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Chera's Podcast

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Be sure to subscribe to my YouTube Channel "CheraTherapy" so you won't miss a podcast!





  • Believe it or not, in my plight to improve the quality (and save) the lives of our cherished first responders (FRs), I am rolling up my sleeves to investigate my theory that dark humor may actually have the potential to prevent PTSD by way of averting the neurological chain of events leading to cumulative, acute, and vicarious traumas--mainly by avoiding the amygdala’s activation of the threat response that leads to the encoding of memories without the cortex’s linguistic narrative timestamps. (You can learn more about the amygdala and PTSD in Podcast #5.)

    We all know laughter feels good, but few people realize how powerful it is at helping us cope. Laughter helps us socially, physiologically, and neurologically. In the case of our FRs, dark humor has the added bonus of relieving anxiety and tension by way of providing much-needed "psychological distancing" from shocking sensory information.

    Ironically, research shows in order to appreciate dark humor (or, in this case, use it strategically as a tool to avert PTSD), one must already be in a good mental state beforehand, which is yet another argument for my mission to provide all FRs both prerequisite and ongoing emotional agility training.

    I think it would be great to create "Dark Humor Therapy" for our FRs, where we could provide them entertaining standup comedy to help normalize the difficult situations they are faced with day to day. It will intentionally not desensitize, which could lead to objectification of people, but normalization while modeling mindfulness and strategic cognitive reframes.

    I cannot wait to dig even deeper into the scientific research of how the brain processes dark humor and hear about more experiences from my responder clients and friends. It’s absolutely fascinating to me that such a powerful tool can be used by anyone, anywhere, day or night, free of charge.



  • Even before recent Antifa and “defund the police” political campaigns, the jobs of our first responders (FRs) were already challenging and hazardous. Going into their careers as FRs, and even for myself, as a FR therapist intentionally entering into their world, I can’t help but compare my experience to that of Neo Anderson, Keanu Reeves’ character in the movie “The Matrix,” who intentionally chose to take the red pill to forever abandon his formerly safe, naïve, cocooned existence in order to see the world as it really was. But I feel it’s the least I can do to show my appreciation for their sacrifice to keep me safe all these years.

    I wish I could say I believed all FRs entered into their careers courageously, with a full understanding of the extent of sacrifice they would be making to mind, body, and relationships, but I can’t. Instead, I think most FRs enter into their careers with their attention fixated on their desire to better themselves and establish a respectable career with room for growth, to enjoy the thrill of the unexpected each day with the camaraderie of their colleagues. What better way to serve as a role model and contribute to the safety of your community?

    In reality, I wish FR careers came with a warning:

    WARNING: This career may be harmful to your health. While it may pump you up and make you feel great as a respectable contributor and protector of your community and provide you on a straight shot, rapid route to self-efficacy and -actualization, the truth is, without adequate emotional agility training and ongoing psychological support, this career can also lure you down a slippery spiral of cognitive and emotional exhaustion, depression, anxiety, anger, social isolation, and suicidality.

    THE PROBLEM?

    The problem is, there’s little or no awareness of (or appreciation for) the importance of self-care and the harmful effects of hypervigilance and the threat response are normalized within training academies and FR agencies. Another problem is there are not enough professionally competent therapists to train peer support teams or provide officer wellness programs/crisis support, so even if FRs had the awareness to seek help, they can’t find it.

    I had been working with veterans the past few years, but after my nephew joined the San Jose PD I began to wonder “who has the backs of our LEOs?” I was somewhat pissed off to find there were no licensed therapists certified as first responder counselors between Fresno, CA and Beaverton, OR! That’s when I decided to do something about it. This winter, I completed my training to become not only a certified first responder counselor (CFRC), but also a certified clinical trauma professional (CCTP), and first responder peer support team leader/personnel trainer (CPST/L). (I will put some links below if you are a clinician interested in supporting the FRs in your state.)

    SO, WHAT IS EMOTIONAL AGILITY?

