Prophylactic Stress Treatment
It is no secret that healthcare is a challenging profession. Whether in the hospital or prehospital environment, institutions are constantly burdened. Aside from the institution issues such as understaffing and low pay, health care workers bear witness to pain and suffering on a daily basis. As our unit doctor once told us before coming home from deployment, no one comes home the same. Trauma and stress have lasting impacts on the body, and no one is immune. Like many veterans, it seemed while we were serving that our military paid the price for costly management of PTSD, emphasis on the "post," no one seemed attuned to the possibility of "pre managing" or "pre-treating" stress before the incidence. Almost like a stress vaccine…introducing smaller amounts into the system to build up a natural tolerance for when the main event happens. Soley from observation, it seemed that many attempted to address the pre-treatment problem with fitness, and let's be honest, it wasn't the wrong place to start. Fitness has been shown in many studies to have lasting benefits when it comes to stress management and coping. However, like myself and possibly many others, PTSD doesn't do the worst damage to the body. PTSD lives in the mind and manifests in the body. This realization made the pre-treatment problem much harder to solve. The brain is a complex, multifunctional unit with billions of neuro connections being made at every moment. Is it possible to pre-treat the mind and get it ready to embrace chaos?
Yes. The answer for me lies within the several thousand-year-old practice of Yoga. Outlined explicitly in the second yoga sutra, where Patanjali outlined the true goal of Yoga which was to reduce the mental modifications of the mind "stuff." Here, I think the ancient origin of trauma was revealed. It wasn't the act; it was the story surrounding the action. We created that story and, as such, became slaves to its triggers. Occurrences in our day would take us back to that time and space, away from our current selves, almost as if we were somewhere else entirely. Even such, Patanjali speaks in very vague and broad concepts that, while useful, are hard to apply in our modern world. The goal isn't for everyone to escape and eat bugs and stand on one leg in the forest; the goal is for everyone to lives a fuller, more enriched life exactly where they are and in our field of healthcare, continue to provide the best care for our patients but not at the expense of ourselves, lest we become a patient in the process.
In a recent article in Outside magazine, a ranger talks about how the mountains that he loved became a trigger when responding to two climbers who had fallen nearly 200 feet to their death in a tragic accident. The sight of their mangled bodies ruined nature for him as he was then unable to see a simple beauty and instead saw a death trap of "rotten rock." It was during this time their service started a program whereby the rangers, rather than waiting for the event to occur, began to talk about "what if" and explore emotions of grief in a safe space, almost like a way of mentally preparing the body to receive the stress they all knew would eventually come. As a practicing paramedic, I find myself doing the same thing, asking myself and sometimes my students, if this was you, what would YOU do? What decisions would YOU make? Preparation is the purpose of asana in Yoga. Asana prepares the body to receive higher levels of energy, and this is a daily practice. Skip your daily preparation, and your body is less prepared. The less prepared you are, in general, the greater the propensity for injury. Yoga offers a structured means by which to prepare for not only chaos but also offers liberation from chaos.
