The Things We Say Vaughn Donaldson Midland, TX [email protected]

The Things We SayThe Things We Say

Vaughn DonaldsonVaughn Donaldson

Midland, TXMidland, TX

[email protected]

www.cism1.comwww.cism1.com

Things We SayThings We Say

BreathingBreathingExerciseExerciseReligion or SpiritualityReligion or SpiritualityNutritionNutritionMassageMassageSleepSleepTalk about itTalk about it

A Couple Extras For Your A Couple Extras For Your ConsiderationConsideration

EMDREMDRTFTTFTRehabRehab

More on these later…….More on these later…….

BreathingBreathing

Diaphragmatic breathing stimulates vagus Diaphragmatic breathing stimulates vagus nerve facilitating full relaxationnerve facilitating full relaxation

Exhalation – may decrease neural firing in Exhalation – may decrease neural firing in the amygdala and hippocampus – the amygdala and hippocampus – prolonged expiration may further reduce prolonged expiration may further reduce neural firing that can lead to calmingneural firing that can lead to calming

Conscious breath control can get us back Conscious breath control can get us back calm with associated reduction in pain and calm with associated reduction in pain and anxietyanxiety

Pre-frontal lobes Limbic system

Brainstem

ETOH

Another ViewAnother View


Brainstem


Brainstem


Brainstem


Brainstem

Stress


Brainstem


Brainstem

Strange Suicide In Bank-Slay CaseStrange Suicide In Bank-Slay Case

Nebraska Trooper's Death 'Connected' To Bank Nebraska Trooper's Death 'Connected' To Bank Robbery MassacreRobbery Massacre

Robbery Turned To Gunfire In Robbery Turned To Gunfire In NORFOLK, Neb., Sept. 27, 2002NORFOLK, Neb., Sept. 27, 2002 Bank robbery Bank robbery suspects Jose Sandoval, left, and Jorge Galindo. suspects Jose Sandoval, left, and Jorge Galindo. (AP)(AP)A distraught state trooper killed himself Friday in the wake of a bank robbery A distraught state trooper killed himself Friday in the wake of a bank robbery that left five people dead a day earlier, the Nebraska State Patrol said. that left five people dead a day earlier, the Nebraska State Patrol said.

Mark Zach, 35, shot himself with his service revolver at Mark Zach, 35, shot himself with his service revolver at around 1 p.m. CDT just outside of Norfolk. around 1 p.m. CDT just outside of Norfolk.

Zach had stopped one of the four robbery suspects, Zach had stopped one of the four robbery suspects, Erick Fernando Vela, 21, last week and ticketed him for Erick Fernando Vela, 21, last week and ticketed him for carrying a concealed weapon. However, Zach carrying a concealed weapon. However, Zach transposed two digits when entering the gun's serial transposed two digits when entering the gun's serial number into a police computer, said Gov. Mike Johanns. number into a police computer, said Gov. Mike Johanns.

Because of that mistake, the computer indicated that the Because of that mistake, the computer indicated that the weapon had not been stolen, the governor said. weapon had not been stolen, the governor said.

Zach was a 12-year veteran of the State Patrol based in Zach was a 12-year veteran of the State Patrol based in Norfolk. He and his wife had six children, ranging in age Norfolk. He and his wife had six children, ranging in age from 4 to 15, Nesbitt said.from 4 to 15, Nesbitt said.


Brainstem

ExerciseExercise

ExerciseExercise

Is stressful but different than emotional related Is stressful but different than emotional related stress of livingstress of living

Stress = cortisol is released, breaks down Stress = cortisol is released, breaks down adipose tissue, which releases FFA into adipose tissue, which releases FFA into bloodstream, during exercise FFA is being bloodstream, during exercise FFA is being utilized by muscles, but during emotional related utilized by muscles, but during emotional related stress FFA is not utilized as well and converts to stress FFA is not utilized as well and converts to triglycerides then to LDLtriglycerides then to LDL

Facilitates degree of physical and psychological Facilitates degree of physical and psychological stress resistancestress resistance

ExerciseExercise

Exercise stress preferentially releases Exercise stress preferentially releases norepinephrine while emotion related norepinephrine while emotion related stress preferentially releases epinephrine. stress preferentially releases epinephrine. Circulating epinephrine represents the Circulating epinephrine represents the greatest risk to the integrity of the heart greatest risk to the integrity of the heart muscle because the ventricles are muscle because the ventricles are maximally responsive to epinephrinemaximally responsive to epinephrine

ExerciseExercise

Exercise seems to fine tune the bodies Exercise seems to fine tune the bodies response and secretion of these hormones. response and secretion of these hormones. Physical exercise is capable of using the Physical exercise is capable of using the constituents in a healthy manner. constituents in a healthy manner.