    Emotional agility training is not much different from the bullet proof vest LEOs wear to protect their vital organs from bullets and knives, but it protects the FR’s mind. In the military cultural training I took, it was referred to as “psych armor,” an effective name for describing what it does.

    How can we protect the mind? I think it will make more sense to you if I explain how the brain works...

    Just like your house’s smoke detector detects smoke, your brain’s amygdala detects threats (some refer to it as a “threat detector”). It is centrally located within the brain and serves as the first stop for all sensory input, where it can within milliseconds assess all incoming sensory information for threats. But how does your amygdala know what is a threat and what isn’t?

    That’s where your hippocampi come in (plural for hippocampus). Your hippocampi are where the bulk of your memories are stored, so your amygdala checks in with them to look for matches with the incoming sensory information.

    For example, you are sitting on the couch and suddenly see a cat walking across the living room floor toward you… is it a sabretooth tiger? Should you be going into the “fight, flight, or freeze” threat response? Nope, fortunately, your hippocampi confirm it is just the same old family cat you’ve had the past ten years, so you can remain relaxed.

    But what if there were a saber tooth tiger? Then what would your brain do?

    Over the millennia, our brains have evolved to protect us by detecting threats and going into a threat response, which sets off a chain of events within our bodies to help us escape the danger. So, if there were a saber tooth tiger after us, the first thing that would happen is our cerebral cortex (thinking part) of our brain would lose blood flow, more or less shut down—after all, we don’t want to waste time “thinking” about running away from the tiger, we just want to reflexively get the hell out of there! (It’s a “run first, think later” situation.)

    Our amygdalas would also pull our blood away from digesting our food in our digestive system so it can feed oxygen and nutrients to our arms and legs to help us run or defend ourselves.

    Interestingly, some FRs believe hypervigilance is a tool to use, like the classic story of the adrenaline-juiced mother lifting a car to save her baby. But research shows we are actually less able to defend ourselves while in the threat response, and most people do not realize this until they learn martial arts.

    This threat response is only meant to last a duration of 1-2 minutes, I guess by then, we’ve either escaped or been eaten by the tiger. The problem for us today is our brains tend to spend not minutes, but hours in the threat response, because we cannot always outrun what is threatening us. It also leads to all kinds of negative effects on the mind and body. For example. have you ever wondered why stress causes stomach ulcers and insomnia? It also messes with cortisol and insulin levels, leading to long-term weight gain and chronic health conditions, such as diabetes and cardiovascular problems. (This is one of the reasons so many FRs gain weight five years into their careers.)

    WHAT ABOUT PTSD?

    While in the threat response, the cerebral cortex is shut down, affecting thinking and language. Research with brain imaging shows PTSD results from a brain in the threat response erroneously encoding memories of the negative, often traumatizing sensory information without their corresponding language narratives that would provide a time stamp. Without the time stamp, the brain thinks the threat is ongoing and causes the memories to endure, unable to stay in the past where they belong on the brain’s time continuum.

    In PTSD, the brain thinks the threats are still there, and your amygdala actually becomes more and more sensitized, creating more and more irrational triggers throughout your environment. These triggers can become debilitating and not only affect you, the responder, but also your friends and loved ones as they see you in pain and you begin to withdraw from them socially. If you have children, you might also become irrationally overprotective of them.

    PTSD aside, it makes sense FRs should not be in the threat response because a compromised cerebral cortex affects their ability to manage chaotic situations and make split-second decisions where people’s lives are at stake.

    Once your amygdala becomes sensitized, every call gets worse and worse, and you can actually get anxiety about having anxiety on a call! You can see this response in some FRs when the 911 dispatch line rings.

    WHAT TO DO ABOUT IT?

    Well, if we don’t do anything about it, which is happening now to thousands of our cherished FRs, they will either quit their careers or find ways to cope on their own, which are usually not sustainable. As I explained in my third podcast “Responders Coping with Alcohol,” most responders keep their emotional pain to themselves. Either they don’t want to worry their superiors or loved ones or they think they can handle it on their own, the problem is it only further isolates them and does nothing to address the real problem.

