 All right, hello everyone. This is Jess Unger here. Thank you for joining us for today's webinar. This is, of course, the first in your eight-part series to complement the in-person training for the Texas Heritage Response Team. These programs are made possible through the generous grant funding support of the Andrew W. Mellon Foundation. We're kicking off this webinar series with three programs that take a broader approach to the topic of disaster response. I'm just going to pull over for you all here. A reminder of the overview of our webinar schedule. Today's program, of course, is on the Psychology of Disaster Situations. We'll be holding our next session on March 7, regarding health and safety. And then we'll be holding another session on March 21 about funding sources for cultural institutions affected by disasters. From there, we'll move into programs that address material-specific salvage considerations. Photos on electronic media, textiles, wooden and upholstered furniture, paintings, and book and paper objects. We'll wrap the final program on May 23, which will be just about one month before our final in-person meeting and disaster scenario training. If you miss any webinar sessions, I'll email you with a recording of the program. Write to me when you finish with the recording, and then I'll note your attendance. You will be expected to complete all webinars before we meet again on June 21. Before we begin today's presentation, I wanted to share some brief technical notes. On your screen, you'll see several boxes, including one labeled chat on the left-hand side. You can use this chat box to say hello, ask questions, share any information or links that you'd like. Links will be live, so all attendees can click directly on them. If you post a question in the chat box, you'll receive a response from me. Any questions will be noted, collected, and then I will verbally ask them of our presenter when she completes her remarks. You'll also see a box at the bottom of the screen, titled Web Links. So click on one of these links to highlight it in blue, and then click the Browse To button at the bottom of the window in order to open that page. And with that, I'm very pleased to introduce you all to today's presenter, Dr. Jody Hortsman. Dr. Hortsman is a PhD, HSPP, and a licensed psychologist. She has 28 years of experience in community mental health, serving youths, adults, and families. In her current role at Aspire, Indiana, she serves as Chief Clinical Officer. Prior to that, she served as Senior Director of Comprehensive Outpatient Services and Senior Director of Youth and Family and Community Services. Since 2005, Dr. Hortsman has taught courses on psychological first aid with the state of Indiana. She has been involved with multiple disaster mental health responses, both nationally and internationally. She served with the American Red Cross in New York following September 11th as part of the Indiana Task Force that assisted Mississippi following Hurricane Katrina and worked in Haiti following the 2010 earthquake. She is a member of Indiana's state disaster mental health team and a trainer of psychological first aid, PFA. Dr. Hortsman received her Bachelor of Arts degree in behavioral science from California State Polytechnic and University and her Master of Arts and Doctoral degrees in clinical psychology for the United States International University in San Diego, California. Dr. Hortsman was involved with training the team of national heritage responders on the topic of the psychology of disaster situations. So we're incredibly fortunate to be joined by her today. And with that, I'd like to turn things over to Dr. Hortsman. Thanks, Jessica. I really appreciate the introduction and I appreciate the opportunity to be here today. Looks like we have quite a few participants, so that's exciting. I always welcome the opportunity to talk about this, so this is not my day job. I work at a community mental health center, but this is truly my passion is disaster response. So thank you again for letting me participate in this. So I am going to drive the presentation today. I do wanna note that I have included some photos in here. I know it's very dry to sit and watch a webinar and hear someone talk and not be able to look at things. So I'm gonna try to punctuate this with some photos and some stories along the way. So let's talk a little bit about what we're going to talk about. So I'm gonna talk a little bit about disasters in general and then the impact or consequences of those disasters. The focus of today is going to be providing some background information related to that, some general understanding of that impact and those consequences, understanding some of the special needs of certain populations and then what are the needs of the survivors and responders? And then we're gonna move into psychological first aid and a little bit about self-care. So let us begin. All right, so I'm gonna start with a slide that may seem odd to start with, but it's really about resilience because resilience is really important here and is often underestimated. So when we hear about a disaster or a traumatic event or widespread impact of something negative, oftentimes we are led to believe that this is an absolutely devastating event that everyone is severely negatively impacted. I'm gonna talk a little bit about why we're led to believe that, but what is often not noted and isn't I guess maybe felt to be attention worthy is that really resilience or that ability to bounce back to maintain a stable equilibrium or to better cope with things, negative events in the future is really more common than we believe. Now I'm a psychologist and so the second point here has been true for me as well. So mental health workers, we