Dr. Brooke Bartlett's Blueprint for Overcoming Stigma in First Responder Mental Care

Jerry: 0:15

Welcome to today's episode of Enduring the Badge Podcast. I'm host Jerry Dean Lund and if you haven't already done so, please take out your phone and hit that subscribe button. I don't want you to miss an upcoming episode. And hey, while your phone's out, please give us a rating and review. On whichever platform you listen to this podcast on, such as iTunes, apple Podcasts and Spotify. It helps this podcast grow and the reason why, when this gets positive ratings and reviews, those platforms like Apple Podcasts and Spotify show this to other people that never listened to this podcast before, and that allows our podcast to grow and make a more of an impact on other people's lives. So if you would do that, I would appreciate that from the bottom of my heart. My very special guest today is Brooke Bartlett. How you doing, brooke?

Brooke: 0:56

Hey, I'm doing well, Thank you.

Jerry: 0:58

Good Brooke, can you introduce yourself to the audience?

Brooke: 1:02

Yeah, I am a licensed clinical psychologist based out of San Diego and I am a specialized psychologist specifically with first responders and military and their loved ones.

Jerry: 1:16

I've got to ask how'd you get into this field?

Brooke: 1:19

Yeah, that's a good question. So, okay, let's just go all the way back, right?

Jerry: 1:24

Let's do it yes.

Brooke: 1:26

So growing up in my childhood always very, very much fascinated by trauma and like really drawn towards trauma. I know it sounds worrisome, but yeah, always was like. The books I read as a nine-year-old was like Ken Burns, vietnam War right, I was always just getting like nonfiction books reading them, always really drawn to it. I had a couple of family members in the military. I'm very patriotic, very thankful for the people who sacrifice not only their lives but also I always say that the sacrifice of their mind.

Jerry: 2:00

As well as what they do.

Brooke: 2:03

And so I decided I wanted to become a psychologist and specialize in working with military. So I had started on the road it takes about 12 to 15 years to become a psychologist and started working at the National Center for PTSD doing my predoctoral research for a few years. So that's in Boston, at the VA there, and so it was tracking to become a military psychologist. And then when I started my PhD, we had just made a connection with one of the largest fire departments in the country and police departments in the country and immediately hit the ground running working with first responders. So both on the research side so I have a very heavy research background but also in the clinical, like in-person side, and I immediately fell in love with working with first responders, immediately realized that there was a lot of overlap between first responders and military, both in terms of their culture and in terms of the struggles that they faced, and decided I'm just going to continue to ride this train and spent all seven years of my doctoral training working with first responders. Again on the research side, I was on call 24-7. I had a therapy office seeing first responders and their family members. I was there for everything funerals, promotions, etc. And yeah, that's how that came to be.

Jerry: 3:28

And now you have your own private practice after all that.

Brooke: 3:32

Correct, yeah. So I knew that once I. So to become a psychologist takes about five years of training and schooling and then you have to do a full year of internship, which was basically full-time job, working in like in my case I was working at a VA hospital and then you have to do anywhere from one to three years of fellowship. So after you get the PhD, before you get licensed, you have to do one to three more years of full-time fellowship. And so I knew that once I was done with all that and I got licensed, that I wanted to open up my own business. So, yeah, I have a therapy practice where I see first responders or loved ones, military, and a big part of what I do is on the consultation side. So I help agencies, public safety agencies across the country with their wellness programming. So I get brought in a lot to do educational seminars on different types of mental health topics like post-traumatic stress and anxiety and moral injury. I also get brought in to help build peer support programs, help supervise peer supporters, consult on policies, things like that. So I really, really, really, really love it.

Jerry: 4:46

You must, because that is an incredible amount of dedication and time to put into getting one to where you are today.

Brooke: 4:55

Yeah, it's a long. It's a long. I was very burnt out. I'm not going to lie about that.

Jerry: 5:00

So I bet. I bet I appreciate your dedication and thank you for having that dedication so you can help first responders. I have the best life. I think that's what I try. To teach people on the podcast or have guests kind of bring out is just like this is a job, this is a career and we're very passionate about it. Sometimes it becomes who we are, unfortunately, which is, I think, is not a good thing. We need to be better at that. So we're going to explore some things today that Brooke and I kind of just bounce around a little bit before we jumped on here, and one of them I'm just going to start right into it I'm broken, brooke.

Brooke: 5:41

I'm broken, yeah okay, please go on yeah.

Jerry: 5:48

First. You know, too often first responders get told they feel like they're broken and then they find somebody that will kind of just maybe feed into that and say, yeah, you are broken. Like yeah, what do you think about?