    Whether drinking, using drugs, playing video games, watching Netflix, engaging in social media, gambling, or promiscuity, these behaviors may escape the pain, but they add another whole layer of problems. With drinking, you could get ruin your career with a DUI, or worse, hurt yourself or others. You might also be too intoxicated to socialize with friends or loved ones (further contributing to social isolation) or unable to respond to emergency calls from your agency. This now introduces one of the most self-destructive concepts known to man, shame, because now the FR is engaging in behaviors incongruent with their ideals as FRs. And further down the spiral they go…

    Some escape behaviors can not only get you fired, but they can also get you divorced, incarcerated, or killed. It makes sense that a FR who is emotionally fragile and socially isolated could be craving support and intimacy, which leads to the common behavior of FRs having affairs with dispatch personnel.

    GOOD RESPONDERS MOST RISK

    I want to clarify here that it is not the bad or weak responders who find themselves on this downward spiral, it is actually the more dedicated FRs who, day after day and year after year, sacrifice their physical and mental wellbeing for their communities without even realizing it.

    WITHOUT THE EMOTIONAL AGILITY TRAINING, WHAT KINDS OF CALLS COULD TRIGGER THE THREAT RESPONSE AND LEAD TO PTSD?

    Our FRs experience different types of trauma: vicarious, acute, and cumulative. Vicarious trauma is when the FR witnesses another person become injured, die, or almost die. Vicarious trauma can then be passed onto another layer of people, such as the FR’s family, as in the case of becoming overprotective of their spouse or children. An example of acute trauma would be a FR experiencing a very powerful single incident, such as a case I learned about in my FR counseling certification training. An EMS arrived to the scene of a traffic accident to find a LEO being burned alive in his patrol car. The EMS managed to get him out, but his body was so badly burned, like charcoal, he could not find any viable flesh in which to inject pain medicine. This EMS felt so helpless and guilty. They flew the officer to the nearest trauma center, where the hospital was able to remove a boot and inject medication into a toe. Not surprisingly, the officer did not live. By the time the video was made, I was surprised to hear the EMS had been carrying tremendous guilt for 15 years and was just now getting mental health support.

    Sometimes it’s not guilt, but the memory of disturbing sensory information from a difficult call that can lead to acute trauma. It could be the dreaded welfare check, where FRs are faced with the sight, smell, and texture of vomit, pools of blood and other bodily fluids, and decomposition. Bodies left lying on the floor can stick to the surface, so when they are rolled over or picked up, the flesh tears, releasing gases and fluids that have built up during the decomposition process. FRs often describe getting fluids and tissues on them and stuck to their uniforms. Sometimes it gets into their hair and it is impossible to wash out the odor. Sometimes the odor just gets trapped in the clothing and it has to be thrown away. They feel guilty having parts of people’s bodies on them, especially if they are encountering loved ones of the deceased. They have to go home with those fluids and tissues on them, sometimes getting it into the patrol car.

    I think some of the more troubling cases I’ve been told about were those with people dying in front the FRs, where the person was scared and in tremendous pain, trying desperately to speak but could not due to half of their face or the bottom half of their jaw being mangled or missing.

    The third type of trauma is called cumulative trauma. These are incidents that may not stand out to the FR as particularly traumatic at the time, but FRs brains are still impacted due to repeated exposure to the same or similar incidents over time. An example of this could be finding children living in bad conditions with negligent parents.

    Trauma can also be insidious… A female Army medic once told me she had no problem helping young mothers with their newborns during her tour in the Middle East. But two years after returning home, when she got married and had her first baby, PTSD symptoms were immediately triggered when she realized she could not let the baby cry. Obsessing and panicking, she was up with her baby around the clock. I can’t help but wonder if emotional agility training could have inoculated her against this type of PTSD?

