Stress Management for Emergency Responders: the journey begins

Zippy at the Soup Box Derby

When Zippy died on Christmas Day in 2011, Rob put his head on the chief’s car and wept, right there on the scene. He’d been a volunteer firefighter for 15 years and witnessed a great deal of physical and emotional pain. But Zippy’s death broke him. He knew her. Knew her family. Put a bandage on her knee after a Soupbox Derby accident one year. This was personal.

Rob wasn’t the only one who was shaken by the accident. In a small community like ours, chances are high that a call you respond to will be someone you know, and calls involving the deaths of young people are always especially difficult. So after the accident that killed Zippy, the fire district called for a Critical Incident Stress Debriefing. It was the first CISD Rob had been to, and he hoped it would make him feel better. It didn’t. “Every time I opened my mouth, I started to cry,” says Rob. “No one acknowledged my tears. No one touched me. Few of the 15 or so participants spoke, and they they all sat in a circle with their arms and legs crossed.”

The CISD didn’t make Rob feel better, and it turns out that’s not unusual. In an article titled
The Forgetting Pill Erases Painful Memories Forever, which was published in Wired magazine, Jonah Lehrer writes:

A typical CISD session lasts about three hours and involves a trained facilitator who encourages people involved to describe the event from their perspective in as much detail as possible. Facilitators are trained to probe deeply and directly, asking questions such as, what was the worst part of the incident for you personally? The underlying assumption is that a way to ease a traumatic memory is to express it.

The problem is, CISD rarely helps—and recent studies show it often makes things worse. In one, burn victims were randomly assigned to receive either CISD or no treatment at all. A year later, those who went through a debriefing were more anxious and depressed and nearly three times as likely to suffer from PTSD. Another trial showed CISD was ineffective at preventing post-traumatic stress in victims of violent crime, and a US Army study of 952 Kosovo peacekeepers found that debriefing did not hasten recovery and led to more alcohol abuse. Psychologists have begun to recommend that the practice be discontinued for disaster survivors.

If the CISD Rob attended had helped him, Whidbey CareNet might never have been founded. Fortunately, the fact that it didn’t led 30+ healthcare providers to offer emergency responders like him free services through Whidbey CareNet. And it has inspired me to seek and provide an alternative to CISD.

CISD is a cognitive, left-brained approach that relies on participants to recall a traumatic event and put their experience into words. Unfortunately, our left brain is largely offline when we experience trauma. It’s our right brain that experiences and records traumatic events while our entire body experiences a surge of “survival energy” that prepares us to to defend ourselves or flee from danger. If that energy isn’t physically released, it causes a sort of short circuit in the brain that can lead to conditions such as PTSD.

In his foreword to Peter Levine’s book, In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness, Gabor Maté writes, “Trauma, as Peter brilliantly recognized decades ago, does not reside in the external event that induces physical or emotional pain–nor even in the pain itself–but in our becoming stuck in our primitive response to painful events. Trauma is caused when we are unable to release blocked energies, to fully move through the physical/emotional reactions to hurtful experience.”

I am so glad to be learning somatic (of or relating to the body) approaches to healing trauma.    I’m excited to share what I learn with you via this blog, and ultimately, with emergency responders via workshops.

Stay tuned . . .

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2 Replies to “Stress Management for Emergency Responders: the journey begins”

  1. Petra, I would be happy to partner with you, as a clinical nurse specialist, I teach stress management. It is really my only contribution to Carenet because I’m not a therapist. I help folks develop their own stress management plans. I would love to work with you to do this as I use a somatic meditative approach.but is about the person getting control over their stress rather than a modality as others do.

    1. Thank you, Eileen! We’re learning so much–but mostly we are learning how much we don’t know! For the short-term, please let me know if I get anything wrong scientifically in these posts. And also please let me know of sources that were especially useful to you in understanding somatic approaches to healing trauma.

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