Brooke: 6:04

that it's an unfortunate, unfortunate misconception, right yeah, when we get to the point where we're really struggling whether it be post traumatic stress, anxiety, substance abuse, whatever it is that at that point that means that we are broken in a permanent way, like there's no going back, there's no fixing this, that this is almost just like our. This is who we are now in our permanent state, and that's a very unfortunate misconception for many reasons. It keeps a lot of people from even seeking help, because it's almost kind of what we call learned helplessness, like what's the point?

Jerry: 6:42

Yeah, yeah.

Brooke: 6:45

But it also is very stigmatizing as well. Right, it can be very stigmatizing, and, as we know, in the first responder culture, stigma is probably the biggest roadblock for people seeking help, and so that couldn't be further from the truth. In terms of any type of mental health issue that someone is experiencing or struggling with. These are things that can be addressed and that can resolve. They don't just happen on their own, though.

Jerry: 7:15

Right, right, right. You got to invest time into healing yourself.

Brooke: 7:22

Absolutely. I mean, I always I like I'm a big per, I love analogies. Okay, so I'm always using analogies and I love to use analogies like, compared to like physical things, because I think that we're we find physical injuries or physical illnesses and diseases more real right, and mental health it's always like I don't know like right. We don't really believe in it as much, so to speak. But physical health and mental health go hand in hand. Mental health is physical health, but I like to use the example of like. I broke my knee about 10 years ago, cracked it in half. I was living in Boston, slipped on ice. It wasn't a cool story, I was just walking to the VA to go to my job and slipped. So when I broke my knee, if I had just not done anything about it probably definitely wouldn't have healed properly, right? Maybe like the bone would have like tried to kind of refuse itself in some way, but I'd definitely be walking with the gate, wouldn't be able to physically move the way I normally could. So I had to get it fixed right. I had to get my knee fixed and then it took about a year of physical therapy and rehabbing. I had to go to physical therapy twice a week and of course I had to be doing my little exercises and things in between, right To build, to repair and then rebuild my knee and my leg, which at the time was very atrophied, to get back to where I was. And it's the same thing when we're talking about mental health, like it doesn't just happen on its own, like no, you can't just like cross your fingers and hope for the best. And honestly I tell people too, you know, if you're just kind of going through the motions, like okay, I went to a therapy session here and there and I'm going through the motions, but I'm not really taking that and applying it outside of the therapy office, there might not be much progress either.

Jerry: 9:17

There's.

Brooke: 9:18

I tell my therapy clients you know there's a. They're with me one hour a week and there's the math 12 times seven, like 160 hours in the week, right? So most of the work that they're doing is outside of our sessions together. Right, there's things that we need to be doing to start to mend, heal and rebuild our mental health. So it's the same thing as physical health. We just can't see it the same way that we do with a physical injury.

Jerry: 9:48

And would you say that, like people experience, like you know how, a physical injury, people no-transcript, still things differently, right, and with a, we'll call it I don't know how to properly word this like a mental health injury, like just the same as the kind of analogy. You know they look different for different people, right, they're not all the same. Just because I break my arm, you know it's not always, you know it doesn't. Everybody doesn't break their arm the same way or heal the same way.

Brooke: 10:18

No, no, exactly. Yeah, you're exactly right. I mean, you got to think about the I called them predisposing and post-disposing factors. But yeah, the injury is not the same for every single person. I have a. I was an athlete before all, before my my other life of becoming a psychologist, I was a competitive athlete, a D1 athlete. I had a lot of preexisting injuries already, one in my hip and you know so that impacted my knee break differently. I think it's why I had to go to you know, do the physical rehab for an extended period of time. But yeah, there's all these different factors that go into it. So it's not, it's not a, it's not a clear cut thing. The two people can have a post-traumatic stress injury and, yes, they, they experience similar symptoms and everything, but they're they're not exactly the same, right, and and every unique, every individual is unique in terms of what their treatment plan looks like and what their recovery looks like.

Jerry: 11:14

Yeah, and that's probably kind of a fascinating part for your job is to to figure out the, the unique way to get them on the right track of feeling better and healing themselves.

Brooke: 11:25

Yeah, it is. It's really interesting because throughout all my my my pre-doctoral training and my doctoral training, you know like I trained in three of the biggest VA's in the country. You know, working in different public safety agencies, there's a big emphasis on like really sticking to the protocol, meaning I use evidence-based treatment, which means treatments that have been scientifically proven to be effective in treating, let's say, post-traumatic stress. You know, as you kind of go on and become more independent and start practicing on your own, you know everyone's different, so I use the same evidence-based approaches and treatments for people, but you have to adapt it to the unique individual. It's not a cookie cutter type of process, and so that is a big part of what I do in. In working with each individual that I work with is we need to see how this fits for you specifically, right? What does this look like for you? And I always tell my therapy clients and I wholeheartedly mean it like I can't do my job without you. In fact, I am useless without you, right?

