Critical Incident-Trauma-Grief Intervention & Debriefing: Train the Trainer/Caregiver Workshop

Just last week, Dr. Charles Hicks a Baltimore psychologist and life coach and Linked-In comrade, approached me about developing a proposal on Primary and Secondary Trauma/Grief Intervention and Debriefing.  He wanted to pitch it to a local “faith-based” organization.  The request was intriguing, and I immediately got on the keyboard.  As I was developing the package, it was soon clear I could integrate both ideas developed decades ago as a Crisis Intervention Adjunct Professor at Tulane University Graduate School of Social Work and more recent work as a Critical Incident/Stress-Trauma-Grief Debriefing Consultant.  (See below, “The Stress Doc’s Critical Incident Intervention-Chicken Gumbo Recipe for Soothing the Heart, Sustaining the Soul, and Searching Anew for Purpose and Passion:  Nine Steps.”)

In addition to a program blurb and objectives-outline and relevant testimonials, and a sample list of my trauma intervention experience, there are two powerful and relevant Resiliency Raps.”  Dr. Hicks thought the proposal “great.”  I hope you find it thought-provoking and, if applicable, of use to you, your group/organization, or other entities.  Please email or call with any questions, ideas, or suggestions.  Peace,

Mark

Mark Gorkin, MSW, LICSW
The Stress Doc ™

Stress & Change Resilience Counseling-Coaching-Consultation
Crisis Intervention-Burnout-Bullying/Conflict-Loss-Grief
Phone-Electronic-Skype-In-Person

301-875-2567
stressdoc@aol.com
www.stressdoc.com
http://www.orate.me/resume/mark-gorkin/  (ORATE Speakers Bureau)

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Critical Incident-Trauma-Grief Intervention & Debriefing:  Train the Trainer/Caregiver Workshop

In a world where encounters with sources of aggression and violence, trauma and grief are all too common, understanding the dynamics of “critical incidents/hazardous events” – both for adults and/or children directly impacted and for those encountering second-hand effects – is vital.  This “train the trainer/caregiver” workshop is for family members or close friends, colleagues, educators, religious or community leaders, emergency responders, or an array of helping professionals.  Critical Incident Intervention demands an ability to respond using both head and heart to connect and comfort those caught in the radiating circles of trauma.

And the Stress Doc’s lively, high-energy programs are the perfect answer.  In fact, the Doc’s workshops help audiences “Get FIT”…by being FUN-Interactive-Thought-provoking.  The program involves a mix of brief lecture, real world group exercises, and group discussion.  You will walk away with “hands on” tools and skills, techniques and strategies for responding purposefully, efficiently, and with compassion in times of trauma and crisis.   And these tools and strategies will enable you to effectively engage both individuals immediately impacted by trauma and loss, and especially with those emotionally connected to or in the emotional shadow of trauma or grief ground zero.

Program Objectives

The Critical Incident/Trauma Debriefing Professional needs to have working knowledge in the following key areas, including:

A.  Overview of Stress, Crisis, and Trauma

1. The Head and Heart Support and Resilience Goal of Critical Incident/Trauma Debriefing
2. Types of Stress, Smoke Signals, and Crisis Theory
3. Crisis Window of “Danger & Opportunity”
4. Different Types of Trauma/Grief Situations
5. Predisposing Factors to Traumatic Stress Reactions

B.  Dynamics of Loss and Grief

1. Unfinished Grieving and “Grief Ghosts”
2. Understanding the Multifaceted Nature of Loss and Grief
3. Stages of Loss and Grief, including Shock, Denial, Rage, Helplessness, Guilt, Ambivalence, etc.
4. Difference between “Feeling Sorry for Yourself” and “Feeling Your Sorrow”
5. The Magical Healing Path of Grief

C.  Critical Incident Settings and Use of Personal-Professional Self

1. Types/Settings of Interventions
2. Use of Personal/Professional Self in Critical Incident/Trauma Debriefing
3. Capacity for Relaxed Attention, being Focused & Fluid, Absorbing & Scanning, and Detached Involvement
4. Conscious Use of Verbal and Nonverbal Communication

D.  Key Critical Incident Communication Skills

1. How to Engage in Reflective Listening
2. How to Ask Courageous “Good Questions”
3. How to Tentatively Reflect and Appropriately Reveal

E.  Key Intervention Process Components, Tools and Techniques

1. Transitioning from Educator to Group Facilitator
2. “Nine Step Trauma & Grief Orientation-Engagement Recipe.”
3. Carefully Using Healing & Harmonizing Humor:  The Link between Comedy and Tragedy

F.  Taking Care of the Critical Incident Caregiver

1. Recognizing, Preventing, and Recovering from Burnout
2. Engage in Acclaimed Relaxation-Visualization Exercise
3. Stress Doc’s Natural SPEED Formula for Stress Resiliency and Brain Agility
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Credentials and Experience of the Primary Presenter

Mark Gorkin, MSW, LICSW, known as the Stress Doc ™, is a nationally recognized speaker, Stress Resilience and Critical Incident/Hazardous Workplace Expert.  Mark has been:

a) a Stress & Violence Prevention Expert for the US Postal Service; was the “Social Worker/Consultant on the Beat”

b) a Stress Resilience-Humor-Team Building Expert for the US Military,

c) a Critical Incident/Trauma-Grief-and Hazardous Workplace Debriefing Expert for numerous corporations, government agencies, and institutions

d) over the past fifteen years, under the banner of Total Learning Solutions, has led a series of one-day Stress Resiliency & Conflict Management programs for Managers and Supervisors at Washington Metro Area Transit Authority (WMATA)

e) taught Crisis Intervention/Brief Treatment for ten years at Tulane University Graduate School of Social Work

f) recognized stress, transition stress, burnout and grief, transforming anger and conflict speaker and writer; has worked with hundreds of companies, institutions, and federal, county, and city agencies

g) author of Practice Safe Stress:  Healing & Laughing in the Face of Stress, Burnout & Depression, The Four Faces of Anger:  Transforming Anger, Rage & Conflict, and Resiliency Rap:  The Wit & Wisdom of the Shrink Rapper ™

h) private practice therapist for nearly thirty years, specializing in stress, burnout, loss, grief, and couples counseling

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A Sample of Critical Incident/Trauma Debriefing Interventions includes:

a) bank personnel/robbery at gun point

b) with postal facility’s personnel after an employee threatens to shoot two colleagues

c) postal worker held up at knife point

d) beloved Manager killed by a stranger after work outside a club

e) federal supervisor threatened with a knife

f) employee having a fatal heart attack on the workfloor

g) employee suicide in the context of some conflict-laden work relations

h) employee having a psychotic break at work

i) intense racial antagonism, and/or sexual harassment, and/or bullying/emotional intimidation in the workplace

j) supervisor losing son to AIDS and husband to a heart attack in a two month period

k) supervisor killed in a head-on vehicular crash while driving to work

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Testimonials

 

University of Maryland's Diabetes/Endocrinology Center's Managing Diabetes Conference; 100 + Allied Health Professionals

 

Practice Safe Stress:  Stress and Change Resilience through Humor

3/12/2015

Hi Mark-

Great presentation. It really inspired me to improve my own presentation skills and brainstorm with my coworkers how to make our diabetes education classes more fun.