After exercise – muscles which have been After exercise – muscles which have been tense as a result of stress relax and have less tense as a result of stress relax and have less tensiontension

ExerciseExercise

After exercise – O2 is used more efficiently After exercise – O2 is used more efficiently which leads to reduced cardio responses to which leads to reduced cardio responses to stress, which leads to less coronary artery stress, which leads to less coronary artery disease, may help in the prevention of disease, may help in the prevention of osteoporosis, help in the prevention of colon osteoporosis, help in the prevention of colon cancercancer

Long term – exercise seems to be as effective Long term – exercise seems to be as effective as other forms of psychotherapy for mild to as other forms of psychotherapy for mild to moderate depressionmoderate depression

ExerciseExercise

Exercise releases endorphins – Orgasm also Exercise releases endorphins – Orgasm also releases endorphins.releases endorphins.

Helps you fall asleep faster and reduce high Helps you fall asleep faster and reduce high blood pressure, higher metabolismblood pressure, higher metabolism

Religion or SpiritualityReligion or Spirituality


90% of studies showed those with 90% of studies showed those with religious beliefs have lower BPreligious beliefs have lower BP

A study in 1998 of people with Advanced A study in 1998 of people with Advanced Aids – 40 healers from various religions Aids – 40 healers from various religions prayed from a distance. Prayer group had prayed from a distance. Prayer group had fewer out patient visits and fewer fewer out patient visits and fewer hospitalizations than nonprayer group.hospitalizations than nonprayer group.


1988 double blind study of people in CCU 1988 double blind study of people in CCU patients were assigned to either a patients were assigned to either a nonprayer group or a prayer group. nonprayer group or a prayer group. Christians outside the hospital who were Christians outside the hospital who were unknown to the patients were asked to unknown to the patients were asked to pray daily for their rapid recovery. Prayer pray daily for their rapid recovery. Prayer group did better with less chf, pneumonia, group did better with less chf, pneumonia, need for diuretics, cardiopulmonary arrest, need for diuretics, cardiopulmonary arrest, need for ventilation/intubation, and a better need for ventilation/intubation, and a better overall outcome.overall outcome.

NutritionNutrition

Carbohydrates – simple = sugars, complex = Carbohydrates – simple = sugars, complex = starches, vitaminsstarches, vitamins

Fats – fat cells contain triglycerides which is Fats – fat cells contain triglycerides which is used for energy, this is good but if there is too used for energy, this is good but if there is too much then they convert to body fatmuch then they convert to body fat

Proteins – used to rebuild, repair and replace Proteins – used to rebuild, repair and replace cellscells

NutritionNutrition

When we are under excessive stress the body When we are under excessive stress the body starts using protein for energy after carbs and starts using protein for energy after carbs and fat are depleted. The body uses lean muscle fat are depleted. The body uses lean muscle tissue including the major organs such as the tissue including the major organs such as the heart is converted to glucose for energy – heart is converted to glucose for energy – hence, this is why we need to eat even hence, this is why we need to eat even though we may not be hungrythough we may not be hungry

NutritionNutrition

This is also why we need to drink plenty of This is also why we need to drink plenty of water to help maintain homeostasis – body is water to help maintain homeostasis – body is going to retain water, conserve, so we need to going to retain water, conserve, so we need to drink plenty to maintain balancedrink plenty to maintain balance

Carbohydrates have serotonin and serotonin Carbohydrates have serotonin and serotonin plays a role in eating and emotionsplays a role in eating and emotions

NutritionNutrition

When serotonin levels are low the brain sends When serotonin levels are low the brain sends impulses to eat. Having carbohydrates at impulses to eat. Having carbohydrates at every meal helps maintain the serotonin levelevery meal helps maintain the serotonin level

During times of extreme stress digestion may During times of extreme stress digestion may be shut down or working inefficiently, so we be shut down or working inefficiently, so we must be careful not to overeat or have big must be careful not to overeat or have big meals….sympathetic is working, while meals….sympathetic is working, while parasympathetic is not.parasympathetic is not.