    HYPERVIGILANCE CAN HARM IN OTHER WAYS

    If you’ve watched my other FR podcasts, you’ve heard me talk about hypervigilance. It frustrates me how normalized it is within the FR culture as though it were a good thing, little more than an extra dose of adrenaline when needed. The truth is, while it’s okay to be vigilant, it’s not okay to be hypervigilant.

    One way hypervigilance is harmful to our responders is by draining excess cognitive energy throughout the shift. Just like people partying on ecstasy all weekend, the brain eventually runs out of dopamine and needs to crash to replenish. If a FR is hypervigilant on 12 hour shifts, their brains wait until they walk through the front door, when the FR finally lets his guard down, to crash. This means the FR is tired and cranky, doesn’t want to do anything but rest, zone out, drink a beer, play some video games, or watch TV.

    Without emotional agility training, the FR would logically assume it’s the wife and kids making him feel so shitty, because he only feels bad when he’s at home with them. So he might avoid them, resent them, or simply stay out the with boys (or the dispatch gal) a little after his shifts in order to avoid the negative feelings. Ironically, time with the loved ones is just what the FR needs to feel better.

    HELP

    Hopefully, your agency has a peer support team or officer wellness program, but if it does not, like our local PDs, you will need to find a licensed clinician, like me, who is qualified to treat FRs. There is a directory on the website of the agency that certified me, which I will link below. But I can tell you there simply are not enough and I hope I can inspire existing clinicians and upcoming psychology majors to consider FRs as the focus of their practice.

    If you came to see me, here is how it would go: We would start out with an intake session, during which we would fill out paperwork, gather background, and create treatment goals together. The next time we meet, usually once per week, we would begin unpacking all that causes you emotional pain, loneliness, or tension in your body—this could be things from your childhood or on-duty as a FR. We would work together to teach you to scan your body for tension and release that tension, because research shows a brain cannot be in the threat response when the body is relaxed. So the key is total relaxation of the body. (I realize it’s easier said than done, though.)

    I would also be teaching you Mindfulness skills, such as exploring both your pain and strengths with self-compassion and self-curiosity, letting negative feelings reveal themselves and then float away, as if down river, as you wait with curiosity and compassion to see what feelings come next. Your feelings are fleeting and do not have to “stick” to you and become part of who your identity.

    I would also teach you about self-care. In grad school, we were taught, contrary to belief, it is not a luxury, but mandatory if we wanted to be effective therapists and last longer than five years without burnout. Otherwise, we would be vulnerable to violating ethical boundaries, such as using our clients to meet our personal social needs. Most of the FRs I spoke with said they felt guilty at the thought of practicing self-care. I ask them, you take good care of your vehicles, right? Why? Because you want them to run well and last a long time? And what do the airline stewardesses tell you about putting on the oxygen masks? They say to put it on yourself first, then your children. If you don’t take care of yourself, there will be nothing left to give to others. I wish more professional institutions put as much emphasis on self-care for their students as our grad school professors did.

    I might assign you some homework between session, such as therapeutic journaling to facilitate the expression and purging of all underlying feelings and possibly to identify any conflicting core beliefs causing you painful incongruence.

    By the way, if you were self-medicating with escape behaviors, please know I would not necessarily fixate on those, because that will only cause you more distress. Instead, my goal would be to empower you, to diffuse your need to escape, so you can simply (and painlessly) outgrow your need for them.

    My hope is that you will expand your understanding of your identity and your role within the world around you, both as a FR and as a human being. I would help you regain your sense of control over your life and relationships, and therefore, your enjoyment of them. And I will want you to believe in your heart that you deserve it, too.

    CONCLUSION

    In conclusion, for any of you FRs still resisting the idea of counseling, let me ask you this… if the roles were reversed, if I needed you, you would risk your life to save me, right? That’s why I am doing everything I can to save your life. Just as you would want me to call 911 day or night when I’m in trouble, I want you to contact me, day or night, when you are in trouble.