Jerry: 12:39

Yeah.

Brooke: 12:39

I'm the expert in post-traumatic stress, but you're the expert in you Like, so we're, we're a team Like. We work through this together.

Jerry: 12:50

Do you feel that first responders are willing to put the work in to help healing themselves, or do you feel like maybe part of it is just like this is part of our job is just to suffer through this stuff?

Brooke: 13:04

You know I don't want to make a blanketed statement. Sure, first responders are less likely to seek help, and I think that's one of the reasons why, right, I am the helper, I am the life saver, I am the problem solver. I don't need to get help myself, right? And then again, the stigma. I mean it is highly stigmatized to show any what they perceive as weakness. Right, and weakness is any issue that I'm experiencing being bothered by that call, not being able to get that call out of my head, suffering, you know, starting to have more conflict at home with my wife because XYZ, right, all these things that so many first responders experience but yet, you know, suffer in silence from, because of the fear of being open about any of these things, because of that, just massive stigma.

Jerry: 13:56

What do you think about vulnerability and the power in that?

Brooke: 14:00

Vulnerability is very important. I mean vulnerability if we're talking about in the therapy room and the therapeutic process. It's, it's. I'm just this is my personal opinion it's a requirement to have the actual results that you want. Now that does not mean that you have your first session. Let's say with me and like, yeah, I'm expecting you to just open yourself up and be fully vulnerable. That's not the way it works. It takes time to build a relationship and build that rapport. But vulnerability in the fact of, ok, I do need help. This is something you know. It's gone on long enough. It's starting to affect my life in a lot of different ways that I don't want it to, and you know I'm. I'm vulnerable and open in the sense of to seeing how I might be able to get this address.

Jerry: 14:48

Yeah, I mean, if you're hiding something or not fully trusting the person you're with or don't feel like they're culturally competent, they don't understand you. You kind of just like you said, kind of like just going through the process but you're not going to really benefit a lot from it.

Brooke: 15:05

Yeah, and, but it's equally as important to find someone. That again, one of the most, if not the most, important thing this is supported by the research is that the the the most dominant factor in positive outcomes and treatment right prognosis, so to speak is rapport, the relationship that you have with your provider right, and so the most important thing is that you feel comfortable with your provider and not everyone's a fit for everyone, right. Someone could be there could be a psychologist out there who's just so incredibly good at X, y, z, right they're, they're an OCD specialist, but their personality and approach might not be the best fit for John Smith, right, that's OK, but so, but it's so important to find that fit and in the first responder world, to really find someone who's culturally competent, right. And I tell my first responders, like grill, the person that you're considering working with, Like you get free, free consultation, called beforehand with a therapist, like ask in their background, if they say they're culturally competent, ask them how, like, what makes you culturally competent? What's your background? What experience do you have? What training do you have? Right, All these different things to really assess that cultural competency as well.

Jerry: 16:21

Yeah, I've spoken to a lot of first responders and they've gone to one visit and they're like it didn't go as planned or the way they wanted it to and they didn't. They didn't like the person they were meeting with and they're like oh, I tried, I'm done, yes, I'm like no, no, this is like dating. You like you got to like seek some different other people. Don't just, don't just give up, because you've already taken a really big step. You know to go seek help, so don't, don't stop now.

Brooke: 16:50

Yeah, yeah, 100 percent, and I hear that all the time too, and it's, it's unfortunate, it's like, oh, I tried, or you know, I've had, I've worked, I've worked with first responders who told me that like about like their first experience going to someone and it was like a really bad one, like someone who is clearly not equipped or culturally competent and I don't blame like that. That's a really shitty experience, right, yeah. And it doesn't mean like that doesn't mean OK, well, I tried and I'm done. And I hear a lot of first responders like you know well, that just means I'm stuck like this forever, Like I'm never going to get the help I need, Like there's no one that can help me, and that also is is not true. Like it take, like said it takes time. Like shop around, shop around, I shop around, I had to shop around for for the psychologist, I see, you know, and and hey, if you find one that you like right away, awesome. But just because you don't find a fit right away doesn't mean that there's no fit out there.

Jerry: 17:44

Yeah, I have this. I've had this thought since we first talked a little while back and around, like first responders, like around their, their teams right, that they work with and stuff like that. I was thinking do you think some of them like marry each other's problems? Is that, does that make sense?

Brooke: 18:03

Can. Can you go a little bit more into like what you mean by that?

Jerry: 18:07

I just feel like sometimes, like they like someone in the group has an issue and it starts kind of manifesting, then all of a sudden other people start kind of like marrying that same same. They're starting to have those same problems too.

Brooke: 18:21

Yeah, I mean, you know the sociological phenomenon of observational learning, right? I mean, that's where behaviorally wired to do that. But I would also say that I think they start mirroring a lot of each other's problems because they're all experiencing the similar circumstances that are affecting them the same way, and that also might be why they're kind of it seems to be almost like a I don't know it sounds like a bad word, but like contagion.

