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Emotional Responsibility for Each Other

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محتوای ارائه شده توسط C3 Pathways. تمام محتوای پادکست شامل قسمت‌ها، گرافیک‌ها و توضیحات پادکست مستقیماً توسط C3 Pathways یا شریک پلتفرم پادکست آن‌ها آپلود و ارائه می‌شوند. اگر فکر می‌کنید شخصی بدون اجازه شما از اثر دارای حق نسخه‌برداری شما استفاده می‌کند، می‌توانید روندی که در اینجا شرح داده شده است را دنبال کنید.https://fa.player.fm/legal

Contact information for Dr. Metz:

Sara Metz, PsyD
Public Safety Psychologist
Code-4 Counseling
Facebook (@code4counselingllc)

Code-4 Counseling YouTube channel videos

Episode 30: Emotional Responsibility for Each Other

An important discussion on emotional responsibility for your fellow first responders.

Bill Godfrey:

Welcome back to our next podcast. Thanks for joining us. You're back with the Active Shooter Incident Management podcast series. Now a few weeks ago, we recorded a podcast on what we called an Emotionally Responsible Room Entry. And that subject came up specifically from one incident where responders made... Well Robert, how would you put that?

Robert McMahan:

There was a lot of dynamics during some of those entries that were causing problems for people that were in those rooms. And we got some negative feedback from some of the students and teachers following that incident.

Bill Godfrey:

So essentially that podcast, which if you haven't heard it, please go back and give it a listen, was about how to make some adjustments to the way we handle these calls so that we're not scaring the hell out of kids, not to put too fine a point on it. But that's not what we're here to talk about today. At the tail end of that podcast, we drifted a little into talking about the emotional responsibility for each other as responders. And if you've heard that podcast, you know Harry and Robert were on that with me and I've asked them to join us again. Harry, thanks for being back again today.

Harry Jimenez:

Thank you, Bill, happy to be here.

Bill Godfrey:

And Robert, thank you for coming in again. I know you've already said hello to the group. But we have also asked a special guest to join us by phone today. So on the phone, we've got Dr. Sara Metz. Now Dr. Metz is a Public Safety Psychologist. She's also the owner and founder of Code 4 Counseling in lone tree, Colorado. And Dr. Metz has quite a bit of experience. Dr. Metz, thank you for taking the time out of your schedule to join us.

Dr. Sara Metz:

You bet, thanks for having me.

Bill Godfrey:

Fantastic. Dr. Metz, just to kind of get you oriented, so Harry was talking about his experience at the Sutherland Springs church shooting, which is I'm sure you recall, involved a lot of kids, and Robert was talking about his experience at the STEM school shooting that they had in Douglas County just before he retired. And it got a little emotional and reminded me of some events that we've had that hit a little close to home. So as a place to start out, I know that you've handled counseling for a lot of these types of events. What are the things that we need to be watching for and paying attention to both short-term, immediately, in the medium term and in the longterm?

Dr. Sara Metz:

So with our responders, responders are very well-trained tactically to go into an environment like a church shooting, like unfortunately a school shooting and handle that tactically. Unfortunately, oftentimes the training doesn't really address... one of the things that we see causing the most distress to them is the feeling of helplessness. They at their core want to help people, it's why they go into this, they have a heart for service. And when they go into an active shooter scenario and they see the fear and the distress they, unfortunately at times, may have to walk past victims who are asking for help because they're clearing the scene, still looking for the active shooter. There's a lot of complexities to these incidents and the emotional toll that takes on them, isn't necessarily well addressed in the training.

And again, it's the sense of helplessness that they don't always have language for what that is doing to them. They believe that the quote unquote trauma of the event that gets to them and oftentimes they think, "No, I did okay with that, but something's still stuck with me." And often when we really peel it back, it's feeling helpless, not having been able to necessarily help in the way they wanted to, dealing with kid victim is always its own beast. So there's definitely certain parts of these tactical events that aren't really addressed in training and really take a pretty big toll emotionally, on these folks.

Bill Godfrey:

Dr. Metz, when you're dealing with responders, and I mean both male and female, is there a bit of the typical responder, tough guy persona that gets in the way?

Dr. Sara Metz:

Absolutely. And what's interesting when you say gets in the way in terms of, there're well when they're doing their job, but then they have a hard time putting that down. That armor is great for them. Civilians, we benefit from them having that very tough exterior, but as I've learned in 15 years of working with responders, a lot of them have a soft mushy center and they're big, giant hearted people. And again, that big hearted-ness about them, they aren't trained how to use that. They aren't trained how to show self-compassion as they notice psychological injury in themselves. They don't really even know how to help each other, they want to and they definitely give each other hugs or a slap on the back saying, "Hey, are you good?" But then they don't really know what else to do. So again, it comes back to that tough exterior, is well-trained into them, it's the deeper, more complex layer that they get a little stuck.

Harry Jimenez:

Doctor, this is Harry. I echo what you said but also, comes to mind the fact that even if we somehow understand that we may need some help, we fall back on the persona of toughness. We don't want to look weak, we don't want to be that guy in the squad that people will talk behind you and say, "Well, I'm not going to roll out with this person, or I'm not going to call out this person to back me up because I'm afraid that this person might snap." And there's a stigma in law enforcement and in my case, law enforcement and military service. We leave with this stigma that we have to be tougher and we have to be strong, and that gets in the way of understanding what's really happening on... What else? Robert, what do you think?

Robert McMahan:

Yeah, it does. And I personally battled that for a while before I got help because I needed to get help. And I've seen a number of things that put a bunch of stuff in my bucket, as we say. But Dr. Metz, you and I worked together in Colorado when I was still there and we worked through a number of these things. Why don't you tell us about what are the first steps to start taking care of these responders after an incident?

Dr. Sara Metz:

Yeah. I think Harry brought up a big point. I know Robert, it's something that you and I have both really seen your agency in Colorado tackle over the last couple of years. That stigma is something that's been there for generations, it's certainly been there for a very long time and I do think that the stigma itself is really that first step. If we're going to get responders to seek help, we have to normalize that and we have to celebrate it. That has to become something that is part of the culture, it's part of the common language people say, "Hey, you've gone to talk to the doc, good for you. You haven't made an appointment yet, definitely do it. I got mine on Tuesday." That sort of language is something that has never been a part of the culture, I get that. I've been, like I said, doing this for 15 years.

I would say in the last one to two years, we've had some really amazing responders step forward, military personnel as well, to really start to lead from the front and show what that would look like to bulldoze past the stigma. And that takes folks who are really willing to be vulnerable, who are willing to say, "I know there's been a stigma, but screw it. I'm doing it anyway." And that has really done wonders for the culture. And we've seen fairly quick change. Responders are not, one who change quickly, they don't like change. But seeing folks really step forward that they respect, that the agency's respect, the culture respects, and those folks saying, "I'll share my story, I'll start. Here's what I went through. Here's what worked for me and I will advocate for and respect anyone who follows the path of recognizing when they're struggling and they will seek help." And that is step one. Once you from the top down, really start to see that be advocated for, folks are much more willing to say, "All right. Well, I guess I'll give it a try." So step one is beating that stigma piece.

Robert McMahan:

Dr. Metz, when we were working together in Colorado, when we had critical incidents, including just officer involved shootings or whatever it was, we always called you out and your staff to do a debrief, and to talk to those responders after the incident. Is that enough? Or do we need to be doing more?

