Wednesday, July 15, 2009

Put On Your Own Mask First

I recently exchanged emails with the coordinator of our county CISM team. I had been approached to assist an acquaintance who recently was in a serious car accident, and I was checking in with him before doing so. Think of it as analogous to a police officer being asked to investigate a crime -- you wouldn't just go off and do that without notifying your commanding officer, no matter how wonderful you think you are. The following is a piece of the reply I received:
I think that one of the areas leaders in CISM can have a positive impact on others is encouraging and role modeling good self care. From what I’ve observed, you may have some growing to do in this one area.
He then proceeded to caution me about the risks of responding to incidents that affect me or with which I might particularly identify.

I thought that was one of the most carefully and diplomatically worded pieces of constructive criticism I have ever received. Someone a little less tactful, such as, say, me, might well have written, "When will you ever learn? You really stink at knowing when you are too close to a situation." I appreciated the skillful word-craft.

So, in the interest of having a positive impact on my readers, here are some thoughts on self-care. My coordinator might add that you should do as I say, not as I sometimes do!

As my regular readers know, secondary trauma is a big risk for those who work in trauma response. I often describe it like this: Trauma is a steaming pile of manure (OK, I don't use the word manure, but this is a family friendly blog). When you help someone who has been traumatized, you help them shovel their manure. But there's only so much manure you can shovel without getting some on you. At some point, you have to stop and take a shower.

Now that you all have that lovely visual image . . .

It's true, though. Other's trauma traumatizes us. Every single CISM team member should be taking good care of their body, mind and spirit after every single response. There is no such thing as, "I don't need to, I'm fine." There is only, "I need to" and "I really need to." What that self-care looks like is highly individualized, but it closely mirrors what we advise for the traumatized people themselves: get exercise; eat healthy food; access your support network of friends, family and faith; do more of whatever you do to decompress (because ironically the more stress we are under the less we feel like doing the things we know help us); steer clear of alcohol and drugs; give yourself time.

I have never been bad at doing those things. What I'm really bad at is recognizing when I need to step back altogether. Because I am passionate about this work, I have strong opinions about how it is done. It's hard to care that much and then say that I myself will not be doing it. I once likened it to watching someone else parent your child -- it's hard not to be involved. But I also know, even if I need to be reminded, that when an event impacts me or my school community or the people I love significantly, I just can't be part of the response.

When airlines do the demonstration of oxygen masks before takeoff, they remind you to put on your own mask first and then help others. The same goes for crisis response. We're no good to anybody until we're good to ourselves, and sometimes that means referring incidents to someone else.

There, does it seem like I've done some growing in this one area?


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Naomi Zikmund-Fisher
is a clinical social worker, former school Principal and a Crisis Consultant for schools and community organizations. You can learn more about her at
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