Jerry: 18:51

Yeah, yeah. No, I did see some of that throughout my career. I mean, sometimes that's just people just opening up and starting to break open, and then other people have had these same feelings that they now feel like they can share.

Brooke: 19:05

Yeah, yeah, the trickle down effect. I mean, it will never cease to amaze me when I always, when I give, like training seminars, presentations, you know, to different agencies, whether I'm giving giving one on post-traumatic stress or moral injury or anxiety or whatever it is One of my tips is always talk, talk to people, talk to people you trust, right, and it doesn't mean to open up and talk about your deepest, darkest secrets or struggles, but like just the act of saying man, that call really sucked for me. I'm, I'm, I'm all messed up in the head from that call that's. That is like we'll start to kind of have that like pinball effect and the I can see that people kind of are more comfortable. Yeah, bothering me too, like I, I didn't sleep well last couple of nights. Right, I mean it just opens up the floodgates as opposed to just stoic or good, we're just going to keep going.

Jerry: 20:04

Right, right I was. I was thinking about some like my crew members in the past and going through some of the difficult incidents and difficult incidents affect everybody differently. Once again, like some people like I'm okay and then some people are, are bothered. And then those some people that are okay Sometimes like why is that bothering you? I don't understand, I don't. I don't get why. This doesn't seem to be like a nothing kind of call to me. I don't get it.

Brooke: 20:33

Yeah, yeah. So that's a big part of what I talk about when I do my trauma trainings is that we all experience trauma differently. No two people experience trauma the exact same way. Yeah, not your best friend, not you and your best friend, who's also your crew member. No two people experience trauma the exact same way, and that's something that I hear so many of my first responders when they come to see me for therapy is they'll be like something wrong with me, doc, like I don't know. Everyone else is my crew saw this, you know respond to that same call, but there's something wrong with me, like I just can't shake it. Like what's wrong with me? Right, we all respond to trauma differently. We all have different experiences, backgrounds, beliefs, all these different things and post disposing factors, what I call them. Like we go home to different circumstances, we do different things to cope, we have different lifestyles, right, all these things play into how we experience that.

Jerry: 21:26

Yeah, how do you right? Our brains are made up completely different, right you should? For the most part, I maybe that's not the right way to put it. Maybe the neural pathways are a little bit different in each one of our brains. Would that be fair to say?

Brooke: 21:39

Yeah, oh, absolutely. None of us have the exact same brain.

Jerry: 21:43

And when it comes to like these PTSD or PTSD, you know, type injuries what's a good way to start going about? Try to like, maybe heal some of these things.

Brooke: 21:57

Yeah, so the here's the good thing. We were talking about the broken type thing, right, the broken type misconception and that, like my issue, is permanent type thing. That's not true, because we are all born with a superpower and it's called neuroplasticity. Have you ever heard of that?

Jerry: 22:17

I have, I love it. I love brain science.

Brooke: 22:20

Brain stuff. Yeah, yeah. So whether we're talking about a post traumatic stress injury, or we're talking about someone suffering from depression or anxiety or whatever it is, our brain is literally designed to change. It's malleable, right, and that doesn't stop as we age, like back in the day, before all the science, technology came out and we, you know, could examine these things. We as if I'm not a neuroscientist, but you know that that neuroscientist could examine these things they thought, okay, we must, you know, we stop learning at it like there's some kind of all right, you're this age and your brain, just you know what you got is what you got. But that's not the case. So in any type of any time, any time someone is trying to address a mental health issue like post traumatic stress, you have to engage in evidence based treatment. And that treatment is evidence based because there's scientific things that have been proven to rewire your physiological body right Physiologically. You know your HPA access and your brain. Our brains can rewire their neural connections to then fire in a different way. But, as we were saying earlier, this doesn't just happen on its own.

Jerry: 23:45

Can I do it on my own?

Brooke: 23:47

We can do it on our own. Well, you need help and assistance. Yes, then you can do it on your own. You need a direction. For example, if I'm going back to my physical therapy example like they weren't having me do any groundbreaking exercises to rebuild my knee and my leg. But I need a direction on exactly what this looks like. What are the exact exercises to do? How many times do I do them? Then I could go and do them on my own and it's no different in this case Neuroplasticity. There's two different types of neuroplasticity. We call it structural and that's where we can actually build up and regain strength in certain neural connections and then prune away the weak ones. That's synaptic pruning, which prune away the weak ones. There's a functional aspect of neuroplasticity in cases where someone who has actual brain damage say traumatic brain injury of some sort, a veteran who was near an IAD and got knocked out at the time, or individuals who suffered a stroke, where if there's a part of the brain that is damaged and that can't function because of that, actually blunt force trauma, so to speak that different parts of the brain are able to build up their strength to try and make up for the lost strength in that area of the brain. It's really incredible what our brain can do.

