Relaxing music v. emotional memory

One of the ways we can help cope with high-stress events is to do things that, strange as it might sound, interfere with our brain’s ability to remember the emotions. Music has that power. Psychology researchers at Monash University in Australia took a look at the ability of relaxing music to lower the impact of traumatic events and found a strong correlation between listening to the music and reduced recall of an emotional story.

The research abstract is available here,  with a link to the full article (payment required).

I find myself wondering if we would do well to play relaxing music at the start of every crisis intervention. In any case, it’s probably a good idea to have your own playlist of relaxing music ready to listen to after a critical incident.

 

Grand plans, simplistic solutions and comparison stress shopping

Whether you face long-term or acute stress, whether you work in public safety or elsewhere, you will find in these pages invitations to ways of thinking and acting – attitudes and actions – that lead to wholeness and balance.  I invite you to let go of three bad habits that our culture encourages. Reject grand plans, simplistic solutions and comparison stress shopping.

Grand plans don’t work for grief and trauma. They fail partly because they have an end goal in mind: to “get over” whatever has happened. However, we don’t get over losses and traumas that are life-changing – we figure out how to live with them. Grand plans also fail because it is impossible to plan your reactions.

Instead of planning what you are going to do in the future, healing comes from figuring out how to be in the present as much as possible.

Even if any of us had enough self-knowledge to make such a plan, the rest of the world rarely cooperates. Instead of planning what you are going to do in the future, healing comes from figuring out how to be in the present as much as possible. Just like major physical injuries and illnesses, predicting a fixed path to healing and timing is foolish (which doesn’t mean we don’t want it – of course we do).

Trust that you will know what to do when it is time to do it, if you take the time to listen to your heart. For example, at my house we have several boxes of my father-in-law’s clothing. He died more than a decade ago. When it is time to do something with them, my wife will know. Until then, my job is to patiently wait and set aside the idea that we really could use that storage space for something else.

One of Mother Teresa’s oft-quoted sayings rejects grand plans: “Do small things with great love.”

Simplistic solutions are the cheap answers that often come out as supposedly comforting clichés. After losing a loved one, have you ever been told something like, “She’s in a better place?” That’s a half-truth because the reality of your loved one’s death is missing.

Faith accompanies, rather than erases or cancels, the pain of loss. It doesn’t reduce the pain, it makes it easier to bear.

Faith indeed says she is at peace, but at the same time your senses are telling you, “She’s not here and I miss her!” Faith accompanies, rather than erases or cancels, the pain of loss. It doesn’t reduce the pain, it makes it easier to bear.

When people hear clichés and other simplistic answers they are often left feeling alone and criticized for being weak when they find – as they almost always do – that grief and trauma are never simple. Truly stressful life events are always messy and complicated.

Overly simplistic solutions are pervasive. We see suicidal high school students overloaded with pressure to get into the best colleges and leap to the conclusion that to end the self-destruction we have to figure out how to lower their stress. In the quest for the simple fix, focusing on academic pressure, we ignore what is missing from their lives – most critically, social support – when academic achievement crowds out everything else. They don’t need lower stress (the best schools are also the most challenging), they need us to restore priorities that were abandoned when academic success became the only thing that mattered.

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This kind of black-and-white thinking has also given us political parties that are defined by who and what they are against. In this atmosphere, debate rarely rises above criticism, as if by proving the “other side” is wrong, our problems are solved. Christian churches split over whether or not a particular idea is right or wrong, forget that the only true unity in our faith is the result of a work of ultimate sacrifice by God alone.

We are uncomfortable with ambiguity, so we focus on competition, right and wrong, and accomplishments – winning/being right is the only thing. Sadly, if we stick to that mindset when we experience grief and loss, the world will seem wrong and we feel like losers because we have no other dimensions in which to live. And yes, stress is indeed toxic when we view the world as a place in which our responses are limited to “fight or flight.” When we are stuck there, we have forgotten that we are also deeply wired, spiritually, psychologically, and physiologically, to connect with one another, the divine and the physical world, engaged in the often-holy work of tending and befriending. We are not created to focus only on correcting ourselves and others, we are also made for connecting – with people, the world and the spiritual or divine.

Comparison stress shopping is a name that our crisis intervention team uses to describe a way that people often minimize their own or others’ stress. “It’s so much worse for that person; it’s not so bad for me.” Caregiving professions such as public safety, medicine and teaching are full of people who are in the habit of putting others’ needs ahead of their own. Many of them are accustomed to putting their own emotions on “hold” so that they can take care of those around them.

