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WHAT FIRST-RESPONDERS CAN TEACH US ABOUT STRESS



Psychologist Lisa Barry, PhD, is a Licensed Clinical Psychologist in the State of California. She has been nurturing the health of her patients for the past 18 years using several different modalities. She relies on evidence-based therapies and tools to nurture mental health and provide physical comfort. She combines cognitive and emotionally focused therapies with EMDR and hypnosis to help you develop coping strategies, awareness, and skills that will support you in healing and reaching your goals. She specializes in working with individuals who are suffering with chronic pain or other health related conditions like ADHD, anxiety, adults with Asperger's, cancer, depression, high blood pressure, insomnia, obesity, PTSD or trauma.






Surgeon Dr. Barbara Persons was an ER trauma doctor in the busiest trauma unit in the country and currently runs the Persons Plastic Surgery Center in the Bay Area in California. She is an accomplished pilot and a horrific accident survivor.








Gabrielle Pelicci, aka “Dr. Gabby,” is a leading expert on Holistic Medicine, author of Blissful Business, and Expert Wellness Blogger at MindBodyGreen, the Huffington Post and Thrive Global. Dr. Gabby has traveled to 40 countries, worked with thousands of clients – including celebrities and high-profile people – and has more than 2000 hours of training in yoga, bodywork, meditation and energy healing. Dr. Gabby is the founder of Women in Wellness, and has more than a decade of teaching experience under her belt at top universities in mind-body medicine and holistic health. Her expertise is regularly featured in national and local media such as MSNBC, The New York Post, and U.S. News & World Report.

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WHEALTHY MAGAZINE: Dr. Persons, there's a difference between stress that is situational, that occurs suddenly and unexpectedly, and anticipatory stresses such as going into an important surgery or taking a test. What's really the difference between someone who just sort of wanders upon a car crash versus someone who is dispatched to a car crash to help the victims, as far as stress levels go?


DR. BARBARA PERSONS: I think the key difference is mentally, if we're there as first- responders, we're operationally prepared. I was a trauma surgeon for five years at the second busiest trauma center in the country, in Las Vegas, and in that situation, every night there were gunshot wounds. We were prepared. We knew exactly what we were going to do when people came in. We didn't know exactly what was coming in, but we were prepared for whatever it was. We had a heightened level of awareness, we felt confident about what we were going to do, and just like firefighters and paramedics, we did our job. That is very different from someone coming across a house that's burning or a car crash in terms of physiologic response.


WM: That's one of the things that first responders benefit from - the fact that they have been trained how to deal with stress, to some degree. Obviously the training varies from department to department and individual to individual, but even if you are prepared, even if they do it every day, which is one of the reasons we're looking at first-responders to begin with, is because it's one thing to have an issue where you're taking an important test or having an important surgery, it's another thing to do it day after day after day. They have to be able to do this because it's their job to be put into these situations day after day after day, so they have to have the tools. And it's not enough just to have the tools, you have to be able to know how to use those tools, is that right?



DR. PERSONS That's exactly right, and the tools involve critical incident stress management, which really encompasses the concept that if you do this stressful work day after day after day, emotionally you still have to deal with it. What I know just from the years of trauma surgery in a Level One trauma center was that you do your job and then at some point you do have to deal with it. It might be driving home after 36 hours and three gunshot wounds and five car accidents and someone even dying, and then all of a sudden you can't see the road because you're crying uncontrollably and the emotional response is coming out, or you talk to a friend about it, but it does have to be dealt with.


WM: Dr. Barry, Dr. Persons was mentioning that there’s a difference in how our body reacts to a car accident versus knowing your in-laws are coming for Christmas. Those are both very packed with stressors but the reaction isn’t the same, is that right?


DR. LISA BARRY: That’s right. It really all depends on the individual and where they are in their state of mind. So stress is really a state of arousal that gets us ready to cope with whatever challenges are in front of us. A little stress is good, it helps us to perform well and helps us be effective in what we're doing, it mobilizes our body so that we can respond accordingly. But the brain gets to decide what a threat is, not us consciously. Unconsciously is where the decisions are being made and it's really based upon a perception of confidence-- is this something we can manage? First-responders have been trained, surgeons have been trained, and people who are in the trauma centers have been trained to respond to certain conditions really well. So what might stress somebody who isn't familiar with being a first-responder - like let’s say if I was the first one to a car accident. I might be more highly aroused than someone who does that for a living. Interactions with in-laws, a store clerk taking their time when we're in a hurry-- those are the types of things that we lack control about, and can cause a perceived threat to our timeline and where we’re headed. Those are the things that can set us off-balance in terms of the stress response.


