Dr. Jean Cirillo: and Lt. Tom Antonetti: After the Tour: How first responders process Trauma

n this episode of Why Not Me, host Tony Mantor, broadcasting from Nashville, Tennessee, delves into the mental health challenges faced by first responders and veterans.
Featuring Dr. Jean Cillo, a clinical and forensic psychologist, and retired Lieutenant Tom Antonette from the NYPD, the discussion explores the PTP (Post Tour Processing) program, a pioneering mental health support initiative designed by law enforcement for law enforcement, now expanded to all first responders.
The episode emphasizes the importance of providing a safe space for first responders to process trauma, the critical role of peer support, and the continuous efforts to ensure mental well-being in highly stressful jobs. Both guests shed light on the nuanced experiences of police officers, EMTs, and other first responders, underscoring the necessity for accessible mental health resources and the shift in cultural attitudes towards seeking help.

First Responders and Mental Health
Introducing Dr. Jean Cillo and Lt. Tom Antonette
Understanding Trauma in First Responders
Coping Mechanisms and Dark Humor
The Role of Post-Tour Processing
Tom Antonetti's Background and Insights
Challenges and Support for Retired Officers
Final Thoughts and Resources
Closing Remarks and Call to Action

INTRO/OUTRO: T. Wild
Mantor Music BMI

The content on Why Not Me: Embracing Autism amd Mental Health Worldwide, including discussions on mental health, autism, and related topics, is provided for informational and entertainment purposes only. 

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Why Not Me is not a medical or mental health professional and does not endorse or verify the accuracy, efficacy, safety of any treatments, programs, or advice discussed.

Listeners should consult qualified healthcare professionals, such as licensed therapists, psychologists, or physicians, before making decisions about mental health or autism- related care.

Reliance on this podcast's contents is at the listener's own risk. 

Why Not Me is not liable for any outcomes, financial or otherwise, resulting from actions taken based on the information provided.

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intro/outro music bed written by T. Wild
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Transcript

SPEAKER_01 0:06

Welcome to Why Not Me, Embracing Autism and Mental Health Worldwide. Hosted by Tony Mirator. Broadcasting from the heart of Music City, USA, Nashville, Tennessee. Join us as our guests share their raw, powerful stories. Some will spark laughter, others will move you to tears. These real life journeys inspire, connect, and remind you that you're never alone. We're igniting a global movement to empower everyone to make a lasting difference by fostering deep awareness, unwavering acceptance, and profound understanding of autism and mental health. Tune in, be inspired, and join us in transforming the world one story at a time. Hi, I'm Tony Mantor. Welcome to Why Not Me, Embracing Autism and Mental Health Worldwide. First responders and veterans often witness more trauma in a single shift than most people will face in a lifetime. Over time, that weight can compound. Too many suffer in silence, afraid that asking for help could cost them their career or their identity. Today, we are joined by Dr. Gene Sorillo, a renowned clinical and forensic psychologist and retired Lieutenant Tom Antonetti to talk about PTP, Talk2Me Post Tour, a first of its kind mental health support program built by law enforcement for law enforcement and now expanded to support veterans and all first responders. This is a powerful conversation about trauma, trust, and why no one who serves should ever have to carry it alone. So before we dive into our episode, we'll be back with an uninterrupted show right after a word from our sponsors. Thanks for joining us today.

SPEAKER_00 2:05

Thank you. I appreciate your invitation.

SPEAKER_01 2:08

Oh, it's my pleasure. If you would give us a little information on what it is that you do.

SPEAKER_00 2:14

Okay, I'm a psychologist. I've been a practicing psychologist on Long Island for about 35 years. I'm also an attorney. That's been for about six years. So I love to do things like family therapy, custody issues, uh post-traumatic stress disorder, as with the postal processing for police and military, and anybody, EMTs, who has a stressful job that they don't get to process. The crisis is not over after they leave work. Sometimes it's just beginning when they go home and take it home with them. That's what we seek to prevent.

SPEAKER_01 2:55

Can you give us an insight to some of the scenarios? I mean, you just brought up some very interesting facts. I think a lot of people realize this, but they don't realize it to the extent of what you're seeing. Everyone thinks they are made out of stone, yet here they are having issues and bringing it home with them.

SPEAKER_00 3:15

Exactly. And you know, sometimes they act like they're made out of stone. They use dark humor in order to cope with a very dark situation. So it's not unusual for when they're picking up after a really nasty crime scene for them to appear insensitive to a lay person that doesn't understand that they're joking about it to keep themselves sane and in the moment and able to do it. But there has to be a regulated crashing time, which is what post-talk processing is about, to prevent them from taking it out on their wives, kids, or the bottle or drugs or any means that they think will provide short-term relief.