Deferring or ignoring their own needs is especially common for leaders. For example, every time I ask a school administrator in the midst of crisis the question, “What’s hardest for you right now?” the answer is something like “Making sure my staff is okay.” Ask the teachers and the reply is, “Making sure my students are okay.” Ask a fire captain or police sergeant and the response is similar – they will be focused on taking care of those who report to them, rather than themselves.

Comparison stress shopping is more than just an obstacle to self-care. It isolates those who are struggling, which aggravates their stress. When people honestly express grief, sadness, frustration or other emotions that those around them are also feeling, the others know that they are not alone, which is crucial to living with stress. This is what it means to carry each other’s burdens, as the Bible and other spiritual writings urge us toward.

Retreat to move forward

For almost 25 years, I’ve helped put on spiritual retreats (the Walk to Emmaus) that focus on renewal – building up leaders and potential leaders, rekindling passion for their values and beliefs. I recently participated in a different kind of retreat. WCPR‘s goal is to help first responders find their way again in the aftermath of high-stress events or careers.

The starting point for attendees at these retreats are different – Emmaus retreats are for building people up from a foundation, while WCPR is focused on healing after psychological injury. WCPR is run by public safety peers and therapists, often with a chaplain present; Emmaus retreats are run by lay people and ordained clergy.

The activities are more similar than I might have expected. Not surprisingly, both kinds of retreat feature great food and fellowship.  There’s a lot of education – Emmaus is essentially a short course in Christianity, with a lot of kindness and love; WCPR is a short course on living with post-traumatic stress, also with much kindness and love. Both give the attendees a safe place to talk about the toughest parts of their lives, along with symbolic steps to let go of old hurts and habits.  In both cases, some of the weekend’s safety and support come from being among strangers who have been through similar circumstances.

Betrayal and forgiveness are common themes of injury and healing at both retreats. Betrayal is a deeply spiritual issue, I realized at WCPR.  A Darwinist view – survival of the fittest, no room for spiritual issues – says that there’s nothing wrong with betraying others if you can get away with it. Nothing personal, just competition! Or, to use a more popular reference – in Star Trek VI: The Undiscovered Country, Mr. Spock, basing his decision on Vulcan logic, had no problem betraying Captain Kirk to volunteer the crew for a peace mission to the Klingons. (Okay, no more Star Trek; back to forgiveness.)

At WCPR, I was introduced to Dr. Fred Luskin’s excellent book, Forgive for Good: A Proven Prescription for Health and Happiness. Luskin describes how we can lose ourselves in shoulds and should nots (my words) – things that should not have happened, but did, or things that should have happened, but did not. When these things are beyond our control, Luskin calls them “unenforceable rules.” They have the power to make us miserable. For example, one of my unenforceable rules was that rescuers should not make mistakes that kill the people they are supposed to be rescuing. Yet that happened right in front of me once and it haunted me for a long time. A common one, not just for responders, is “children should not suffer or die.”

One of Luskin’s guidelines is to separate what is personal from what is not. Rescuers make mistakes every day and some of them are fatal – it’s not personal when it happens on your shift. Children die every day; in that sense, it’s not personal when your child dies. When another person betrays your trust, it feels terribly personal, yet in reality such behavior is almost entirely their issue (they treat everyone that way) rather than about you. That difficult co-worker may have had a rough upbringing – “If they were raised by wolves, they’re going to bite” is a reminder not to take others’ bad behavior personally.

Luskin presents the idea of a “grievance story,,” which I found enlightening because I’ve always believed in the power of stories to transform and redefine experiences, lives and even entire communities. Narrative is powerful – but Luskin points out that we can become stuck in a negative one, which he calls a grievance story. His methods for processing a grievance story – forgiveness – are relatively simple. Sometimes telling your story doesn’t bring healing or growth.

He argues that forgiveness is something we do entirely for our own well-being, not for the sake of the person who hurt us. He separates the idea of forgiveness from any requirement to repair a relationship that has been broken by abuse or other betrayal. This is food for thought relative to the central role that forgiveness plays in Christian theology. “Forgive us as we forgive others,” is perhaps the most challenging line in Christianity’s most central prayer.

I don’t think that Luskin is talking about exactly the same thing as the Lord’s Prayer. The prayer is entirely in a plural voice, while Luskin’s approach focuses entirely on individuals. At the same time, Luskin expresses great hope that his methods will bring about greater peace in troubled communities – he has developed and tested his approach with people deeply impacted by violence in Northern Ireland.