Jerry: 25:13

Yeah, it really is. I think we're like you're saying I don't think the new science is quite getting out there yet on what our brains can do, and they're pretty magnificent things that it can do with help. I mean, you can rewire some things on your own, I feel like, but you're going to have to maybe find a good book to help you do that, or different things like that.

Brooke: 25:37

Yes, I agree. So it all depends on what the person where the person is at, so I can never just give a blanketed answer. I have a lot of people come and be like, okay, how do I fix this? It really depends Someone who has a full diagnosis of post-traumatic stress disorder, which that means they have clinically significant symptoms. They're severe, they're not going away, they are causing significant impairment in multiple areas of their life. Once they reach past that threshold, then it's more than what can I just do on my own. You need professional help to help you get there. Now we all struggle with different things and experience different things. If someone's level of severity or their issue or issues that they're experiencing are not past that threshold, then, yeah, there's certain things we can just do on our own. A lot of the tips I give are just small little things to do on your own, Like you even said, reading a book, learning about these things and practicing some of these things that you learn, Keeping up your mental health just as we would our physical health. I think it's really important for people to understand that too. It's not always not everything that you're dealing with, or even if you're trying to be proactive and just build strength mentally. Mental health strength doesn't always require that you go see a professional, but once someone passes to a certain threshold, doing these things on your own will probably not end with it being resolved.

Jerry: 27:07

Yeah, I think that's very, very fair to say. Mm-hmm, as far as first responders go, what do you like being proactive? Do you feel like they are proactive or are reactive? Because most of that type of job is reactive. Not a lot of proactive stuff goes into it, so I just feel like it kind of carries over into our personal lives 100%.

Brooke: 27:32

I would say again, generally speaking no, I don't feel like first responders are proactive, and I think there's a few different things that go into that. I feel like in my experience, more often than not, someone waits until shit hits the fan and then it's like oh no, I got to do something about this. And at that point, that's when this issue, or these issues are starting to get in I'm going to keep saying it causing significant impairment in someone's life. Consistently, I'm not able to perform my job as well. My wife and I are nearing a divorce, my physical health is deteriorating. I haven't been sleeping for months, all these different areas where it's having that impairment. And then they're like OK, maybe I need to do something about this, but a lot of the work I do in wellness program with agencies is we need to build up the proactive side of things, and what proactive means? There's two. I think of it as three lines of defense. The third line of defense is the reactionary, that basically crisis or like the shit has hit the fan, crisis. We got to intervene and help this person because they're not doing well. That's very necessary. We always need those reactionary things in place and, just as important, we need to emphasize the proactive, which is the first line of defense. Keeping healthy people healthy. That's the best scenario right there, right.

Jerry: 29:03

Yeah, I totally agree.

Brooke: 29:05

Yeah, the way we keep ourselves healthy is to engage in behaviors, activities, whatever you want to call it, that keep us healthy. I mean, again, if we're just talking about our diet or things like that, if we stay healthy physically, like that, generally speaking, we have a habit of eating well and, yeah, maybe we go throw down a few beers and a burger and some fries on a Saturday. It doesn't mean we have to adhere to it perfectly, but we have a behavioral pattern of doing that, and that's what we want to emphasize on the mental health side. The best case scenarios I get brought into an agency and someone's like yeah, I'm doing great, awesome, let's keep it that way, what are you doing that's working, and what are things that you can proactively do to prevent potentially getting to that other side? Right, that's the first line of defense, and the second line of defense is early intervention, and what that basically means is we all get to the point where we are at the second stage, where things aren't going so well, like, yeah, we're still functioning, there's no significant issues, we're not having major problems that are consistent or anything like that, but we're not feeling ourselves, we're having trouble in this area, we're doing that, and then that's the area where we want to be able to intervene and do things to prevent that snowball from continuing to roll. Those first two lines of defense are so important and I think we all kind of forget about them sometimes and we wait until it gets to that third line and then we're like, oh no, this sucks. I guess I have to do something about this.

Jerry: 30:54

Yeah, you think between that second line of defense and the third line is there a lot of addiction that kind of takes place, or where is that? Because I know the dictionary in first responder to different things is fairly high.