Dr. Sara Metz:

No. I would say it's a great step, but it goes back to, it depends on what the culture thinks of the debrief. I've seen plenty of folks walk into a debrief and say, "I just got to sit here and I don't give a shit. And I'm not going to talk," because they believe that stigma is still present. "I'm not going to say anything. I'm not going to out myself." I will say the agency that you come from, I just did a debrief for them what, two days ago. Gosh how many people were in that room? I would say at least 20 folks who were involved in a critical incident, an officer involved shooting for that agency, 20 folks in the debrief. Every single one of them talked, every single one of them was willing to say what they had experienced the day of the incident, whether it was adrenaline dump, they weren't able to sleep, they hit the wispies, they snap at their kids when they got home, they talked about that.

And they talked about four days later, which is when we did the debrief. They talked about the signs and the symptoms that were still present. And they talked about the things that were fading and healing naturally on its own. And as a group, we were able to talk about those signs and symptoms, normalize it for folks, "Hey, you're still not sleeping? Hey, I'm not sleeping either. All right. Well, here's some ideas. Here's some things we can think about to see if you can get that to heal on its own." But that dynamic took years to create, that took a long time for folks to really respect the process.

But I would say there are definitely agencies now in Colorado and around the country, that are creating the right environment for those debrief to go well, and are also educating folks on all of the different things that they can do to take care of themselves. Whether that's wellness checks, whether that's in-service training that specifically highlights psychological stress injury, whether it's family night, getting the families involved, that they understand this shared language. There's so much that goes into a successful well integrated wellness program within an organization.

Bill Godfrey:

Dr. Metz, that's really remarkable what you're describing there. And it's encouraging to know that there are agencies that have been able to cross that bridge and deal with this a little more head on. You mentioned that our culture isn't very quick to change, and boy that's not an exaggeration. We have a saying in the fire service, "200 years of tradition unimpeded by progress," and we mean that shit.

Dr. Sara Metz:

Oh yeah, you do.

Bill Godfrey:

But on the lines of the symptoms and I may be off base here, but my personal experience. Now, Harry and Robert are both law enforcement, I'm from the Fire-EMS side. But my personal experience is that the immediate after, we're usually pretty there for each other. So Harry, you and I were telling the story in the earlier podcast about, when you were driving home for Sutherland Springs late at night, I was already in bed. And got the phone call and I knew, I got up got out of bed and we were on the phone how long?

Harry Jimenez:

I think I called Bill right after I left the scene. And I've been in the scene for probably 12 hours and I'm heading home and it was about an hour drive. And I think we spoke all the way until I pulled into my driveway, and he was making sure that I made it home.

Dr. Sara Metz:

Wow, that cool.

Bill Godfrey:

Yeah. So I guess where I'm going with that is, my personal experience and that may not be fair, but my personal experience is usually the immediate after the event, we're all kind of they're checking each other, but then I think we fall down. And I wondered if you could talk a little bit, it's a two-parted question. Number one is, in the near term, the days and the weeks that follow, what are the signs and symptoms that we need to be watching out for in each other? And then the second part of that is going to be, what are the things, if someone's reluctant to get help, reluctant to acknowledge that it's been an issue, what are the things that we as their peers can do? I'm not talking about supervisory intervention, but what are things that we as their friends and peers can do to try to help them see that they need it?

Dr. Sara Metz:

I think those are both great questions. I'm going to actually start with the second one first, and then I'll circle back to it here in a minute. But Robert will laugh at me because he knows where I'm going to go with this.

Bill Godfrey:

He's actually sitting here already chuckling, he's got this big smile on his face.

Dr. Sara Metz:

Yeah, he knows where I'm going. I promised him I would try to behave on this call. But this is where I think there's a little bit of tough love that needs to come in to this profession. I often hear that sort of thing. "Well, what if someone is reluctant?" Bullshit. Go to the doc because it's the right thing to do. You guys don't use that excuse for anything tactical. "Oh, I'm a little hesitant. Oh, I'm a little uncomfortable. That makes me nervous. I'm scared to do that," is not part of the culture. And yet it is so often the thing that prevents them from coming in the door. Now it's our responsibility as clinicians to create a safe space for that and to understand the culture and to do the work, to be culturally competent, to serve responder population.

But I would say with all the love in the world, to my responders out there, "Get your butt in there, get checked out because it keeps you at the top of your game. And if you have a bad fit, a clinician who doesn't get it, or it doesn't feel like the right fit? Find one who is a good fit." And that's where responders, one of the things they can do to take care of each other is, everybody get out there, find clinicians that are good and share that information with each other. "Hey, you know what? I had a really great session. You should go see so and so." And have there be variety, have there be male clinicians, female clinicians, folks who specialize in EMDR (Eye Movement Desensitization and Reprocessing) versus talk therapy versus this, that, the other thing.

But the more clinicians are available and the more responders will not feel shame and we'll share that information with each other, I think is my answer to the second part of that question. Now to the first question of, what are the signs and symptoms that folks should be looking out for? I think there's some really common ones. And what I typically will tell folks is, the body is actually fairly good at recalibrating itself over the course of a few days and a few weeks, what typically hinders that process is shame and judgment. So for example, if someone in the first few days, or first week or so, they go through a critical incident, they're involved in an active shooter scenario, for example, and they are having a hard time sleeping, they really want to drink because they know that will calm their system. They're moody, snapping at their kids, snapping at their partner... Go ahead.

Bill Godfrey:

By the way Dr. Metz, you had three guys shaking their heads up and down, yes, When you mentioned the drinking part.

Dr. Sara Metz:

Yeah, absolutely. It's a big one because unfortunately it works. So we know it works. The problem, it does so much damage to the system's calibration. It's trying to numb a system that would work if you gave it a chance.

Bill Godfrey:

That's interesting.

Dr. Sara Metz:

And part of that is letting your system be uncomfortable. Your system is looping and it's anxious and it's got adrenaline still sparking through your system, that's all normal. It's wildly uncomfortable and I don't dismiss it as, "Oh, just get over it." It is wildly uncomfortable, but alcohol and substances is nodding that, which doesn't allow the system, the human body that is actually very brilliantly structured in so many ways, it will recalibrate if you let it, but you have to let it do it in its own natural time. So when folks drink to try to numb because they're so uncomfortable, what we know the alcohol does is, it makes it so you cannot get REM sleep.

REM sleep is where your system during your sleeping hours is going to, again, recalibrate. It moves experiences from the front of the brain, into the memory center, which is where we block them, because it means you remember it but you don't re-experience it. If you're drinking in the evenings or right before bed, that alcohol in your system locks the door to that process. So those experiences stay at the front of the brain, that's why things like flashbacks and re-experiencing happens, because it didn't get moved to the memory center. So we need that process to work and so we really encourage people, just give it a week or two, see if your system naturally recalibrates on its own. Watch for the increase in alcohol use, try to keep that out of the picture, watch for the moodiness, watch for the restlessness and the difficulty sleeping. Those are some of the pretty normal things that we see after a critical incident, but oftentimes they will say it on their own.