SPEAKER_01 3:56

That makes perfect sense. I see Tom just joined us.

SPEAKER_00 3:59

Hi, Tom.

SPEAKER_01 4:00

Hi, good afternoon. Thanks for joining us today. Oh, my pleasure. Thanks for having me. Oh, it's my pleasure. If you would give our listeners a little information on what it is that you do.

SPEAKER_02 4:11

Well, I've uh retired. I've retired from the New York City Police Department. I retired in the rank of uh lieutenant, and I spent the last 13 years of my time there in the press office as a spokesperson for the department. Prior to that, I worked various units on patrol in both Manhattan and Brooklyn. In Manhattan, I worked in Midtown, the Midtown South Precinct, and in Brooklyn, in the East New York section in the 75th precinct.

SPEAKER_01 4:37

Okay, so how did you and Dr. Cirillo connect?

SPEAKER_02 4:40

Oh, we connected through a uh mutual friend, a mutual acquaintance who put us both in contact with each other, had conversation obviously prior to today, and from there decided to go forward in speaking further on the topic and current matters, or excuse me, uh relatable matters of this topic and related topics, law enforcement, also first responder generally speaking, and the effects, both current and after effects.

SPEAKER_01 5:10

That's a huge subject when you start talking about the mental well-being of the first responders. Now, this next question is for either one of you. When they go through those traumatic situations, then afterwards they have to process everything they've been through. Everyone thinks it's just the victim or the victim's family that has to go through this trauma. They don't realize the first responders have to process as well, and then depending upon the level of the trauma that was involved, will have everything to do in the way that the first responders process this. So how do you help them get through all this?

SPEAKER_00 5:45

I know with the EMT people, what they see is the the first, they're often the first people to arrive, say, at a horrible car accident where somebody's been decapitated. And they have to get in there. They have to, first of all, do triage as to who can be saved and who can't. And I know there was somebody where there was a shooting in his house on Thanksgiving. Seven out of eight people died. He was the survivor. And the police, when they it happened to be the police then, and then the EMT came, but the police would be in there. They'd say fatal, fatal. Okay, this guy can be helped. And you right away decide who can be helped, how you're gonna help him in a split second. So yeah, they have to process that too. They can be very calm, collected, and cool because they know their job. So they rise to the level of their training. But then later on, after it's over, they can fall to the level of their emotions, and that's when they need the post toll processing.

SPEAKER_01 6:43

How do you help them get through that? I mean, that's very traumatic. It's one thing if it happens once in a while, but they're dealing with this pretty much on a daily basis. So, how do you help them get through it? And how do you help them process it?

SPEAKER_00 6:57

It's available anonymously. They can come on the website, they can sign on with an email, they can sign on anonymously, they can text, they can show their face, they can speak without showing their face, they can give their name or not give their name. It's totally up to them. The anonymity is guaranteed, and that's so important, especially for police, because if they're seen as too traumatized, let's say they had to use their gun to take somebody down because that person was threatening an innocent civilian, then they still have to process guilt, depression, fear, everything else. And they need to process it with their peers who understand what you go through after you just did something that you wouldn't normally do in the regular world, but that you have to do as an authority figure. And they can process it either way. And sometimes they don't want to admit to drinking, fighting with their wife or anything, or husband or anything like that, because they don't want to lose their gun. And the police will sometimes take away an officer's gun. Since a gun is a major tool or one of the major tools, if he or she doesn't have their gun, they can't work. They have to be behind a desk and they don't want to do that.

SPEAKER_01 8:14

Right. Now, Tom, how do you fit into this whole scenario? You're retired now, so how are you incorporating yourself into helping these people that need the help?

SPEAKER_02 8:26

Well, I can tell you twofold. First off, I still maintain a strong network and connection with those that I've worked with, both those that I've served, both that have served under me since I was in the supervisory capacity, but also in a more splintering effect. I'm with the fraternal order of police, and in my local area, I serve on the board and in the capacity of secretary. Now, with that, it's not just clinically effective as the secretary for the fraternal order police. There's a great interaction, and in that interaction, there's an exchange, an exchange of ideas, an exchange of how you're doing, how the family is. It's more personal. It's it's very uh interpersonal. When we have our meetings, when we have our events, you know, the fraternal order police obviously looks to help those within that community, first responders, all lines, all lines. So I've maintained that communication, that direct contact with active, retired members of law enforcement, just seeing how they're doing and not on obviously to the depth or to the extent that the doctor's speaking on and dealing with, but on this personal, almost colloquial level where there's that comfort of, I know, I understand, we're part of the same quote unquote fraternity. So in speaking with you, you understand what I'm expressing to you. You understand the good, the bad, everything in between. So the opening up, the hearing, and now as we get older, as the years go by, and their offspring become members or become first respondents, excuse me, or family members, friends, you hear their story. So now it becomes almost generational, and you're getting a deeper dive into how they're dealing with it on a new level because things are different today than they were when I had first started, or from even 10, 12, 15 years ago. So still staying connected, obviously to both active and retired in those two different capacities.