Please add me to your newsletter list.

Best Regards,

Alison Massye

Alison Massey MS, RD, LDN, CDE
Director of Diabetes Education, Mercy Medical Center
250 N. Calvert Street Baltimore, MD 21202
amassey@mdmercy.com
P: (410) 659-2833
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Developing Stress Resiliency, Humor, and Passion Power:  The Gift of Interactive Engagement; for Human Resources Palm Beach County (HRPBC), FL; Kickoff Speaker; 100 attendees; 1.25 hrs

Feb 27, 2014

Hello Mark.

HR Palm Beach County had the wonderful pleasure of having Mark Gorkin “The Stress Doc” present at one of our monthly dinner meetings. Mark’s presentation was both insightful and engaging. He has a way of captivating the audience and makes them want to hear more. We enjoyed his insights on the factors that cause stress and how to overcome them. We hope to hear more from “The Stress Doc”. It was definitely time well spent. We especially enjoyed his perspective of Passion and Power. Mark Gorkin is a must hear!

Tanya Vaughn-Patterson
HRPBC Program Chair

Diversity & Inclusion Consultant
NEXTERA ENERGY
Ofc: 561-694-4199
tanya.vaughn-patterson@fpl.com
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Fairfax County Government/Dept of Administration for Human Services; Keynote for 120 on "Energizing and Expanding Team Mindset, Motivation & Morale"

Subject:   THEY LOVE YOU IN DAHS
Date:     3/25/2013

Hi Mark,

Hope you had a great weekend.

I spoke with Gail this morning and she is absolutely DEE-lighted with the Stress Doc! 

[Gail Ledford, Department Director, was going to share her observations with Dept. of Public Work's Director James Patteson.]

WE have had nothing but rave reviews from the staff

“Engaging and Educational”

“Just a note to say how much I enjoyed yesterday’s event at the Government Center.  I think it changed the attitudes of many because not only were we ‘away’ from the office but also having Mark Gorkin as a guest speaker helped everyone connect better….and laugh. Thank you!”

“We are already using some of the tools and suggestions from the training. Our vote is more like this, whether it’s him or similar activities.”

I will be in touch. All the best,

Robyn L. McCoy
Resource Development and Training Manager
Department of Administration for Human Services

703-324-3597
Robyn.McCoy@fairfaxcounty.gov
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Counseling Testimonial

Oct 12, 2013

I am so glad you are offering your services to many. You are an insightful man who helped me to have clarity and find my strength in chaos. I honestly believe that "God" put you in my path. I am still unsure of my future but I do know that I made the right choice. Without your understanding, patience and knowledge, I would not have been able to make that move. I may have slip-ups but I hear your voice and your words in my head and you continue to guide me.

A

Long Island, NY
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Mark Gorkin, MSW, LICSW, "The Stress Doc" ™, a Licensed Clinical Social Worker, is an acclaimed keynote, kickoff and webinar speaker as well as "Motivational Humorist & Team Communication Catalyst" known for his interactive, inspiring, and FUN programs for both government agencies and major corporations.  In addition, the "Doc" is a Team Building and Organizational Development Consultant as well as a.  He is providing "Stress and Communication,” as well as “Managing Change, Leadership and Team Building" programs for a variety of units at Ft. Hood, Texas and for Army Community Services and Family Advocacy Programs at Ft. Meade, MD and Ft. Belvoir, VA as well as Andrews Air Force Base/Behavioral Medicine Services.

A former Stress and Violence Prevention Consultant for the US Postal Service, the Doc is the author of Practice Safe Stress and of The Four Faces of Anger.  The Stress Doc blog appears in such platforms as HR.com, WorkforceWeek.com, and MentalHelpNet.  His award-winning, USA Today Online "HotSite" – www.stressdoc.com – was 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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Supporting Documents

The Stress Doc’s Critical Incident Intervention-Chicken Gumbo Recipe for Soothing the Heart, Sustaining the Soul, and Searching Anew for Purpose and Passion

Critical Incident Interventions come in many forms and functions, shapes and sizes.   For example, one common format:  providing a ten-minute overview of the effects of trauma and loss along with the signs and stages as well as the typical and individual workings of grief with a large group of employees (fifty or more).  You typically close by providing info about the Employee Assistant Program (EAP) for possible follow-up as needed.  Sometimes an intervention consists of meeting briefly with a team or segments thereof followed by consultations with individual employees.  These individual sessions may be scheduled beforehand; they also may arise right after a grief orientation, as an individual realizes s/he needs to talk.  In addition, an employee may be guided to you by a manager, or the start of an intervention can occur as you walk the halls, engaging people on the spot.

However, there’s another CISD (Critical Incident Stress Debriefing) model and method that appears to be effective for a time-limited orientation-intervention (e.g., 15-30 minutes) with a moderate-sized group (around 20-30 participants). Based on a recent 20-minute, 20-person group sessions, for maximizing intervention benefits consider this strategic, content-process, “Step-by-Step Trauma & Grief Orientation-Engagement Recipe.”  (Please know that deviations and trial and error experimentations will be highly likely and/or necessary.)  Let’s call this “The Stress Doc’s Critical Intervention-Chicken Gumbo for Soothing the Heart, Sustaining the Soul, and Searching Anew for Purpose and Passion.”