And even if they don't, all that tells us as clinicians is that, "Yeah, go in and get a checkup." And it may just take some verbal processing or looking at it from another perspective, some additional coping strategies. Those are things we can certainly provide someone if they are not matched, really kind of moving through the process on their own in a week or two. But back to Harry's point a while back, it's shame and fear of judgements that prevents people from doing that. They think, "I have to just figure this out on my own. If I say, I'm not healing on my own, people won't think I'm a good partner. They don't want me as a car partner. They won't want me to back up. They won't won't walk me on their crew." What we have to help people recognize is, "We'll get you there, you're not going to live in the red forever. We'll get you back, but we need to know what those symptoms are so we can help you."

Bill Godfrey:

It's really fascinating listening to you explain that. And I mean, I've been a paramedic for over 30 years and knowing the physiology doesn't mean you take it home and into your brain. And something you said kind of-

Something you said kind of made me think about something my therapist once threatened me with a baseball bat over. And he said, "Damn it, sometimes you just have to sit with those uncomfortable feelings."

Dr. Sara Metz:

Yeah, so true.

Bill Godfrey:

If you keep pushing them away and you never process them, is that kind of a little bit related to what you're talking about here?

Dr. Sara Metz:

Absolutely, it is. And again, I really try to encourage responders to recognize, you all are well equipped to be uncomfortable. You do it all the time in environments that you choose to be uncomfortable in. You go into burning buildings, you go into hoarder house for medicals, you go through the maze, you put the gas mask on, you guys go into critical incidents of shootings, there are a million and one scenarios where you guys will put yourself in uncomfortable situations and you believe that it's worth it. But for whatever reason you guys, hate, all humans do, this is not just a responder thing, but people hate to be uncomfortable when it comes to their feelings and it comes to processing their experiences. If responders would go into it with that same level of, "All right, I just got to hunker down and be uncomfortable because it's serving a purpose," they would do a lot better.

Bill Godfrey:

You just need to set your office on fire and then we'll show up.

Dr. Sara Metz:

There you go.

Bill Godfrey:

I'm sorry, that's a terrible idea. Just for the record. That was a joke.

Dr. Sara Metz:

... wow, how have I never tried that? I have South Metro just down the road, they'll come in a heartbeat.

Bill Godfrey:

Robert, you were getting ready to jump in and say something, I'm sorry.

Robert McMahan:

Yeah, Dr. Metz, we've been talking about how to deal with these things and making sure that we get our officers and first responders in to see a clinician. If we do that initial debrief, and typically after a shooting, we'll send an officer in for a one-on-one with a therapist and oftentime they come out okay. But you and I saw a number of first responders months after the incident, where issues started cropping up. Can you talk about that a little bit?

Dr. Sara Metz:

It is a great point, because we often will see things start to bubble to the surface right away. However, it is very, very common and very, very normal for those symptoms to take months, sometimes years to fester. I often will describe psychological stress and compare it to an infection. Sometimes an infection again, without a paramedic on the call, probably somewhere else, but sometimes you'll notice it fairly quickly-

Bill Godfrey:

Just for the record, I used to be, I don't do that stuff anymore. For the last-

Dr. Sara Metz:

I knew this stuff back in the day, all right.

Bill Godfrey:

The last patient I touched was when a space shuttle went up and that guy died. I'm not the guy to touch on it, I'm the guy that goes send for the defibrillator.

Dr. Sara Metz:

Again this comes back, yeah I talk about it all the time, shame and judgment. Prolong when people will get help, if you take that piece out and simple have someone say, "Well, I was doing okay and now I'm not, I guess it's time to go to the doc." They go to the doc, they say what their symptoms are and they get the help they need. It's very normal. It really is fine. Honestly, the other side of the normal spectrum is that, it's absolutely fine if someone does absolutely fine forever after a critical incident. Every now and then I'll have a responder come into my office and say, "Everyone is telling me that this, even though it's not bothering me now, it's going to." And then they get anxious thinking, "So this is just going to be the spawn, it could go off at any point I feel in my head at any moment?" No, live your life.

If it pops up, it pops up. If it doesn't, it doesn't make you a psychopath. If you're fine, uou're fine. It's great to be able to articulate why you're fine, so you have an understanding of what strategies seem to be working for you, but if you're fine, we're not going to try to poke the bear.

Harry Jimenez:

Doctor, Harry here. When you were talking about what type of things to look short-term, mid-term, long-term, I felt that you were describing me. Just to put in perspective, military with five combat deployments and then law enforcement for over 30 years. What you're saying is exactly the way I felt, after multiple deployments and law enforcement and loosing an officer under your watch and being involved in critical incidents and saving someone's life and not remember how the hell that happened. I thought, "Okay, I'm visible, everything's fine." And then one day, hill came down crashing on me and the first thing that I did was fight. Fight not because of the shame or the stigma, but was fighting with myself. "How come this is happening now, since I've been good all these years?"

And it took me a couple of clinicians to finally, like you said, find the one person that I felt that could understand me, if you may, in my own whatever crazy designation I gave to that. And there were two things, first he told me, each one of us experienced the same incident in an own personal different way. And that was a very significant to me because sometimes we as first responders, we look to the left and to the right and if the person that you know that responded is not going through what you're going, you might start trying to cover it and push it down because you don't want to seem to be weak or weaker. And when he told me that, "No, we all going to feel it and understand it and react in own personal way."

And the second one which goes with, I remember now, because you mentioned about the alcohol, he told me, "Harry we're going to go back to not only this incident, but we're going to go back to every one of these incidents that we know that you are dragging for years and you have not face." And I thought he was insane and I immediately refused, I said, "No, I don't want to re-live that." And he said, "Oh, on the contrary, you still live in it." He told me a story and I don't know if you have heard this and if you do please tell us more about it. He said, "When the first person start deciding that, AA, Alcoholic Anonymous, it was a good idea, a lot of people laugh to the whole idea. Because they say, 'So you're going to get a group of drunks together to talk about drinking, that makes no sense.'" And talk to us about that.

I mean, that was my experience. I was like, "No way I was going to re-live this in my own brain, thinking about it." And he helped me... basically the same analogy, he got me around with other people that were coping with their own incidents. And in a way allows you to free yourself.

Dr. Sara Metz:

Mm-hmm (affirmative), totally agree.

Bill Godfrey:

It's fascinating to know how parallel our lives have all been, even though we didn't know each other until the last few years that we've been teaching and training. And Dr. Metz, I'd like you to kind of comment on this and if you'll forgive me, I'm going to do a little bit of wind up here with it. I went through most of my career, some ups and downs, but I did not really struggle with any one particular thing. But what has been a challenge for me, and the best way I can give this example is the idea of institutional noise, it's not typically one gunshot that makes you go deaf, it's not wearing hearing protection while you go through thousands of gunshots or it's not being around a jet engine one time without hearing protection. It's being around them all the time. That idea of that constant repeated exposure. And Dr. Metz, are you by chance familiar with the Enneagram?

Dr. Sara Metz:

Mm-hmm (affirmative), I am.

Bill Godfrey:

Okay. So I'm an Enneagram eight. And for those that don't know what it's about it-

Dr. Sara Metz:

You're and eight aren't you.

Bill Godfrey:

Yeah, don't worry about it, I'll just say this. It means that I tend to be a fairly strong personality and aggressive, and that's cover for not wanting to reveal vulnerability.

Harry Jimenez:

I will never have guessed that.

