Michael V. Genovese, M.D., J.D., is the chief medical officer of Acadia Healthcare which operates a network of 585 behavioral health facilities with approximately 17,900 beds in 40 States, the United Kingdom and Puerto Rico. As well, he is the Medical Director of the Officer Safety and Wellness Committee of the FBI National Academy Associates. Dr. Genovese is also an advocate for attorneys and first responders seeking treatment for addiction and co-occurring disorders.

Dr. Genovese writes, speaks, teaches and consults widely in the disciplines of pharmacology, neuromodulation and pharmacogenomics. He has kindly agreed to allow us to share his article on the impact of trauma on first responders. 

Bravery is one act, but courage is consistent. And our nation’s first responders are the very definition of courage. Each day, they make the difficult choice to run towards the danger that we run from. In doing so, these officers experience significant trauma, yet rarely have the opportunity to process those experiences before speeding off to the next emergency. 

Science shows that repeated trauma alters the neural pathways and injures the brain. These Post-Traumatic Stress Injuries are linked to startling, yet often unreported, rates of mental health illness, which can manifest into substance abuse or worse. In fact, first responders are more likely to die by suicide than in the line of duty. 

So why are our heroes not receiving the help they need? In my role as medical director of the Officer Safety and Wellness Committee of the FBI National Academy Associates, I’ve met countless officers who have struggled to overcome the trauma experienced in their line of work. Many say they’re expected to be mentally and physically tough, and the stigma around mental health treatment prevails. Admitting they have a problem may cost them their badge – and their identity. 

This is quickly becoming a national crisis, but too many departments are reluctant to admit this crisis exists, much less implement programs to address it. Here are four ways we can change that:

Acknowledge mental health injury

Post-traumatic stress is an injury, not a weakness. If a first responder broke his or her leg in the line of duty, treatment would be a no-brainer. We must recognize and treat brain injuries in the same way. 

Build resiliency through training

It is not enough to wait until officers are injured. We need to proactively provide training to help officers build resiliency. Resiliency can be learned and can help officers manage the extreme pressure and trauma inherent in the job. 

Shift the culture, from the top

Law enforcement agencies must normalize mental health care by proactively offering support services and treatment. This requires a shift in culture which must be led from the top. Support systems can include employee assistance programs, peer support policies and confidential resources, to name just a few.

I am proud to be a part of Treatment Placement Specialists, which provides treatment guidance that reflects the individualized needs of officers. Substance Abuse and Mental Health Services Administration (SAMHSA) also provides excellent resources for mental health treatment.

Build pathways back to work

In most professions, overcoming personal challenges, such as depression or substance abuse, is supported and celebrated. But for first responders, the result is often the loss of their job. This severe punishment is unnecessary and leads to further trauma and depression. We need to formalize a pathway back to service, so individuals aren’t penalized for seeking help. 

These are not just academic suggestions. These are practical measures that progressive departments are already taking – and they are working. 

We all know the saying, “To whom much is given, much is required.” When we consider all that is asked of our first responders, we should consider a new phrase:

From whom much is required, much should be given.

We must support those who serve by acknowledging the trauma they experience and providing treatment to address the very real impacts on their health. Will you join me? 

References: 

Genovese, M. (2018, October). How Trauma Causes Alternate Pathways in the Brain. Rebuilding Officer Resiliency: A Treatment Guide, 4-6.

Heyman, M., Dill, J., & Douglas, R. (2018). Mental Health and Suicide of First Responders [White Paper].

Dr. Deb Thompson is a registered psychologist, certified Integral Master Coach™ and longtime colleague of Françoise’s. They met over 23 years ago while working as clinicians at a University Student Counselling Service and subsequently shared a private practice office for many years.

In this guest blog post, Dr. Thompson share’s tips gained from her many years working with clients in the field of body wellness. You can find out more about Deb on her website or follow her on Facebook. 

As a psychologist/coach and course facilitator specializing in weight wellness, I’ve noticed time and time again how over-eating in the evening is such a common and maddening challenge. I also know this terrain personally, as someone who struggled mightily with food, self-care and weight from my teens to late 30’s.

Are you frustrated by the wheels falling off your wellness bus after work and/or at night despite nourishing yourself fairly well during the day?  