WM: There’s a word there that needs highlighting: PERCEIVE. The body makes decisions on its own, the consciousness is out of play. The difference between a firefighter and a regular citizen rolling up on an auto accident is the perception of competence. I perceive I am capable, therefore my stress level is reduced.


DR. PERSONS I get really stressed out shopping, or putting together a nice dinner for friends, whereas surgery is not stressful to me at all, because my perception is that I’m confident as a surgeon but not as Martha Stewart.


DR. BARRY There are some things you can do that are very straightforward. The first is to take your daily stressors seriously. Recognize that we watch in the media, the violence or on the news, those things that are disturbing, we have a choice to take in. Now, those things might interest you but they might not be in your body’s best interest. There are times of course when we can’t avoid that stuff, like if it just comes on the TV or radio, but we do have say about what we let in. So taking care of your baseline anxiety is pretty straightforward. Getting enough sleep, getting vigorous exercise, and healthy eating help too. The reason mindfulness is so important is because it gives you a mini-vacation. Your body doesn’t discriminate between an actual vacation and a perceived vacation. So when you imagine going off to your ‘peaceful place,’ the body reacts as if you’re really there. On the subconscious level, your body will respond almost immediately with the biochemical markers of reducing stress. If you take seriously your physical and mental health you would be much more careful about what you do and what you choose not do. What you see and what you avoid.


WM: So you’re saying you can trick your body into releasing the same sort of chemicals that actually going on that vacation will give you?

DR. BARRY: Yes! And it’s not even a trick. There’s something called Psychoneuroimmunology that studies what your brain does and how your body responds. So those things you do to be ‘mindful’ make a difference immediately on cortisol levels, the stress hormones produced in our bodies, in response to, for instance, a picture of war or a picture of salmon. Our bodies respond immediately to that image. So it’s very effective if you can control what you see because you can control your level of stress.

WM: How do we recognize we’re about to enter a stressful situation?


DR. BARRY: One of the things that people need to learn is to recognize the external triggers, and avoid them. Some people are very good at recognizing how their body reacts to these stressors, but others aren’t. Like traffic. You need to understand the things in the environment that triggers your stress, and leave earlier for instance. Recognizing what triggers you is key.


DR. PERSONS: How then, if you know you’re going into that stressful situation, like you’re already late for work, what can you do?


DR. BARRY - When we can’t reduce the stressors by keeping our baseload as low as possible, we make sure we go into that day having had lots of water, eaten properly, gotten sufficient sleep. Let’s say you’ve got a presentation to make and you’re not as prepared as you could be. You can take a few deep breaths, and if you’ve done this before and practiced this in advance of needing it, it works much better. So just letting the air out, imagining yourself on a beach, and doing your mindfulness exercises. This will allow you to be calmer going into that perceived threat situation.


There are also some tools that I can share that will allow you to feel less powerless. Anything you can do to imagine yourself as powerful is something you should do. Dr. Amy Cuddy does research about simply taking 2 minutes to do a power pose. This might sound insignificant but it immediately changes the neurochemistry of your body. So for two minutes before that meeting, do a power pose for 2 minutes. Now you’re practicing confidence.


WM: You have a quote on your website by Albert Einstein, ““The intuitive mind is a sacred gift and the rational mind is a faithful servant. We have created a society that honors the servant and has forgotten the gift.” Can you speak to that?


DR BARRY: That speaks to the idea that in our society we don’t spend enough time to what happens intuitively inside of us, and we spend a lot of energy in technology and a lot of things that add to our general well-being. So that’s more of a reminder to pay attention to what happens inside us more, instead of just what happens outside us.


GABRIELLE PELICCI: A great way to integrate mindfulness is to integrate a yoga or meditation practice into your life. Also, you can try writing, journal writing, writing down your feelings, and using the journal to dispute any of the negative thoughts that can creep into your life. We talk about perception - well you can use writing to remind yourself about your strengths, and your power and ability to overcome challenges. Counseling and support groups are a great way to get peer support and professional therapeutic support. If you feel like you need more comfort and advice, that’s a great way to reduce stress and feel better.

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