Bill Godfrey:

I know, shocking. Exactly. And now I cry at a double mint twin commercial. It's just these moments of just uncontrollable sadness that lasts for a second, second and a half, two seconds, three seconds. We'll be teaching the classes that we teach and there's some sensitive material that we talk about and some things that we cover. And there's particular modules that I don't like to teach, because about 50% of the time I get choked up doing it and I don't want to get choked up in front of the class to do that. And I'm not really worried about somebody making fun of me for getting choked up because, screw them if they don't get it. This is serious topics, and we're talking about kids dying and things like that. Is that a real issue? That it's not necessarily one horrible... in other words, it can be one horrible tragic event, but can it also just be a career of shit?

Dr. Sara Metz:

Yeah. And most likely, it's probably a combination of both of those. Absolutely, are there folks who have been through really significant pin point events that they can point to and say that, "That has stuck with me all this time and I've never fully been able to process through it," absolutely. We also do see folks who are 20, 25, 30 plus years into their career and they may say exactly what you're saying, that there's not a specific event that they point to, but they're tired. They're burned out, they're tired. They feel they've lost compassion for people, that usually takes about 30 seconds on the job of, "Oh, I don't like people at all." So that sort of thing-

Bill Godfrey:

Yeah that was me at 3:00 in the morning every time.

Dr. Sara Metz:

Real quick, like nope I've decided I hate humans. Those sorts of things absolutely happen. And we still have to look at the whole human and figure out how to help them. Are there specific events that we need to reprocess? Is there just more burnout, tired, that sort of repair that needs to happen again. Think of it in terms of muscle aches versus a broken bone. A broken bone, we have to do something very specific with, muscle aches where the whole system is just, "I don't really know what's going on I just feel icky." We can treat either one, we just would treat them differently.

Robert McMahan:

And Dr. Metz, I think for me I hit about that 28 year mark, and then we had an officer killed in the line of duty that we worked. And I didn't know what was happening to me, I was depressed not real bad, but it was getting worse. And about a year later, you were in our office talking to our command staff about wellness programs and you started to talk about some of this stuff and I went, "Holy crap, that's me." I think you remember that day.

Dr. Sara Metz:

I do.

Robert McMahan:

And I grabbed you and we went to my office after that and we started talking. As a result of that, I spent many hours on your couch after that. And I'm not ashamed of that and we don't need to be ashamed of this, and we got to get over that shame and stigma. For me, when we were talking through those things, the analogy we used with me was that, my bucket got full, and you can only put so much crap in a bucket. And I think it's that cumulative stress and cumulative effect of seeing all those things, that one day you just reach a capacity where it starts to really affect you.

Dr. Sara Metz:

You do. And so often people again, will tell themselves, "Well I was handling it just fine. What's wrong with me now that I can't when handled it just fine all those years?"

Robert McMahan:

Oh, that sounds familiar.

Dr. Sara Metz:

Yeah. And what people forget, to Robert's point is, just because the bucket wasn't full didn't mean it wasn't filling up. And at a certain point, once it's full, everything is skimming off the top. Anything you put in there, it doesn't fit anymore. So if you wait until it's completely overflowing, yes of course we can still help, but that's just the point at which it overflowed. It doesn't mean that whatever you were doing was working for all those years, it just means there was room in the bucket for it. And oftentimes unfortunately, once the bucket overflows, we gotta deal with what's right at the top first. But then we probably are going to have to go back through the years and really process some things that may have happened years ago, that they were sitting at the bottom of that bucket waiting to be dealt with.

Bill Godfrey:

Dr. Metz, quick question on the bucket. If you wait until it overflows, and then you deal with the overflowing stuff, is it possible for people to deal with the overflowing stuff and never empty the bucket and just be one marble shy of overflowing again?

Dr. Sara Metz:

Well, they can, I don't recommend it. I say, clean that shit out. That's like going into the dirtiest closet in your house and saying, "I shall clean for five minutes and then shut the door again." Clean the damn closet out. And again, it requires you being uncomfortable, but it's work that ultimately does benefit the person.

Robert McMahan:

The concept of that bucket makes me think that, if we are getting to these first responders earlier in their careers, taking care of these things, even if it's not bothering them so much, but we need to be taking care of that early on so that bucket doesn't fill up so fast.

Dr. Sara Metz:

Very much so.

Robert McMahan:

Yeah. And I think one of the ways we can do that is by, as peers remembering to reach out to each other in the days, weeks and months after those events, and checking in on each other. What do you think about that?

Dr. Sara Metz:

I completely agree. And I think this is where too, teaching the language to the young guns who are just starting out in law enforcement, in the fire service. Teaching them the language makes it so much easier for them to speak this fluently throughout their career. The folks who've been doing this, the older school generation, they didn't learn the language and so they are more likely to be struggling with a lot of this and feeling they're floundering and really struggling at the tail end of their careers or post retirement. But the ones who are really willing to lean into this, step forward and learn the language, have such incredible value to give back to the younger generation, because once they learn the language to be able to check in and share those experiences with the younger ones, it's so hugely valuable.

Bill Godfrey:

So Dr. Metz, we need to obviously get wrapped up here, but there's one last area I want to go into just briefly before we wrap up and close out. So I opened by talking about how we kinda got to this conversation, which was wrapping up that other podcast. And Robert, I don't know if you remember what you said to me not five minutes after we quit recording that other podcast, do you remember?

Robert McMahan:

No, I don't.

Bill Godfrey:

You said, "Damn, I wish I would've just said get help, it doesn't make you weak."

Robert McMahan:

Yeah. And thanks for reminding me of that. If you're listening to this, you've probably been to some event, you've been to some traumatic scene, and it doesn't have to be a full blown active shooter event, all these things take a toll on us. But you also know people that have been involved in events and you have anniversary dates that we remember from the really bad ones. And so, if you have those people in mind and those anniversary dates, reach out to each other and take care of each other, and please get some help if you need it.

Even if you don't think you need it, it doesn't hurt to check in once in a while with a therapist, just to get a checkup. We go to the doctor for checkups and that's okay, this is okay too. And I think if we would do that as a first responder profession, we would as Dr. Metz said, stay at the top of our game.

Bill Godfrey:

As in, you can't always tell when your own bucket is full.

Robert McMahan:

Exactly.

Bill Godfrey:

Yeah. This has been a great conversation, Dr. Metz, I cannot thank you enough for taking the time out of your schedule to share with us your words of wisdom and your thoughts. And I want to give you the opportunity to have the closing words here.

Dr. Sara Metz:

Oh gosh, no pressure. Well, I will say that Robert is just one of the coolest people I've ever met. And so I appreciated him asking me to join the three of you today and I enjoyed our conversation and if there's anything else that I can do for the podcast or for you folks, let me know. But I echo what Robert said in that, take care of yourself and take care of each other. And a big part of doing that is staying tactically fit, ready to go and staying psychologically fit as well. And if you're willing to put the effort into that, there's a lot of us out there that are absolutely willing to step into your space and help you thrive in your career and thrive in your retirement.

Bill Godfrey:

We spend our careers trying to save lives, let's make sure we save each other too.

Robert McMahan:

That's right.

Dr. Sara Metz:

Agreed.

Bill Godfrey:

Well, Dr. Metz, if you'd like, I can list your counseling group in the show notes. I'm not sure if that's something you'd like me to do or not for people to reach out-

Dr. Sara Metz:

Sure.