1.  First Impression.  Addressing the assembly, the Human Resources Director began her brief introduction, explaining who I was and why I was present.  Actually, her first words, not surprisingly, were a reflexive, “Good morning.”  My first words:  “Normally I would say ‘good morning,’ but today’s is not a good morning; it’s a very tough one.”  Immediately I had distinguished myself and my role while demonstrating an awareness of the emotional state and place of the folks in the room.  It wouldn’t be business as usual, yet…

2.  Getting Down to Business.  Having only 20 minutes necessitates a strategic opening and basic outline, including:

a) sharing some common traumatic effects of sudden and horrific death (a violent death often heightens the sense of trauma) and grief – e.g., an immediate state of shock, feeling numb, sadness, generalized angst, and/or anger (ranging from being angry with God and fate to the deceased, himself), social withdrawal, feeling bereft or emotionally out of control, possibly losing one’s appetite (or overusing substances to numb pain), having difficulty sleeping, etc.

b) placing these stress and loss smoke signals in a time frame, that is, the presence of some or a number of the above effects for a handful of days is fairly normal, (unless, of course, these grief signals are of overwhelming intensity); if the distracting or disturbing presence of any effects approach two weeks, then an assessment with an Employee Assistance Grief Counselor is strongly advisable.  And here’s why…

3.  Trauma takes off the Stress and “Grief Ghost” Cover.  Another piece of educational information relates to the disruptive potential of a sudden traumatic experience:

 

a) individuals currently experiencing high levels of stress in their lives, separate from the tensions related to the death of a colleague, are more likely to have heightened reactions to the immediate loss; they don’t have room to handle another stressor on their emotional plate and

b) consciously or not, we all carry around some emotional baggage from our psychosocial-historical past; if a person has not sufficiently grieved a previous loss or disruptive event – actual or psychological – especially regarding significant others or family/group relations, then the weight of this baggage becomes more onerous.  For such a burdened individual, a traumatic experience:

1) either increases the heaviness of one’s emotional load or

2) breaks open your luggage; now painful feelings and memories from the past – what I call “grief ghosts” – begin or are primed to flood your work-life space.  During trauma or “crisis,” defenses are lowered or punctured, the mask is uncovered.  People often wonder why they are having such a strong reaction to the immediate tragedy:  “Why am I suddenly thinking of people who don’t typically appear on, let alone crowd, my psychic radar?”  The short answer:  you are likely grappling with multiple losses – one’s both immediate and historic.  Consider this poignant example:  several days after 9/11, my webmaster, a former US Army officer and Vietnam combat vet, couldn’t understand why he was still having a vague sense of unease.  Asking a few questions helped him reconnect to the subterranean memory of having lost his first wife decades earlier in a tragic house fire.  He had been unsuccessful in his rescue attempts.  Trauma surfaces the overt and the covert.

4.  Grief Is Still Individual.  Finally, upon reviewing useful grief data, remind one and all there is no one right way or exact timetable for grieving.  The process is truly personal, based on one’s life stage and experience, temperament, cultural influence, etc.  I do close this portion of the session with a heartfelt Stress Doc ™ adage:  There’s a real difference between feeling sorry for yourself and feeling your sorrow.  When feeling sorry for yourself, you are likely blaming others.  When feeling your sorrow, you have the courage to face your pain.  And there will be times when each and every one of us must face and embrace our sorrow!”

5.  Changing Direction.  The educational component should not be more than 5-10 minutes.  Shifting idea and energy flow, I paused and asked if anyone wanted to speak.  In one group, initially, no one responded.  (This is not so surprising when many are feeling numb or are still in a state of shock; still others are not sure what to say.)  In the second session, one person shared a general observation about life’s vulnerability.  And then silence loomed; I affirmed this was understandable.

6.  The Power of Silence.  A suggestion:  consider going with the flow.  Ask for a minute of silence so all could all be with their own thoughts.  Based on my experience as a group facilitator, an uneasy or weighted quiet often is a stimulus and space for helping people focus, and get more centered.  Ironically, silence itself becomes a lubricant for communication.  And in fact, participants in both groups began sharing personal, heartfelt stories capturing some poignant or playful interaction with the deceased.  One or two revealed the recent death of a significant family member.  I noted my availability after the final grief session.

7.  Build On the Sharing.  I mentioned there may be several ways of memorializing the deceased, beyond a service, including a visual-verbal picture-board or scrapbook, planting a garden, or turning an activity that the deceased enjoyed into an annual event, etc.  (For example, one hospital department named a bocce tournament for a fallen colleague who enjoyed the pastime.)

Then, with time running down, I compressed a grief exercise into a head- and heart-provoking encounter.  After summarizing many of the positive qualities mentioned, and also surmising the deceased “wasn’t always an angel” – sometime he might even be a “pain in the butt” (which elicited some knowing laughter) – I then posed a powerful question…

8.  An Existential-Spiritual Challenge.  “What would happen if each one identified a trait or quality that they admired or valued in the deceased? … And, too, if all committed to cultivating that trait within ourselves?”  While time constraints did not permit group discussion, I answered as follows:  “First, I believe you’d be giving yourself a gift by honoring your colleague.  And second, if each person took up this challenge, while your colleague would no longer be physically present, his spirit would certainly walk the hospital halls.”  The energy rise in the room was palpable.

9.  Closing Review and Resources.  After thanking everyone for their attention and for the individual sharing, I briefly affirmed the depth of emotion that can be evoked by trauma and grief.  Also underscored was the importance, during such trying times, of having a personal and/or professional ear and shoulder to lean on; a “stress buddy,” as I like to call it.  Sometimes, after the shock wears off, the pain and confusion may warrant talking to a professional.  Again, I reminded people of the availability of the Employee Assistance Program for free time-limited stress and grief consultation or counseling.  And finally, the HR Director reminded people that I would be available for one-on-one meetings after the group session.

I hope this strategic content-process “step-by-step” yet fluid recipe for acute stress relief and grief counseling proves useful should your company or organization find itself in the throes of life-and-death trauma.  Unfortunately, such understanding and capacity for therapeutic response may be increasingly critical in a rapidly changing world that too often appears to be outpacing the human and organizational capacity to adequately adapt.  More than ever…Practice Safe Stress!
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Grief Ghosts:  A Viral or Vital Metamorphosis

And the Grief Ghosts will rise from the ashes
When one tries to bury the pain.
Feeding a fire that chokes dreams and desire
Oh when will your tears fall like rain?

Too late…look, soul-sucking phantoms
Spiral higher and higher, madly morph and conspire
As Trojan worms raiding while aerating your brain.

Wait…Perhaps there is still time to reach for the sublime:
Grieve, let go…and grow with the flow!

