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Saturday, June 27, 2009

The Post-Metro Malaise: Strategic Steps for Managing Post-Trauma Aftershocks

Hi,

In light of this week's Wash, DC Metrorail tragedy, a number of folks in federal agencies responded positively to my idea for an article providing strategic tips for managing the emotional aftershocks and to help the community heal.

Mark Gorkin, LICSW, The Stress Doc ™301-875-2567 and stressdoc@aol.com

P.S. If I can help you plan a speaking or workshop program that will provide some relief and rejuvenation while building a stronger sense of team and community, email or call.
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The Stress Doc reflects on the recent Metrorail tragedy and outlines key steps and strategies for those of us not directly injured but nonetheless still dealing with lingering dis-ease or any post-trauma effects.

The Post-Metro Malaise: Strategic Steps for Managing Post-Trauma Aftershocks

For many of us, another date, Monday, June 22nd, has been painfully etched in personal and collective memory. For folks in the Metro-DC area, this tragedy erupting so close to home, the aftershocks are palpable and unnerving. Still, this is more than a local story. While Metro is a vital part of the DC psyche and lifeline, and is the hub of the region’s transportation fabric, it is also a national icon. Especially for many millions of visitors, one might say Washington, DC, is known far and wide for its “Three ‘M’s”: Museums, Monuments and Metro. People from all walks of life felt the impact of the fatal collision.

Of course, our hearts, tears and prayers go out to the victims and their families. Alas, words alone cannot console the grief and heal the pain of lives tragically torn asunder; one fervently hopes that family, friends, faith and renewed focus over time may provide some relief and encourage psychic healing and human bonding. So my purpose, then, is to mostly speak not to those physically injured or jolted by the catastrophic collision but to address all of us who must continue riding Metro as well as those who can imagine someday riding Metro and are weighing the pros and cons. My words are for those likely no longer in a state of shock, but possibly in a present state of dis-ease, feeling that one’s world is shadowed by a greater sense of vulnerability and diminished control.

For me this essay is personal. Monday I was on the Red Line. I had just attended a seminar on “Mentoring” at the Dept. of Homeland Security (a tad ironic, perhaps). I stopped to have lunch across the street at L’Enfant Plaza, and was sitting outside soaking up the sunshine. Around two thirty in the afternoon I began my northward trek to the Wheaton station, unconsciously passing the Fort Totten stop. Just another day in the life of a Metro-DC citizen/consultant.

But, of course, it wasn’t. Now questions linger: how do you/we make sense of the unthinkable? And how do you/we come to grips with any trauma or emotional angst that is an understandable byproduct of closely identifying with the specific tragic event and the overall psychosocial-infrastructural-“the degree of safety in my world of Washington, DC” gestalt now shaken in light of the Metrorail disaster?

Let me say that we in Washington – whether inside or beyond the Beltway – are no strangers to tragedy, whether it manifests as 9/11, sniper fire or an anthrax attack/scare. (In fact, I have drawn on some of my previous post-trauma strategic reflections for this article.) Many of us are battle-hardened; still each tragedy must be acknowledged and wrestled with on its own terms. And also worth mentioning is that we are presently living in uncertain times – economic, job- and budget-related challenges, mortgage crises, depleted savings, etc. abound – stressors which may propel uncertainty into outright anxiety or lack of control moodiness. Finally, the nature of a post-traumatic stress reaction may be influenced by three dynamics:

a) in general, the overall level of work and home life uncertainty or vulnerability, non-stop demand or disorganization that one is currently experiencing when tragedy or trauma hits,
b) the degree to which a person has had significant losses, especially early in life, one example being a child who experiences the death of a parent; or the degree to which significant losses throughout the life cycle have not been sufficiently or adequately grieved; for example, persistent upsetting dreams about earlier experiences of loss -- whether of a love one or of a “loss of control or hope” scenario -- might be a signal for seeking some grief counseling, and
c) intimately knowing someone involved in a tragedy or being physically near the calamity in place or time (experiencing that “close call”) often heightens a feeling of identification and may ratchet up personal anxiety or a sense of loss.

The Stress Doc's Tips for Managing Post-Trauma Stress

With this descriptive and diagnostic opening, let me share some tips and strategies for maintaining a realistic sense of control, some healing humor and grace in these trying times.1. Do a Self-Inventory. Are you experiencing any of these common post-traumatic stress symptoms?:
a) generalized anxiety or helplessness; loss of concentration or racing thoughts
b) eating or sleeping disturbance; increasing your use of alcohol and drugs to chill out
c) feeling numb or unpredictably weepy; sudden crying
d) somatic stress, e.g., headaches, muscle tension, rise in blood pressure, etc.
e) loss of interest in previously enjoyable activities, roles and relations
f) impending doom; preoccupation with what will happen next.

You don’t have to have all these indicators to be a candidate for increased nurturance or reassurance, whether personal or professional. When one or two of these “smoke signals” reach intense levels, consider reaching out. Fortunately, federal employees have access to agency Employee Assistance Programs (EAP), that is, free, time-limited counseling. Talking with a trained and objective professional may be the best way to engage your thoughts and feelings and regain a sense of emotional equilibrium and perspective.