Bill Godfrey:

... to you for some additional information or maybe even information about how they can get a program started somewhere in their locale. And again, thank you so much for taking the time. Robert, Harry, thank you very much. Ladies and gentlemen, thank you for joining us for this episode. Please, if you haven't subscribed to the podcast, please do subscribe to the podcast and until next time, stay safe.

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Contact information for Dr. Metz:

Sara Metz, PsyD
Public Safety Psychologist
Code-4 Counseling
Facebook (@code4counselingllc)

Code-4 Counseling YouTube channel videos

Episode 30: Emotional Responsibility for Each Other

An important discussion on emotional responsibility for your fellow first responders.

Bill Godfrey:

Welcome back to our next podcast. Thanks for joining us. You're back with the Active Shooter Incident Management podcast series. Now a few weeks ago, we recorded a podcast on what we called an Emotionally Responsible Room Entry. And that subject came up specifically from one incident where responders made... Well Robert, how would you put that?

Robert McMahan:

There was a lot of dynamics during some of those entries that were causing problems for people that were in those rooms. And we got some negative feedback from some of the students and teachers following that incident.

Bill Godfrey:

So essentially that podcast, which if you haven't heard it, please go back and give it a listen, was about how to make some adjustments to the way we handle these calls so that we're not scaring the hell out of kids, not to put too fine a point on it. But that's not what we're here to talk about today. At the tail end of that podcast, we drifted a little into talking about the emotional responsibility for each other as responders. And if you've heard that podcast, you know Harry and Robert were on that with me and I've asked them to join us again. Harry, thanks for being back again today.

Harry Jimenez:

Thank you, Bill, happy to be here.

Bill Godfrey:

And Robert, thank you for coming in again. I know you've already said hello to the group. But we have also asked a special guest to join us by phone today. So on the phone, we've got Dr. Sara Metz. Now Dr. Metz is a Public Safety Psychologist. She's also the owner and founder of Code 4 Counseling in lone tree, Colorado. And Dr. Metz has quite a bit of experience. Dr. Metz, thank you for taking the time out of your schedule to join us.

Dr. Sara Metz:

You bet, thanks for having me.

Bill Godfrey:

Fantastic. Dr. Metz, just to kind of get you oriented, so Harry was talking about his experience at the Sutherland Springs church shooting, which is I'm sure you recall, involved a lot of kids, and Robert was talking about his experience at the STEM school shooting that they had in Douglas County just before he retired. And it got a little emotional and reminded me of some events that we've had that hit a little close to home. So as a place to start out, I know that you've handled counseling for a lot of these types of events. What are the things that we need to be watching for and paying attention to both short-term, immediately, in the medium term and in the longterm?

Dr. Sara Metz:

So with our responders, responders are very well-trained tactically to go into an environment like a church shooting, like unfortunately a school shooting and handle that tactically. Unfortunately, oftentimes the training doesn't really address... one of the things that we see causing the most distress to them is the feeling of helplessness. They at their core want to help people, it's why they go into this, they have a heart for service. And when they go into an active shooter scenario and they see the fear and the distress they, unfortunately at times, may have to walk past victims who are asking for help because they're clearing the scene, still looking for the active shooter. There's a lot of complexities to these incidents and the emotional toll that takes on them, isn't necessarily well addressed in the training.

And again, it's the sense of helplessness that they don't always have language for what that is doing to them. They believe that the quote unquote trauma of the event that gets to them and oftentimes they think, "No, I did okay with that, but something's still stuck with me." And often when we really peel it back, it's feeling helpless, not having been able to necessarily help in the way they wanted to, dealing with kid victim is always its own beast. So there's definitely certain parts of these tactical events that aren't really addressed in training and really take a pretty big toll emotionally, on these folks.

Bill Godfrey:

Dr. Metz, when you're dealing with responders, and I mean both male and female, is there a bit of the typical responder, tough guy persona that gets in the way?

Dr. Sara Metz:

Absolutely. And what's interesting when you say gets in the way in terms of, there're well when they're doing their job, but then they have a hard time putting that down. That armor is great for them. Civilians, we benefit from them having that very tough exterior, but as I've learned in 15 years of working with responders, a lot of them have a soft mushy center and they're big, giant hearted people. And again, that big hearted-ness about them, they aren't trained how to use that. They aren't trained how to show self-compassion as they notice psychological injury in themselves. They don't really even know how to help each other, they want to and they definitely give each other hugs or a slap on the back saying, "Hey, are you good?" But then they don't really know what else to do. So again, it comes back to that tough exterior, is well-trained into them, it's the deeper, more complex layer that they get a little stuck.

Harry Jimenez:

Doctor, this is Harry. I echo what you said but also, comes to mind the fact that even if we somehow understand that we may need some help, we fall back on the persona of toughness. We don't want to look weak, we don't want to be that guy in the squad that people will talk behind you and say, "Well, I'm not going to roll out with this person, or I'm not going to call out this person to back me up because I'm afraid that this person might snap." And there's a stigma in law enforcement and in my case, law enforcement and military service. We leave with this stigma that we have to be tougher and we have to be strong, and that gets in the way of understanding what's really happening on... What else? Robert, what do you think?

Robert McMahan:

Yeah, it does. And I personally battled that for a while before I got help because I needed to get help. And I've seen a number of things that put a bunch of stuff in my bucket, as we say. But Dr. Metz, you and I worked together in Colorado when I was still there and we worked through a number of these things. Why don't you tell us about what are the first steps to start taking care of these responders after an incident?

Dr. Sara Metz:

Yeah. I think Harry brought up a big point. I know Robert, it's something that you and I have both really seen your agency in Colorado tackle over the last couple of years. That stigma is something that's been there for generations, it's certainly been there for a very long time and I do think that the stigma itself is really that first step. If we're going to get responders to seek help, we have to normalize that and we have to celebrate it. That has to become something that is part of the culture, it's part of the common language people say, "Hey, you've gone to talk to the doc, good for you. You haven't made an appointment yet, definitely do it. I got mine on Tuesday." That sort of language is something that has never been a part of the culture, I get that. I've been, like I said, doing this for 15 years.

I would say in the last one to two years, we've had some really amazing responders step forward, military personnel as well, to really start to lead from the front and show what that would look like to bulldoze past the stigma. And that takes folks who are really willing to be vulnerable, who are willing to say, "I know there's been a stigma, but screw it. I'm doing it anyway." And that has really done wonders for the culture. And we've seen fairly quick change. Responders are not, one who change quickly, they don't like change. But seeing folks really step forward that they respect, that the agency's respect, the culture respects, and those folks saying, "I'll share my story, I'll start. Here's what I went through. Here's what worked for me and I will advocate for and respect anyone who follows the path of recognizing when they're struggling and they will seek help." And that is step one. Once you from the top down, really start to see that be advocated for, folks are much more willing to say, "All right. Well, I guess I'll give it a try." So step one is beating that stigma piece.

Robert McMahan:

Dr. Metz, when we were working together in Colorado, when we had critical incidents, including just officer involved shootings or whatever it was, we always called you out and your staff to do a debrief, and to talk to those responders after the incident. Is that enough? Or do we need to be doing more?