NutritionNutrition

Adrenalin releases glucose in the form of Adrenalin releases glucose in the form of glycogen which gives us an extra burst of glycogen which gives us an extra burst of energyenergy

NutritionNutrition

When we are anxious or tense every muscle When we are anxious or tense every muscle cell in our body is consuming energy. They’re cell in our body is consuming energy. They’re using B vitamins, vitamin C and magnesium. using B vitamins, vitamin C and magnesium. When under stress, we made need as much When under stress, we made need as much as twice as many vitamins than when we’re as twice as many vitamins than when we’re not under stress, but we don’t need twice as not under stress, but we don’t need twice as much food….this is why we may need a much food….this is why we may need a supplement of B vitamins. This is also why we supplement of B vitamins. This is also why we need to eat whole grains, oats, brown rice, need to eat whole grains, oats, brown rice, and small amounts of high quality protein like and small amounts of high quality protein like fish, eggs, chicken, cheesefish, eggs, chicken, cheese

MassageMassage

MassageMassage

Increases blood circulation and flow of Increases blood circulation and flow of lymphlymph

Lymph carries away wastes and impuritiesLymph carries away wastes and impurities

Movement of lymph depends on muscle Movement of lymph depends on muscle contractions – inactive people aren’t contractions – inactive people aren’t stimulating lymph movement, so wastes stimulating lymph movement, so wastes and impurities build up in bodyand impurities build up in body

MassageMassage Vigorous activity – produces more lactic acid Vigorous activity – produces more lactic acid

and wastes than can be carried out, either way and wastes than can be carried out, either way massage can help the body get rid of impuritiesmassage can help the body get rid of impurities

Increased blood flow in turn helps oxygen and Increased blood flow in turn helps oxygen and nutrients reach the cells while also doing a nutrients reach the cells while also doing a better job of carrying away wastes and toxinsbetter job of carrying away wastes and toxins

Helps relaxation, insomnia, digestive problems, Helps relaxation, insomnia, digestive problems, arthritis, carpal tunnel syndrome, sinusitis, arthritis, carpal tunnel syndrome, sinusitis, reduce pain, helps w/depression, reduced heart reduce pain, helps w/depression, reduced heart rate and blood pressurerate and blood pressure

SleepSleep

SleepSleep

Exxon Valdez, Chernobyl, Three Mile Exxon Valdez, Chernobyl, Three Mile Island, Challenger, Bhopal chemical plant, Island, Challenger, Bhopal chemical plant, Iraqi ambush near Nasiriya decisions were Iraqi ambush near Nasiriya decisions were made after midnight by sleepy peoplemade after midnight by sleepy people

Effects of sleep deprivation – cognitive Effects of sleep deprivation – cognitive decline, mood dysregulation, psychosis, decline, mood dysregulation, psychosis, delirium, hypothermia, deathdelirium, hypothermia, death

SleepSleep

Alcohol may help one to fall asleep Alcohol may help one to fall asleep initially, but it increases the number of initially, but it increases the number of times you wake up later in the nighttimes you wake up later in the night

Rats normally live 2 or 3 years, but when Rats normally live 2 or 3 years, but when deprived of REM sleep only live about 2 deprived of REM sleep only live about 2 weeksweeks

24 hours without sleep leaves one just as 24 hours without sleep leaves one just as impaired driving as someone legally impaired driving as someone legally intoxicatedintoxicated

Talk About It (Catharsis)Talk About It (Catharsis)

Talk About It Talk About It

Study with college students – experimental Study with college students – experimental group wrote about traumatic experience group wrote about traumatic experience while control group wrote about while control group wrote about nonemotional topics (4 consecutive days nonemotional topics (4 consecutive days for 15 minutes per session). Emotional for 15 minutes per session). Emotional writers had fewer doctor visits.writers had fewer doctor visits.

