Back on the Water - Part Two

Part Two of a Three-Part Blog Series By Julia Yanker

Photos | Julia Yanker and Emily L. Doig

This is the second article in a three-part series about how to recover our “mental” edge after a scary swiftwater incident - the repercussions of which are referred to in the wilderness first responder community as “stress injury”. If you missed part one, check out it out here.

I was shaking like a leaf. I raised my hand in front of my face and tried to hold it level, but the shaking only increased. With the rapid roaring in the background, I looked around at my friends on the river bank, securing spray skirts and reattaching throw bags. No one else seemed to be showing any signs of impact from the rescue our group had just carried out for one of our partners. “Stop being foolish,” I would have told myself a few years prior. “Everyone’s fine and we’re all back in our boats, get your shit together and move on,” is how I would have tried to talk myself into continuing on.

But that was before my training to become a Somatic Experiencing Practitioner; before I learned about the psycho-somatic effects of high-stress situations that can leave lasting impacts on body and mind; before learning about what some call psychological first aid. This second article will focus on just that: how can we provide psychological first aid to ourselves and others when a high-stress incident has occurred to mitigate the long-term impacts of trauma?

In order to answer this question, let’s reacquaint ourselves with the general psychosomatic threat-response cycle that creates a long-term trauma response:  

1. Our senses perceive a threat in our environment.
   
2. The oldest part of our brain reacts automatically to the threat - going into fight, flight or freeze.
   
3. The body generates an immense amount of energy to carry out life-saving measures.
    
4. This energy is utilized until the threat is neutralized.
   
5. There is energy left over that needs somewhere to go - it usually releases itself through shaking/trembling, crying, anger/rage, or heat.  
   
   This is where we humans (and some pets) differ from wildlife by disrupting the cycle, which creates trauma:
   
   
6. The newest part of our brain suppresses or diverts the body’s attempts to dispel the extra energy and the cycle thus does not complete. The energy is stored in the body.
   
7. Sometime in the future, we encounter or create a situation similar enough to the original trauma and are thrown back into the threat-response cycle, exhibiting symptoms of trauma.
   
8. The body attempts to release the old, stored up energy again.
   
9. Repeat 6-8 until the old energy is successfully released.

...Ok, but how does all this scientific mumbo-jumbo translate into the real world?

When applying psychological first aid after an incident, we are essentially trying to end the cycle at number five, listed above. What can we, as bystanders or first responders, do to help the victims successfully complete the threat-response cycle to reduce future suffering?

There are five steps to remember. You can follow them for yourself or apply them to others - whether within your group or if you are a first responder to someone else’s emergency.

Step 1 - Neutralize the Threat

Remember that our nervous system responds to a threat whether it is actual or perceived. Secure the scene of any actual threats you notice. If the victim is barely out of the water and perched precariously on a rock, get them to solid ground. If their boat is being may-tagged endlessly in the big hole they just swam, position them so they’re not watching it get chomped. If they keep mentioning they’re worried about their paddle but you saw someone toss it to shore, show it to them or move it further from the water’s edge.

Create a sense of safety. You can do this by telling them, “You’re safe now,” or, “you made it.” Reinforce it by showing them how they are safe - for instance, pointing out they’re out of the water, or that that was the last rapid of the day, or that they can walk to the road and hitch back to the vehicles. Have them look around and feel their feet on the ground. Of course, safety is relative - do what you can to help them feel safe, but by virtue of being in the great outdoors, you may not be able to remove all perceived threats.

Step 2 - Help the Body Complete the Threat-Response Cycle

Encourage and validate whatever way the excess fight/flight energy may be showing up. If you see them shaking, trembling, or crying, you can say “I see that you’re shaking. That is the body’s very normal response to being in a stressful situation. Would it be ok to just let that happen?” Understand that the person, yourself, and others around may be uncomfortable witnessing these releases because they don’t understand it’s normal and healthy. In our society, many people are socially conditioned NOT to express anger, for instance. If you sense anger in the person, don’t try to tamp it down. You can support it by saying, “Yeah, f@!& the river!” or “It seems you’re feeling really angry right now - that is a totally normal response and I’m here for it, I would be pissed if that happened to me, too.” 

Try to encourage the person not to just jump right back into moving on down the river. Obviously in some situations, moving on isn’t an option; but if it was merely a stressful situation that needs to be moved on from eventually, see if you can help them sit through the rest of the cycle until their nervous system has become regulated again. Oftentimes, people will see themselves and their needs as a burden on the group and not ask for what they need. You might advocate for the person by suggesting a quick 15-20 minute break.

Step 3 - Stabilize and Regulate: Apply the Antidote

As mentioned above, you’ll want to get the nervous system stabilized and regulated as soon as possible after the incident is over. Here are some tools that help people get regulated:

• Social connection. Humans are social animals who rely on their companions for safety and survival. Eye contact, jokes and other verbal connection, as well as physical touch can be used to help someone get regulated. Obviously, use your best judgment here. I wouldn’t jump in and touch a stranger, whereas I might sit next to a good friend and put my arm around their shoulders. Don’t underestimate the power of just sitting quietly with someone and being attuned to them. Pets can also be a powerful resource in this way.
  