Brooke: 31:09

Yeah, yeah, that's a tough question. So substance misuse and abuse in first responders is extremely high. I've done a lot of research on it. I mean at least a third, and this is under-reporting, by the way. But at least a third, one out of three first responders misuse substances. There's different types of. I like to kind of when we're talking about addiction versus substance abuse, versus substance misuse. Substance abuse is not always someone that is drinking, let's say, all the time, right, like the frequency of their drinking. Now, of course, if someone is drinking all the time, yeah, that would be constitute an addiction. But what I see often in my firefighters is that they do two things. They utilize, let's say, alcohol to calm down their arousal system, their fight or flight system after shifts to try and sleep. They're using it in ways to try and cope with some of these things and that's maybe in the moment it helps, but in the long term it starts to cause more issues. But then I also see a lot of first responders that it's this is what I call them, it's the go big or go home kind of first responder, where they don't really drink that frequently, but they're known that when they do drink they go big or go home. Right, they blast it out of the park and even if it's just once a month, let's say that they drink, that when they do they get so drunk. It always leads to some kind of problem they pick a fight with their wife when they get home, or they start a fight at the bar or something. They can't wake up the next morning and show up to shift, or they show up to shift kind of drunk, right, all these different things that like, yep, that's oh great, so-and-so is going to be drinking tonight. We know how that's going to go right. That's the other common type of substance abuse that I see among first responders.

Jerry: 33:13

Sorry, I chuckle a little bit when you're giving those explanations and examples, because like, yeah, but I've seen that before. I'm not saying I'm perfect, by any means yeah yeah, images popping up in my head, yeah, yeah. What can advice can you give to some of the first responders listening to maybe make that turn either to start self-care or maybe seek some help.

Brooke: 33:42

Yeah, in terms of self-care, I really like to emphasize that it is the little things that make the biggest difference. The little things Like when again, when I'm giving tips or you know how to approach this, I'm not saying anything groundbreaking, right. But to utilize that superpower of neuroplasticity right, it takes intentionality, right. We can't just be like, oh okay, I guess I did something good for me because that just happened, like I didn't intend to do that but it worked, right. So, intentionality, consistency and repetition right. Find the little things that work for you. I could throw out 10 different things right now that are scientifically proven to help. Maybe that helped me, but it doesn't mean all 10 are going to help you. So I always like to tell my first sponsors in terms of self-care, being proactive is spending time doing the little things. The little things go a long ways, right. So, if it's spending four minutes in the morning listening to your favorite guided imagery audio, right, do that right. If it's writing down three things at the start of your day, what you intend to do that day are things that you're grateful for, right, do that right. Try a bunch of different little things that, added up, really help in the long term and stick with them. Right Again, if I'm going to bring it back to the physical side of things, like if I stopped doing and I did this if I stopped doing the little things during the day that were rebuilding my injury, all of a sudden my injury started to hurt more again. Right, and so we have to consistently do these things and make it almost part of our routine, so to speak, not meaning we do it the same time every day or the same exact thing every day, but really paying attention to all these little things that we can do to keep ourselves as healthy as possible, and not only does it make us feel better at the time, but it also you know, the word resilience is very popular right now- but, what it does is it makes us more likely to be able to prevent, you know, worsened issues from forming. It makes us, in that way, right, we're starting off on a stronger foot. That doesn't mean that we can't experience issues and struggles, right With these things. It just gives us a stronger footing to be able to handle it if and when that does happen.

Jerry: 36:12

Yeah, I was teaching a few years back. In one of the classes I was teaching, I put together like a menu of like self-help, like type things like here are the things you can do. Just look at all the different things you could do for yourself. But as caregivers I feel like they just don't, they don't want to take the time to do that type of thing. They get stuck in these, in the routines of whether they're good or bad Most of them are, you know, they get stuck in these routines and they don't deviate from them.

Brooke: 36:42

Yeah, 100%. And I think, too is another unfortunate misconception is that, in order to make the change that I'm hoping for, it's going to have to be these big things. Right, like I don't have the time or the energy to make all these big life changes, and that's what you don't need to make these big life changes, it's just the littlest things. So, yeah, doing some type of a guided imagery, progressive muscle relaxation. Some people like to write down, not like a diary, but whatever you want to call it like write down certain things to the day, having a board where they write down three things they're grateful for at the start of the day, reading 10 pages out of their book a day. You know, whatever it is that works for you is doing these things and doing them consistently and finding what works for you, right. And then they give you 50 different things to potentially try that help with all these different things. But it's up to the person to test them out. And if you try journaling, you're like this is dumb, like this does nothing for me Great, you tried it, you know it doesn't work for you. Try something else, right?

Jerry: 37:47

Yeah, yeah, you know, people are struggling like with their physical health and then they want help like getting started and stuff like that. And it's like, you know, okay, let's start with a walk, a short walk, and then, as they start doing that right, they start feeling like maybe there's a five minute walk and then I'm going to go a minute longer today and I'm going to because I'm starting to see and feel the benefits of walking. It's same things with these other things for your mental health.