SPEAKER_01 10:25

Now, have you seen, and I'm really sure that you probably have, situations where people fall through the cracks, then they retire? How do you find ways to help them? They're still part of the fraternal order. Yet, even though that's true, they still feel very alone and by themselves. How do you get past that firewall that they will put up? So their mental health stays strong and they don't go down that deep dark hole that no one wants to see them in.

SPEAKER_02 10:56

And it's true, you make a good, unfortunate point because there are some. And sometimes, and I don't mean to say anything or to speak anyway with just a broad brush, it's individual specific. So you're going to have individual remedies, you're going to have individual conditions, but if I can speak just by and large with this, sometimes some people will think, well, you know what? That's just Joe being Joe. And he'll get through it, he'll get by. Or I'll tap him on the shoulder and say, hey, is everything okay? Not really invested in what that answer would be, but I felt I've done my part. Again, rhetorically speaking. So what is done or what can be done, what I've seen done is just the follow-up, just not letting those that you know slip through the crack. Unfortunately, there will be a number that that is the case that they do slip through that crack. You try to minimize that. I know that if I, and I had seen, and I obviously wouldn't name names or conditions or circumstances, but I've seen those that were struggling, active members, and even retired. They haven't adjusted to the trauma that they encountered in whatever capacity it came, be it something they encountered while on the job, while working, something they encountered in their personal life, but they're not right. They're not right. Now I don't have that degree that I can speak to them with that level of professionalism that's going to set them on the right way, but I can still speak to them in that conversational aspect or in that conversational tone to get them to where they need to be, to get them to the programs that exist or to the people to speak to further the conversation. It's not going to start or end with me, but it can with these other entities, these other individuals, these other programs that can best serve them. So to get them there and to say, hey, did you follow up? Did you call that number I gave you? Did you email the person, the company, the entities that I provided to you to see if they are in fact doing so? And then always just to follow up with them at irregular intervals to see, hey, how are you doing? I care for your well-being.

SPEAKER_01 13:01

Yeah, that's a great thing you're doing for sure. When some of these people get to a point where they ultimately need more help than what any of the first responders precincts can do. What are some of the steps that you do as a psychologist to help them smooth things out and tamper everything down so they can tolerate and live with all the emotions that they've been through?

SPEAKER_00 13:24

Sure, we have referral sources. Most of them have kept their health insurance for New York City or Long Island or upstate or whatever they have. So we can refer them to people that are psychologists, social workers, and sometimes psychiatrists if medication seems to be needed, that take their insurance, that have worked with many people in their field, and they're used to hearing about a lot of these problems, and especially a retired person will talk more. They're glad to because they don't have to worry that somebody's gonna know they have a mental health record, even if it's confidential between the therapist, the insurance company. It doesn't go to the employer like it used to 20 years ago before HIPAA rules. But the idea is that it'll be confidential. They don't have to worry about losing their gun. They do take a gun with them if they want to do security work or for their own protection. But normally that doesn't become an issue is when they're on active duty policing. So, yes, we have plenty of referrals to healthcare professionals, and they always have that option. Even without coming to us, they can go directly. But sometimes when we start to realize, hey, this guy needs a little bit more, and maybe their situation or the precinct was a lot more traumatic. Every day you have to remember a police officer sees more trauma and horror in one day on the job than most people see in a lifetime. So, yes, we can refer them on to mental health resources and let them know that many of their colleagues use these resources also, and the therapist is somebody that is used to dealing with veterans, with police, with EMTs, and people who deal with very high stress jobs.

SPEAKER_01 15:12

Yeah, I can't disagree with you there. They're very high stress jobs and they do see a lot, a lot more than the average person sees. Now, most people they go to work, punch in, they get out of work, they punch out. But with your job, it can be a 24-hour day job sometimes. You might be off the clock, but then you see something happens, you can't just walk away from it, and you jump in and try and help out. Then it creates another trauma, yet they go back to work like it never happened. How do you help them? Because there are some that are very good at masking their feelings and their emotions and what they're going through. Most people would never know that they were going through it because they hide it so well. How do you sift through that, or can you sift through that not knowing, so they don't go down that deep dark hole that no one wants to see them go into?