© Mark Gorkin  2012
Shrink Rap ™ Productions
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As a Critical Incident Consultant, I’m poignantly aware how unexpected dramas and tragedies lurk behind every corner and crevice of our hearts and minds…and also lie in the shadows of our homes, schools, and places of work.  Out of the quiet, out of The Death of a Salesman closet, Arthur Miller screams:  Attention must be paid!  And sometimes we must risk trusting our gut, risk "overreacting" and being mislabeled, and say something to the right someone...or be the right someone!

Learning from the Fatal Flaw

Did she really take her life over a phone?
Taken from a colleague…now all’s undone!
One woman dead, one torn apart
Guilt spears a throbbing heart
Regret for filing that stolen report
Who is at fault?  Who is at fault?  Who is at fault?

Can one grasp obscure knowledge
On the all too human fatal edge?
To get on the same page, one must leave a stage
Masked by “got it together” pain and rage.
Even with the latest gauge, who knows faux-taupe from beige?
Who is a sage?  Who is a sage?  Who is a sage?

Yet a friend sensed her look, a fearful absent look.
Still her head stayed by the book...
Why didn’t she speak up?
Neither one trusted their gut
"Don’t be a pain in the butt!”
So we doubt?  So we doubt?  So we doubt?

Do we pass in the hall and nod
In a hazy-distant fog
And mouth, “How you doing?”…
But only reminiscing; more simply whistling
Who has time for real listening?
Do your thing?  Do your thing?  Do your thing?

Now so sad; maybe wiser: are we respecting one another?
Whatever happened to “sister” and “brother”?
Wide-eyed to foreign experience
Energized by expressive variance
Growing through world view contrariance.
Will you dance?  Will you dance?  Will you dance?

Is it too risky to share
Without some faith in the air?
Of course, you can’t flip a switch, still
Pull one from a ditch; let another bitch…
The sky’s not falling – more like a glitch.

For a culture to be rich, offer a broad-shouldered niche.

Hey, it’s "get real" or be a bust:
Now they might trust!  Now they might trust!  Now they might trust!

© Mark Gorkin  2014
Shrink Rap ™ Productions

The Four-Step Rise of Grief Ghosts and Seven Factors Influencing their Nature – Part VI

Grief Ghosts: A Viral Metamorphosis

And the Grief Ghosts will rise from the ashes
When one tries to bury the pain.
Feeding a fire that chokes dreams and desire
Oh when will your tears fall like rain?
Too late…look, soul-sucking phantoms
Spiral higher and higher, madly morph and conspire
As Trojan worms raiding while aerating your brain.

Perhaps there is still time to reach for the sublime:
Grieve, let go...and go with the flow!


As noted in Part IV of my series on “Burnout and Burn-in, Loss and Grief Ghosts,” burn-in involves the silent, chronic drain of harboring unconsciously repressed or consciously resisted lingering and reverberating memories and painfully smoldering emotions connected to: a) recent and past, b) physical, psychological, and spiritual, c) personal and interpersonal, and d) professional and family, socio-cultural and organizational losses, transitions, and traumas. And, perhaps most disorienting, pressure-packed emotions and memories long denied or prematurely buried become the crucible for the birth of “Grief Ghosts.”

Let me simplify this “Four Step Rise of Grief Ghosts”:

1. Lingering Loss. You experience a painful loss – from the personal to the organizational – whether from the distant or recent past. The nature of the loss is denied or, more likely, acknowledged but quickly pushed to the back of your mind, out of everyday emotional consciousness. “It’s time to move on.” Of course, the more powerful the loss the greater is the potential for kindling grief ghosts. (In general, lingering, unrecognized, minimized, or denied loss + the significance of the loss + the absent or limited nature of grief time (the shorter the overt grief time the higher the kindling potential) + the dysfunctional/defensive characteristics of grief avoidance (e.g., substance abuse, keeping a manic- obsessive distracting schedule or pace, subtle or disguised depression, etc.) x time = the formula for ghostly production.)

2. Prematurely Buried Grief. The energy and feelings connected to the loss and the avoided or alienated grief process means painful emotions and memories are smoldering and reverberating inside. The longer and tighter one tries to keep the lid on this psychic crucible the more potent the condition for this combustible mix to become increasingly pressure-packed and incessantly loud, and to swarm furiously. Clear thought and decision-making processes are scrambled; heightened emotions if not numbed can become overwhelming.

3. Precipitating Event. Other life transitions, traumas, and losses experienced along the burn-in path may only compound and intensify this fuming and rumbling process if, once again, the grief process is basically avoided. In fact, one of these triggering hazardous events will finally be the spark that detonates the proverbial final straw, firing up, launching, and animating the underground ghosts.

4. Burn-in and the Rise of Grief Ghosts. Finally, one will implode or explode; constantly smoldering and smoking pain or shame not only is exhausting, it burns away your emotional defenses as well as your mind-body-heart-spirit insides; alas, it may be hard not to make an ash of yourself! Your combustible “burn-in” psychic mix, like the high temperatures and pressure that forms metamorphic rocks, now morphs into “Grief Ghosts.” Or subterranean, conflicting and clashing past and present voices in your head, like colliding tectonic plates, may spark the rise of metamorphic and metaphoric ghosts. Whatever the genesis, you are suddenly dealing with two battlefronts: a) the immediate real world problem in the present and b) and the unleashed spectral presence of formerly dormant, now painful, confusing, and often critical grief ghosts. And your inner reserve and resolve feels depleted if not devastated. This ‘Burn-in” process has you susceptible to depression, exhaustion or burnout, emotional overreaction, agitation, or regressing to old self-defeating “survival” patterns. These burn-in smoke signals may occur especially during times of crisis, trauma, loss, and high stress or when in the throes of challenging performance, identity-related transition, and/or intimate relating.

Seven Factors Influencing the Nature of Grief Ghosts

Are all grief ghosts alike? Of course not. The character of our “Grief Ghosts” depends on the nature of our loss, the variables surrounding this loss, and the subsequent grief reaction (including “Prematurely Buried Grief”) or response. According to Judith Viorst, in Necessary Losses: The Loves, Illusions, Dependencies, and Impossible Expectations that All of Us Have to Give Up in Order to Grow, (The Free Press: New York, 1986, p.238), certain factors increase vulnerability to loss: “Those with a poor prior history of mental or physical health are at greater risk. So are those dealing with death by suicide. So are those spouses whose relationship with the husband or wife who died was especially ambivalent or dependent. Those who experience loss without the support of a social network tend to find trauma more intense. And the younger do worse than the older – studies find that one frequent consequence of childhood loss is a higher risk of adult-life mental illness… (Finally,) adolescents can mourn but are still more vulnerable than adults because they are experiencing so many other (psycho-physiological) losses and changes.”