Our Inner Critics can attribute this to weakness, but I encourage your Inner Mentor to get more grounded in knowing that our evening over-eating arises from the perfect storm of being hungry, depleted and/or churning with emotions.  

Here are ten tips for circumventing these vulnerabilities with some new or renewed habits, practices and mindset moves:

1. Don’t arrive home ravenous!

Plan and pack or buy a snack for late afternoon because high, high hunger is high, high risk! When our blood sugar is dropping and our bellies are growling, our primal brains direct us to mow down, which can make for chunks of cheddar or handfuls of trail mix that not only derail our dinners, but also our wellness over the long run.

Snacks with some protein, such as whole grain crackers with hummus, a hard-boiled egg or cheese string, almonds with an apple, Greek yogurt or a decaf latte, will stick to your ribs and see you through your commute and transition to home. Higher fiber foods like apples or popcorn can be filling too.

See if eating in a planful way during the late afternoon helps you eat less in the evenings, and thereby, helps you to eat less overall. It almost always does!

2. Prep a snack

Alternatively, prepare a snack to be ready for you when you get home — a kindly gift from earlier-more-energetic-you to later-whipped-you!  If you have kids, this can also help you get through what I used to call the “Arsenic Hour” when everyone is hangry.

Cut up veggies or fruits with different healthy dips are handy, as well as helpful for getting in our seven or more recommended daily servings of produce.

3. Disrupt your pathway

Aside from a planned snack, don’t mindlessly head to the kitchen as soon as you get in the door or you are off duty for the night. Go to a different room, do something different — even a few minutes of belly breathing, getting into comfies, or washing your face can break the auto-pilot pattern of cruising the cupboards or fridge.

As Viktor Frankl said, “Between stimulus and response, there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.” — creating the gap is key!

4. Take a few minutes to transition

In this space, take a few minutes to transition — after work, change your clothes, put on upbeat or chill music, bring in nice scents with lotions or essential oils, create your own shifting gears ritual…

You may have to train other people to leave you alone for a few minutes, especially if those people are wee ones, but it can be done. You can also create a non-food ritual for exhaling at the end of your second shift… once you are off duty for the evening (more on this in Tip #8).

5. Meal planning for success

A little meal planning and preparation can go a long way to ensure faster and easier healthy suppers on busy work nights… you don’t have to be Martha Stewart, but having veggies ready to stir fry or roast, planned-overs to warm up, a soup or stew or chili in the slow cooker, or a sheet pan dinner ready to assemble in minutes are all golden.

Again, re-frame this as an empathic gift from the person that you are on Sunday afternoons to the person you sometimes become by Tuesday 7pm when you are more depleted, hungry and feeling worn out. Try to keep perfectionism out of the equation to avoid tipping into all-or-nothing thinking or what has been called the “what the hell” phenomenon where we overeat to deal with our emotional frustrations and feelings of self-blame.

Having a sticky note reminder of some quicker-than-take out and healthier-than-cheese-and-crackers options, like scrambled eggs or ready-made soup, is also helpful.  

6. Process your thoughts and feelings

The emotional residue of our days often rumbles through us into the evening, and it is so very tempting to soothe, numb and reward with food (and wine!).

One strategy is to use free writing to honour and process thoughts and feelings — set a timer for 7 minutes and write without pausing the pen (or editing — this is a *dump* — not journaling or essay writing!) to help process your day…let it rip, say *anything*… vent, rant, complain, yearn.

When the timer goes, aim to have your Inner Mentor extend kindness and empathy to yourself, as well as see if there are any *Actions* or *Don’t forget* items that need put on your To Do list. Then shred or burn the papers over the sink, wash up and exhale.

Cultivating compassion for having done your best… as well as showing yourself kindness and generosity for the true complexity of the challenges of our work is also a powerful component of this practice. For further strategies for lessening the grip of emotional eating, check out these downloadable resources:

Four N’s Instead of Food as Friend [PDF]

Meeting Emotional Needs without Food [PDF]

Getting support, such as through coaching, counselling and the excellent courses here at TEND also helps with reducing the burnout, compassion fatigue and vicarious trauma that can leave us overly vulnerable to turning to food as a (lousy) “friend”.

