Resilience Skills
Your health and well-being have a huge impact on how resilient and effective you are. There are a lot of social messages that self-care is a luxury, that you treat yourself in your free time and neglect yourself when you're on the job. Those messages are wrong. You can always cultivate well-being exactly where you are.
In this training we teach skills developed by street medics to maintain our resilience and effectiveness as self-organized health support workers in high-stress, low-sleep, high-stakes environments: mass protests and catastrophic disasters. These skills are a major intervention into the wider macho culture of emergency care and incident management of which we are a part. During today's training, consider how you can modify these skills to create a similar culture of care for your social circle in the legal profession.
Things you can start doing now
Get a buddy and ground
This workshop started with you getting a buddy and checking in with each other. Street medics work in pairs or groups of three. Multiple buddy pairs may work as a team. We look out for each other, check in with each other, and debrief together. We don't face our dilemmas alone. A medic without a buddy is off-duty.
Choose a good buddy for you
Someone calm, who you trust and with whom you feel safe.
Similar risk level of situations you will take on and situations you will avoid.
Different experience levels, different training, and different skills (so you can learn from each other).
Lay your cards on the table and get to know your buddy right off the bat. You can choose a buddy and get to know her quickly with PEARL.
P for Physical strengths and vulnerabilities. Share about your stamina, your best hours, what you do to adapt to your disabilities or impairments, routines that keep you healthy, medical conditions, medication schedules, and food/bathroom needs.
E for Emotional strengths and vulnerabilities. Share about hopes, fears, how to cheer you up, what situations you try to avoid, who is in your support network, how to tell if you're not doing well, how to know when you're doing great!
A for Arrest or Assault risk. Medics decide whether we are willing to risk arrest or assault in the line of duty. We work in unsafe scenes, and buddies must be honest about how much danger is too much, so they do not abandon each other.
R for Roles. In the field, one medic buddy will focus on a patient while the other focuses on the scene and communications. Out of the field, medics take on other roles, like emotional support, sexual assault advocate, or clinician.
L for Loose ends. What special skills do you have to offer? What's a little-known fact about you? Does your political or religious practice sustain you in your work?
PEARL has a lot in common with Wellness Recovery Action Plans (WRAPs) used in the mental health recovery movement and for living well with trauma, addictions, diabetes and fibromyalgia. A free digital copy of a guide to writing a WRAP is available at store.samhsa.gov/shin/content/SMA-3720/SMA-3720.pdf
Grounding is a way to free yourself from feeling too much (overwhelming emotions or memories) or too little (numbing and dissociation). When you are conscious of your body and the world around it and able to tolerate both, you can do a better job of helping and spreading calm to others. Here are some ways people ground (from Cindy Crabb's Support zine):
Blink hard. Blink again. Do it once more as hard as you can.
Make tea. Drink it.
Call a friend.
Eat a snack.
Jump up and down, waving your arms.
Lie down on the floor. Feel your body connect with it. Keep your eyes open. How does it feel? Describe it out loud to yourself.
Clap your hands.
Breathe deeply. Keep breathing. Pay attention to your every breath.
Hold a pet, stuffed animal, pillow, or your favorite blanket.
Alternately tense and relax some muscles.
Move your eyes from object to object, stopping to focus on each one.
Wash your face.
Go outside for sunshine or fresh air.
Listen to a song you love.
Check in
A simple way to check in with your buddy (or yourself) in hectic times:
What did you do to take care of yourself today?
What do you need to do?
Our basic needs are pretty simple. You can inventory them with the acronym HALTS, borrowed from 12-step support groups. Are you Hungry (or thirsty), Angry, Lonely, Tired, or taking yourself too Seriously? People in addictions recovery identify these five needs as key to preventing relapse, and people in mental health recovery identify them as key to avoiding breakdowns. If you identify that you've forgotten to eat all day, for example, you can do something about it, and feel better!
Check out or debrief
Each time you and your buddy part ways or sleep, debrief first.
What was your low point today?
What was your high point?
Daily debrief counters feelings of isolation, creates a shared narrative of the day, and strengthens learning. After particularly stressful days, debrief interrupts post-traumatic stress formation by helping you reveal, recognize, and integrate acute stress before sleep hardens it.
Separately from debrief, get together with your buddy and a few allies to regularly evaluate the work you're doing. Do this in a safe and trusting space, without hierarchy. Evaluation gives you a chance to celebrate; to modify your vision, goals, strategy, and logistics; and to recognize when you need more back-up or need to let go and move on.