2. Stay Connected, Not Compulsive. As a general coping strategy, don't just bury your head in work as a way to tune out anxiety. Conversely, beware the deer in the headlights syndrome from CNN or internet overload. Beware being mesmerized by “news addict” media. Talk with significant others to help release and reduce your fears; however, seek a serene mean: constant venting (or being exposed to such an invasive "stress carrier") likely will fuel anxious ruminating.

3. If at All Possible, Get Back On the (Iron) Horse. The next two post-trauma management/prevention tips come from post-9/11 experiences. About a week before 9/11, I confirmed a visit to my folks in NYC via AMTRAK. I was to arrive on the 14th. Then 9/11 happened. Despite some anxiety, on the phone we agreed that short of a credible bomb threat at Penn Station I would head up. And I’m glad I did. Traveling on the train, landing in Penn Station, and later that weekend walking around Union Square with a friend, viewing the candlelight vigils, hearing the haunting strains of music and seeing the heart-wrenching, “Have you seen…?” photos, letter scraps and posters, was incredibly poignant and also cathartic. Confronting the myriad of emotions helped me tangibly feel the loss as well as find some sense in the ineffable and the irrational. I believe this emotional immersion ultimately prevented the development of phobic-like avoidance reactions and reduced the length and severity of the post-trauma experience. (Again, the experience is very different for an individual or family who more directly and tragically experienced “ground zero.”)

4. Sustain Commitment, Demonstrate Courage. When it comes to managing trauma and strengthening emotional muscle, more is on the line than just individual stress. How you handle challenges, including personal stress, often has important implications for others, especially the ones closest to you. Consider this second post-9/11 vignette. (I’m not equating the two tragedies; just trying to present a story for your consideration.): a Ph.D. Research Psychologist working at the National Institutes of Health (in the Metro-Washington area) at a Center meeting recalled the terror-induced distraught weeping of her ten-year-old daughter. The girl was trying to dissuade her mother from attending an out-of-town conference about one month after the September attacks. Despite having left the child with her parents, this single mother was still not sure she had done the right thing. Once discerning that the daughter was doing fine, I asked this Mom to loosen her guilt knot and to consider that, "You've been a role model for courage. That despite having some fears, the message you gave your daughter was not of neglect. Your actions revealed having enough confidence in yourself and in her, and a belief in meeting important responsibilities even in tough times."

5. Share the Humor. Clearly, there's no joking away today's litany of fears, scares and tragedies yet, as the comedic genius, Charlie Chaplin, understood, more than ever we need to laugh: "A paradoxical thing is that in making comedy the tragic is precisely which arouses the funny...we have to laugh due to our helplessness in the face of natural forces and (in order) not to go crazy." Right now, some light and enlightening in-house training and conference programs filled with some safe venting, laughter and fun just might make a timely and invaluable healing and inspiring gift.

Sometimes, though, major planning isn't necessary; healing humor may only require a deft touch at a sensitive or "higher power" moment. Consider the repertoire of a Southwest Airlines employee at a traditionally somber interlude. Reviewing takeoff procedures, the steward, holding both oxygen mask and float cushion, suddenly says, "Since part of this trip will be over water, in the unlikely event that this flight becomes a cruise"…and before he could complete his instructions, waves of laughter rolled through the cabin.

Whether getting on a plane, train or being apart from family while attending a conference, being able to find some humor or a sense of the absurd in the face of our doubts and demons are all vital components for long-term relief and rejuvenation. According to psychiatrist, Ernst Kris, "What was once feared and is now mastered is laughed at." And as the Stress Doc inverted: "What was once feared and is now laughed at is no longer a master!"

But it was the great humanitarian and disability pioneer, Helen Keller, who truly captured the importance of humor as a heart-to-heart healing and uplifting source, especially in trying times: “The world is so full of care and sorrow it is a gracious debt we owe one another to discover the bright crystals of delight hidden in somber circumstances and irksome tasks.” Amen and women to that!

6. Distinguish Probable vs. Possible. As the former Washington Post reporter, Doug Feaver, who covered Metro and other local and national transportation issues, stated in his June 24 op-ed piece, despite the recent tragedy and the age of some of the trains, “Metro is extraordinarily safe. About 40,000 people nationwide were killed in traffic accidents in 2007, the last year for which totals are available…A total of 12 passengers and two metro employees have been killed since the system opened.”

When decision-making is driven by "the possible" (adverse consequences) then we are nearly always anxious, vulnerable and on the edge. With a fertile mind, almost any negative influence or occurrence or omen can be lurking in the shadows. However, by evaluating situations more objectively, often with the help of fact-driven feedback, thereby discerning what is a reasonable expectation or likely result, that is, "the probable," we can: a) better assess past and present issues and events as well as future warning indicators, b) identify more accurately the problem-solving content and context, what's relevant background data, what's noise, and c) generate more reliable, optimally risk-taking and more likely to be effective individual and collective response options and actions.

