Tag: social support

The danger of “nobody else can understand”

If you are in public safety or the military, as well as some other fields, you know that some people insist that there it is pointless to talk about work to any “outsider.” Often, big agencies have this attitude toward smaller, less busy, ones –  “We are the only REAL firefighters, police, medics, etc., around here.” So they close themselves off from  support by people who otherwise might be peers.

The walls even go up within agencies – specialized, elite teams form a “tribe” mentality that says if you haven’t been part of a similar unit, there’s no point in talking to you about stresses and challenges, even if do the same kind of job.

No doubt, there is some truth to this. Working at a big, busy, urban agency certainly is different from smaller ones. Combat experience absolutely has unique aspects. Being part of an elite or specialized team really is different. People who haven’t walked the walk truly cannot understand. Experience is the only instructor – words quickly fail if we were to try to fully communicate it, especially the emotions around high-stress events (which can directly impact the brain’s speech center).

For a number of years, I have suspected that organizational isolation – that’s this is about – could be as toxic as individual isolation. We know that social support is the most important factor in resilience under stress or recovery from trauma; isolation aggravates stress. In fact, almost any trauma expert will agree that people will continue to suffer as long as they remain isolated –  connections with others give us strength and healing.

I recently began reading Ellen Kirschman’s book, I Love a Fire Fighter: What the Family Needs to Know, which has been sitting on my nightstand for a while. Dr. Kirschman, a well-regarded therapist in public safety, is also regularly involved in the West Coast Post-Trauma Retreat, where I have volunteered and learned.

Here’s the light bulb that went off as I read Kirshman’s introduction – the “nobody else can understand” attitude cuts us off from our friends and family. If you are certain that even a co-worker who isn’t part of your elite unit can’t support you because “they don’t understand,” then how can your friends and family who are civilians, possibly support you?

Here’s one of Kirschman’s observations about going through a fire academy (emphasis mine).

No one acknowledged how the emotional courage fire fighter families need or the independence that is forced on them contributes to the fire service mission. This is extremely puzzling in light of the many studies that confirm how family and friends are the heart of a fire fighter’s emotional support system.

Her books (she wrote a similar one for law enforcement) are for families, but the message to public safety is just as important. Your social support outside of work is also critical to your strength and resilience in the face of occupational stresses, and recovery from critical incidents and other injuries that aren’t physical.

The following words are why it does not matter that outsiders can’t understand the job.

Empathy does not require understanding.

It’s true – if you are an outsider, you will not understand. If you’ve never been there, I can’t explain what it was like to talk to a patient one minute and then do CPR on him, unsuccessfully, the next. You won’t understand how difficult it was to walk past his wife in the ER waiting room, seeing her comforting another wife, not knowing her own husband was just pronounced dead. If you’ve never done anything like helping a family bury their dogs who couldn’t escape a wildfire, nothing I can say will make you understand. If you haven’t been part of a rescue that went all wrong and killed the victim, I don’t have words for the emotions. If you haven’t done shift work, you don’t know the toll it can take.

Even if you cannot understand, that doesn’t have to stop you from supporting a responder if you are a trusted friend – because empathy does not require understanding. They may spare you details. They probably won’t repeat the sick jokes that helps many get through the day. But if you are willing to simply walk beside them, your presence can be healing.

You don’t need to understand responder experiences to know that they are painful. You don’t have to work shifts to that it is hard to be exhausted and miss family events. Everyone has experienced pain and frustration, he stress of an event or life going out of control. Co-workers can appreciate it more than outsiders, so co-workers are an essential part of any responder’s network of social support. So are spouses, friends with completely different careers, pastors and may others.

Camaraderie is powerful. Every agency – and groups within them – benefits from friendships, mutual support and teamwork. However, the idea that only our co-workers or people like them can support us is a misguided obstacle to wellness. We should not want anyone, from new recruits to  seasoned veterans, to believe that their friends and family have little to contribute. As Ellen Kirschman says, that idea cuts t them off from the heart of their social support system.

Paramedics with social support sleep better

An article in the Journal of Occupational Health Psychology earlier this year described a one-week study of paramedics’ sleep and their social support. Those who saw themselves as having more social support reported better sleep. The researchers also observed that the sleep quality of paramedics who perceive more support isn’t as impacted by job stress.  On the other hand, they reported “Those with low levels of support displayed poor sleep quality in the face of high occupational stress.”

In recent years, it has become quite clear that good, deep sleep is vital for coping with stress – poor sleep is associated with increased risk of developing PTSD.  The correlation between social support and coping with stress has also been observed repeatedly in studies. It’s unsurprising to find a link between social support and sleep quality – this reinforces the importance of both.

Building Gratefulness

A few years ago, my spiritual director challenged me to list three things I was grateful for, daily, for 30 days. There were a couple of other parts to this exercise, but it was aimed at helping build an “attitude of gratitude.” I’m happy to report that it stuck with me. One of the instructions that helped overcome my perfectionist and self-criticism tendencies was the instruction to not worry about missing a day – just pick it up again. The 30 days didn’t have to be consecutive. gratitude

Psychologists have only recently begun to look into the benefits of cultivating gratitude, but early findings are encouraging, confirming traditional teachings. In two long-term studies of college students and gratitude, researchers in England found that the more often and intensely people feel grateful, the more social support and lowered stress and depression they believe they have. This makes sense because anything that builds social support will almost surely help us cope with stress and do better overall.

