CISM Protection Bill Introduced in California

California may join Michigan and other states that have made CISM activities “privileged” communications, meaning they could not be subpoenaed or otherwise demanded by a court. Michigan’s legislature unanimously passed the “First Responder Privileged Communications Act” a year ago.Subpoena protection for California CISM

California will consider AB 1116, the Critical Incident Stress Management Services Act.

Here is the key provision.

Except as otherwise provided in this section, a communication made by an emergency service provider to a CISM team member while the emergency service provider receives CISM services is confidential and shall not be disclosed in a civil, criminal, or administrative proceeding. A record kept by a CISM team member relating to the provision of CISM services to an emergency service provider by the CISM team or a CISM team member is confidential and is not subject to subpoena, discovery, or introduction into evidence in a civil, criminal, or administrative proceeding.

The exceptions are not problematic – they cover referrals, events where most of us are already mandated reporters, imminent threats and waivers.

The bill was introduced last month by Assemblyman Tim Grayson, former mayor of Concord, California, who is also a Concord Police Department “Critical Response Chaplain.” He undoubtedly knows a thing or two about this issue.

In my dozen years in CISM I’ve dealt with this through our team’s policy of never keeping written records and my own lousy memory for what other people say during interventions.

Guest Post: Emotionless

This week I had a hard time deciding what I would write about. This is my 10th article, so I guess I wanted to write something special. I decided to write about police work and the toll it takes on a person’s emotions . This is not based on any science or psychological analysis but my own experience. Remember also that every person is different and other police officers might have had different experiences, but I think they will find similarities with my story.

To start off, I would like to say that when I first started out as a front line officer, I was learning a lot from more experienced officers. I would take from these officers what fit my personality and also what would work in the field when dealing with the public. I found that I was the type of person who would connect better with the public, whether complainants, victims or even suspects. I would be to get to know them better and know where they are coming from.

No, not the place they are coming from but what type of life they had and what brought them to this point…so in other words, empathize with them. Well for me to do this and for them to come and trust me, I would need to let a little bit of myself go also. Otherwise it’s one-way communication and you will never get any good rapport with anyone that way.

Then all of a sudden, the pulling and tugging stopped.

So this was the way I decided that I was going to police. It fit my values of life better and when I think about it, it saved me from a few tight situation. For example, one night I was working on the Reserve and keeping a close eye on a beer garden along with a local reserve officer. Close to midnight as we were driving in the parking lot, we were flagged down. One of the patrons was going nuts and wanted to fight everybody. My partner and I got out of our vehicle, approaching the subject of complaint and were going to arrest him then and there. Then all of a sudden, his buddies started tugging on us and we were being circled. The more we fought to arrest the subject, the more we were getting pulled and pushed away from this guy. Then all of a sudden, the pulling and tugging stopped. Well lo and behold, when I turned around, a bunch of people that I had built a rapport with in the past had formed a line and were keeping the subject of complaint’s buddies away from us.

For me to get a rapport of that kind,  I had to let a little bit of my personal past out to them as well. But what happens when you do this is that you start to connect with people and the people you connect with the most are the ones you deal with almost on a daily basis – which are the one you get to arrest on a regular basis! You start to really sympathize with most of them because you start finding out that they are the way they are today because of what happened to them in the past.

I found out that some of them had parents that were alcoholics or only one parent who was an alcoholic and sometimes would roam the streets at 2-3 o’clock in the morning at 6-7 years of age so they wouldn’t see the dad, or boyfriend beat up on their moms. Or that some of them had been sexually assaulted by a parent, an uncle or even grandparents as young as three years of age. A lot of social problems resulted in young kids growing up with having to deal with traumatic events when they were very young . I think some of them wanted a different life but growing up just didn’t know where to turn to for help.

Those became what I call today my “robot years.”

Some of these people I got to connect at a close level ended up committing suicide, including two hockey players I had coached a few years before. That really took a toll on my mental health, although I didn’t realize it at the time. Dealing with these types of situations after awhile, those became what I call today my “robot years.” I would actually go to certain calls and it would be like I was on automatic. I would not care at all about a break-and-enter with minor value stolen. I would take notes, make believe that I was concerned, and then leave and write my report and on to the next call.