Dr. Sara Metz:

No. I would say it's a great step, but it goes back to, it depends on what the culture thinks of the debrief. I've seen plenty of folks walk into a debrief and say, "I just got to sit here and I don't give a shit. And I'm not going to talk," because they believe that stigma is still present. "I'm not going to say anything. I'm not going to out myself." I will say the agency that you come from, I just did a debrief for them what, two days ago. Gosh how many people were in that room? I would say at least 20 folks who were involved in a critical incident, an officer involved shooting for that agency, 20 folks in the debrief. Every single one of them talked, every single one of them was willing to say what they had experienced the day of the incident, whether it was adrenaline dump, they weren't able to sleep, they hit the wispies, they snap at their kids when they got home, they talked about that.

And they talked about four days later, which is when we did the debrief. They talked about the signs and the symptoms that were still present. And they talked about the things that were fading and healing naturally on its own. And as a group, we were able to talk about those signs and symptoms, normalize it for folks, "Hey, you're still not sleeping? Hey, I'm not sleeping either. All right. Well, here's some ideas. Here's some things we can think about to see if you can get that to heal on its own." But that dynamic took years to create, that took a long time for folks to really respect the process.

But I would say there are definitely agencies now in Colorado and around the country, that are creating the right environment for those debrief to go well, and are also educating folks on all of the different things that they can do to take care of themselves. Whether that's wellness checks, whether that's in-service training that specifically highlights psychological stress injury, whether it's family night, getting the families involved, that they understand this shared language. There's so much that goes into a successful well integrated wellness program within an organization.

Bill Godfrey:

Dr. Metz, that's really remarkable what you're describing there. And it's encouraging to know that there are agencies that have been able to cross that bridge and deal with this a little more head on. You mentioned that our culture isn't very quick to change, and boy that's not an exaggeration. We have a saying in the fire service, "200 years of tradition unimpeded by progress," and we mean that shit.

Dr. Sara Metz:

Oh yeah, you do.

Bill Godfrey:

But on the lines of the symptoms and I may be off base here, but my personal experience. Now, Harry and Robert are both law enforcement, I'm from the Fire-EMS side. But my personal experience is that the immediate after, we're usually pretty there for each other. So Harry, you and I were telling the story in the earlier podcast about, when you were driving home for Sutherland Springs late at night, I was already in bed. And got the phone call and I knew, I got up got out of bed and we were on the phone how long?

Harry Jimenez:

I think I called Bill right after I left the scene. And I've been in the scene for probably 12 hours and I'm heading home and it was about an hour drive. And I think we spoke all the way until I pulled into my driveway, and he was making sure that I made it home.

Dr. Sara Metz:

Wow, that cool.

Bill Godfrey:

Yeah. So I guess where I'm going with that is, my personal experience and that may not be fair, but my personal experience is usually the immediate after the event, we're all kind of they're checking each other, but then I think we fall down. And I wondered if you could talk a little bit, it's a two-parted question. Number one is, in the near term, the days and the weeks that follow, what are the signs and symptoms that we need to be watching out for in each other? And then the second part of that is going to be, what are the things, if someone's reluctant to get help, reluctant to acknowledge that it's been an issue, what are the things that we as their peers can do? I'm not talking about supervisory intervention, but what are things that we as their friends and peers can do to try to help them see that they need it?

Dr. Sara Metz:

I think those are both great questions. I'm going to actually start with the second one first, and then I'll circle back to it here in a minute. But Robert will laugh at me because he knows where I'm going to go with this.

Bill Godfrey:

He's actually sitting here already chuckling, he's got this big smile on his face.

Dr. Sara Metz:

Yeah, he knows where I'm going. I promised him I would try to behave on this call. But this is where I think there's a little bit of tough love that needs to come in to this profession. I often hear that sort of thing. "Well, what if someone is reluctant?" Bullshit. Go to the doc because it's the right thing to do. You guys don't use that excuse for anything tactical. "Oh, I'm a little hesitant. Oh, I'm a little uncomfortable. That makes me nervous. I'm scared to do that," is not part of the culture. And yet it is so often the thing that prevents them from coming in the door. Now it's our responsibility as clinicians to create a safe space for that and to understand the culture and to do the work, to be culturally competent, to serve responder population.

But I would say with all the love in the world, to my responders out there, "Get your butt in there, get checked out because it keeps you at the top of your game. And if you have a bad fit, a clinician who doesn't get it, or it doesn't feel like the right fit? Find one who is a good fit." And that's where responders, one of the things they can do to take care of each other is, everybody get out there, find clinicians that are good and share that information with each other. "Hey, you know what? I had a really great session. You should go see so and so." And have there be variety, have there be male clinicians, female clinicians, folks who specialize in EMDR (Eye Movement Desensitization and Reprocessing) versus talk therapy versus this, that, the other thing.

But the more clinicians are available and the more responders will not feel shame and we'll share that information with each other, I think is my answer to the second part of that question. Now to the first question of, what are the signs and symptoms that folks should be looking out for? I think there's some really common ones. And what I typically will tell folks is, the body is actually fairly good at recalibrating itself over the course of a few days and a few weeks, what typically hinders that process is shame and judgment. So for example, if someone in the first few days, or first week or so, they go through a critical incident, they're involved in an active shooter scenario, for example, and they are having a hard time sleeping, they really want to drink because they know that will calm their system. They're moody, snapping at their kids, snapping at their partner... Go ahead.

Bill Godfrey:

By the way Dr. Metz, you had three guys shaking their heads up and down, yes, When you mentioned the drinking part.

Dr. Sara Metz:

Yeah, absolutely. It's a big one because unfortunately it works. So we know it works. The problem, it does so much damage to the system's calibration. It's trying to numb a system that would work if you gave it a chance.

Bill Godfrey:

That's interesting.

Dr. Sara Metz:

And part of that is letting your system be uncomfortable. Your system is looping and it's anxious and it's got adrenaline still sparking through your system, that's all normal. It's wildly uncomfortable and I don't dismiss it as, "Oh, just get over it." It is wildly uncomfortable, but alcohol and substances is nodding that, which doesn't allow the system, the human body that is actually very brilliantly structured in so many ways, it will recalibrate if you let it, but you have to let it do it in its own natural time. So when folks drink to try to numb because they're so uncomfortable, what we know the alcohol does is, it makes it so you cannot get REM sleep.

REM sleep is where your system during your sleeping hours is going to, again, recalibrate. It moves experiences from the front of the brain, into the memory center, which is where we block them, because it means you remember it but you don't re-experience it. If you're drinking in the evenings or right before bed, that alcohol in your system locks the door to that process. So those experiences stay at the front of the brain, that's why things like flashbacks and re-experiencing happens, because it didn't get moved to the memory center. So we need that process to work and so we really encourage people, just give it a week or two, see if your system naturally recalibrates on its own. Watch for the increase in alcohol use, try to keep that out of the picture, watch for the moodiness, watch for the restlessness and the difficulty sleeping. Those are some of the pretty normal things that we see after a critical incident, but oftentimes they will say it on their own.

And even if they don't, all that tells us as clinicians is that, "Yeah, go in and get a checkup." And it may just take some verbal processing or looking at it from another perspective, some additional coping strategies. Those are things we can certainly provide someone if they are not matched, really kind of moving through the process on their own in a week or two. But back to Harry's point a while back, it's shame and fear of judgements that prevents people from doing that. They think, "I have to just figure this out on my own. If I say, I'm not healing on my own, people won't think I'm a good partner. They don't want me as a car partner. They won't want me to back up. They won't won't walk me on their crew." What we have to help people recognize is, "We'll get you there, you're not going to live in the red forever. We'll get you back, but we need to know what those symptoms are so we can help you."

