Resiliency in Disaster Behavioral Health, Episode 2 Transcript: Behavioral Health Reactions and Ways To Enhance Resilience

Read the transcript of the second episode of the Resiliency in Disaster Behavioral Health podcast.

Moderator: Welcome to Resiliency in Disaster Behavioral Health, a six-part podcast series from the Substance Abuse and Mental Health Services Administration. The goal of this podcast is to inform local behavioral health agencies on strategies for building resiliency in individuals and the community before, during, and after a disaster. The series discusses specific behavioral health interventions across the stages of disaster response in addition to focusing on the needs of specific populations.

In this installment, we hear from Dr. Melissa Riley, the State Coordinator for the Tennessee Disaster Crisis Counseling Program, the K9 Coordinator for Tennessee Task Force 2, a flight instructor for Wings of Eagles Aviation in Nashville, and a reserve police officer for the City of Mount Juliet. She discusses behavioral health reactions and ways to enhance resilience.

Dr. Melissa Riley: Hello. I’m Dr. Melissa Riley, and I’m here to talk with you about behavioral health reactions and ways that we can enhance our resilience. There’s lots of ways that we have behavioral health reactions to disasters, whether it’s a natural disaster or it’s a personal disaster, whether something going on in our daily lives at home or at work, and a lot of these behavioral health reactions can manifest themselves, such as difficulty concentrating, difficulty sleeping—we’ve all experienced that from time to time—becoming anxious and fearful, how we worry more so than usual; hypervigilance—you ever find yourself hearing a loud noise or someone comes around the corner unexpectedly and you just visibly jump? So being hypervigilant and on guard all the time; experiencing types of emotional numbness—You don’t get really happy anymore, and you also don’t get really sad. You just kind of have a flat affect, so to speak, across the board. You’re just numb to feeling anything. You become very impatient with others, also with yourself, so easily frustrated, which can also lead to anger issues, becoming more trigger happy with your anger, where you’re quick to react to things or quick to snap back at other people; and also withdrawn—you just find yourself not going out with your friends as much as usual, not wanting to go out and see family members, just kind of being on your own and isolating.

So these are some of the ways that our behavioral health reacts when we’re under duress, such as from a disaster, again, on a national scale, such as tornadoes and floods that we’ve been experiencing heavily this spring and summer, and also from events in our personal lives—losing loved ones, bad news, stress at work, any of those can be stuff that puts us under great duress.

Most of the things that we use on a regular basis with coping with natural or personal disasters are a lot of what we just mentioned above. If you can remember that all behavior is purposeful and if you notice yourself reacting throughout the day, if you can think back to what is a purpose of myself behaving in that way? Are you quick to anger because it’s becoming a defense mechanism, because you’re worn down and you can’t take being attacked anymore? So you tend to jump the gun and be the first person to come back so they can’t attack you, so to speak. So finding ways to be aware of what your behavior is—if you’re numb, why are you afraid to experience emotion? Because possibly the hurt is too great, and so instead of allowing yourself to feel the hurt, you don’t feel anything at all because that’s safer for you. Becoming hypervigilant because there’s bad news or stress around every corner. You can’t get the flood work cleaned up, there’s always something going wrong with the contractor, someone trying to scam you. So you become hypervigilant where you’re just on guard for all the time.

We have areas of our country that have been hit by repeated tornadoes year after year after year, and so people become hypervigilant to all the news reports. If there’s a storm coming, then they just find themselves becoming almost a tendency to OCD. You’ve got to have stuff cleaned, have stuff ready, have a go bag, be on top of the weather watching every news report. So it’s in our body’s way of trying to protect ourselves, and in the past, that may have worked well, but on a long, ongoing period, that becomes reverting back to hurting ourselves, unintentionally.

So, in the past, what may have worked before for us when coping with a disaster in a short term doesn’t necessarily work in a long-term basis. So finding if we’re having behavioral health reactions that endure over a longer period of time, weeks to months, that’s something that we need to note and maybe start to speak with someone about, “Hey, how can I—I’ve noticed this about myself. What can I do to work on it and make it better?” Because just the behavioral health reactions that we’ve spoken of already today are very distressful, and they’re going to be hard to let yourself enjoy life very much anymore, at least in the way that you used to do so.

In an earlier podcast, Episode 1, “What Is Community Resilience?” they define resilience very well, where it’s the collective capacity to respond to adversity and change, it’s our ability to adapt to stressors or basically our emotional elasticity—being able to stretch and encompass more emotional reactions when they occur, and then to come back to our new normal afterwards, but be able to be flexible, not to be overwhelmed and shut down by something, but to give and to take.