SPEAKER_00 16:08

Well, when they come on the website, there's some knowledge that this isn't normal, that they've been feeling bad lately. Certainly, other police officers, other EMTs know about the program, they can encourage it. But a lot of them are taught on the job, they have to mask their feelings. You know, I remember once a cop saying to me, he said, Oh, that lady was frantic. The cop was calm. And the abuser in this case was calm. He was an ex-com. Okay, he got kicked out because he was doing things that were not acceptable and he wasn't going for help. But anyway, you're taught to keep calm, not to show how afraid or how angry or how depressed you are. So it's hard to put the mask down, and that's one of the aspects of the program. You're taught this is a place where you can let your hair down, let you take your mask off. You know how you shower after going through a dirty neighborhood or rummaging through garbage bins to find a piece of evidence? You shower. You're not ashamed to do that. That's what the post toll processing is.

SPEAKER_01 17:14

Yes, that makes perfect sense. They're taught to mask it. They're taught to stay calm. Let's say they do it so well, so well that most people around them do not know that they are going through some very serious issues. Every time they go out, every time they see something bad, they're holding it in, and each piece of that puzzle is forming a picture, and that picture is one that's going in a very bad place. So, how do you address this so it does not get out of control?

SPEAKER_00 17:48

Well, I would say it's situation specific. What you're really teaching them is the ability to discriminate among different situations. When the ambulance pulls up and someone's badly hurt, you don't have time to process feelings. When you go home and you have some time to go on the computer, to go to post-processing, or to even make a therapy appointment, that's the proper time. The therapist's office, post-tour processing, which again can be anonymous. So if there's something you wouldn't want to tell a therapist, you can say it here. And if you're anonymous, you know it's not going to be traced. Because you can develop a certain paranoia after being in, especially the police field. You feel like everybody's looking out to catch you at something because you're always catching people. But there's a proper time and place. On the job, no. Out of the job when you're home and when you're safe in a safe environment, the therapist and postal processing are safe environments.

SPEAKER_01 18:52

Now, Tom, I understand that there's kind of a continuing education for first responders. Is there one for continuing education on how to avoid any circumstances that could put them in a bad place with their mental health?

SPEAKER_02 19:09

Well, insofar as certain degrees or programs that I had taken.

SPEAKER_01 19:14

I'm thinking more of internal programs to where they learn to process it and work with it so that they don't have any issues moving forward.

SPEAKER_02 19:24

Yes, that's twofold. Now, there are members of the service who are designated, who work in those designated units, who are there 24 hours a day to answer that call, and they are specially trained for that. To take that call, then for the furtherance. It could be just as Dr. Gene had mentioned, to then bring it to that program, to that level, but at least to be the first responder for the first responders. So there are specially designated members of the service who are set aside in those units to be there for help, and that's 24 hours a day, seven days a week. Now, for a supervisor for a coworker, just to bring it down to the most basic, immediate level, for a supervisor for a coworker, your on the job training is, and you're told this, you're told this directly, implicitly. Hey, are you okay? Colloquially speaking, directly speaking, are you okay? That manifests itself in a number of ways through humor, through direct conversation, through taking someone on the side. As a supervisor, yes, it was my responsibility to identify, to see those signs, verbal and nonverbal cues of is there something manifesting here? Is there a problem, potential, or an actuality? Maybe something at home, maybe something from a heavy job that we left, something that is still bugging this individual, this officer. So you try to identify that and you try to talk with them, get them to open up. And a lot of times, as you both mentioned, they're not willing to do that. There's a belief, and I've seen this, I've seen this thankfully erode over the years. Where, again, when I had first joined the department, the belief was you don't have to talk to anyone. Again, overriding. I'm speaking in generalities here. You don't have to talk to anyone. We're here, we'll handle things when we close ranks, we'll handle things in and of ourselves. That has dissipated, that belief has eroded. And I have seen that in my over two decades with the department, and now having left it and still being connected in the ways in which I am, seeing that there is no blemish on your record or how you're viewed in seeking the help that you need. So there's the direct, those that are trained to answer and respond, and those who are we're all part of the same organization, you just know don't turn a blind eye. Don't say he or she will be okay. Ask the question you do have a responsibility. You do have a responsibility. And you have to act on that.

SPEAKER_01 22:01

I think that's great that you have that set up. Now, you're talking New York City, one of the largest cities in the world. You have a very large police force. It's not like some of the smaller towns or smaller cities where everyone knows everyone. How do you maintain that level and that stability so that no one falls through the cracks?