Rejoice always, pray continuously, give thanks in all circumstances – 1 Thessalonians 5:16-18.

When we are more grateful, we tend to see the world in a more positive light, which protects against stress and depression. We also make our own world better by thanking helpful people – expressing gratitude – because they become more likely to offer us more support.

Does making gratefulness lists work? Yes, says a recent study titled, “Counting Blessings Versus Burdens.” Across three groups who either kept lists of hassles, things they were grateful for or ways in which they were better off than others, the people who tracked gratitude ended up with a more positive outlook. The gratitude list-makers were also more likely to offer emotional support to others – another example of gratitude encouraging social support. They also spent more time exercising, slept better, had fewer physical complaints and were more optimistic. Daily gratitude tracking was more powerful than weekly.

I will not be afraid, Lord, for you are with me – Psalm 23:4

Another study, on religious involvement and gratitude, showed that attending church more often leads to more gratefulness. The increase was greater for people who believed that God works with them to overcome difficulties and challenges.  This makes perfect sense through the lens of stress as a threat or challenge. When we feel ill-equipped to deal with a situation, our bodies have a “threat” stress response, raising the levels of hormones and neural pathways that cause long-term health problems. On the other hand, if we see the same situation as a challenge – because, in this study, we believe God is with us – our bodies react differently, in a way that doesn’t jeopardize long-term health.

Some other studies on the effects of greater gratitude:

  • Daily well-being increased with daily gratitude practices for Vietnam veterans with PTSD.
  • Gratefulness helps people stick with self-directed interventions to improve their body image.
  • Gratitude in children was related to positive functioning after the 9/11 attacks.
  • People who are more grateful tend to recall more positive life events, which helps make them more positive.
  • Writing about how a good thing, such as finding a romantic partner, might never have happened, increased their positive outlook – to the surprise of the writers.
  • Writing a letter of gratitude, about a time you were at your person best, identifying character strengths all contributed to happiness and positivity, while reducing depression.

Bibliography

Algoe, S. B., & Way, B. M. (2014). Evidence for a role of the oxytocin system, indexed by genetic variation in CD38, in the social bonding effects of expressed gratitude. Social Cognitive and Affective Neuroscience, 9(12), 1855–1861. http://doi.org/10.1093/scan/nst182
Emmons, R. A., & McCullough, M. E. (2003). Counting blessings versus burdens: An experimental investigation of gratitude and subjective well-being in daily life. Journal of Personality and Social Psychology, 84(2), 377–389. http://doi.org/10.1037/0022-3514.84.2.377
Fredrickson, B. L., Tugade, M. M., Waugh, C. E., & Larkin, G. R. (2003). What Good Are Positive Emotions in Crises? A Prospective Study of Resilience and Emotions Following the Terrorist Attacks on the United States on September 11th, 2001. Journal of Personality and Social Psychology, 84(2), 365–376.
Geraghty, A. W. A., Wood, A. M., & Hyland, M. E. (2010). Attrition from self-directed interventions: Investigating the relationship between psychological predictors, intervention content and dropout from a body dissatisfaction intervention. Social Science & Medicine, 71(1), 30–37. http://doi.org/10.1016/j.socscimed.2010.03.007
Gordon, A. K., Musher-Eizenman, D. R., Holub, S. C., & Dalrymple, J. (2004). What are children thankful for? An archival analysis of gratitude before and after the attacks of September 11. Journal of Applied Developmental Psychology, 25(5), 541–553. http://doi.org/10.1016/j.appdev.2004.08.004
Kashdan, T. B., Uswatte, G., & Julian, T. (2006). Gratitude and hedonic and eudaimonic well-being in Vietnam war veterans. Behaviour Research and Therapy, 44(2), 177–199. http://doi.org/10.1016/j.brat.2005.01.005
Koo, M., Algoe, S. B., Wilson, T. D., & Gilbert, D. T. (2008). It’s a Wonderful Life: Mentally Subtracting Positive Events Improves People’s Affective States, Contrary to Their Affective Forecasts. Journal of Personality and Social Psychology, 95(5), 1217–1224. http://doi.org/10.1037/a0013316
Krause, N. (2009). Religious Involvement, Gratitude, and Change in Depressive Symptoms Over Time. The International Journal for the Psychology of Religion, 19(3), 155–172. http://doi.org/10.1080/10508610902880204
Park, N., & Peterson, C. (n.d.). Positive Psychology Progress: Empirical Validation of Interventions Martin EP Seligman & Tracy A. Steen University of Pennsylvania. Retrieved from http://guardianlv.com/wp-content/uploads/2013/09/happiness01.pdf
Watkins, P. C., Grimm, D. L., & Kolts, R. (2004). Counting your blessings: Positive memories among grateful persons. Current Psychology, 23(1), 52–67.
Wood, A. M., Froh, J. J., & Geraghty, A. W. A. (2010). Gratitude and well-being: A review and theoretical integration. Clinical Psychology Review, 30(7), 890–905. http://doi.org/10.1016/j.cpr.2010.03.005
Wood, A. M., Maltby, J., Gillett, R., Linley, P. A., & Joseph, S. (2008). The role of gratitude in the development of social support, stress, and depression: Two longitudinal studies. Journal of Research in Personality, 42(4), 854–871. http://doi.org/10.1016/j.jrp.2007.11.003