Dear Everyone:

Stress isn’t a bad thing.

In fact, stress - particularly when appropriate, scaffolded supports are in place - is central to growth and development for both children and adults. The stress that results from adversity builds strength, courage, and stamina.

This last year, however, has been something else for most of us. A continuum exists from stress --> trauma, and while there are multiple factors that separate healthy stress from harmful trauma, the unrelenting toxicity and uncertainty of this year have tilted the majority of us closer to the trauma end of that spectrum.

Trauma primes us for trauma; once those paths are forged, we step back onto them reflexively, habitually. Our brains are hardwired for threat detection, and process social pain in exactly the same way they process physical pain. Given the social pain of the past 12 months, you can easily see the pattern set up. And the danger isn’t just that trauma begets trauma (hurt people hurt people), but also that trauma becomes physically embodied. Unmitigated, this exacts a heavy toll on our health.

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Waiting is hard.

We’ve been waiting a lot lately. Waiting for risk to decline; waiting for the latest data; waiting for a vaccine, and now waiting for our place in line. Waiting for reopenings and return-tos. Waiting. Waiting. Waaaaaiiiiting (yes. I just whined that in my head like a sleep-deprived 5-year-old).

Patience - having it, demonstrating it - is linked to well-being, coping, lower rates of depression, and fewer health problems. Patience buffers us against stress and helps us cope adaptively. And without question, all three types of patience – interpersonal, daily-hassle, and life hardship – are being taxed right now.

The good news is that patience isn't a fixed entity. It is both a trait we have at baseline and a state of being in the moment, and so we can train and expand our capacity in both. Doing so reduces the risk of inadvertently harming others and allows us to “self-mitigate” the harmful impact of these times on our health.

Where do we begin? By noticing when we're feeling ungrounded and getting tethered.

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When strong emotion “hijacks” our nervous system (extreme stress/trauma hijacks our entire being – not just our brains), much of it shows up in our bodies physically, sometimes long before our “thinking brain” realizes what is happening.

The physical symptoms of extreme stress reactions are wide ranging and can be highly individualized. It is useful for each of us to identify what happens physically in times of extreme stress so we can better recognize “hijackwhen it happens. For example, we may notice our hearts begin to pound, our breathing becomes shallow, numbness or tingling in our fingers/toes, a tightness in our throat, a flush in our neck or face or ears, and a sense of being unable to speak or even think clearly.

Moving out of emotional hijack requires, first and foremost, The 3R’s of Recognition, Regulation, and Reconnection with our body.

The symptoms that accompany caustic stress or trauma are a protective reaction – autonomic, designed to ensure our survival, and therefore outside conscious control. However, by learning to Recognize our physiological cues, we can begin to Regulate our physiology by Reconnecting with our bodies. There are innumerable ways to do this, but all of them begin with noticing then controlling our breathing. Tending to breathe immediately and deliberately brings us “back into” our body and moves us out of hijack.

The 4:8 (four count inhale, eight count exhale) breathing technique has been extensively studied. It activates our Vagus nerve, moves us out of hijack, and significantly improves our decision-making ability. 4:8 Breathing puts us into a “pause” state; from there we can step into choice about our response rather than acting out of survival reflex.

Practicing this breathing when in a “non-activated” state is critical. Practicing in non-urgent situations creates muscle memory, and repetition helps us move into this (more) automatically when stress-reaction has already taken over. We have to practice to be proficient, and experientially, the hardest step is recognizing we need to do it in the moment!

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None of us were born knowing how to do these things, and few of us were taught these basic skills at any point in our lives. Learning to manage our own acute stress reactions allows us to ask my two favorite questions:

Who do I want to be in this situation?

How do I choose to respond?"

The pause gives space for grace and allows us to disrupt the trauma cascade. This decreases the odds of inadvertently perpetuating harm to self or others.

If you know someone who appears to manage this effortlessly – believe me, they have practiced. There is as much muscle memory built into emotional regulation as there is to driving a car or performing surgery. I've been learning and practicing this for a lot of years, and the last 12 months have pushed (beyond) my limit. And that is a great reminder: there is no finish line. We just keep practicing to be and do better.

Happy (frozen!) Valentine's Day to all who enjoy this day. Stay warm. Hydrate. Connect. Laugh. Vaccinate as soon as you're able.

More soon,

K

Visit our SERVICES page to learn more about what Lodestar has to offer your organization.

#vaccinate #anythingbutdead #traumamitigation #listenprotectconnect #breathe #hydrate #laugh #coaching #physiciancoaching #lodestar

Kemia M. Sarraf, MD, MPH, CCC, TIPC

President & CEO

The arc of Dr. K's 25+ year career includes patient care, medical education, public health programming, nonprofit & leadership development, and executive coaching. Dr. K founded Lodestar in 2016, responding to a growing need for advanced leadership development and subspecialty coaching for professionals who were reporting high levels of severe burnout, vicarious trauma and moral injury.

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