Bill Godfrey:

It's really fascinating listening to you explain that. And I mean, I've been a paramedic for over 30 years and knowing the physiology doesn't mean you take it home and into your brain. And something you said kind of-

Something you said kind of made me think about something my therapist once threatened me with a baseball bat over. And he said, "Damn it, sometimes you just have to sit with those uncomfortable feelings."

Dr. Sara Metz:

Yeah, so true.

Bill Godfrey:

If you keep pushing them away and you never process them, is that kind of a little bit related to what you're talking about here?

Dr. Sara Metz:

Absolutely, it is. And again, I really try to encourage responders to recognize, you all are well equipped to be uncomfortable. You do it all the time in environments that you choose to be uncomfortable in. You go into burning buildings, you go into hoarder house for medicals, you go through the maze, you put the gas mask on, you guys go into critical incidents of shootings, there are a million and one scenarios where you guys will put yourself in uncomfortable situations and you believe that it's worth it. But for whatever reason you guys, hate, all humans do, this is not just a responder thing, but people hate to be uncomfortable when it comes to their feelings and it comes to processing their experiences. If responders would go into it with that same level of, "All right, I just got to hunker down and be uncomfortable because it's serving a purpose," they would do a lot better.

Bill Godfrey:

You just need to set your office on fire and then we'll show up.

Dr. Sara Metz:

There you go.

Bill Godfrey:

I'm sorry, that's a terrible idea. Just for the record. That was a joke.

Dr. Sara Metz:

... wow, how have I never tried that? I have South Metro just down the road, they'll come in a heartbeat.

Bill Godfrey:

Robert, you were getting ready to jump in and say something, I'm sorry.

Robert McMahan:

Yeah, Dr. Metz, we've been talking about how to deal with these things and making sure that we get our officers and first responders in to see a clinician. If we do that initial debrief, and typically after a shooting, we'll send an officer in for a one-on-one with a therapist and oftentime they come out okay. But you and I saw a number of first responders months after the incident, where issues started cropping up. Can you talk about that a little bit?

Dr. Sara Metz:

It is a great point, because we often will see things start to bubble to the surface right away. However, it is very, very common and very, very normal for those symptoms to take months, sometimes years to fester. I often will describe psychological stress and compare it to an infection. Sometimes an infection again, without a paramedic on the call, probably somewhere else, but sometimes you'll notice it fairly quickly-

Bill Godfrey:

Just for the record, I used to be, I don't do that stuff anymore. For the last-

Dr. Sara Metz:

I knew this stuff back in the day, all right.

Bill Godfrey:

The last patient I touched was when a space shuttle went up and that guy died. I'm not the guy to touch on it, I'm the guy that goes send for the defibrillator.

Dr. Sara Metz:

Again this comes back, yeah I talk about it all the time, shame and judgment. Prolong when people will get help, if you take that piece out and simple have someone say, "Well, I was doing okay and now I'm not, I guess it's time to go to the doc." They go to the doc, they say what their symptoms are and they get the help they need. It's very normal. It really is fine. Honestly, the other side of the normal spectrum is that, it's absolutely fine if someone does absolutely fine forever after a critical incident. Every now and then I'll have a responder come into my office and say, "Everyone is telling me that this, even though it's not bothering me now, it's going to." And then they get anxious thinking, "So this is just going to be the spawn, it could go off at any point I feel in my head at any moment?" No, live your life.

If it pops up, it pops up. If it doesn't, it doesn't make you a psychopath. If you're fine, uou're fine. It's great to be able to articulate why you're fine, so you have an understanding of what strategies seem to be working for you, but if you're fine, we're not going to try to poke the bear.

Harry Jimenez:

Doctor, Harry here. When you were talking about what type of things to look short-term, mid-term, long-term, I felt that you were describing me. Just to put in perspective, military with five combat deployments and then law enforcement for over 30 years. What you're saying is exactly the way I felt, after multiple deployments and law enforcement and loosing an officer under your watch and being involved in critical incidents and saving someone's life and not remember how the hell that happened. I thought, "Okay, I'm visible, everything's fine." And then one day, hill came down crashing on me and the first thing that I did was fight. Fight not because of the shame or the stigma, but was fighting with myself. "How come this is happening now, since I've been good all these years?"

And it took me a couple of clinicians to finally, like you said, find the one person that I felt that could understand me, if you may, in my own whatever crazy designation I gave to that. And there were two things, first he told me, each one of us experienced the same incident in an own personal different way. And that was a very significant to me because sometimes we as first responders, we look to the left and to the right and if the person that you know that responded is not going through what you're going, you might start trying to cover it and push it down because you don't want to seem to be weak or weaker. And when he told me that, "No, we all going to feel it and understand it and react in own personal way."

And the second one which goes with, I remember now, because you mentioned about the alcohol, he told me, "Harry we're going to go back to not only this incident, but we're going to go back to every one of these incidents that we know that you are dragging for years and you have not face." And I thought he was insane and I immediately refused, I said, "No, I don't want to re-live that." And he said, "Oh, on the contrary, you still live in it." He told me a story and I don't know if you have heard this and if you do please tell us more about it. He said, "When the first person start deciding that, AA, Alcoholic Anonymous, it was a good idea, a lot of people laugh to the whole idea. Because they say, 'So you're going to get a group of drunks together to talk about drinking, that makes no sense.'" And talk to us about that.

I mean, that was my experience. I was like, "No way I was going to re-live this in my own brain, thinking about it." And he helped me... basically the same analogy, he got me around with other people that were coping with their own incidents. And in a way allows you to free yourself.

Dr. Sara Metz:

Mm-hmm (affirmative), totally agree.

Bill Godfrey:

It's fascinating to know how parallel our lives have all been, even though we didn't know each other until the last few years that we've been teaching and training. And Dr. Metz, I'd like you to kind of comment on this and if you'll forgive me, I'm going to do a little bit of wind up here with it. I went through most of my career, some ups and downs, but I did not really struggle with any one particular thing. But what has been a challenge for me, and the best way I can give this example is the idea of institutional noise, it's not typically one gunshot that makes you go deaf, it's not wearing hearing protection while you go through thousands of gunshots or it's not being around a jet engine one time without hearing protection. It's being around them all the time. That idea of that constant repeated exposure. And Dr. Metz, are you by chance familiar with the Enneagram?

Dr. Sara Metz:

Mm-hmm (affirmative), I am.

Bill Godfrey:

Okay. So I'm an Enneagram eight. And for those that don't know what it's about it-

Dr. Sara Metz:

You're and eight aren't you.

Bill Godfrey:

Yeah, don't worry about it, I'll just say this. It means that I tend to be a fairly strong personality and aggressive, and that's cover for not wanting to reveal vulnerability.

Harry Jimenez:

I will never have guessed that.

Bill Godfrey:

I know, shocking. Exactly. And now I cry at a double mint twin commercial. It's just these moments of just uncontrollable sadness that lasts for a second, second and a half, two seconds, three seconds. We'll be teaching the classes that we teach and there's some sensitive material that we talk about and some things that we cover. And there's particular modules that I don't like to teach, because about 50% of the time I get choked up doing it and I don't want to get choked up in front of the class to do that. And I'm not really worried about somebody making fun of me for getting choked up because, screw them if they don't get it. This is serious topics, and we're talking about kids dying and things like that. Is that a real issue? That it's not necessarily one horrible... in other words, it can be one horrible tragic event, but can it also just be a career of shit?