    Unfortunately, too many FR careers end by way of PTSD-related worker comp claims, terminations, substance addictions, divorce, and suicide. Now, more than ever before, our responders need us. Please help me get the word out by liking and subscribing my videos. I will continue to record at least one per week.
    If you are a licensed clinician wanting to learn how to become a certified first responder counselor or a FR (or clinician) wanting to become a certified peer support team leader/trainer, please visit the Academy Hour, an amazing program created for licensed therapists with ongoing support and crisis resources. It was founded and continues to be managed by a truly amazing, inspirational woman, Amy Morgan, MSC, CFRC(D), CPSL-T(D), TECC-LEO; CEO/Founder of Academy Hour (info@AcademyHour.com).



  • In this video, I discuss military cultural training and encourage other clinicians to consider seeing veterans as a focus of their practice, as I did. I explain how our veterans end up needing support as a result of their experiences entering into and returning from service in the military. I talk about how, even if they do not have PTSD, which most do not, it can still affect their relationships with friends and loved ones when they come home. If you think about it, they go into the military sacrificing their sense of independence and autonomy in exchange for "plugging into" to their new military family, their team--with whom, day after day, they will be getting up in the morning, getting dressed, eating breakfast, training, planning and carrying out missions, risking and saving lives, then coming back to eat dinner, shower, and climb back into bed to start it all over again. They become intimately connected in mind and body, their individuality gradually disappearing as they join forces with their teammates to fight for a bigger cause, our freedom and beliefs, our beautiful country.

    I can only imagine how unexpectedly painful it could be to leave such an intimately connected team--the people you've come to know and love, who talk and think like you do, who "get" how you feel because you've been through so much with them, those for whom you'd die and would die for you--only to return home, to resume civilian life with the family you've loved all along and thought about day and night, but are surprised to find yourself suddenly feeling lost, "unplugged," completely disconnected, no longer with the security of a day-to-day plan or purpose in life. To make matters worse, you're disappointed to discover your family, even your children, have all moved on without you, all found their own ways to cope in your absence. Their routines have changed; you don't know what they are, nor are you included in them. You might even feel like an outsider in your own home and family, the home you dreamed about coming back to since the day you left.

    I share the story of a general who came home from his tour in the Middle East to discover his 13 yr old daughter had all but replaced him, even treated him as a threat to the family and took actions to protect it (from him). She especially felt the need to protect her mother, which caused complications in the entire family system. Combine this rejection of family with suddenly feeling lost, having no routine of your own, no team around with whom to joke or plan and carry out missions... in fact, there are no missions to accomplish, you have no plans for today, tomorrow, or the next day...

    As I explain in this podcast, it's no wonder people decide to return to active duty at any cost, including breaking promises to spouses and destroying marriages. And if you were physically and or mentally injured in the line of duty, you might feel anxious and depressed, possibly suicidal, as you realize what your life is like, now, on disability. Your identity is gone and so is your ability to contribute to society (at least as you once knew it). You went from being a hero to a dependent outsider in your own home, a role you did not sign up for and with which you are not prepared to cope.

    As I've said so many times with clients and in my podcast videos... in my perspective, it is the isolation that kills, not the alcohol, not the guns, not the drugs... It is the isolation from loved ones and friends and community, worse, it can even be an isolation (or attempt to escape) from oneself… That's what kills. And that is why we need to get the word out to normalize the need for proactive training to prevent this emotional pain in new recruits and to provide psychological first aid to those who have already served without this "psych armor".

    As with my first responders, veterans also do not want us to know they are hurting emotionally, they probably do not want to believe it, themselves.

    If the role were reversed, I have no doubt in my mind they would do whatever they could to protect me, to save my life, and this is why I am going to keep fighting for them--the same way they fought for me, us, our beautiful nation.



  • Help me escape police badge whiskey glass




    Keeping on track with my proactive theme in podcast one, an intro to first responder wellness, what I want to talk about in depth today are the things you may not know in terms of our cherished first responders’ mental schema and the role alcohol plays in it—the “how” and the “why” they use it, why it is different from most people and why it can quickly evolve into a vicious downward spiral.

