Therapists Suggests A Crisis Response Career

[Iyllsa]

Last weekend when I spoke with my therapist, we started to discuss again about how I respond to situations that are of "immediate danger" or "crisis" like scenarios.

As some back story, I've been abused all my life. I've been manipulated in many ways, all kinds of abuse, and the way I handled it was by learning to read the people. I started this at a very young age and I remember when it clicked for me. I was around preschool age when everything started.

I simply got slapped by my mom and I now realize that what happened to me, mentally, was that I dissociated. I remember leaving the room because I couldn't process anything. I wasn't sad, upset, scared.. it was just empty. I didn't even think about walking away, I just did it because I saw the open door. I got called back and my mom hugged me, but I remember just being emotionless. It felt like I was a puppet/inanimate object as she hugged me. I don't remember what happened afterwards.

Anyways. Fast forward, I've experienced a lot of stuff. I've held dying people in my arms and I wouldn't do anything because I knew there was nothing that could have been done. I knew they were too far and if someone tried anything, it would be a waste of materials.

The first one happened when I was in 7th or 8th grade. I don't remember exactly. I remember holding this old guy who was bleed profusely. His head was badly smashed in and although I called the paramedics, I did nothing. I held him there and spoke to him. Comforted him. It was raining hard and the water made the blood look worse.

I remember him asking if he was dying and I confirmed his question. I remember saying something like, "It seems so, but don't worry. I'm going to stay here with you." I remember him holding my forearm and saying I'm too young to experience this. He then started talking about his grandson and how he got lost looking for him. Adults were near by and they were panicking trying to compress paper towels on the guy's head but they didn't want to touch him. Some freaked out by all the blood and one of them tried to pull me away from the guy.

Eventually paramedics came and saw me, they tried to give me reassurance that he was going to be okay. I knew he was dead and I could tell by them that they knew as well. I wasn't sad, upset, uncomfortable. I felt calm. It was like I could think clearly almost. I don't know how to explain it, but it's like I could breathe.

Other events have come up. I've caught a guy that collapsed and started having a seizure. I've never gotten hands on training but I have an interest in medical and psychological issues/events (typically I heavily read up on things) and since I've read so much into seizures, seen instructional videos, as well as met people online who have different ways of managing their seizures, I knew what to do. I had to help keep people calm and instruct them to call the paramedics, asked them for their jackets so to use as a pillow, and I even scolded a few people who were just there to watch and couldn't handle the sight.

I just felt present and there. I'm not sure if maybe I am at some level of dissociation, but it feels so relaxing.

The irony, though, is that if I'm not in a situation like that then I become paranoid. I become super anxious and my symptoms come up. If I'm in a crowd, I'll have a panic attack but if there's a person in that crowd that is dying or having a seizure, it all gets pushed away and everything feels light.


I've thought about getting into EMT training and seeing if I can tie into my current interests. (Dog training. At the moment I am training a service dog.)

But I also thought that because I have mental health issues, it could cause problems or make me unqualified.

What are your thoughts or experience with that?

 

[Sweet_E]

Last weekend when I spoke with my therapist, we started to discuss again about how I respond to situatio...

It sounds like you react really well in a crisis.

I am the same way, I automatically go into crisis mode and do what I can to reduce the trauma for others. I think this is because I did not get the help I needed when I experienced a crisis/abuse as a child. I don't want anyone to suffer the way I did.

The thing is, for these examples, they are someone else's crisis, primarily. Maybe that is irrelevant. Another thought is that you are anxious when there is no crisis perhaps because you are conditioned to think that there is always something going wrong - that's how you grew up. So if there is no crisis to respond to, your subconscious automatically looks for a crisis, thinking you must be overlooking it.

 

[desiderata310]

From what I've seen and heard that's not all that unusual.
I work in theater and dealt with front of house for many years. I've seen everything. EVERYTHING. From people pooping themselves, to drinks bashing their heads in to crazies brandishing guns.
I can't deal with doing my grocery shopping but put me in a crisis situation and I'm dead calm.
I figure it's the one good thing about PTSD

 

[Sweet_E]

From what I've seen and heard that's not all that unusual.
I work in theater and dealt with fron...