The Lord’s Prayer is often translated as “Forgive us our sins as we forgive those who sin against us.” Luskin is a psychologist, not a theologian or pastor, so sin isn’t his topic. It is a loaded word, sometimes referring to particular actions, but its deeper meaning is to be disconnected from God, to be outside of God’s will. Forgiveness then is re-connection. Applying that thinking to Luskin’s work, I find myself wondering what kind of re-connection is happening in his process. The trivially easy answer is that Luskin is talking about re-connection to life. When we are consumed by how we were wronged by parents, lovers, business partners or others who have the power to betray our trust, we’re often stuck, unable to enjoy much of anything. Christianity at its best is an invitation to life – not the moral code it is often misrepresented to be. Luskin, though secular, clearly recognizes that we are not fully living when as long as we are carrying a grievance story.

Forgiving is a letting go, always a kind of surrender. Retreats can create a safe place in which to let go, to surrender the need to be in control of everything, to see others and be seen for who we really are, warts and all. In that safe place, people often gain great insights into themselves. The best retreats also help them figure out what actions to take in response to the new insights – how to move forward from the retreat.

 

LCES for Everybody

If you spend time around wildland firefighters, you’ll notice the abbreviation “LCES” quite often. Some people have it on their helmets. It can be a hashtag (#LCES) in social media. You might hear crews calling “LCES!” to one another as they head out to the fireline.

LCES stands for Lookouts, Communications, Escape routes and Safety Zones. Before firefighters engage the fire, they are always supposed to establish LCES – it is the starting point for fireline safety. It can also be a starting point for maintaining your emotional safety.

Lookouts

Lookouts at a fire are in a position where they always can see what the fire and the crew are doing. They should always know where everyone is – if crew members are moving out of view, they let them know. They monitor the weather and maintain communications between the crew and the rest of the world. They stick to their position until the hazards are no longer present.

Who are your emotional lookouts? Are you “visible” to your co-workers and family enough that they’ll be able to notice when you have had a rough time or you’re heading for trouble? Emotional transparency can be difficult in public safety, where there will always be some stigma about appearing “weak.” However, it’s life and death – the same macho attitude that has killed firefighters – by leading them to take on more than they can handle – can also kill you emotionally and spiritually. Do you have lookouts that are independent of your family and job – a support group, religious study or other small group that you can trust? Sometimes strangers are the easiest people to trust.

Are you being a lookout for people around you? Are you paying attention to your co-workers, family and friends, watching for signs that they are struggling or getting into trouble? Are you willing to gently confront and offer to support them when you can see possible danger signs? Look out for people who are drinking, eating, spending or working too much. Watch out for changes such as increasing isolation, depression, anger, anxiety, unfocused, not sleeping enough, having affairs.

Communications

Lookouts are useless without communications. In firefighting, lookouts have to maintain communications with their crew and the outside world. Radios are the most frequent means, but non-verbals are also important. Daily communication starts with briefings – what’s the current situation, other information that’s necessary to going through the day safely. Communications failures have led to firefighter deaths, including the 19 who died in the Yarnell Hill Fire in Arizona in 2013. Only their lookout survived.

Do you have regular and thorough communication about your current emotional situation with the key people in your life? Even if you and your family are lookouts for each other, that won’t do any good unless you communicate regularly and effectively. Effective communication, which is an essential part of any public safety career, has to be a two-way process – clear messages from senders with confirmation and clarification from receivers. The same applies to personal communications – speak and listen well. Do you raise your defenses when your lookouts give you negative feedback? Do you schedule time to talk with family, friends and other sources of support – a spiritual director, small group, counselor or therapist – as needed? Are you willing to give others direct feedback about themselves even though they might perceive it as rude? That’s the kind of communication it takes to stay alive on the fireline. You’ll find that even though it is uncomfortable in daily life, a friend who is fearlessly honest about communicating your blind spots is a friend to hang onto. Psychologists repeatedly report studies demonstrating that our resilience correlates to our social support more than any other factor.

Escape routes

Escape routes are the paths that firefighters will take to leave an area quickly and reach a safety zone. Everyone needs to know at least two escape routes; those routes have to be cleared of barriers.

