomponia, usuram corporis sui non
modo accommodans petulantiæ meæ, sed et ipsa jubens, dulcissima
mihi pellex, et sibi lena. Demum factum est longo hujus voluptatis
usu, ut ab ea me vix queam abstinere; sed ubi fulgetris tuis
innumeris cor meum perculisti, Octavia mea, amore tuo ita exarsi, ita
exardeo, ut omnia, imo Calliam meum, præ te habeam despectui, et
in amplexibus tuis mihi credam repositam voluptatem omnem. Noli
præterea me putare proterviorem. Nam hic mos ubique fere
terrarum inolevit. Italæ, Hispanæ, Gallæ fœminæ invicem amant
altera alteram; et si pudor absit, omnes confestim, altera in alteram,
ruant prurientes. Lesbiis præsertim olim id sceleris familiare, quod
Sapphus nomen commendavit, atque adeo nobilitavit. Illius lumbos
Andromeda, Athis, Anactorie, Mnais, et Girino amasiæ, quam sæpe
fatigarunt! Ejus generis heroidas Græci Tribadas [pg 20] vocant;
Latini Frictrices et Subagitatrices. Philænis vero, quod huic voluptati
indulgeret perditissime, invenisse credita est, et usu suo, quæ
scilicet magni nominis erat, inauditæ ad suam ætatem voluptatis
usum fœminis puellisque apud suos suasisse. Tribadas dixerunt quod
tererent ac tererentur; frictrices a corporum frictione; subagitatrices
a motu concitatiori. Quid plura? Octavia mea, agere et pati mulieris
est non inficetæ, ac cui cor salit sub pectore.
Octavia. Hercle! mira narras, sed jucunda æque ac ridicula. Tu
igitur jam audies et tribas et frictrix et subagitatrix: quam me vero
dices?
Tullia. Cypridem meam mollem, mellitam, auream. At enim nihil
admovi quo fieres minus integra, quo perfringerem ostiolum istud
tuum, quo delibarem virginitatem istam tuam florentem.
Octavia. Quo potuisses, scilicet?
Tullia. Milesiacæ compingebant sibi e corio veretra octo digitos
longa, et pro modo crassa. Aristophanes author est his uti solitas
fœminas sui ævi; ac hodie quoque Italis, Hispanisve maxime, sicut
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