Wow! I don't know how I would handle if someone pooped his or her self, seriously. I mean I did help out with a family member who did that but they were very sick.

 

[Cabinfever]

I come from a similar trauma background (afterall myPTSD right?) and have worked in crisis intervention and emergency relief. I have always been drawn to high-risk type of situations and am a little bit of thrill seeker. Those tendencies coupled with my empathicness and "savior-complex" led me to very unwisely accept a crisis-intervention position at age 22, which involved wandering around the shady neighborhoods of a large metropolitan city on foot, monitoring the well-being of homeless individuals with intractable schizophrenia and polysubstance abuse. I will also mention that I am very small person, 5 feet tall, not athletic, and female. Everyone thought I was crazy for accepting such a high risk position... but I thrived off the danger.

My thinking at the time was that there was nothing I could encounter that would surprise me, or make things any worse than they already had been in my life. Some fearless person needs to do it... so why not me?! The job gave me a thrill. There was no time for planning or organizing, every decision was gut-based (it had to be)... acting, not thinking. You were almost always "in the moment." For me, being in the midst of a crisis felt natural and even exhilarating... at first. I told people entertaining stories about how one of my client's started strangling me on the city bus, or how another one tried to sell me to Korean pimp... And then there was that time that I found a dead body with all the weapons strapped to his chest... or what about the time I saved a woman from dying of alcoholism while administering CPR and she threw-up in my mouth... so many good stories... so many migraines. I didn't realize it at the time, but I was poisoning myself with stress. (Oh, and my colleague was shot in the head by a client while in the community and died from her injuries - so that was also quite the "wake-up")

I have found personally that some level of disconnection/dissociation is helpful when responding to an emergency situation, but that as a previously traumatized person, you have to stay self-aware because your stress-level is in reality going up, up, up... but because of the handy-dandy dissociation go-to, you tend to not notice. Disconnection goes both ways. While it might be good to be disconnected from the tragedy of a gunshot wound in the moment so you can administer oxygen and start an IV line, the reprieve from stress isn't real. In reality, your body is getting stressed-out and your automatically pushing all of those thoughts and feelings to the side, just as you learned to do when you started dissociating.

And what is the key problem with dissociation? The memories, thoughts and feelings that we partitioned-off and made inaccessible in order to protect ourselves become fragmented & buried within us, causing physical pain and destroying our immune system. We deny the experience of the horrible thing, but that doesn't mean we didn't experience the horrible thing and that our body didn't keep a record of how the horrible thing made us feel. The process of becoming integrated and healing from trauma relies heavily on our ability to make sense as adults of the terrible things we experienced and to liberate the associated emotions and thoughts from the prison of our body.

Having a history of trauma is an interesting thing, because on the one hand you've learned to disconnect from experiencing people and situations that are too overwhelming to bare... which in itself is a skill that emergency-responders try to cultivate, but at the same time, the life-long trauma has fundamentally changed your homeostatic stress level giving the appearance of being able to deal with an incredible amount of stress, but in reality causing further damage to your body without consciously realizing it.

That's not to say that you couldn't be an awesome EMT... but when I read your post, I felt the strong desire to write this out and caution you a little bit about diving into emergency response head first, without considering the personal toll it can take on you when you have an extensive trauma history.