Talk About ItTalk About It

Same results with senior-level engineers Same results with senior-level engineers being laid off from their jobs, some after being laid off from their jobs, some after many years with the company. many years with the company. Experimental group wrote about being laid Experimental group wrote about being laid off while control group did not write. off while control group did not write. Experimental groups got jobs faster than Experimental groups got jobs faster than control group.control group.


Even writing years later can be beneficial. Even writing years later can be beneficial. Holocaust survivors in the DFW area were Holocaust survivors in the DFW area were assigned to either a control group or assigned to either a control group or experimental group. The experimental experimental group. The experimental group wrote about the holocaust, while the group wrote about the holocaust, while the control group did not write. Experimental control group did not write. Experimental group had fewer doctor visits.group had fewer doctor visits.


Writing has been found to boost t-helper Writing has been found to boost t-helper cell growth which helps our immune cell growth which helps our immune system, also lowered pain and medication system, also lowered pain and medication use, lowered depression in students taking use, lowered depression in students taking the GRE.the GRE.

Comparable results have also been found Comparable results have also been found by talking about it.by talking about it.


Studies have also shown writing to provide Studies have also shown writing to provide positive benefits with maximum security positive benefits with maximum security prisoners, medical students, distressed prisoners, medical students, distressed crime victims, arthritis and chronic pain crime victims, arthritis and chronic pain suffers and women who have given birth.suffers and women who have given birth.

AvoidsAvoids

Too much caffeine – amphetamine like Too much caffeine – amphetamine like stimulant, triggers release of stress stimulant, triggers release of stress hormones which increase heart rate, hormones which increase heart rate, increases bp and O2 demands of the heartincreases bp and O2 demands of the heart

Caffeine can be lethalCaffeine can be lethalFrequent side effects include anxiety, Frequent side effects include anxiety,

irritability, diarrhea, arrhythmia and irritability, diarrhea, arrhythmia and inability to concentrateinability to concentrate

SaltSalt

Excessive fluid retentionExcessive fluid retentionWhich increases nervous tension in the Which increases nervous tension in the

general nervous tissue and cerebral tissuegeneral nervous tissue and cerebral tissueExcessive fluid retention can also lead to Excessive fluid retention can also lead to

high bphigh bpBP may become high enough to increase BP may become high enough to increase

the risk of CVA or MIthe risk of CVA or MI

NicotineNicotine

Stimulates the adrenals, which releases Stimulates the adrenals, which releases the stress hormones – increased bp, heart the stress hormones – increased bp, heart rate, release of fatty acids and glucoserate, release of fatty acids and glucose

Physiological functioning continually Physiological functioning continually elevated to where arousal state becomes elevated to where arousal state becomes normalnormal

Being without nicotine leads to mild Being without nicotine leads to mild depression and desire for more nicotinedepression and desire for more nicotine

NoiseNoise

Can produce cardiovascular changesCan produce cardiovascular changesModerately high noise frequencies can Moderately high noise frequencies can

reduce circulation to arms, legs, hands reduce circulation to arms, legs, hands and feetand feet

May result in a permanent rise in bp due to May result in a permanent rise in bp due to structural adaption of heart and blood structural adaption of heart and blood vessels vessels

Other TechniquesOther Techniques

Time managementTime managementTask reductionTask reductionSelf talkSelf talkCognitive reframingCognitive reframingExpectationsExpectationsJoin a social groupJoin a social groupAvoid change / plan for changeAvoid change / plan for changeSerenity prayerSerenity prayer

Good for Traumatic StressGood for Traumatic Stress

TFT – Thought Field TherapyTFT – Thought Field Therapy

EMDR – Eye Movement Desensitization EMDR – Eye Movement Desensitization and Reprocessingand Reprocessing

Rehab – sometimes folks just need that Rehab – sometimes folks just need that extra help that only rehab can provideextra help that only rehab can provide

Don’t ever lose your sense of Don’t ever lose your sense of humorhumor

THE ENDTHE END

ConclusionConclusion

The next time we’re teaching about coping The next time we’re teaching about coping with critical incident stress let’s not just tell with critical incident stress let’s not just tell people to eat right and exercise, but people to eat right and exercise, but explain WHY we need to eat right and explain WHY we need to eat right and exercise.exercise.

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