That is what resiliency is about, is being able to adapt to the changes and then come back to our new normal, because every event that we experience in our lives—happy events, sad events, horrid events, and just normal day to day—they change us, they help us grow. They make us a better person from going through the hard stuff and also from experiencing the great stuff. So we’re constantly changing. We’re growing and learning beings, but finding ourselves our way to create resilience. So when we do experience difficult times in our lives—and we will—there is no error-proof living. That’s just part of the world that we live in. So if we can find our ways to enhance our resiliency so we come out stronger at the end of hard events, that makes us a better person. And we are the sum of our experiences. So the more enriched we can be from what we go through, whether it’s the good or the bad, the better off we’re going to be down the road for ourselves, for our friends, our family, our loved ones, all of that, and just healthier overall.

So there’s ways that we can note resilience skills that already exist in our lives and build on that. So if someone is going to go out and get ready to be the quarterback in the football game, they’re doing—going through plays, going through the motions, going through the passes before they get to the big game or the college bowl or the Super Bowl. And that’s what we can do in our daily lives is build up resilience skills that we already have and exist so that when something larger hits us, we’ve already practiced for it, we’ve got our skill set down and our muscle memory down to adapt when life gets hard. And things we can look at for that are how we have our connections with people—how many folks can you name that you can turn to if you had an emergency right now? And if you feel like that’s a fewer number of fingers than you’d like to count, then think of ways, “Okay. How can I work myself to meet more people to start to develop better friendships, maybe outside of my work environment or outside of my home environment?” So just find your ways to have more good backup, more good, trusted people in your corner so when bigger things do happen, you have a wonderful cadre of resilient friends and community that you can draw from.

Finding ways to practice accepting change, because that’s part of our lives. When we were children, our world has changed significantly from what it was when we were 5, 10, 15, 20 years or more younger. And everything changes, our relationship with others, because life is just about change. So finding ways in the small that we can accept change helps us be prepared if we have to accept a larger change, such as our house burns down or a tornado hits us or a flood wipes us out or we lose friends and loved ones. But if we have—if we have good practice accepting change and adapting to it in a small scale, whether it’s at work—taking on a different work assignment, getting a different role, finding a different way you have to go to work—I know it sounds “That’s ridiculously simple,” but being able to adapt and be flexible in the small things helps you be flexible in the larger.

Someone told me one time that things that don’t tend to have any give to them will just snap and break, and I think that was a great analogy to life. So if you’re able to flex and have change, you can become resilient and come back to your more original form. But if you’re rigid and can’t accept even the smallest things, it’s going to break you, and I think that’s—we find that oftentimes in behavioral health—if you can’t adapt, it tends to break your heart, and it takes time to repair that and come back to be a better person, and come back a whole person from that becoming broken.

And as that factor, resilience is, I think, the most critical factor in being able to recover from a disaster, and if you don’t have the warrior mindset that “we can overcome,” that we can adapt to this, we can overcome this, we can beat this, then the disaster is going to defeat us.

The average emotional reaction time to natural disasters is 3 to 5 years. So you may experience a tornado or a flood or an earthquake or even a personal disaster—maybe your house burns to the ground or something else happens that takes away what you have—that can sometimes take 3 to 5 years for the emotional side to catch up to us, and the reason for that is there’s so many other things we’re trying to do cognitively is rebuild and speak to all the people it takes to rebuild a house and then go through the insurance and replacing the things that we lost, which had emotional significance to us. So even once your house is rebuilt and your sitting in it for the first time in this brand-new, up-to-date, standardized home, because most of us don’t come out and buy new houses from the start, you look around, you’re like, “This is a home, but it’s not where my heart is,” because the things that meant something to you are all gone, you’ve lost those. So the blanket that your grandmother made for you before she passed away, or the pieces of paper on your refrigerator that your child painted for you. The things of emotional significance, they go away when that natural disaster takes them, and so it takes time to rebuild those symbols in our lives. So becoming a way to become resilient so that you’re like, “Well, you know, I have those in my memory. Those are never truly lost to me. So how can I go out with new people, make new connections, and have new symbols in my home of the love and the wealth of emotion that I have in my life?”

So finding ways to become resilient in all different kinds of situations so we don’t become stuck in the past of what we’ve lost, but can keep the emotional and the memories of what we lost, so that’s still a part of us. It doesn’t have to be a thing. It’s still in our mindset—and then creating ways to go forward and create newness and become resilient and bounce back and have that emotional elasticity of “I have been through this, and I understand it, and I accept that it was a horrible event. And how do I build and make myself better going forward?” So having that resiliency and being able to bond with the community and yourself and your loved ones to create that resiliency is critical. We can’t be resilient as an island of one, I think is one of the key facts to remember.