Viorst also addresses the nature of grieving: “How we mourn, or if, our mourning is going to end, will depend on what we perceive our losses to be, will depend on our age and their age, will depend on how ready all of us were, will depend on the way they succumbed to mortality, will depend on our inner strengths and outer supports, and will surely depend on our prior history – on our history with the people, (positions, partnerships, programs, plans, possibilities, etc. who/that) ‘died’ and our own separate history of love and loss.”

Let’s take a closer look at these loss and grief variables. The propensity for: 1) the unleashing of ghosts, 2) the varying nature of the ghosts, and 3) the danger and opportunity for positive grief ghost resurrection and psychic rejuvenation is contingent upon:

a) Loss Significance, Identification, and Complexity
1) loss significance. The mind-body-heart-spirit significance of any loss (person, place, loss of control and competence, loss of a dream, etc.) clearly impacts the grief ghost process; to reiterate, the degree a person has prematurely buried or denied significant past “loss” issues and emotions and they now arise as grief ghosts, the immediate reaction is often a sense of danger and disorientation. Feelings of worthlessness and isolation, a sense of being hollow, profound identity confusion, and a loss of personal/professional direction may predominate. However, as we will subsequently explore, much as in the double-edged – danger and opportunity – nature of crisis, the rise of grief ghosts also allows one to more knowingly and purposefully tackle these subterranean issues which have been disrupting and constricting a life outside of one’s awareness,

2) identification, internalization, and introjection. Another factor is the degree of “identification with the lost person/object that is, the process of internalization by which we modify our self (consciously) and introjection (unconsciously) to become in some ways like this or that person out there” (Viorst); according to Freud, positive identification facilitates our letting go of the lost person, that is, we now possess internally some of their essence; of course, one may also consciously try to disavow a connection to a person (or place), e.g., the individual who says, “The last person I will be like is my old man” simply tells me how deep the kindred hook is lodged; avoiding the grief process naturally impedes more healthy and current identification; avoidance also builds up and exaggerates critical voices and subterranean introjects or internalizations, along with subconsciously heightening feelings of early abandonment and separation anxiety; all these dynamics influence a person’s overt and covert thoughts and behavior and fuel the creation of grief ghosts,

3) loss complexity. Early childhood internalizations along with the degree of closeness and/or conflict in an intimate relationship and/or with significant role relations affects the depth and personal impact of a loss; ironically, for example, grief research indicates that for couples who had more dysfunctional or codependent relationships than couples in healthier partnerships, instead of relief (which might seem commonsensical) the death of a spouse typically results in more complicated grieving; clearly, there is burdensome amount of emotions and issues that not only remain “unresolved” and ghostly but likely were never honestly and healthfully addressed,

b) Loss Dynamics/Context – the bio-psycho-social-cultural-historical dynamics surrounding the loss altogether impact: 1) the immediate emotional experience, 2) the subsequent grief, 3) the reaction to a triggering event or stressor, as well as 4) the genesis and make-up of ghosts; e.g., one’s reaction may be different when losing a family member to a heart attack when death is sudden and unexpected compared to a second fatal attack; either cardiac scenario is obviously a different “loss context” than having a family member incinerated in the Twin Towers on 9/11 or die in a head-on vehicular collision.

I also want to highlight two compelling factors regarding the nature of loss dynamics-context and subsequent ghostly impact:

1) Gender. Gender differences clearly can have a ghostly impact. In Carol Gilligan’s thought-provoking In a Different Voice she refers to a study indicating that while men represent powerful activity as assertion and aggression, women in contrast portray acts of nurturance as acts of strength. Openly grappling with and sharing sadness, loss, and emotional pain clearly is still not the masculine norm. The result is a grief process more quickly aborted or altogether avoided. Conversely, under stress and in pain, women typically see a capacity for nurturance and interdependence (giving and receiving support and sustenance) as a sign of strength. Even highly successful professional women describe themselves in the context of a relationship, while men perceive their identity in terms of power and separateness. And finally, concerning moral reasoning women emphasize connectedness and care (attachment) and men stress personal integrity (separateness). To expand the old stress survival adage, men, especially the “strong silent types,” typically fight or flight while women (not necessarily adolescent girls of any age) often tend and befriend.

However Gilligan is trying to rebalance the scales; one moral code is not superior to the other. Rather they represent two modes of experience and interpretation which together could enable us to “arrive at a more complex rendition of human experience.” Both the voice of relatedness and the voice of separateness are needed to define adult maturity.

2) Transition. Daniel Levinson, in The Seasons of a Man’s Life, highlights a wide-ranging psychosocial context that often triggers and shapes ghostly manifestations: In periods of transition we are challenging/terminating the premises of our life structure – raising questions, exploring new possibilities. Each termination is an ending, a process of separation and loss. The task of a developmental transition is to terminate a time in one’s life; to accept the losses the termination entails; to review and evaluate the past; to decide which aspects of the past to keep and which to reject; and to consider one’s wishes and possibilities for the future. One is suspended between past and future, and struggling to overcome the gap that separates them. Much from the past must be given up – separated from, cut out from one’s life, rejected in anger, renounced in sadness or grief…

As our past realities start to collapse, we challenge the self-definitions that have sustained us, finding that everything seems up for grabs, questioning who we are and what it is we are trying to be, and whether, in this life of ours, the only life we have, our achievements and goals hold any value. Does our marriage make sense? Is our work worth doing? Have we matured – or have we simply sold out? Do our connections with family and friends rest on a loving exchange or on desperate dependencies? How free and how strong do we wish – do we dare – to be?...There is much that can be used as a basis for the future. Changes must be attempted in both self and the world…

My compressed poetic take on Levinson: One must begin to separate; one must be separate to begin. The complement of that masculine, yang-like perspective may well be the more maturational and evolved, yin-like need to merge in order to reemerge (Gilbert Rose, author and student of psychoanalysis and creativity). For example, according to Levinson, the demands of parenthood press us into a polarization of roles. However, the potential of grappling with “mid-life transition” is the development and the direct expression of our shadow gender side (men explore tenderness and sensuality; women explore executive and “political” capacity), that is, some blending of our yin-yang natures.