Habits you can cultivate
Drink water
Water flushes waste from your body and keeps things moving. Drinking water helps prevent and ease stress, headache, asthma, aches and pains, and fever. Chronic stress elevates your body's production of the stress horomone cortisol. Many people who drink alcohol to relax before sleep are trying to drown out the effects of their elevated cortisol. By adding the burden of alcohol to their liver, they are actually increasing the long-term effects of elevated cortisol. Drinking lots of water helps your body flush out excess cortisol, leaving you calmer, cooler, more collected, and more capable of sleep.
Eat well
You are what you eat. In high-stress situations, it is a good idea to:
Take time to eat. Eat with others.
Eat colorful fruit and vegetables.
Avoid processed, fatty, and fried foods.
Add fresh herbs, garlic, and ginger to your food.
Eat fermented foods like yogurt, sauerkraut, kimchi, or miso.
Minimize nicotine, alcohol, caffeine, and other chemicals that put a strain on the body.
Increase your mineral intake by eating seaweed or drinking a high-mineral tea (like oatstraw, nettles, or lemon balm).
Move
If you want to deal with difficult emotions, the most appropriate starting point is in the realm of motion -- movement, excercise, and laughter. The more you sit each day, the greater your chance for chronic problems like cancer, diabetes, and heart disease. If you sit for more than four hours a day, remember that you have a body and decrease your risk!
Take short, fast walks during your breaks. Also try to walk around the room or at least stand and stretch every hour.
Pay attention to how you sit and breathe. If necessary, adjust the height of your chair or table to allow you to work in a better position.
Support without rescuing
Being supportive
If you find yourself attracted to crisis, ask yourself if you have a rescue fantasy. Rescuing is a very draining activity. Rescuing means:
Doing something for others that they can reasonably do for themselves.
Assuming you know what another person wants or needs.
Not doing something because of its assumed effect, such as not saying something because you assume somebody can't handle it.
Doing something you really don't want to do for someone.
How to be supportive without rescuing
Ask the person what he wants and doesn't want.
Be clear about what you want to do and don't want to do.
Be clear about what you are and are not capable of doing.
Negotiate about what you will and what you won't do.
Acknowledge you may have an investment in rescuing others. Learn where it comes from and care for that part of yourself.
People in crisis are often treated as if they're the problem. If your buddy or client is in crisis, don't think, "What's wrong with you?" Start thinking, "What happened to you?" and then "What are we going to do about it?" Help your buddy get to where she needs to be to do what she needs to do. Each time you see her, you can help her continue to pursue whatever plan she makes.
Minimize alcohol
Drinking after trauma or in high-stress environments significantly increases your risk of addiction and your risk of disabling post-traumatic stress -- even if you drink no more than usual. Here are some ideas about how to minimize alcohol:
Don't use alcohol as a coping mechanism. After a hard day, go to bed sober, and plan to go out for a social beer the next night. That gives you a full day to cope in other ways.
Debrief sober. Separate alcohol from emotional processing.
The most important time to not drink is when the little voice in your head tells you that you really need a drink. Ask the little voice what it is you actually need -- are you HALTS?
Sleep
What prevents sleep?
Stress, anxiety, anger, and fear (adrenaline in the short-term and cortisol in the long-term).
Caffeine, especially after 2pm. Sugar and sweetners. Alcohol, especially within two hours of bedtime, disrupts deep sleep.
Medication side effects. Read labels carefully.
Poor nutrition. Lack of food. Heavy meals right before bedtime.
What promotes sleep?
Routine: try to go to bed at night and rise in the morning at regular times.
Keep your bedroom dark and a comfortable temperature.
Deep, slow breathing from the belly: don't push or use effort, breathe naturally but deeply.
Relax with simple yoga stretches, a bath, or grounding.
Eat raw broccoli -- it absorbs free cortisol, decreasing stress. Try herbal teas (such as chamomile). Try bananas, melatonin, or fish oil.
Acupuncture, including NADA ear treatment, is effective for many people, including people in manic states or with extreme sleep deprivation.
Doctors prescribe benzodiazepenes such as Xanax, Valium, and Atavan for sleep. These drugs can help in the short term, but are addictive and make sleep problems worse in the long term. Use with great care or find alternatives.
Ask for support
Everyone needs supportive community. Helping professionals often give deeply to others and yet find themselves without as many supportive relationships as they would like. Learning to ask for support can feel very awkward, especially at first, and especially for attorneys! Learning how to ask for support makes you stronger and better able to support other people in the long term. Often people put off reaching out for support until things are really bad, and then reach out impulsively. At that point they may just want bad feelings to stop immediately, but the people they reach out to may not be prepared to respond appropriately.
You can ask for support at any time -- before, during, or after a hard time. Here are some suggestions to help with asking for support:
Start small: practice on safe people, with simple requests.
Know what you will do if the person refuses your request for support.
You do not have to tell the whole story.
Be gentle: do not demand, threaten, or insult.
Carry a written list of phone numbers you can call, even if the numbers are in your cell phone.