And in today’s society, because we are so globalized, we’re listening to this on a form of social media. We’ve got podcasts now. We’ve got Facebook, Twitter, all of these things out there where we are constantly bombarded by news and information and people’s opinions. And most of the time, those news and information isn’t good—feel-good stories, unless you’re watching the cat play the piano or something on social media, on YouTube. It’s seeing people’s disasters unfold in real time before our very eyes. We’re watching people videotape as their plane makes an emergency landing. We’re watching people BASE jumping to their death on YouTube videos.

So there’s all kinds of things that we see that are constantly bombarding us with people’s disasters—and being aware that in a global society, we don’t really get a break from bad news anymore. Every time you log on to something or listen or watch TV, it’s a series of who’s been bombed, who’s been shot, who’s been washed away in a flood, who’s been taken, lost everything in a tornado. So we’re constantly bombarded by horrid news because that’s what drives the ratings, so being able to be aware of that and saying, “Okay. When I turn this on, I expect I’m going to have some things that are going to hurt me emotionally.” And it builds up over time, so being aware of this, finding different ways in our daily lives to de-stress, to go get that extra cup of coffee that we want or something to treat ourselves to say, “I recognize that I live in a time where I have a lot of information coming at me that’s stressful,” and building up ways to be resilient in this way from those news—whether you take a time, an hour a day, and turn off everything that’s electronic so you just have time to be with yourself and a book or a good meal or your animals, your loved ones, you’re out in nature, but just finding a way to unplug so that you’re not bombarded from vicarious trauma for just a little bit of time, and understanding that that vicarious trauma impacts us, whether we recognize it or not.

If you’re watching, you know, people looking for their loved ones across Texas who have been swept away, that hurts you, because in some way, you identify with that because that could be your hometown. It could be any of us in a moment. We can’t control Mother Nature, and we’re all at the whim of what the storms are coming next, so being aware that things can change, so building in breaks and building in an awareness that vicarious trauma is a new way in our lives that we’re bombarded with and how to take a break from that, a purposeful break, so that we can let our body and mind begin to heal some from all the news that we’re experiencing.

And so practical ways to enhance our own resilience to new disasters is just learning our own stressors. How do we—what are ways that we notice when we’re more stressed? For myself, when I start to cuss more, that’s a red flag to me that my stress level is going up, and oftentimes, we’re the last ones to recognize our stress level is up. Usually, our friends, family, coworkers are like, “Yeah, man. You’ve been off. You’ve been off your rocker for a while. I’ve noticed that, so finding the ways in your own life to notice your stressors before others do.

And then practicing resilience, like we said earlier, in small things, little ways to build up our skills. I practice going to work a different way, just so I know I can do it, so finding ways to be flexible and to overcome little things and to come back a better person for that.

And then most importantly is, right now, building a foundation of good self-care. I think in our American society right now, that’s kind of looked down upon. You’ve got to work harder, spend the most time at work, and we can’t unplug from work anymore. You get emails and phone calls and text messages on your days off, at night when you’re about to go to sleep. Maybe after you’re asleep, a text message regarding work wakes you up. So it’s hard to find time for good self-care. So that must be practiced, and it must be intentional nowadays.

So kind of to sum all of this up is becoming a resilient person is learn to have good flexibility. Build you a cadre of trusted people around you, whether it’s family, whether it’s friends, people you can go to when you know that the real stuff is going on, and then finding ways for good self-care, intentional self-care, whether it’s a hike, whether it’s an extra cup of coffee that you love from your coffee shop, but just so you’re intentionally sitting down with yourself and saying, “You know what, I understand that I’m under stress, and I’m coping with it well. And I’m going to treat myself,” and just acknowledge that “I’ve gone through some hard things today or this week or in the past year.”

So practicing resilience is key to becoming a stronger person for your daily life and especially for down the road when disaster hits us because it’s going to hit all of us at some point in our lives. There is no error-free, perfect living. That’s a made-up TV episode, but working with each other, building our community, building ourselves up will help us become as strong as we can and as resilient as we can to become a better person and a happier person as we walk through this life.

So I appreciate your time to listen to this, and please stay with us for all future podcasts because we are here to support you and support your emotional side and to help make all of us stronger as we walk through this life. So thank you for your time, and have a wonderful rest of your day.

Moderator: Thank you for listening to the Resiliency in Disaster Behavioral Health podcast series. If you would like to learn more about the topics and materials discussed in this episode, contact the SAMHSA Disaster Technical Assistance Center at dtac@samhsa.gov or at 800–308–3515. For products such as tip sheets, webcasts, and collections of research materials, visit our website at www.samhsa.gov/dtac. If you or someone you know are experiencing distress related to a natural or human caused disaster, call the Disaster Distress Helpline at 800–985–5990.