c) Capacity and Opportunity for and Extent of Grieving – one’s own psychological capacity for grieving along with family-socio-cultural support or discouragement to grieve; in addition, there’s the extent of initial, conscious bereavement before prematurely burying live grief; an axiom of this model is that for a significant loss grief is never “finished or resolved”; such losses and accompanying emotional memories, overt and covert voices and messages, etc., will always need to be recollected and reflected upon, if not require some periodic emotional remembrance or mourning, if ghosts are not to roam your psychic mindscape,

d) Childhood Losses – whether you also experienced early childhood losses or traumas through for example, death of a family member, disaster, separation, remarriage and reconstituted families, and illness – involving person, place, personal control, developmental progress and identity, etc.; research indicates the earlier an individual experiences loss or abandonment the more susceptible to disruptive trauma and the less resilient they are in overcoming post-traumatic reaction or disorder,

e) Psychological and Developmental Parallels – the degree of emotional connection or psychological similarity between past and present losses, e.g., I previously noted the initially unrecognized psychological connection for a Vietnam Vet between the death of his wife in a household fire and his emotional disorientation one week after 9/11; however, this is also a normative process as delineated by Therese Benedek in “Parenthood as a Developmental Phase,” Journal of the American Psychoanalytic Association, Vol. 7, pp. 389-417: “At each successive stage of a child’s development his (or her) parents are afforded another chance to work through, or reinforce, solutions to (unconscious developmental) conflicts arising at a comparable stage of their own childhood,”

f) Prematurely Buried Timeline – the length of time that the loss or trauma has been suppressed or repressed, that is, insufficiently grieved; in general the longer the dismissal or denial the greater the intensity of “Ghost Grief”-building psychic pressure from internal heat-stress to conflicting-agitating voices,

g) Tightness of Lid and Rigidness/Riskiness of Coping – the tightness of the lid on your psychic grief ghost crucible, and the self-defeating nature of coping strategies used to neutralize or numb the subterranean pain, e.g., substance or sex abuse, co-dependency, mania or depression, a wide range of escapist behaviors, etc.; however, this rigidity only delays the time for reckoning while eroding the mind-body-spirit; as Viorst avers, “until we can mourn that past, until we can mourn and let go of the past, we are doomed to repeat it.” Until we can embrace our grief ghosts, that is, dig behind the mask, open the psychic coffin, and then consciously resurrect and wrestle with our ghosts, we are doomed to be hounded and haunted by them.

Surely words to help one and all at critical moments of transition or trauma...Practice Safe Stress!


Mark Gorkin, MSW, LICSW, "The Stress Doc" ™, a Licensed Clinical Social Worker, is an acclaimed keynote and kickoff speaker as well as "Motivational Humorist & Team Communication Catalyst" known for his interactive, inspiring and FUN programs for both government agencies and major corporations. In addition, the "Doc" is a Team Building and Organizational Development Consultant as well as a Critical Incident/Grief Intervention Expert for Business Health Services, a National EAP/OD Company. He is providing "Stress and Communication, as well as Managing Change, Leadership and Team Building" programs for the 1st Cavalry Division and 13th Expeditionary Support Command, Ft. Hood, Texas and for Army Community Services and Family Advocacy Programs at Ft. Meade, MD and Ft. Belvoir, VA as well as Andrews Air Force Base/Behavioral Medicine Services. Mark has also had a rotation as Military & Family Life Consultant (MFLC) at Ft. Campbell, KY. A former Stress and Violence Prevention 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.

Loss, Ghosts, and the Stages of Grief -- Part II: Grieve, Let Go, and Grow with the Flow!

Current writings about grief and ghosts have enabled the Stress Doc to appreciate parallels between burnout and his newly conceived and coined burn-in. This essay will connect emotional losses that linger and loiter and the negative energy that sows shadowy ghostly seeds. Both conditions are impacted by feelings of loss and unrecognized grief which provide a crucible for the gestation of a spectral presence the Doc calls “Grief Ghosts.” Comparing and contrasting the two concepts will help individuals and companies better understand how both burnout and burn-in can set in motion an “erosive spiral” that undermines: a) personal health and motivational focus, b) interpersonal communication, connection, and cooperation, as well as c) team and system productivity. Are you and your company or organization ready for some Workplace Griefbusting?


Loss, Ghosts, and the Stages of Grief -- Part II:
Grieve, Let Go, and Grow with the Flow!

Thinking about loss factors and being a member of that AA group, Alliterations Anonymous, I couldn’t help but coin the “Eight Dramatic-Depressive ‘D’s” – Death, Disability, Defeat, Damage, Dysfunction, Disillusionment, Disruption, and Disorientation. The “D”s are significant events or experiences infused with bio-psycho-social and/or economic loss. When they are cursorily connected to or disconnected from the process of grief then psychic ground is being laid for restless and roaming if not haunting post-traumatic reverberations. Over time, this hovering, lingering, loitering sense of loss, still not acknowledged or embraced, more often shunned, morphs into alienated grief, or what I call grief ghosts. Burn-in grief ghosts sit heavy on many people’s minds and bodies, hearts and souls. (Actually, in light of the number of Boomers who are showing signs of dysfunctional cognitive deficit, I’m on the verge of expanding my “D” list to include premature Dementia. Causing so many levels of loss, this disease is especially haunting for the individual still aware of its debilitating and dependency-inducing effects and, of course, for family members in caretaker roles.)

Let me illustrate some recently encountered “grief ghosts” in my Grief Counselor role for a young government employee and father instantly killed in a “head on” vehicular collision on the way to work. (A big truck crossed over a highway dividing line.) While the employee’s tragic death was the immediate catalyst for the request for a consultation, many of the folks encountered were on what I call the emo-existential edge because of their own long-lasting, lumbering ghosts. A common yet psychologically complex and multifaceted shadow now brought to light was the ghost of stormy marital or intimate relationship past, even one of seemingly ancient history – especially when tensions and tearing down had eventually become a staple of the relationship. Not only were many searing memories connected to the loss-divorce of a spouse or mate who invariably defied simply being loved or detested, but loss involved both the loss of one’s role and identity as a partner, that state of disruption and disorientation. Actually, research indicates it’s harder to emotionally grieve the death of a spouse from a troubled marriage than a mate from a healthier one, perhaps because the interaction of the former was a breeding ground for an array of disturbing ghosts.