Brooke: 38:12

Oh, 100%. They're reinforced, right, positively reinforced when you start seeing the benefits of them, right? It doesn't mean that's again where we're going when I'm talking about like the big things versus like these little things. It doesn't mean that writing three things down that you're grateful for at the start of your day I keep saying this one because I do it, because it's really helpful for me I think it doesn't mean that right, when I do that, I'm like, oh my God, I feel so much better, I'm all better, I'm done.

Jerry: 38:41

Right.

Brooke: 38:41

Yeah, it's the accumulation of these things. It's the small things, the small gestures, the small behaviors that we do intentionally, that are meant to make us feel better. You know, help us address if we're working on anxiety or negative thinking patterns, whatever it is we're working on, it's those little things that add up. It's not necessary that immediately it's going to fully relieve whatever stress or problem you're experiencing, but it does start to chip away at it.

Jerry: 39:11

Yeah, but, brooke, I don't have any free time. I don't have any free time to do these things. You're saying what do you mean?

Brooke: 39:20

It's too bad. I guess it's time. I guess you just got to keep suffering, right.

Jerry: 39:28

That's where I was heading with that. It was like being intentional, right, Like if you intentionally structure out your day, you'll find the free time to do a lot more. But what happens generally when we don't structure a day, we pick up our phones and then, oh, spend 15 minutes scrolling through Instagram when it could have spent 15 minutes meditating, reading, doing breath work, taking the cold plunge. You know, doing like whatever, it is something for yourself.

Brooke: 39:56

Yes. No one can make you do it 100%, and that's why I always tell people too, like, yeah, I'm a psychologist, I'm specialized in all these things, but I'm not a wizard. I can't just shake my wand and then all of a sudden, you know your problems are solved, Like it is up to you, Right? And I've really built like itineraries with some of my first responders to see when we can fit in 10 minutes, 10 minutes in a day, right, to do something beneficial for them, right? Or if they have homework to do from their therapy session that takes five minutes, All right, let's schedule it in. We're going to set a reminder on your phone to do this, right, Actually scheduling these things in. And sometimes I've even done full itineraries with what you were just talking about, where let's take a look of. Let's go from yesterday. I want to go through every minute of your day, exactly what you were doing, right? And then we see these little I'll call them like pieces of fat throughout the day when it's like you said, 15 minutes scrolling through Instagram, and you know I spent 30 minutes, you know, kind of just lounging on the couch watching TV, and then I spent, you know, 10 minutes, whatever it is right, and so it's like those are those little pockets of time that we can be more intentional in incorporating these things. I just I'm a very busy person and I understand there might be, you know, days here and there that are just truly just so packed but no one doesn't have the time to incorporate. You know, intentionally, try to incorporate these things on a on a semi consistent basis.

Jerry: 41:33

Yeah, yeah and I think intentionality is is is huge. A famous football player is a quarterback still in the NFL. He schedules his day to for every five minutes.

Brooke: 41:45

Wow, which one.

Jerry: 41:47

Kurt Cousin.

Brooke: 41:48

Oh, I love.

Jerry: 41:50

Last I heard that's what he was doing.

Brooke: 41:52

I'm not supposed to love him because I'm a Packers fan, right, so, like Vikings are arrivals. But I love this guy man. He seems like such a down home guy and I've I, okay, I've heard that he's very regimented with these things.

Jerry: 42:04

Yeah, I mean that's one, that's who I couldn't have. Another person that you know plans their day out like that, but I mean they're just put some thought into your day and and he's that we'll call it fat time to to do those things that'll help you have a better career, a better life. You know, when you retire, when you come home, when you go to work, like my goal is just, I would love to see first responders just like go to work, do an excellent job and come home, have an excellent life, you know, and retire and have an excellent life. You don't have to fall into these cultural traps of like this is our job, so I'm going to run the chainsaw all day, you know, and not worry about your protection and just be deaf at the end of my career.

Brooke: 42:50

Right, you don't have to do that. Yeah, no, no, you don't. You know, and along with that too, Jerry is I'm thinking, not only incorporating the the little things throughout the day, but sometimes self care can also look like setting boundaries with ourselves too, and I know that a lot of my first responders struggle with this, and I know that I struggle with it. Sometimes the worst, like the hardest thing to do is set boundaries with ourselves. So it could be I'm just going to give my own personal example is you know, I had to start setting a boundary with myself of when I will stop looking at my email. So I now have a cutoff time at night that I'm not checking, you know, because I have access to it on my phone. Notifications are off. I don't look at it because, needless to say, you know it'd be like eight o'clock. No, I see that email, oh crap. Yeah, I got to, you know and it would just kind of keep me going and then just stress up and stress up, and stress up, right. So not only does this, does self care look like incorporating things, you know, small little things, but it could look like okay, what are things that aren't required or necessary of me that I can maybe kind of set a boundary with Right? Are there things I'm doing, for example, if I'm not sleeping? Where are there things that are keeping me up, or whatever it is to set that boundary of like, okay, what does this look like? Maybe, instead of looking at my phone, for you know a total of an hour a day, I cut it down to 45 minutes. Right, stuff little things like that, boundaries like that.