I had built a wall so well that I was forgetting what it was like to live life like a regular human being.

The robot years started to carry on during my days off. I still remember my wife telling me years after how she would look at me and it would seem like I was a person that just didn’t have any emotions left. I wasn’t seeing it that way, but now that I reflect back on it, I really didn’t have any emotions left at all. Everything was on a level. No highs and no lows. Just functioning through life… like a robot. I had built a wall so well that I was forgetting what it was like to live life like a regular human being. I still feel the effects today, although I do have glimpses of feeling emotions of happiness and sadness, but not as much as before I joined law enforcement. I feel like I am empty inside. Nothing left. This was actually mirrored to me by a very good friend of mine who also worked 28 years in policing and just recently retired. He told me those exact words. That he felt like he had no emotions left inside. That he was dead inside.

I think as police officers, especially the ones who try to empathize with people that are struggling through life, we try to keep our emotions so much in check when attending calls that our mind starts to think that it is not good to have any emotions. And when you think about it, police officers do have to hold back emotions frequently. We can not start to break down and cry uncontrollably in front of the public at a serious accident scene where kids are deceased. Or in one of my cases, tell a seven-year-old that his mom would be okay and asking a firefighter to bring the kid up the embankment for me as I was with the paramedic attending the mom. Her face was a grayish pale with purple lips. I had a feeling she was badly bleeding internally and the paramedic confirmed my assumptions. She died soon after. I always felt a lot of guilt, even today for lying to that kid. But I just didn’t want him to see his mom this way.

I just want to enjoy the peacefulness that nature brings. That to me is true happiness.

I could go on and on about these types of calls that other police officers and I attended. We are to hold our emotions in on a daily basis. After awhile, you do not want to let go of all those emotions at home. Why would I burden my wife on the violence I witness during my shift? I don’t even want to remember them today. So why would I give this hell to someone I love? Doesn’t make any sense. Today, I find a lot of peacefulness and happiness just walking in the woods with my dog. Even though my wife tags along with me at times, she knows that sometimes, I just don’t want to talk. I just want to enjoy the peacefulness that nature brings. That to me is true happiness.

Thank you for those taking the time to read my articles. Please share to whomever you feel could benefit from them. I would really appreciate that. Until next week. Stay safe my friends. 🙂

Norm

New! Pocket Guide to Stress Management and Crisis Intervention

Until now, nobody has offered a pocket guide covering all of the protocols and methods that we use in stress management and crisis intervention.

Good news! Now there is one.

I have written and published a 60-page pocket guide (spiral-bound with durable, Stress Management and Crisis Responsewaterproof covers), including essential references for self-care, peer support, psychological first aid, critical incident stress management (CISM), suicide, death and trauma notification and more. I’ve included sections on helping children and grieving people, and what to keep in mind when dealing with various faiths and cultures – the essentials to review and remember.

In the back of the book, I’ve included a guide on when and how to make referrals, with contact information for national crisis lines and online resources, plus plenty of space for you to write in your own contact and referral information.

For more information, including the Table of Contents, see the Pocket Guides page, where you’ll also find testimonials from the expert reviewers who helped me ensure that this is  a high-quality reference guide.

You can order the guide on Amazon, where you will also find a Kindle version.

Article: How One Paramedic is Recovering from PTSD

The Journal of Emergency Medical Services has published the PTSD recovery story of Benjamin Vernon, a paramedic/firefighter in San Diego. Vernon and his partner who was knifed by a bystander during an ordinary call. He describes the attack, recovery and the nightmares – a word he says isn’t strong enough – that followed. Unfortunately, the therapist he saw had never treated a firefighter or a victim of workplace violence.

“On the fifth day, I finally understood suicide,” Vernon writes.

The story ends well – he finds a competent therapist (whom he’s still seeing weekly) and receives EMDR (Eye Movement Desensitization and Reprocessing), which he describes as “the coolest Voodoo.” (It’s also sometimes called “FM” for “F%&#ing Magic.”