• Stay or get calm yourself. Acting calm when you’re not, doesn’t count - humans, like other animals, can sense when another is feeling stressed out. When everyone is stressed out, it tends to escalate the group’s level of stress. If even one person can stay relatively calm and anchored, the group can trend that way as well. Remember any of these tools can be used on yourself and you may have your own energetic release that needs to happen as part of the threat-response cycle. Allow it to occur and then utilize some of these other tools. You can also use your own process to strengthen the sense of social connection by saying things like, “Gosh, I notice I’m shaking right now,” or, “I feel it too - there are definitely some tears coming on.”
  
• Get grounded. Just like when used in an electrical circuit to ground out extra charge, getting the physical body grounded can be a powerful way to come back to homeostasis. To do this, simply shift your awareness to the weightedness in the parts of the body that are being supported by the ground; feel into the pressure on the soles of your feet or your backside. Allow yourself to become aware of being supported by the ground, the earth. I invite you to take a moment now to practice and embrace this awareness.
  
• Orient to your space. Use whichever of your five senses you find most calming. Looking around can be very impactful, REALLY looking. Allow yourself to notice there is no threat and your environment is safe, or at least focus on the parts of your environment that ARE safe or bring pleasure (like a flower or bird). You might listen to the birds or some other sound you find pleasurable. You can pick up a really smooth rock that feels nice to the touch and focus all your attention on your touch sense. If there is a pleasant smell, you can shift your attention to it. The possibilities are endless. The main point is to find something pleasurable or calming through the five senses and to focus on the physical sensations it inspires (yes - sights, smells, and sounds create physical sensations in the body!).
  
• Self touch or posture. We all have postures or movements we make with our bodies that are self-soothing. For instance, there’s something about assuming my meditation posture after a hectic day that helps me feel relaxed. When I’m nervous, crossing my arms in front of my chest helps me feel more secure. Babies suck their thumbs and sometimes people may rock themselves. Find out what feels good for you. Is it placing one or both hands over your heart, on your stomach, or your forehead? Perhaps it feels good to wrap both of your arms around yourself, or to hold your face. If helping someone else regulate, you can bring these postures into conscious awareness by saying something like, “The way you have your arms wrapped around your torso looks really comforting and protective.” 

It’s important to note that not all of these tools are always calming for everyone. Grounding might make someone feel more antsy, for example. Eye contact makes some people feel nervous. Perhaps there’s someone in the group you don’t get along with; attempts at social connection with this person might feel more threatening than helpful.

I encourage you to play around with all these tools for yourself to see what feels the most calming to you, so you can apply it when you might need it later. When working with others, by paying careful attention, you can see if your suggestions are resourceful for them or more agitating. There’s no harm in using all of these tools in one go. Our bodies are smart and will figure out what’s helpful to us and what’s not.

Step 4 - Agency

One of the key ingredients of trauma is a sense of helplessness and inability to exert influence on your environment. Helping someone who is coming directly from a situation where they felt out of control and re-establishing a sense of control and personal agency is a crucial step in mitigating the long-term effects of trauma. Let them be an active participant as it makes sense in the aftermath, participating in self-care, decisions, and rescue. This doesn’t have to include big acts - it can be as small as “can you hand me that rope? Would you like some water or gatorade? Could you please refill these water bottles for the EMS team?” Have them do things that create a sense of efficacy and success, meaningful things that drive towards a successful outcome.

Step 5 - A Way Out

Establish or share the plan to get out safely and establish a hopeful atmosphere. If someone is terribly shaken by the whitewater, assure them that the group is happy to portage the rest, or wait for them while they portage. If it’s a complex situation that requires some sort of rescue, come up with a plan and reassure the most stress-impacted members of the group. Keep a hopeful attitude that everything is going to be fine - within reason. Find the things that ARE hopeful and good about the situation and highlight them. 

If you are like most of us, this is all new to you. Like me, you may have many incidents in your past that certainly didn’t get the benefit of psychological first aid. How do you know if there is something unresolved in your past? In Part III, we will discuss long-term recovery, symptoms, treatment, etc. Be on the lookout for that article next.

About the Author:

Julia Yanker is an adventurer and Somatic Coach specializing in trauma resolution who has received 4 years of training in the technique of Somatic Experiencing®, a trauma resolution modality used around the world to help people heal from trauma. She lives in Bozeman, Montana, and jokes that she has participated in every adventure sport at least once (besides the ones that involve jumping off or out of things). She mostly spends her time packrafting, horseback riding, camping, foraging, and skiing. You can learn more about her work on her website or follow her on Instagram.