In addition, even family of origin voices, often of an all too familiar and manipulative nature – that game-playing, blaming, or shaming variety – may once again overtly reverberate in this volatile land- and mindscape’s “echo-system.” Not surprisingly, this relationship rupture was frequently a shock to a person’s core self-image. And when lingering and especially long-standing, festering subterranean grief collides with crisis tremors, there’s a spectral outpouring of mythic-like effect. Akin to a band of vultures spewed from the bowels of the earth, myriad ghosts arise and circle ominously on a now haunted horizon.

A Swarm of Ghosts: Case Vignette

During the above workplace crisis/grief debriefing, one County Supervisor quickly conjured up multiple ghosts from differing time periods. Interestingly, as I was wandering the office halls, making myself visible, this Supervisor was trying to convince a colleague to have a grief debriefing session with me. Not surprisingly, I had to track her down in her office before she would agree to talk. The first riveting revelation was of an older sister killed in the 9/11 World Center attack. The violent death of her colleague likely heightened the connection to her sister’s horrific demise. Her eyes quickly watered; not surprisingly she expressed surprise. But for me most noteworthy, alas, as many are wont to do, she was also apologetic for her overflow. Which begs the question: Why do so many apologize when they unexpectedly cry? My hypothesis is that: a) the bereaved individual feels it is a sign of weakness, that is, she should have basically “gotten over it” by now, b) believes he or she is imposing their vulnerability upon or discomforting the other party, or c) the bereaved individual believes the other person views the crying as a sign of weakness; of course, this assumption may be correct, however, it may also be a projection. (In fact, crying is your emotional wellspring. When crying out of hurt, fear, or sadness (or even joy) the mind-body becomes a safety valve and cleansing process; emotional tears not only let off pressure and tension but also literally flush out accumulated stress toxins.)

This woman also recalled the stormy interaction and termination of a troubled marriage, its impact on the kids, as well as her decision to retrain professionally, eventually uprooting from family in New Jersey to take her current job in Maryland. Another reason for her volatility was that just a few days before, a somewhat close friend in his late 50s died of a heart attack. And when I asked if she had anyone to talk to at work or on the outside regarding her litany of losses, she shook her head. Over the years, the advice received from most people was, “It’s time you got over it.” Clearly, her support system was on the verge of extinction; all work and little play seemed to be sowing low grade depression. After explaining the propensity for past pain to be dredged up by crisis, I made three suggestions: a) keep grappling with the ghosts, there’s no time line for “getting over it,” b) “fight for what you need” (a mantra that she insisted would shine forth from her screensaver), and c) consider some brief EAP counseling to help with a) and b).

Connecting Loss, Transition, and “The Stages of Grief”

As sad and tragic as they are, the unexpected deaths of her friend and of her colleague have also provided a poignant opportunity to open the Pandora’s Box of grief. And while numerous furies rush out, invariably sowing some chaos in their turbulent draft, many forget that the final spirit out of the box was “hope.” So consider this Stress Doc mantra: Grieve, let go, and grow with the flow!

From a common sense perspective, grief is “the cause (and expression) of intense, deep, and profound sorrow, and other strong emotional outpourings involving a specific event or situation” (Encarta Dictionary) triggered by a significant loss or disruptive change. We often connect loss and grief via the premature death, incapacitation, or separation of a parent, child, grandparent, sibling, or any close relative, friend, or colleague. However, as sketched in Part I, grief may be a byproduct of broad array of experiential and psychological losses and transitions. Particularly when the death, damage, defeat, disability, disillusionment, disruption, or disorientation (or even acknowledged dementia), is sudden or unexpected, this triggers or sets the psychological platform for a grief reaction or response. At minimum, the individual is often thrown into an early grief state-stage, such as “shock” or “denial.”

The critical question regarding a grief process is the degree to which an individual gradually and meaningfully navigates or superficially and dismissively circumvents the various stages. Do you periodically visit and revisit (or shun and block out) the complex of emotions and memories surrounding a major or significant loss? Do you admit the daily impact of diminished mind-body functioning and grieve what was in order to adapt to and explore new potential and possibilities? Does the individual over time pursue in depth journeying (from group sharing to personal reflection-journaling) or avoidance and distraction (or maladaptive numbing)? The answer will likely either generate grief growth or germinate grief ghosts.

I will use the timely theme of job/career disruption for illustrating the “Stages of Grief” and the process of grappling with the psychological component of change, i.e., the threat, loss, and challenge of “transition.” Here are:

The Stress Doc's Stages of Grief: Discovering Purpose and Possibility in Trying Times

With all the uncertainty and stress in our economic-job climate (not to mention natural and man-made disasters), most of us can use a refresher on how to grapple with loss and change, how to have the courage to both persist and to let go, how to transform the present danger into opportunity...how to grow stronger, wiser, and better supported-connected through genuine grief.

As I once penned:

For the Phoenix to rise from the ashes
One must know the pain
To transform the fire to burning desire!

A soon-to-be author on motivation and dealing with stress from a break-up emailed asking if he could cite the essay below, which especially looks at job loss, career transition-confusion, and uncertainty. So here are "The Stress Doc’s Seven Stages of Grief":

1. Shock and Denial or “This Is Not Possible” or "It Can't Happen Here!" It's no big surprise when given one day's termination notice that an employee may experience a state of shock. There's such total confusion and disbelief that a person often goes numb; the mind-body system has to shut down. Sometimes shock follows the downplaying or denial of bad news. For example, in the early '90s, there was talk of significant restructuring in the US Postal Service. A number of employees took the early attitude: "We're always dealing with change here…No big deal." Alas, these folks didn't count on "Carvin Marvin" Runyon becoming the Postmaster General. Talk about a shocker...Within a year 50,000 employees were restructured out of the service!

2. Fear, Panic and Shame or "Oh God, What Do I Do Now?" or “What Will They Think Now?” Once the shock wears off, you are no longer numb; there are some predictable next steps, such as profound anxiety and vulnerability: how will I survive this loss of income, identity, my daily routine, my social standing, etc.? There's a mounting sense of being out of control, which for many also evokes feelings of shame and inadequacy. And lack of control, not surprisingly, can stir up childhood memories of the same, being or feeling tormented, bullied, rejected or humiliated by family, peers, teachers, etc.