Registration opening for “The New Science of Stress”

If you are in or near Santa Clara, California, registration opens tomorrow for The New Science of Stressoffered by Santa Clara Adult Education.

Class meets for ten Thursday evenings, 7:30-9:00, starting February 16th. Here’s the description.

Stress management is more than just learning to relax. This class will show how insights from cognitive neuroscience and medical research are revealing how to thrive and perform under pressure. Classes will cover how and why stress — at home or at work — doesn’t have to be toxic to your health. Relaxation methods will be described and practiced, along with coping techniques that use beliefs and social habits to balance your mind, nerves and hormones for greater health and performance. Instructor is experienced in public safety and high-tech business, with more than 10 years in crisis intervention and stress management.

Some of the feedback about a recent class I taught (Psychological and Spiritual Care):

  • Very informative, great Powerpoint, examples and videos.
  • Everything was awesome!
  • Professionalism. Good information/topics.
  • Easily understood and could apply to helping out a friend as well as somebody in a natural disaster.
  • Perfectly balanced with visual aids, group participation and anecdotes. Truly an expert in how to effectively teach on this subject.

Article: You Can Improve Your Default Response to Stress

The Harvard Business Review has published an article by Michelle Gielan (a positive psychology researcher married to Shawn Achor, author of The Happiness Advantage), describing how our response to stress matters more than what happened to cause it.

Our perception of an event – what psychologists call appraisal – makes a big difference in our emotional and physical reactions. If we see a threat, our stress response will be negative. If we see a challenge instead, stress is an ally helping us rise to the occasion. Gielan reports on the results of a study by Plasticity Labs that shows how we can change our response. There are three keys, she says.

  • Cool under pressure.
  • Open communications.
  • Active problem-solving.

People with poor stress management fall into two categories, Gielan suggests, which she calls “Venters” and “Five Alarmers.”  Venters are the people who are quite open about their stress, but they are not cool under pressure and not good problem-solvers. Five Alarmers also share their stress, but they are better able to take action. However, they make no distinction between small and large stresses. They are headed toward burnout, exhaustion and guilt.

Gielan calls people with a healthy, adaptive response to stress “Calm Responders” – they express their stress, but aren’t overwhelmed by it.

The good news is that we really can change how we respond.

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.

News report: Meditation reduces stress, changes your brain

Many studies have shown that meditation can be a powerful way to reduce anxiety and raise the body systems that calm us down after exposure to stress. The Washington Post last May reported findings of Sara Lazar, a neuroscientist at Massachusetts General from brain scans that showed that some parts of the brain expanded and others became smaller after sustained meditation.

This is part of a big change in thinking about our brains, which until recently were assumed to be fixed, unchangeable. Now we we have a word for the brain’s ability to change – neuroplasticity – as well as increasing evidence about what kinds of attitudes and activities encourage positive changes.

Don’t take that bite! Dogs, diets and heart rate variability

Two new reports related to heart rate variability (HRV) reveal more about its significance as a measure of our physical and emotional health. Higher HRV is associated with better stress management. It is a way to peek into the state of a person’s nervous system, particularly the vagus nerve, the mind-body information superhighway. The more active your vagus is, the better you are at coping with stress. It is the neural path through which your “rest and digest” system signals your “fight or flight” system to calm down.

One new article reports that people with high HRV can more easily resist temptation when dieting. Greater self-control of that kind is also linked to better psychosocial and physical health.

HRV is similar in other mammals, so another researcher looked at the relationship between HRV and aggression in dogs, hoping that HRV might predict how aggressive a dog is likely to be. Just as humans with high are better at resisting that extra slice of cake, perhaps dogs with higher HRV would be better able to resist taking a different kind of bite.

The resulting article reports that indeed, less aggressive dogs had higher HRV.  “Dogs with bite histories had significantly lower HRV” and owners who reported that their dogs were aggressive also had lower HRV. The researcher’s work suggested that HRV could be an objective way to measure the effectiveness of dog training that is intended to reduce aggressiveness.

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