    I am not a rehab therapist, so I am not going to tell anyone not to drink or use drugs—in fact, we all know people capable of using alcohol and drugs—even cocaine—in a healthy way. With increased relaxation or socialization, these substances can actually increase our quality of life without negative side effects at all—yes, you heard me (check the science on this one).

    In my perspective, it is not the substances that are bad, it is the isolation. It is the isolation from loved ones and friends and community, worse, it can even be an isolation (or attempt to escape) from oneself… That is what kills.

    First responders are twice as likely to die of suicide than in the line of duty—what does that tell you? They are around people all day long, yet feel isolated. Unfortunately, it’s often their commitment to the rest of us that gets them into trouble. That’s because the ways they’ve attempted to alleviate their psychological pain are in direct contrast with their identity as a first responder, which carries with it a sense of community respect, an almost “hero” status (and expectation). They don’t want us to know they are hurting, and they do not want us to know they need help—they probably do not even want to believe it, themselves. Besides, where would they even begin to look for help? This is why I am here today.




  • And, for those with gender dysphoria (and their loved ones), I want to share with you so many of the things I've discovered and revelations I've experienced in my privileged role of accompanying my dear clients on their personal journeys of gender identity integration. As you will see in this video, it is not always "common sense," there are some unexpected discoveries as to how we become who we are and develop romantic and sexual attractions.




  • I think the most exciting part of my new officer wellness program is my new podcast Youtube.com channel  "CheraTherapy." I say this not only because I am a tech geek always looking for a reason to break out the Sony Fs5 and Showgun Inferno (wait until you see my new gold metalic condenser mic and XLR cable!), but the thing is I also strongly believe I can reach out to help more people if I can talk about these important issues online.

    For my responder clientel, aside from the business-as-usual discussion of "reactive" trauma treatments (EMDR, CBT, CID), my goal is actually to focus on and increase awareness about the "proactive" training we can give them, those capable of actually protecting our cherished responders and giving them the “psych armor” skills they need to safely walk those fine lines between human being and hero, effective responder and emotional mess. (read more below...)


Some more words to my first responders...

Whether we realize it or not, as we go about our daily lives, we are benefitting 24/7 from their sacrifices.

They are sacrificing not only their physical comfort, safety (and lives), but also their emotional wellness by way of lost time and connections with friends and loved ones and the inability to see the world the way they used to--the way everyone else still sees it (a la the red pill in the Matrix movie...). If we don't even know what they do, how can we appreciate how much they give and suffer for us? How can we help but go about our lives everyday (and night) taking them for granted?

LEO careers have always been challenging, both on and off-duty, but the recent wave of anti-LEO political movements across the US has exacerbated the situation with increased stress on the job, budget cuts, low pay rates, reduced recruitment, and even higher turnover. Needless to say, I am compelled to take action. Too many of our LEOs and other responders are suffering behind the scenes, in silence. Justifiably fearful of negatively affecting their careers, they are left to self-medicate, which can trap them into behaviors conflicting with their identities as responders, husbands, or wives. It is no wonder they are twice as likey to die of suicide than in the line of duty.

Chera's Responder Homework LEO Collage

(This is one of many homework assignments I created while earning my certification as a first responder counselor.)
Click to enlarge.

What kills me is how predictable and preventable this suffering is.

Whether the more obvious negative effects (i.e., acute and cumulative trauma response resulting in PTSD and various physical complaints) or the less obvious negative effects (i.e., one's quality of life and personal inner conflicts of self-beliefs, self-value, their role in society, their relationships, and the world around them), we owe it to our responders to have their backs and provide them safety and compassion to help them stay strong and healthy.

I will record a new podcast each week and post their links here. I will also be creating POST trainings, but, again, I believe this podcast will be the most efficient way to get the word out. It is my hope the efficiency of repeated and spontaneious posts will allow me to normalize the idea of reaching out for support within the responder culture.