Equipt© Trauma Preparedness Training
As a trauma therapist, I was working with a juror from a court case that involved a shooting. It struck me how ill prepared this person was to experience what they saw and heard during the trial. Although they were warned they will see and hear things that they may find distressing, it did not prepare them, and as a result were not able to function at work, upon their return. I provided treatment for PTSD (including skills for emotional stability and resilience), and eventually they were able to return to their life and career.
I began to think about how this juror could have been prepared to process what they will experience, and then thought about other people who could benefit from being prepared for traumatic exposure. I thought about our Active Military while I was listening to veterans describe the trauma they struggled to overcome; our First Responders who run in when there is chaos to create safety for us, putting themselves potentially and likely in harm’s way. I thought about the kids in school who are being trained for active shooters because here in Colorado, having an occurrence of an active shooter is all too real and happens too often. One evening I was speaking to a gentleman who was an attorney about what I do, and he stated “Don’t forget us attorneys! Who do you think needs to go through the pictures, recordings and court documents, before they are brought into the courtroom?”.
Then I began to research what programs currently exist and how we can prepare these vulnerable populations to become more resilient and prepared to process trauma experiences. What I found is that the resiliency and preparedness programs teach how to maintain good mental health. This is important and can help decrease anxiety and depression. It can help in cases where someone is going through a divorce or other life cycle changes. However, we are seeing an increase in suicides by our Veterans and First Responders.
VA National Suicide Data Report 2005-2015
Studies show that suicide risk is higher in persons with PTSD. Some studies link suicide risk in those with PTSD to distressing trauma memories, anger, and poor control of impulses. Further, suicide risk is higher for those with PTSD who have certain styles of coping with stress, such as not expressing feelings. *
We help our First Responders and Military understand the risks involved and giving them tools for general wellbeing, but we aren’t providing them with the tools of how to process emotionally and mentally the horrific scene they will most likely experience. When the tools they are given aren’t working, hopelessness and helplessness sets in leading to severe anxiety, depression and suicide.
There is a huge cost to our communities and the people who serve us. PTSD effects the brain and how we respond to situations:
PTSD was associated with assessment of risk in situations that required professional judgement. Further, individuals experiencing PTSD symptoms reported higher levels of acute stress when faced with high acuity situations. Acute stress in these studies was associated with performance deficits on complex cognitive tasks, verbal memory impairment and heightened assessment of risk. *
*[PTSD, Acute Stress, Performance and Decision-Making in Emergency Service Workers. Regehr C1, LeBlanc VR2. © 2017 American Academy of Psychiatry and the Law .J Am Acad Psychiatry Law. 2017 Jun;45(2):184-192.]
There is the cost to time off the job to seek treatment and recover from PTSD. There is a cost of burn out and being forced out of a job. There is a cost to having to train new first responders to take their place. There is a cost to the community as a whole, with a cognitive message of “I can’t show them I am weak, or they will pass me up for a promotion or they will fire me”, “They will think I am crazy or broken”, “This is who I am, I am no one if I can’t do this job”. This kind of thinking leads to isolation, disconnect and suicidal ideation.
The research is clear when any person is faced with an acute stressful situation their cognitive and emotional capability declines. This is what is happening to our first responders. However, we can teach skills to lessen the impact, improve cognitive performance in the moment and assist with reducing any post incident recovery or processing time.
I propose that we prepare people for the trauma we know they will be facing, rather than simply relying on treatment once an injury or disability has occurred.
We know that high levels of physical fitness are required to ensure that a First responder has the physical capability to be able to run,, push, pull and carry – this proposal is not different, we are simply training the first responder with the knowledge and skills to be able to manage a traumatic situation while it is occurring, therefore reducing the likelihood of major mental illness and disability.
Trauma treatment has been around for decades and is evidenced based. It works because trained psychotherapists provide emotional stability through skills before we assist clients in processing trauma. By providing and learning these skills after the traumatic event we are fighting an uphill battle. There is great difficulty in being open to something new and different, when your body doesn’t feel safe inside. A better strategy would be to provide these skills before the First Responder or Military Member is exposed to the trauma. First Responders and Military are repeatedly trained and tested in skills to be prepared to do their job. By providing them trauma preparedness, they will be able to approach their mission clearly, stay in the moment, think clearly, and remain connected to others while processing events and making crutial decisions that are occurring around them. They will know skills to help them get through the day and won’t go into helplessness. Their cognitive stated will remain stable and adaptative. They will have skills to be able to remain the moment without the need for maladaptive reactions. While there is no guarantee PTSD would not occur, as some of these traumatic incidences are difficult to process, having these skills will allow them to stay on the job and shorten treatment for PTSD. The stability piece will already be in place and after a short review along with establishing rapport, a trained psychotherapist could assist them with processing what they have experienced, decreasing time away from the job, and saving lives. This saves time, lives, relationships, and money.
© 2019 Shuman Psychotherapy PLLC