Dr. Sara Metz:

Yeah. And most likely, it's probably a combination of both of those. Absolutely, are there folks who have been through really significant pin point events that they can point to and say that, "That has stuck with me all this time and I've never fully been able to process through it," absolutely. We also do see folks who are 20, 25, 30 plus years into their career and they may say exactly what you're saying, that there's not a specific event that they point to, but they're tired. They're burned out, they're tired. They feel they've lost compassion for people, that usually takes about 30 seconds on the job of, "Oh, I don't like people at all." So that sort of thing-

Bill Godfrey:

Yeah that was me at 3:00 in the morning every time.

Dr. Sara Metz:

Real quick, like nope I've decided I hate humans. Those sorts of things absolutely happen. And we still have to look at the whole human and figure out how to help them. Are there specific events that we need to reprocess? Is there just more burnout, tired, that sort of repair that needs to happen again. Think of it in terms of muscle aches versus a broken bone. A broken bone, we have to do something very specific with, muscle aches where the whole system is just, "I don't really know what's going on I just feel icky." We can treat either one, we just would treat them differently.

Robert McMahan:

And Dr. Metz, I think for me I hit about that 28 year mark, and then we had an officer killed in the line of duty that we worked. And I didn't know what was happening to me, I was depressed not real bad, but it was getting worse. And about a year later, you were in our office talking to our command staff about wellness programs and you started to talk about some of this stuff and I went, "Holy crap, that's me." I think you remember that day.

Dr. Sara Metz:

I do.

Robert McMahan:

And I grabbed you and we went to my office after that and we started talking. As a result of that, I spent many hours on your couch after that. And I'm not ashamed of that and we don't need to be ashamed of this, and we got to get over that shame and stigma. For me, when we were talking through those things, the analogy we used with me was that, my bucket got full, and you can only put so much crap in a bucket. And I think it's that cumulative stress and cumulative effect of seeing all those things, that one day you just reach a capacity where it starts to really affect you.

Dr. Sara Metz:

You do. And so often people again, will tell themselves, "Well I was handling it just fine. What's wrong with me now that I can't when handled it just fine all those years?"

Robert McMahan:

Oh, that sounds familiar.

Dr. Sara Metz:

Yeah. And what people forget, to Robert's point is, just because the bucket wasn't full didn't mean it wasn't filling up. And at a certain point, once it's full, everything is skimming off the top. Anything you put in there, it doesn't fit anymore. So if you wait until it's completely overflowing, yes of course we can still help, but that's just the point at which it overflowed. It doesn't mean that whatever you were doing was working for all those years, it just means there was room in the bucket for it. And oftentimes unfortunately, once the bucket overflows, we gotta deal with what's right at the top first. But then we probably are going to have to go back through the years and really process some things that may have happened years ago, that they were sitting at the bottom of that bucket waiting to be dealt with.

Bill Godfrey:

Dr. Metz, quick question on the bucket. If you wait until it overflows, and then you deal with the overflowing stuff, is it possible for people to deal with the overflowing stuff and never empty the bucket and just be one marble shy of overflowing again?

Dr. Sara Metz:

Well, they can, I don't recommend it. I say, clean that shit out. That's like going into the dirtiest closet in your house and saying, "I shall clean for five minutes and then shut the door again." Clean the damn closet out. And again, it requires you being uncomfortable, but it's work that ultimately does benefit the person.

Robert McMahan:

The concept of that bucket makes me think that, if we are getting to these first responders earlier in their careers, taking care of these things, even if it's not bothering them so much, but we need to be taking care of that early on so that bucket doesn't fill up so fast.

Dr. Sara Metz:

Very much so.

Robert McMahan:

Yeah. And I think one of the ways we can do that is by, as peers remembering to reach out to each other in the days, weeks and months after those events, and checking in on each other. What do you think about that?

Dr. Sara Metz:

I completely agree. And I think this is where too, teaching the language to the young guns who are just starting out in law enforcement, in the fire service. Teaching them the language makes it so much easier for them to speak this fluently throughout their career. The folks who've been doing this, the older school generation, they didn't learn the language and so they are more likely to be struggling with a lot of this and feeling they're floundering and really struggling at the tail end of their careers or post retirement. But the ones who are really willing to lean into this, step forward and learn the language, have such incredible value to give back to the younger generation, because once they learn the language to be able to check in and share those experiences with the younger ones, it's so hugely valuable.

Bill Godfrey:

So Dr. Metz, we need to obviously get wrapped up here, but there's one last area I want to go into just briefly before we wrap up and close out. So I opened by talking about how we kinda got to this conversation, which was wrapping up that other podcast. And Robert, I don't know if you remember what you said to me not five minutes after we quit recording that other podcast, do you remember?

Robert McMahan:

No, I don't.

Bill Godfrey:

You said, "Damn, I wish I would've just said get help, it doesn't make you weak."

Robert McMahan:

Yeah. And thanks for reminding me of that. If you're listening to this, you've probably been to some event, you've been to some traumatic scene, and it doesn't have to be a full blown active shooter event, all these things take a toll on us. But you also know people that have been involved in events and you have anniversary dates that we remember from the really bad ones. And so, if you have those people in mind and those anniversary dates, reach out to each other and take care of each other, and please get some help if you need it.

Even if you don't think you need it, it doesn't hurt to check in once in a while with a therapist, just to get a checkup. We go to the doctor for checkups and that's okay, this is okay too. And I think if we would do that as a first responder profession, we would as Dr. Metz said, stay at the top of our game.

Bill Godfrey:

As in, you can't always tell when your own bucket is full.

Robert McMahan:

Exactly.

Bill Godfrey:

Yeah. This has been a great conversation, Dr. Metz, I cannot thank you enough for taking the time out of your schedule to share with us your words of wisdom and your thoughts. And I want to give you the opportunity to have the closing words here.

Dr. Sara Metz:

Oh gosh, no pressure. Well, I will say that Robert is just one of the coolest people I've ever met. And so I appreciated him asking me to join the three of you today and I enjoyed our conversation and if there's anything else that I can do for the podcast or for you folks, let me know. But I echo what Robert said in that, take care of yourself and take care of each other. And a big part of doing that is staying tactically fit, ready to go and staying psychologically fit as well. And if you're willing to put the effort into that, there's a lot of us out there that are absolutely willing to step into your space and help you thrive in your career and thrive in your retirement.

Bill Godfrey:

We spend our careers trying to save lives, let's make sure we save each other too.

Robert McMahan:

That's right.

Dr. Sara Metz:

Agreed.

Bill Godfrey:

Well, Dr. Metz, if you'd like, I can list your counseling group in the show notes. I'm not sure if that's something you'd like me to do or not for people to reach out-

Dr. Sara Metz:

Sure.

Bill Godfrey:

... to you for some additional information or maybe even information about how they can get a program started somewhere in their locale. And again, thank you so much for taking the time. Robert, Harry, thank you very much. Ladies and gentlemen, thank you for joining us for this episode. Please, if you haven't subscribed to the podcast, please do subscribe to the podcast and until next time, stay safe.

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