In my opinion, you might would want to consider the following things before training or accepting hire as a crisis/emergency responder:
1. Personality -
"Empathic-ness" is a no go. Excellent emergency responders are typically thinking-oriented people, and are a tad emotionally insensitive, have excellent self esteem, are prone to arrogance (who else would believe they were capable of saving someone's life?) and are action, rather than relationship, focused. People that are naturally highly empathetic or very sensitive can get burned-out easily doing this kind of work.
2. Homeostatic stress level/ current physical health -
So if the average, healthy, well-nurtured child's resting stress level is here: ______, the chronically traumatized person's resting stress level is here: -------, fundamentally higher and more over-sensitized.
The chronically stressed person was born into a world that was stressful, and their body has adjusted to and come to expect a high stress environment... but that doesn't mean that their body benefits from this adaption... it's not about benefit when it comes to chronic stress. It's about survival. In fact, the rising of the stress level is a good way to guarantee that you'll die on average 20 years earlier than someone who never experienced that level of stress. (They wouldn't let me post a link but google search ACES and mortality)
The well-nurtured child was born into a world where normal stressers exist, such as learning to communicate with one's caregiver or to walk. Acquiring these skills is just enough stress to stimulate continued growth, but not enough to flood the child's engine (their body) and cause them to fight, flight or freeze.
Children who are the chronic victims of abuse and/or neglect quickly realize that their world is not safe or predicable, and on top of that, have many terrifying experiences (sexual molestation for example) which flood their "engine" with stress hormones. In small supply, stress hormones are good, but when a human body is continually flooded with high levels of stress caused by a stressor that is inescapable, the stress response system begins to erode and subsequently malfunction. In other words, years and years of extremely stressful situations wreak havok with your immune system, adrenals and especially, your resting cortisol levels.

When you are experiencing traumatic stress, you are suddenly in your element, the place that 'feels right'... you are back at the homeostatic resting point that the body is used to. You might find that when nothing is actually happening, that's when you feel the most stressed-out, because your body is responding to the lack of stress inputs and instead trying to create the stress needed to bounce you back up to your resting point.

3. Progress toward recovery
It's possible that through experience and a lot of hard-work you have managed to get your resting homeostatic stress level back down and within normal limits. It's possible that you now know how to respond to and process triggering events and people in your environment. It's possible that you have a fully formed sense of self, and healthy dose of self-esteem. It is possible that you just really like working with bodily systems, and that your mind is right for it. By all means, this may be the perfect job choice for you. It might end-up being extremely fulfilling.

I just want to caution you from experience that you may end up doing alot of physical damage to yourself before you mentally notice it's happening due to the past history of dissociation and trauma.

This response got really long and unbalanced and I apologize. After I started to writing to you, I got really passionate about what I was saying (because I've reflected on this a lot considering my occupation), and then I a little carried-away. So anyone, good luck to you, whatever route you choose to go, just don't forget that it takes a lot of work to heal from trauma, and an EMT job could possibly derail any progress you've made thus far, if you lack the personality or emotional/stress regulation skills needed to manage the unconscious job stress and the constant close proximity to re-triggering events.

 

[Abigail7]

I think that in the interest of healing and self preservation, it is probably best for those of us who already have PTSD to avoid going into careers that oftentimes cause PTSD. That is, although you may be good in a crisis, you already have a diminished (perhaps severely) threshold for handling stress and while it may take a non-PTSD person a lot longer to suffer ill effects from such a job, someone with PTSD has already endured "damage" so we are not as resilient as those who have not already endured trauma and have PTSD. Of course there are all sorts of levels of "crisis" so perhaps find a "quick on your feet" job that doesn't give people PTSD? That is, avoid becoming an EMT, fire fighter, policeman, etc.

 

[Iyllsa]

I think that in the interest of healing and self preservation, it is probably best for those of us who already have P...

This is what I was thinking and was surprised that my therapist suggested I get into such a career. I'm feel like I'm functioning off a twig, sometimes I feel like I'm functioning off a burnt piece of straw! I don't know how I'd be able to handle things if some really bothersome events occurred.

 

[Iyllsa]

1. Personality -
"Empathic-ness" is a no go. Excellent emergency responders are typically thinking-oriented people, and are a tad emotionally insensitive, have excellent self esteem, are prone to arrogance (who else would believe they were capable of saving someone's life?) and are action, rather than relationship, focused. People that are naturally highly empathetic or very sensitive can get burned-out easily doing this kind of work.