When we face critical incidents, we need emotional escape routes when the work is done. Does your agency have protocols so that your critical incident “lookouts” – line supervisors – know when to automatically trigger a defusing or other intervention? Is anyone empowered to call for one if they are having a difficult reaction or they are worried about others? Do you have trusted people you can call or meet with to talk about a rough day – peer support team, family, counselor, therapist, sponsor, pastor, rabbi. Are you good at saying “No” to overtime and other extra tasks when you know you need down time?

Safety Zones

In firefighting, a safety zone is a place where you can retreat and not be injured if the fire burns through. It isn’t just a spot where you might survive using all of your safety gear; it is a place where you can be confident that you won’t even need any of that equipment.

Where are your safety zones? Sometimes, the signal that you’re in a safety zone is that it is where you discover that you’re carrying more emotional baggage than you realized. For me, that is often Sunday morning at church during a particularly powerful song. I find that my throat tightens up and it’s hard to get the words out as my mind drifts back to something that happened earlier in the week. If the feelings are strong enough, I’ll seek out our pastor or a friend after the services.

Any 12-step meeting or other support group had better be a safety zone – a place where you can speak freely and honestly – or it’s not doing its job. The same is true, naturally, of critical incident stress defusing, debriefings and individual support. Above all, these interventions need to be safe, which means confidential, supportive rather than critical and low pressure. If the facilitators of these interventions do nothing more than create a safety zone, that’s a win.

Whose Job is LCES?

Just as we are each the primary person responsible for our physical safety at work, we are responsible for our emotional safety – our own lookouts, communications, escape routes and safety zones. A great peer support team facilitates and encourages these, while supplementing them by creating and maintaining agency-wide lookouts and communications. Escape routes and safety zones – mutual aid, support meetings, clinicians and other shared resources – also need to exist at a higher level, so that there is a strong continuum of care available to all.

LCES for everybody!

How to protect sleep-deprived EMS personnel

EMS1 published an article yesterday, “How to protect sleep-deprived EMS personnel,” in which the main point is the danger of driving home while sleep deprived.

Sleep is also essential for processing traumatic incidents. REM (rapid eye movement) sleep is when our brains put them to rest. Anything that interferes – lack of sleep, alcohol, some medications, sleep apnea – makes it harder to process the day’s emotions. Poor sleep sets you up for post-traumatic stress disorder.

West Coast Post-Trauma Retreat

Next week, I will help staff the West Coast Post-Trauma Retreat. I’ve been aiming to participate for several years, but my schedule hasn’t permitted it until now. I have heard wonderful reports from people who have received care and treatment there; I also have referred first responders to the program when I could see that they were really struggling, hitting a wall of some kind.

The testimonials from attendees are phenomenal – and I’ve heard the same kinds of statements directly from some of them.

WCPR describes itself as ” for first responders whose lives have been affected by their work experience.” It is one of only two such residential treatment facilities in the world. Everyone who staffs the retreat is a volunteer – responders, clinicians and chaplains.

As a new peer supporter, I expect to mostly observe and listen – and learn a lot!

WCPR is part of the First Responder Support Network, which also offers programs for spouses and significant others of responders.

 

Psychological First Aid training online

Psychological First Aid (PFA) is a set of crisis intervention techniques that are primarily intended for the public, including skills for children and families.  This training, and quite a bit more, is available on-line from the National Child Traumatic Stress Network.

Although PFA descriptions seem to always mention that it can be used with responders, that’s certainly not the community it was developed for.  The principles apply, but the methods would have to be adapted quite a bit. It does not include any kind of group process, which can be one of the most powerful aspects of Critical Incident Stress Management, which was developed for public safety and other responders.

I’ve had some discussions lately about figuring out a combination of these approaches for CERT (Community Emergency Response Team) members – CISM for their self-care and PFA for offering support to their communities.

Going to Church Could Help You Live Longer, Study Says

CNN reports a new study that suggests that regular church attendance may also help increase lifespan. Assuming that church attendees tend to have stronger social support networks, which is generally recognized, this study is consistent with others that show a correlation between health (emotional and physical) and our “connectedness” with other people, as well as spiritual practices that connect us to creation and the divine.

What Hiking Does To The Brain Is Pretty Amazing

Michael W. Pirrone reports on Wimp.com about new studies of the effects of hiking on the brain.

Excerpt: “According to a study published last July in Proceedings of the National Academy of Sciences, a 90-minute walk through a natural environment had a huge positive impact on participants.:

Slideshare Overview

Stress, Spirit and Science summary on Slideshare:

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