Breathe, two, three, four…
“Wounded healers. You all are wounded healers,” he said.
About a year ago is when I realized I was dealing with anxiety that was triggered by our profession. Like most of us first responders, seeking help is met with strong resistance, from our self. I was wrapped up, rather consumed with the thought of stigmatization from my colleagues. Reluctantly, I dragged myself to therapy. One year later, I am glad I did.
The gentle recommendations in this post are things I have personally had or have experience in. I am not in the habit of giving “advice” and never having tried it myself. Furthermore, I am not sponsored by any of the products or services mentioned below. Please share with your colleagues if you think they will find this information useful. If you are new or thinking of joining the Fire/EMS/Healthcare field, be sure to sign up for one of our classes to get your questions answered by our working professionals!
Therapy
As first responders, we are programmed to be the saviors, the rescuers, and the pillar of strength for the communities we serve. We walk in to people’s homes and are immediately engrossed in their world. For that moment, our problems don’t matter. Another call drops. For that moment, our problems don’t matter. Another call drops. And for that moment, our problems don’t matter. After a while, this behavior develops where we begin to suppress our
thoughts, emotions, and true needs. Some of us turn to that liquid numb when we are unable to deal with our pleading mind. Others suffer silently. A study found that there is, “an inherent resistance by firefighters to admit the presence of virtually any psychological or emotional problem as well as a persistent, often dysfunctional, need to maintain a ‘macho image.’” [1]
This goes for not only firefighters. Paramedics and EMT’s are just as guilty.
After a traumatic call, most agencies will conduct a Critical Incident Stress Debriefing (CISD).
The debriefings are part of an overarching body, the Critical Incident Stress
Management program (CISM). CISM has four primary components.[2]
1. Reduce impact of a
traumatic event
2. Accelerate recovery process
from the traumatic event
3. Normalize the stress response
4. Provide education in stress
management and coping techniques
For our agency, CISM is notified as soon as a critical incident occurs, if a supervisor alerts them of a potentially triggering call, or if an employee requests them. My first contact with CISM was when they met my partner and I at the hospital after we dropped off a distressing call
involving a pediatric patient. I did not know they were dispatched but I was
grateful for their presence. That form of therapy came directly after a traumatic call and to my surprise, my partner and I were able to return to the streets in great spirits. CISM is an excellent resource and should be utilized even after you feel you should have “gotten over” the call.
While CISM is a great short-term resource, a lot of first responders are in need of therapy outside of work. I am here to say there is no shame in seeking a therapist. As a community, we need to dispel the stigma associated with mental health. A cardiac problem is met with a consultation by a cardiologist. The same goes for kidney, lung, bone problems etc. Respective
practioners are sought out for these various body ailments. In fact, it is considered responsible to seek medical attention for those ailments. However, when it comes to the struggling mind, we’ve come to adapt a vastly different and quite frankly, a perverted ideology in seeking psychological attention. We are in need of a paradigm shift. The old model does not serve us and our dynamic field anymore. It is okay to feel. It is okay to hurt. It is okay to be
scared. Seeking therapy does not make you less of a Firefighter, Paramedic, or EMT. It makes you human.
Meditation
“World’s Happiest App.” [3]
Ever since I developed a meditation habit, I found myself craving that moment of solitude with my breath. While in practice, you will find that your mind hits the accelerator button and begins ruminating over whether you tipped the barista today, if you put on deodorant, why your significant other said that thing 2 years and 5 days ago, and what to eat for
dinner tonight. Meditation lovingly trains your mind to quiet down so you can
focus solely on the very essence of life, the breath. Dr. Andrew Weil, an integrative
practioner, says, “Practicing a regular, mindful breathing exercise can be
calming and energizing and can even help with stress-related health problems
ranging from panic attacks to digestive disorders.” [4] The title of this post makes reference to a popular breathing exercise that Dr. Weil recommends. It is called the “Relaxing Breath” and I encourage you all to try it either during meditation or when you need to reset. Over time, you will hone in on the skills to transport yourself to your island of peace for a
little while. It is a workout for your brain. Everything can wait. Bring it back to the breath, my friend.
If you are new to meditation, try Calm. It is an application anyone can download on their phone and it provides everything from guided meditation, sleep stories, relaxing music, masterclasses, and stretching exercises.[5] I personally love this app. When you purchase the year plan, you unlock daily Calm sessions and other awesome perks. However, you do not need to purchase anything to try it. There is a free trial! The best part about having this app
is that it is versatile. It can easily be used on shift after a stressful call to re-ground yourself. Conversely, it can also be used after a long day with the kids, before boarding a flight, or just literally any time you feel you need to make time for yourself.