I'm not sure if this is a good or and thing... but I am like this. Have been for as long as I can remember and I've created a lot of "enemies" and haters because of it. I am more realistic. I am more of the "If I was in a forest with just me and a starving child and a piece of meat, I would eat the meat and let the child die because it's too young and weak. It has no chance to survive." I don't hesitate. I am only "sensitive" toward a person if I am very very close to them which is only one person really. It took me a while, but I was able to let myself feel badly for her. In a way I feel like it was a mistake because now I'm feeling very depressed by it haha.

But anyone else... I feel very heartless and cold thinking about it, but at the same time I kind of shrug my shoulders at it. I don't want to go into detail because I know it upsets a lot of people.


When you mentioned you searched for danger, it made me think about how I enjoy interesting events to happen, but I can't say for sure about this. I definitely want to make sure I am not depressed and doing reckless behavior due to my depression or any other illnesses. How can I help people if I'm at least stable in some way, you know?

When you are experiencing traumatic stress, you are suddenly in your element, the place that 'feels right'... you are back at the homeostatic resting point that the body is used to. You might find that when nothing is actually happening, that's when you feel the most stressed-out, because your body is responding to the lack of stress inputs and instead trying to create the stress needed to bounce you back up to your resting point.

I am so glad someone has typed this up. I recognized this but I couldn't quite understand why. You explained it beautifully and finally I can put that tugging question away and feel a bit at ease and understanding of myself and my brain's reaction.

I just want to caution you from experience that you may end up doing alot of physical damage to yourself before you mentally notice it's happening due to the past history of dissociation and trauma.

Another thing I feel that will keep me from being qualified is that I already have medical issues. I have pain with my lower back, knee, and feet. I also have a blood disorder that makes me feel fatigued all the time. I don't know how I'd manage such a stressful job like that, but it still does interest me. I'd have to find out why I have those kind of pains and there is no cure for my blood disorder so I'd just have to manage it..

If I ever get into such a career I feel it would be after a long time of preparation and healing for myself both physically and mentally..

Honestly I don't know why my therapist would suggest such a career. She knows about my past. I guess she took into account of my personality and how I react.. but still. I don't know. Maybe she also didn't think much of it and just said it because it was on her mind.

Thank you for the long reply! It was an interesting read and very informative. I don't disagree that if I were to become an EMT, I would have a hard time managing the stress.. if I even can.

 

[DanielSomers]

Last weekend when I spoke with my therapist, we started to discuss again about how I respond to situatio...

Hello Lylisa,

Thanks for this. I have a couple of thoughts. The first is just that I have some sense of this myself, though perhaps not as regular or intense as you. I've been in a phase for several years where long-repressed trauma has been emerging and I've been working through it, but with a pretty remarkable loss of confidence and direction. But in the midst of that, a few years ago I was in L.A. with a group of about twenty people and we saw a small dog in heavy traffic, a four-lane road, get hit by a car and hurtle through the air and land hard on the pavement, rolling end-over-end. It was really awful. About half the people there literally started to turn and run away, very instinctive, and the other half just froze. I was very clear and saw that happening and just immediately, without the need for any thought or conscious decision-making, walked calmly into the traffic, held up my hand to stop it, and walked over to the dog and cradled it in my arms. Finally a few others came to help, and miraculously the dog did not die and was adopted by someone in our group, though I think he had some brain damage since he seemed a little off when I went to visit him a few months later. Still, it was a really extraordinary thing to feel that level of confidence in myself, which I'm sure was a result of my own trauma history, and I think fits with your suggestion that an emergency response career could be a good path.

Second, my former girlfriend had a really awful history and left a successful academic career to become a hospice nurse. She absolutely loves her work, and from what I hear is extraordinary at it. I don't think she would trade it for anything.

So I would think if it's not something that's too much, too stressful, an emergency career could be a very good thing. Let us know what you decide. Good luck!