SPEAKER_00 22:22

Each precinct is like a little society, a subsociety in itself. And they do know the people within the precinct. They look out for their brothers and their partners and their friends. So even though it's a large city and there's a lot more crime and a lot more violent crime as in any large city, it's a small precinct or relatively small. All right, Hugo, you were gonna say something.

SPEAKER_02 22:46

Just to compound that answer, yes, that's true. And I I was gonna speak exactly to that. You don't look in the totality of the numbers, the amount, the amount of um members of the service and how are they served. You're right. Within each command, each precinct, each unit, there is the oversight, there is the watching over of the personnel to identify. So it's in its own respective silo that they see where an issue, a problem, a question may arise, may occur, and deal with that. Then when it has to go up the proverbial chain of command, it does. So at least they're able to be served, at least they're able to have that sort of guidance or penning in of those individuals that would need the services, whatever they may be, within their own respective precinct unit designated command.

SPEAKER_01 23:38

Yeah, that's great. And the reason why I ask that is because a lot of people look at New York City and they just think a large police force and they don't think about smaller precincts scattered around the city. This way they can support each other, and I think that's a very important thing for people to know. Yes, agreed. Now, in closing, and I'll start with you, Dr. Sorello. What do you think is important for the listeners to hear? Not only on what you're doing, but how it applies to everything you're trying to do to help the first responders.

SPEAKER_00 24:12

Okay, first of all, first and foremost, you don't interfere with them while they're doing their job. I mean, you you shouldn't have to say that, but many people, when it's their loved one that was just hurt, or when it's a family member that did something bad, and that's why they called the police. You used to see that a lot more now that there's education about spouse abuse, but you would see that in couples where the woman usually would call the police. He was threatening to bash my head in, he broke this in the house, he hit me. She had a black eye, a bloody nose, but she doesn't want to press charges. And now there are laws to support the police officer. If they suspect a felony's been committed, they have to arrest the person, even if they the other person doesn't want them arrested. So you tell them, stay back, let the police do their job, but you also have to convince the police not to use excessive violence when it is not necessary. And that's what the post-talk processing is about. We don't want them to take all their trauma into one incident, usually a domestic incident where it's not needed.

SPEAKER_01 25:17

Yeah, that's great information. Now, Tom, what would you like to say to the listeners so they understand how you are trying to self-police so that no one gets hurt and everyone keeps moving forward in a mental state that is healthy?

SPEAKER_02 25:33

I think the overarch with that is this police officers, first responders, the whole gamut of first responders, all of them, all lines, they are people. They are humans just like everyone else. The cashier at the supermarket, sanitation worker, anyone, I mean, anyone in any walk of life, they're seen as first responders. They're seen as the heroes that you God willing, they're seen as that, that who respond to emergency situations that others would run away from. They run towards the danger. But they're seen, I think, in conversations that I've had over the years, and doctors, I'm sure you can endorse this statement as well. They're seen clinically, they're just seen as they are above the general feel that you are just like me. These are family members, these are husbands, wives, sons, daughters. They are people that they deal with the same issues health-wise, monetarily speaking, that everyone else does. And oftentimes it's not so easy to see them as that. But in being the same as others in every walk of life, that also means that for mental anguish or stress, things that they deal with, it doesn't just come off them without any lasting effects. That's not true. If anything, because of their line of work, these effects are deeper and longer lasting. And the way to remedy these effects, this massive stress that many of them deal with, they need this, as doctor had mentioned, they need these outlets, these programs available to them for them to take advantage of, because this is where they are not like the others, the cashier and the other individuals who I mentioned, because they are working on that level of dealing with tremendous emergency stress, pressure-packed situations. And when you're dealing with that, and that's what you know in your shift, shift in and shift out, then you need a way to have that remedied when it gets to the point that you can't take care of it yourself.

SPEAKER_01 27:40

Yeah, I think that's well stated and well said. Now, can you tell people how they can find you and a little more information about your organization?

SPEAKER_00 27:48

Well, if you go under police officer post tour processing, it's PTP for short. PTP, and then put in post-tour processing our entire website, and the names of some of the key staff members will come up.

SPEAKER_01 28:06

Okay, perfect. Well, this has been great. Great conversation, great information. I really appreciate you taking the time to join us today.

SPEAKER_00 28:14

Same here. Thanks for the invitation.

SPEAKER_01 28:16

All right, thanks so much. Thank you. Oh, it's been my pleasure. Thanks again. Thanks for taking time out of your busy schedule to listen to our show today. We hope you enjoyed it as much as we enjoyed bringing it to you. If you know someone who has a story to share, tell them to contact us at why notme.world. One last thing, spread the word about why not me. Our conversations, our inspiring guest, the show. You are not alone in this world.