International Critical Incident Stress Foundation, Inc.
International Critical Incident Stress Foundation, Inc.
By: Dr. Kathleen carterMartinez, D.A.A.E.T.S, CRT, CSA, ICISF Member
As a young girl I secretly aspired to be a nurse, just like my hero ‘Cherry Ames’! Whenever possible I took up residence in the school library and over time, I read every single one of the 27 mystery novels about Cherry Ames. Although the nursing journey was not mine to take, I attended Mountainside Hospital School of Radiology where my career began in radiology healthcare.
There was no way that I could have known back then that my journey would go in the direction that it did. As a self-described multidisciplinary blended ball of wax with a career trajectory that started in healthcare and radiology to a degree in Law Enforcement, subsequent degrees in Forensic Psychology, Clinical Psychology and Healthcare I truly embraced the title of ‘multidisciplinary ball of wax’. It would be accurate to say that my career expanded to blend with different disciplines along the way. For me, I did not see ‘separation’ only ‘integration’ and felt that these expanded choices allowed me to be the best multidisciplinary professional possible.
Along the way I got in a lot of trouble for insisting that not only was it possible for healthcare, law enforcement, mental health, emergency services to work together, it was necessary. I relentlessly insisted that we abandon the silo-centric views that separated us and advocated for a homogenous blended professional community where we would be interconnected, in a sense be as one.
Somewhere along the way C.I.S.D. came to the forefront and the world made finally made sense to me. It came at a time when my passion for crisis and trauma response became the driving force for all that I do.
Today I find myself reflecting on that journey and where it has taken me. Today, I wonder how did we find ourselves where we are? How on earth did we find ourselves living in a pandemic health crisis? How did this happen? And then the simple truth hit me, it does not matter, because ‘this is where we are’.
Over the years I learned more about trauma response by developing my ability to simply ‘stay in the moment’, whatever and wherever that moment might be. When you are living in the midst of a traumatic event, the ability to stay in the moment is essential. When you are an essential healthcare provider in the midst of a health crisis the ability to stay in the moment is a matter of survival for you and your patients and your colleagues.
To that end I am reminded of a fundamental truth that cannot be denied, Trauma is trauma. Trauma is the great equalizer and it does not discriminate. This gnawing feeling that I have been struggling with every time I asked myself ‘how did we get here’ for the past month suddenly became clear to me, I have been here before.
A traumatic event has a beginning and an end that typically can be defined, there is visual proof that something started and now it has ended. There is the moment before the traumatic event occurs and then there is the moment that it ends, and these are points in time that everyone has the ability to recognize. What comes next is the aftermath of the traumatic event, where peace of mind and healing can begin. But not for us, we are not there yet.
It is really important that we all remember how we got here. It is important to remember why we made the choice to be of service to others. It does not matter what your professional discipline is, whatever it is, you are needed. To be of service to others, to help where help is needed and to be there when a patient needs you. That is how we got here. This is what matters the most.
In the case of a pandemic health crises we find ourselves living ‘within the active traumatic event’ where we lose sight of where it began, and we have no way of knowing when it will end, this is disorienting. Without those guidelines we are engulfed in the heart of the storm called trauma. These are scary times and it is very easy to become overwhelmed, disoriented and confused. This is a challenge, for those of us called to serve, because others rely on us to do what we do best, care for others. But to do so, we must take care of ourselves.
These conditions present different challenges for all essential healthcare providers because we are living two different lives at one time. We are the family member experiencing the same fears for our loved ones that everyone else is struggling with and yet unlike others, we have to walk out of the safety of our home and into our roles as caretakers ‘of others’. But we must stay focused and we must survive, perhaps the best tool we have to arm ourselves with ‘in the moment’ is the ability to self- diffuse for the purpose of self-care and self-management.
So, what do we do?
By ‘staying in the moment’ we remain where we need to be. While you are at work focus your attention on your patients, your co-workers and on what needs to be done. We function best in times of crisis when we keep it simple, focus on ‘what is needed’.
How do we do that?
The most important tool of all is to remember to breathe. This is the most powerful tool and ability that you have, it controls all that you do and when we forget to breathe, we are unable to respond, we simply react.
The breath:
The breath controls our entire body and it controls how we think. Begin the practice of teaching your body ‘how to breathe’ and use this exercise as often as you need to in order to do what needs to be done.
The breath: Anxiety and Stress buster
Stress, worry, fear and paralyzing anxiety are normal experiences during times of crisis. But we must be able to control them, if not then ‘they control us.’ Breathing is one of the most powerful weapons we have to battle anxiety and feelings of panic as well.
The Breath and the Mind:
You are what you think you are. You feel what your mind tells you to feel. But you control your mind and your thoughts. In times like this it is very important to understand that ‘you’ are in control of what you think and what you do. The most effective way to do this is through the breath, it is that simple. How do we exercise this control? Through the breath. The breath controls the mind.
Keep it Simple:
In order to be effective, the breath must travel through the entire body, this is how we reconnect the body-mind and spirit.
The art of Blow it out your toes!
As slowly as you can take in a very-very deep breath.
Hold this breath as long as you can.
Then very-very slowly and deliberately let it out.
Guide the breath from the top of your head all the way through your body.
As the breath slowly ends ‘Blow it out Your Toes’!
By embracing this practice, you reconnect your body and your mind and ‘you decide’ what is next. Through the practice of ‘Blow it out Your Toes’ you remain in control and you might even smile as you say out loud ‘Blow it out Your Toes and that is OK.
You might ask where or how can I do this? Find a moment. Step away from others. Lift your gear and your mask. Just for a moment to breathe. You need to. Your patients need you to. Your colleagues need you to.
I don’t have the answer to the question ‘how did we get here’ but I am grateful we are here ‘together’
To my way of thinking, those of us called to this kind of work, ‘bring with us’ an unusual ability to accompany and care for the sick, wounded and the dying. Because of what we are in our heart of hearts we possess the unique ability to actually walk into this crisis of pain, sorrow and loss with our patients in a way that allows them to be there, but not alone. We provide a presence where their loved ones cannot be, we stay with them, we remind them, we are here to take them home when they are ready.’ This is a gift. These are moments of grace.
Clara Barton was driven by a passion to help others in times of crisis especially in unfavorable situations. So, what do we do now that the day of ‘unfavorable situations’ is upon us? I leave you with thoughts from Clara Barton:
“You must never so much think as whether you like it or not, whether it is bearable or not; you must never think of anything except the need, and how to meet it.”
Dr. Kathleen carterMartinez, D.A.A.E.T.S, CRT, CSA
Diplomate, American Academy of Experts in Traumatic Stress
CheyWind Center for Trauma and Healing
518-420-3188
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