Of course, using a probability perspective means randomness and hazards are to some degree in play; you cannot be omniscient or be totally in control of all contingencies. We all want to know as quickly as possible the causes of the tragedy. Let the investigators do their job. Be careful not to jump to premature conclusions just to resolve anxiety and create the illusion of control.

Remember, wisdom is usually seen as a yin-yang mix of having knowledge and being able to tolerate uncertainty; taking action yet knowing when to exercise judicious restraint; becoming emotionally involved and demonstrating some detachment. The Serenity Prayer, once again, seems prescient:

Grant me the serenity to accept the things I cannot change, the
courage to change the things I can and the wisdom to know the difference.

7. Take Timely, Concrete and Positive Action. Try formulating two or three action steps that might help you feel a small but significant degree of enhanced safety and security. If you are considering using Metro again, how about riding with a friend or “stress buddy?” For example, I’ve been doing work with officers, soldiers and spouses at Ft. Hood, TX. When the soldiers deploy to Iraq, not surprisingly, it’s a stressful time on the home front. In highly coordinated fashion, the spouses' “battlefield buddy” network swings into action, establishing phone trees and help lines, peer social and support groups, family outings, etc. The BLUF (“Bottom Line Under Fire, not "Bottom Line U Fool"): “Don’t suffer alone in silence!”

Like the state of crisis, post-trauma effects are time-limited; a person will typically regain a state of mind-body equilibrium within one to six weeks. The equilibrium may reflect: a) positive problem-solving and the further development of one’s mind-body-spirit resources or support systems or b) regression using avoidance coping strategies that constrict the choices and boundaries of your life. This is why the Chinese have two characters for “crisis” – “danger and opportunity.” So strike when the ego is hot, for there is a timely learning curve: effective coping during the one-six week vulnerable window not only restores a sense of confidence and competence but often helps develop cognitive and emotional muscles for managing future trauma or crisis effects.

In summary, there is cause for hope and even optimism. Post-traumatic stress is natural, and if purposefully engaged may heighten an individual's problem solving capacity, enhance one's communal circle of support and, in addition, the grief process may be a catalyst for potent healing and growth producing energy. As I once penned: Whether the loss is a key person, a desired position or a powerful illusion each deserves the respect of mourning. The pit in the stomach, the clenched fists and quivering jaw, the anguished sobs prove catalytic in time. In mystical fashion, like Spring upon Winter, the seeds of dissolution bear fruitful renewal.

8. Develop Natural SPEED. Finally, try this daily formula for natural stress inoculation:S = Sleep. Don't be cheap with your need for sleep. Less than six hours a day for most folks dulls cognitive sharpness, a critical faculty for firmly grounding those fear factors and exploring problem solving opportunities.

P = Priorities. One example: distinguish "the urgent" (which must be handled immediately) from "the important" (which can be prioritized). The second approach when it comes to establishing priorities: “learn to say no.” Remember, burnout is less a sign of failure and more that you gave yourself away. Consider these Stress Doc maxims: “A firm ‘No’ a day keeps the ulcers away, and the hostilities, too” and “Do know your limits and don’t limit your ‘No’s.”

E = Empathy. Have a stress buddy at work and/or home; someone with whom you can both give and get support. As I once penned: “E” is for the empathy found in a caring shoulder. But all give without take is a big mistake for now you shoulder a boulder!

E = Exercise. Not only does aerobic level exercise stimulate the mind-body's natural mood enhancing chemicals, but walking two miles or a 30-minute workout at the gym provides a beginning and endpoint for a tangible sense of accomplishment and control. In uncertain times, success rituals definitely strengthen psychological hardiness and resilience.

D = Diet. This is not the time to use food to numb your angst. High fats and simple sugars along with excess alcohol dull the brain in the long run and can even trigger moodiness and depression. A conscious healthy eating regimen will be another self-control component in your strategic plan for mind-body safety and personal-professional integrity.

Hopefully, this article has raised some questions and outlined some steps and strategies for positively responding to these trying if not traumatic times…words to help one and all Practice Safe Stress!

Mark Gorkin, MSW, LICSW, "The Stress Doc" ™, a Licensed Clinical Social Worker, is an acclaimed keynote and kickoff speaker and "Motivational Humorist" known for his interactive, inspiring and FUN speaking and workshop programs. In addition, the "Doc" is a team building and organizational development consultant for a variety of govt. agencies, corporations and non-profits and is AOL's "Online Psychohumorist" ™. Mark is an Adjunct Professor, No. VA (NOVA) Community College and currently he is leading "Stress, Team Building and Humor" programs for the 1st Cavalry and 4th Infantry Divisions, Ft. Hood, Texas. A former Stress and Conflict Consultant for the US Postal Service, the Stress Doc is the author of Practice Safe Stress and of The Four Faces of Anger. See his award-winning, USA Today Online "HotSite" – www.stressdoc.com -- called a "workplace resource" by National Public Radio (NPR). For more info on the Doc's "Practice Safe Stress" programs or to receive his free e-newsletter, email stressdoc@aol.com or call 301-875-2567.

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