7. Build a Nourished Life

Indeed, everyone benefits from support to build nourished lives such that we have less depletion and stress to prompt us to over-eat after work or at night. This can include creating more belonging, boundaries, a less taxing workload, play/fun/hobbies, rest and sleep, regular enjoyable exercise, emotional supports, and especially: alignment between our core values and our actual lives.

Building a nourished life takes time, and guidance/supports, but it’s important that we put some energy into the prevention of being spread thin, not just coping with it.

What’s ONE thing you might do this week to move the needle a tiny bit on behalf of more movement, rest, play, or connection? You could get to bed 20 minutes earlier, you could do a 15 minute yoga video in your living room, you could plan a coffee date with an old friend, you could sign up for art lessons, you could explore options for coaching or counselling.

8. Curate a Menu of Alternatives

Ok, back to more directly disrupting the habit of eating at the end-of-day when you are finally off duty… it’s helpful to develop a menu of alternatives to snacking or imbibing.

Perhaps a bath, a good book, magazine, podcast or show on Netflix? Colouring, crafts, games or texting? A warm drink? Some puttering or light tidying up or getting things ready? Or if this last one feels like more work (which may prompt eating as an escape or reward), then leaving those tasks for morning?

Looking over your menu can help you choose what will soothe, restore and calm you tonight.

9. Enjoy a Low Calorie Treat

For end of day, you may like to plan for a yummy-to-you low calorie treat (eating at night is not necessarily problematic unless it involves EXTRA calories)… winter seems like a wonderful time for a baked apple (here’s a microwave recipe).  

It’s helpful to keep high temptation treats like chocolate, chips, ice cream, cookies, etc. either out of the house, or at least out of sight and hard to access… as we do tend to eat more in response to availability. Forbidding these foods is not necessary (and often really backfires into all-or-none yo-yo-ing), but often having single serving options, planned treats when eating out, and healthier alternatives such as popcorn instead of Doritos; broth, decaf or herbal tea instead of wine; or Fudgsicles instead of Hagen Daz are very supportive.

10. Reconsider the Division of Labour

If part of your evening over-eating is related to feeling beleaguered and exhausted regarding the division of labour in your home, it can be helpful to have a series of conversations about who does what when with your partner/family. Teaching kids to pitch in can be an investment that pays off in the long run.

If you live alone, get creative in how you might outsource some work  such as cleaning or getting more ready-made foods from the grocery store, and/or have chore or cooking parties with other single friends. Finally, most of us can also lessen our weariness (and vulnerability to emotional or “Eff It” eating) by softening our standards, letting go of impeccability and embracing imperfection with more compassion.

For more, check out this webinar with Dr. Deb Thompson and Françoise Mathieu on how to curb emotional eating [from December 4th, 2017]

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Edition No. 2 – Oct. 30th: Overwhelm, Behind at work, Don’t check those after-work emails

Edition No. 1 – Sept. 25th: How to revive when you’re fried, Compassion Fatigue from the news?, 3 Tips for when you’re burned out

In today’s world of work, we can be certain of three things: there will be change, there will be stress and these two factors may eventually cause conflict between staff and/or their leaders.

We speak to many professionals who work in a wide range of sectors and the most common source of distress is the ever-increasing pace and volume of work. The expectations of working faster with fewer resources and having to do more with less, are causing serious problems. These problems can cause team members to experience resentment and internal conflict.

Many of these issues stem from budget cutbacks. As a result, companies and organizations face massive changes: layoffs, reorganizations, job abolitions, changes in mandate, elevated conflict and a lot of uncertainty and fear of what is yet to come. 

Perhaps one of the most significant changes we have seen in the last few years – again, directly related to budget cutbacks – is the increase in competitive relationships in the workplace. This can directly contribute to interpersonal conflict, increased stress and sick leave, and a general dissatisfaction with work.

Navigating through these challenging times can be hard – even for the most resilient.

So, what can we do about all this change?

While conflict and stress are never truly preventable, we can learn effective approaches for maximizing positive outcomes. Here are three strategies to help you navigate change and conflict. 

Understand the Transition Phase

We all know that change can be difficult, however, even more stressful is the time between the end of the old and the beginning of the new – the transition phase.