Jerry: 44:13

Yeah, speaking of phones, like just one little tip for me is because I can do the same thing, right, you're constantly being flooded with messages and emails and stuff. Most all my notifications are all silent, so my phone doesn't really go off a whole lot and it just all that extra time of like oh, who's this, what's this, what's this I don't get, and it builds up like anxiety when I, like you know people get, oh, I got a notification, I got to look, I got to do it instantly, like no, you don't. I always say, say messages are optional, to respond as soon as you can and when you want, and phone calls are a little bit different, you know, because people don't really make them anymore. So that might be urgent. What are those? Yeah, yeah, brooke, before I let you go, do you have any other tips that you can think of that maybe would be beneficial to first responders?

Brooke: 45:07

I mean, I would say, just start to kind of explore different things that might be helpful for you listening to podcasts, finding certain books that are educational for you or books that you just get lost in and enjoy, you know, finding certain activity based things that you enjoy doing right. And starting to really kind of take a look at what your life is right now and see where, maybe, if there are any gaps of things that you want to kind of address or kind of nurture a little bit more, and what think about the things that maybe you can, you know, fill those spots with.

Jerry: 45:42

Yeah, I've been in different parts of my life. I had an injury and I was out for 500 days and it just felt like it is fell into this hole until I hit like rock bottom. But it wasn't so. Like there's always a way to like dig yourself out, you know to start pulling yourself up, you know yourself, and then you know once again reach out to others to help, because most people want to help you. They don't want to see you suffer.

Brooke: 46:11

Yeah, I mean I know it probably doesn't mean that much to some people when I say this, but the thing I see so like just as a first responder psychologist, I see so many different first responders thinking that they are the only ones struggling with whatever it is, and I'm like you have no idea how many other first responders are struggling with exactly what you're struggling with, right, and so I. Just a message I like to get across is that you are not alone in this right what you're experiencing. You're not the only individual experiencing it. This is not some personal failure. It is not some defect. You're not defected in any way. Right that there's so many first responders struggling in silence.

Jerry: 46:59

Amen, Amen. I mean, I've been there and I recently retired and I kind of caught myself one day. I was, I went and had a drink and I was just sitting at the bar just by myself, just kind of pondering and I was like why am I feeling like I'm suffering here? Why do I feel like this, like going through all these emotions of retiring and everything that I feel like I'm just suffering? Why, why, why do I find myself here feeling that, when I know I should not be feeling that and I have all these other options and things I could do? But I mean, right, Sometimes we just lapse back into into places and and we can sit with our feelings for a bit and then get back on the road to where we need to go.

Brooke: 47:44

Yeah, I call it I. The analogy I use is driving the car with the engine light on. It's probably one of my favorite analogies, yeah, first responders, and some of us, including myself, is that you know, when our check engine light goes on in our car doesn't most, most times, doesn't mean there's something horribly wrong or anything like that, but it's just kind of an indicator of like, okay, tom, you know time to look into this, you know time to you know, maybe there's some, some things we need to Take care of, right, but our car can still drive real smoothly, yeah, and so we'll just keep driving it, and driving it, and driving it, and over time, that small little thing that was there can really develop into a bigger thing and, you know, could result in our transmission blowing out, for example? Yeah, but yeah, we get into the habit of just driving our metaphorical car, you know, with the check engine light on, you know, because yeah, we're fine, we can just keep going.

Jerry: 48:41

Yeah, yeah, definitely Brooke. Where can people find you and follow you?

Brooke: 48:46

Yeah, so I am find me on Instagram. I'm sure you'll put some of the links and stuff right, so I don't have to spell it out. But, dr Brooke, phd, I also have a website, centertosscom. But yeah, I really encourage people to. I always love to hear from people like you know. If they something that resonated with them, please feel free, you know, to reach out to me, shoot me a message.

Jerry: 49:11

You know I'm always always happy and excited to network and make connections, so yeah, thank you so much for being on the podcast today and thank you also for your dedication to the first responder world.

Brooke: 49:22

Yeah, absolutely. Thanks so much for having me.

Jerry: 49:24

Yeah, thank you. Thanks again for listening. Don't forget to rate and review the show wherever you access your podcast. If you know someone that would be great on the show, please get ahold of our host, jerry Dean Lund, through the Instagram handles at Jerry fire and fuel or at enduring the badge podcast, also by visiting the show's website, enduring the badge podcastcom, for additional methods of contact and up to date information regarding the show. Remember the views and opinions expressed during the show, so we represent those of our hosts and the current episodes. Thanks,