I vividly recall the lamentation of a postal supervisor on a management fast-track, quickly derailed by reorganization: "I once had a career path. Then this boulder fell from the sky and crushed it!" Is it only a career path that's been crushed? How about the human psyche and spirit? Has it too been burnt up or burned out?

3. Rage and/or Helplessness or "How Dare They!" or "Oh No, How Could They!" Do you think our once fast-tracked supervisor is feeling abandoned and betrayed? Most likely. Often people in this phase swing between rage and profound sadness. Both states can be induced by deep underlying vulnerability or helplessness. You've been wounded, feel exposed, and just want to lash out. Or you turn the rage inward in depression and self-condemnation. Now it's crawling under the covers escapism, or going through the motions of living or, even, straining as hard as you can to reign victorious over your basic unworthiness; to battle a fear of failure and lurking dread of being sucked into that compelling black hole of helplessness.

Consider this: in The Random House Dictionary: The Unabridged Edition, the first six definitions of the word "failure" describe it as an act or an instance. It's not until the seventh and last definition that "failure" takes a personal direction. So losing a job or being confronted with other losses and separations are often more events or individual episodes, albeit powerful ones, than a judgment upon you.

4. Guilt and Ambivalence or "Damned If You Do or If You Don't!" or “Making a Pact with the...Spiritual.” The feelings and old voices of guilt (not living up to an important other's expectations or standards) and shame (violating or compromising an internalized core value or essential part of your self-identity, integrity, and esteem) can become louder and more incessant; self-directed rage keeps taunting you for shortcomings, unworthiness, fumbled dreams, etc., and can ultimately drain and demoralize you. If some energy returns or remains the battle may continue in other arenas. First, the classic approach-avoidance conflict: "Damned if I do, damned if I don't; damned if I stay, damned if I leave." Take the paltry severance or not; leave the faulty marriage or not. And while the uncertainty is terribly frustrating, at least there's a struggle. It’s no longer “black or white”: you are not simply “evil.”

Some may turn to a spiritual source for relief or rescue: "Higher Power, just tell me what to do" or "Higher Power, I turn it over to you." And, of course, some in desperation will proclaim newfound or "born again" allegiance if they are only saved. Yet, in the end, with or without your HP, one must get focused and cut the entangling emotional cord.

5. Focused Anger and Letting Go or "Turning a Lemon into Lemonade" and "Freedom's Just Another Word…" This phase truly reveals the complexity and potential creative energy built into the grief process. To reach that powerful, purposeful, and passionate state of focused anger one must often blend (and temper) rage with sadness. Some rage can propel us out of a shocked, paralyzed or ambivalent state. Yet, you must also face your sadness and loss and struggle with uncertainty to temper uncontrollable aggression, to make sadder yet wiser assessments and decisions. Remember, rage unchecked much more often leads to self-defeating behavior, e.g., “shooting your self in the foot” or “putting that proverbial foot in mouth” than it does to "Going Postal!"

If you've worked hard to integrate the previous stages then the reward is "focused anger": "I really don't like what's happened…but how do I make the best of it?" You're ready to loosen – if not untie – the knot of hurt and humiliation. And best of all, you're getting ready to knock on (maybe even knock down) some doors again.

6. Exploration and New Identity or "Now You're Ready to 'Just Do It!'" (even if scared). Letting go is often unnerving. It's not just the financial security that's at stake. But losing a job or a vital relationship also profoundly shakes our personal/professional identity. We've invested so much time, ego, energy, and/or money in this position, partner, or one possible outcome…Who am I without the job, without my mate or significant other? Even with the most dear and painful loss or separation, the words of Albert Camus, Nobel Prize-winning author and philosopher have the crystalline ring of essential truth:

Once we have accepted the fact of loss we understand that the loved one [or loved position] obstructed a whole corner of the possible, pure now as a sky washed by rain.

7. Acceptance or "The Glass is Half Empty and Half Full." While submerging yourself in the stages of grief for a time will feel hellish, there truly is an opportunity for rebirth. Getting out of the black box is a distinct possibility if you can ride on and ride out this acutely emotional learning roller coaster. The grief encounter is definitely more than a one-trial learning curve. And there's no absolute or fixed period of time for your movement through the stages. My blood starts percolating when I hear "well-intentioned" family members, colleagues, or friends say to the grieved, "Hey, it's been three months (or even six months) already." (On the other hand, if after two or three months, your energy level continues to drain away, don't suffer in silence. Grief and depression can be easily confused as loss and sadness are common to both. One possible differentiating factor to consider: depression often involves internalized anger, and the energy needed to hold down an angry eruption further contributes to an exhausted-depressed state. During a grief process one’s anger, whether rational or not, is eventually acknowledged, the “cause” of the anger is more objectively if not forgivingly perceived. Aggressive energy is eventually transformed into more purposeful if not passionate focus and direction. Speak to a health professional wise in the ways of grief, burnout, and/or depression.)

Finally, remember, there's a real difference between "feeling sorry for yourself" and "feeling your sorrow." When feeling sorry for yourself you are mostly blaming others. When feeling your sorrow you are demonstrating the courage to face your fears and pain. There are poignant moments in life when we all must take time to embrace our sorrow, both alone and with caring or kindred spirits. As I once penned, reflecting on more than one soul shaking grief process: Whether the loss is a key person, a desired position or a powerful illusion each deserves the respect of a 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.

Part III will examine key existential questions that have bearing on the development of and recovery from both burnout and burn-in. Until then…Practice Safe Stress!


Mark Gorkin, MSW, LICSW, "The Stress Doc" ™, a Licensed Clinical Social Worker, is an acclaimed keynote and kickoff speaker as well as "Motivational Humorist & Team Communication Catalyst" known for his interactive, inspiring and FUN programs for both government agencies and major corporations. In addition, the "Doc" is a Team Building and Organizational Development Consultant as well as a Critical Incident/Grief Intervention Expert for Business Health Services, a National EAP/OD Company. He is providing "Stress and Communication, as well as Managing Change, Leadership and Team Building" programs for the 1st Cavalry Division and 13th Expeditionary Support Command, Ft. Hood, Texas and for Army Community Services and Family Advocacy Programs at Ft. Meade, MD and Ft. Belvoir, VA as well as Andrews Air Force Base/Behavioral Medicine Services. Mark has also had a rotation as Military & Family Life Consultant (MFLC) at Ft. Campbell, KY. A former Stress and Violence Prevention 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.