Holism
You should always consult with your care provider before
any supplementation due to the possibility of allergies, adverse reactions, or
drug interactions. The following is not medical advice.
Before I begin this section, I feel clarification is needed
so that we are all on the same page. I am the first to advocate that emergent
or life threatening conditions be solely addressed by modern medicine and not
an aerosol of lavender oil and a tincture of Holy Basil. Now that we got that
out of the way, we can proceed.
Learning about holism is not only a hobby of mine; I am also
a prospective Holistic Herbalist. I begin my schooling next month. I am so
thrilled to soon have this vast knowledge of how a holistic lifestyle can
contribute to our overall response and recovery to the stressful and traumatic
incidents in our profession. Below you will find a few common therapies for
stress, anxiety, and insomnia after a shift or anytime.
Chamomile flowers have been used for many years and it is
one of the most popular therapeutic plants.[6] It can be used as a sleeping aid, to reduce tension, and I don’t know about all of you but my grandmother used to give this to me whenever I had gastrointestinal issues. It worked like a charm.
Like chamomile, valerian root also can be used as a sleeping aid.[7]
While I was in medic school, I experienced some insomnia secondary to stress
from school and my grandparents’ declining health. I used valerian root tea to
help me rest and it didn’t leave me feeling groggy in the morning. Valerian
root is also useful for anxiety. I still use valerian root on days that I can’t
fall asleep.
The often ridiculed lavender oil is my personal favorite.
Lavender is used to help relieve anxiety and to reduce stress. As its herbal
counterparts mentioned above, lavender is also used for insomnia.[8]
I like to diffuse lavender oil in my apartment and sprinkle a couple drops on
my pillow before bed. If your agency allows it and no one is allergic or
extremely repulsed by lavender, add a couple drops to your pillow at work.
Maybe waking up at 0300 for the abdominal pain that has been going on for 5
years won’t seem that bad. Or not.
Those are just a few things you can try. I can spend hours
on this but I’d rather not bore you. Do your own research and comment below on
anything else you have found useful! Just like taking herbs to relax and sleep
or dabbling in aromatherapy, eating well-balanced meals is crucial. I am not
going to go in to exhaustive detail on that as I am sure you have an idea of
what eating healthy means for your individual body. I will leave you with the
root ideology of holism. Everything is connected, especially when it comes to
your eating habits and your overall well-being. Your gut microbiome health is
connected to your brain via the gut-brain axis, thus impacting your mood.[9]
It may be worth doing some research on this remarkable connection and how what
you are eating or not eating may be impacting your mood and sleep. Remember,
everything is connected.
Signing off
We are in this together. Let’s be kind to one another and
encourage seeking help, if needed. Let’s embrace the art of returning to the
breath. Let’s be open to alternative medicine to reduce tension. And let’s eat
to nourish every cell, sinew, and synapse to ensure we can be at our best to do
what we do best.
For more information, please don’t forget to sign up for one
of our classes where you could have a chance to ask questions about well-being
on the job.
Be well, my friends.
Amani
[1] Hokanson and Wirth, “The
critical incident stress debriefing process for the Los Angeles County Fire
Department: Automatic and effective,” 250.
[2] Ibid, 249
[3] Calm, “About.”
[4] Weil, “Three Breathing Exercises and Techniques.”
[5] Calm, “Choose Plan.”
[6] Shealy, The Illustrated Encyclopedia of Healing Remedies, 119
[7] Ibid, 136
[8] Ibid, 161
[9] Lu and Zhu. “Gut-brain axis and mood disorders.”
Bibliography
Calm.
“Welcome to Calm.” About. Accessed April 21, 2020. https://www.calm.com/blog/about
Hokanson, Melvin, and Bonnita Wirth. “The
critical incident stress debriefing process for the Los Angeles County Fire
Department: Automatic and effective.” International Journal of
Emergency Mental Health 2, no. 4 (2000): 249-258.
Liu, Lu, and Gang Zhu. “Gut–brain axis and
mood disorder.” Frontiers in psychiatry 9 (2018): 223
Shealy, Norman C. The Illustrated
Encyclopedia of Healing Remedies. London: HaroperCollinsPublishers, 2002.
Weil,
Andrew. “Three Breathing Exercises and Techniques.” Accessed April 20, 2020. https://www.drweil.com/health-wellness/body-mind-spirit/stress-anxiety/breathing-three-exercises/