The ability to navigate through the transition phase is all about the practice of resiliency. By recognizing our strengths and working on our areas of growth, we will be better equipped to deal with the uncertainty of this phase.

It is also important to explore what about the unknown is causing us the most stress. Is it that we are afraid of losing our job? Losing a good manager? Losing control over certain roles and responsibilities?

A good strategy is to focus on the areas of our lives where we have control. In The 7 Habits of Highly Effective People, Stephen Covey presents the circles of concern and influence. He encourages us to focus on those things in our lives that we have influence over and avoid squandering our energy on those that are outside of our control.

However, there will be times when we truly have no control over the future. During these times, we can fall into what psychologists refer to as “fortune-telling.” This is when we obsess over all the possible scenarios that may or may not take place. Fortune-telling can be a normal response to uncertainty, but if it dominates our days and nights, we may need to seek outside support from a counsellor, coach or a mentor.

Reflect on Your Reactions to Stress

Change can be hard for many of us, and it can elicit a whole host of reactions among different people. Understanding your unique response to stress can help you be proactive about taking positive steps to care for yourself.

A good strategy is to reflect on the question: “What does change and uncertainty mean for me?” Consider this question in general terms, not just as it relates to work.

Here are a few more questions to consider:

• Am I someone who thrives on change? Or, does change make me anxious and irritable? 
• What are my stress responses? How do I act when I am stressed? 
• Are my reactions to stress similar or vastly different from those of my colleagues? How can I use this information? 
• Are my negative reactions to change short-term or longer lasting?

Some of us dislike change and uncertainty but can, with time, adjust extremely well to the new situation. Sharing this process with your close colleague and even a trusted supervisor can help prevent some misunderstandings and ruffled feelings.

Embrace Conflict

As we navigate through our work days, we are confronted with conflict on different scales – perhaps someone drank the last cup of coffee and didn’t make more; maybe someone jammed the photocopier and walked away; or maybe you are experiencing bullying and harassment.

The fact of the matter is that conflict has a ubiquitous influence on our working relationships.

A 2008 study conducted by CPP Global found that employees spend an average of 2.8 to 3.3 hours a week dealing with conflict. Human resource workers spend upwards of 51% of their week addressing conflicts. 

Unmanaged conflict is costly. It affects the mental health of employees, which results in absenteeism, employee retention issues and a negative institutional reputation. 

Good employees and strong leaders are those who are not only aware of their conflict and communication styles, but are those who are able to direct those styles and skills towards win-win outcomes and positive working relationships.

Let’s face it – the work can be fulfilling, but if the relationships are bad, the ship will sink quickly. Anchor yourself at work with the knowledge and skills you need to participate in meaningful conflict.

There are two elements to understanding conflict:

Know yourself 

If you know your default response to conflict, you will be better prepared to deal with conflicts when they arise. There are many benefits to knowing your style, including; the ability to move seamlessly between styles based on the situation; the ability to adapt your style based on the style of those you are in conflict with; and increased confidence with your ability to deal with conflict.

Know your organizational conflict culture

All companies, organizations and workplaces have unique cultures of conflict. Do you work in an environment where conflict is embraced and seen as a force multiplier, or is conflict avoided at all costs?  If you know the culture, you will be better equipped when conflict arises to be a positive contributor to the culture.

Conflict can be fun! People often laugh at this statement, but it is true. Conflict is inevitable, and the best strategy is to develop a good understanding of your own responses to conflict. Learn to welcome conflict as a productive and enhancing workplace force.

Parting Advice

Not all workplaces can afford to send their staff to outside training, so employees may need to take matters into their own hands.

Invest in your future by attending workshops and trainings that will enhance your interpersonal skills. Many not-for profit organizations offer inexpensive workshops on conflict management and communication skills.

Here are some great resources to get started:

Books: 

Resolving Conflicts at Work by Kenneth Cloke

Conflict Resolution for the Helping Professions by Allan Barsky

Is Work Killing You? A Doctor’s prescription for treating workplace stress by David Posen

Rebounders: How Winners Pivot from Setback to Success by Rick Newman

Building Resilient Teams by Dr. Patricia Fisher

The Advantage: Why Organizational Health trumps everything else in business by Patrick Lencioni

Author: By the TEND team with files from Meaghan Welfare.