typically often don't appreciate that and actually in the past decade or so, this has been a focus that's been pointed out to us is to recognize people's strengths and to not make assumptions that because something negative occurred that people are going to automatically say, develop post-traumatic stress disorder, it's actually much more common in both children and adults for people to respond in a resilient manner. And we think of resilience often as something that is kind of innate to someone like you may say, oh yeah, he or she is just a very resilient person, but really only 20 to 30% of our resilience has to do with our genetic or biological makeup. It's certainly impacted some by our early upbringing and exposure, but by far resilience is mostly related to a series of skills that can be developed at any point in our lifetime. And some people have done a really good job at developing those skills. Others have some great opportunities to develop those skills, but the great news is that any of us can do that at any time. So I have a statistic on here, it's fairly old that 50 to 60% of the US population is exposed to traumatic stress. I recently actually just read another one that says really about 85% of adults in the US have been exposed to some type of traumatic event, but the bottom statistic remains the same that really only about five to 10% develop post-traumatic stress disorder. We as a country have been very sensitized to that diagnosis due to military conflicts and our armed forces coming back home, and that's certainly not to minimize that some individuals may be experiencing that, but because of those conversations, we often jump to the conclusion that any exposure to traumatic stress will automatically lead to some serious consequences or potentially a diagnosis, and that simply is just not true. Okay, so let's talk. Actually, you know what? I'm gonna go back a little bit and do, oh, let's stick with this. Okay, so consequences of critical events often include loss, and that by itself makes sense, right? But what we don't often anticipate is that those losses are really beyond what we would imagine at any given point in time. So for example, we may say, well, if a disaster occurred, so here I am in Indiana, if a tornado came through, then, and I lost my home, then I would be able to access these resources or I would be able to be able to stay in a hotel or I would be able to still go out to a restaurant. And oftentimes we just really don't anticipate all the different ways that a disaster may impact us. So I'm gonna go through some of those. The important thing here is that every day, we function with a level of denial, and it's a very healthy level of denial. So for example, we wouldn't get in our cars and drive if we were very focused every day in terms of what the risk is or what the statistics say in terms of our risk of being in an accident or being injured or being killed. So in actuality, we kind of put that out of our mind, right? Same thing when we get in an airplane. So we take those risks and we set those aside so that we can function on a day-to-day basis. And what happens in a disaster is that that is stripped away from us. That sense of safety and security that we base our everyday lives on drastically and abruptly gets stripped away from us, leaving us questioning a lot of things and feeling very vulnerable to a lot of things. So these critical losses that we may experience could include our loved ones, certainly material goods, so the things that we own, but also some real systemic or community type resources. So our employment, most often people don't think of the impact of a disaster is I may lose my job or my employer may no longer be functioning in that community. And again, that trust in the future. So I'm gonna show you some photos from Katrina to illustrate this point. So here's a photo of a church in the aftermath of Hurricane Katrina down in Gulfport and Paloxi. And so when you think about where do people go when they feel like they've had critical losses or they feel like they're lost or questioning where are those sources of support that we would traditionally and habitually turn to? And certainly our religious faith, our spiritual connection, that sense of community through our faith organizations is one of those that's frequently turned to and may no longer be there. When we were deployed to Paloxi, this was a comfort suites motel that was very close to us. And again, back to a previous comment, so your home is flooded or destroyed in a fire. And you are assuming that you'll have another place to stay. Well, as we know, when there is widespread flooding or devastation that that may not really be an option but we don't really think about that at the time. We also typically don't think about how we're gonna get around. We make assumptions that I'll be able to drive to Walmart or I will be able to get to the bank. I will be able to exit this area and go somewhere else. And the reality is that we may not have access to that transportation. And again, on a day-to-day basis, that's not something that we even consider. This was a Winn Dixie. When I was down in Mississippi, this was probably one of the biggest surprises that we as responders faced is that we got there and there was nothing. There was literally nothing. There was no access to getting material goods. There was no electricity. There were no cell phones. The water was contaminated. People had been faced with this. The people that reside there had been faced with that for some time. But that infrastructure was not there. And we base our day-to-day assumptions again on that. Another piece of infrastructure that I'd like to bring up that I learned about while I was there was banks. So I'm gonna encourage everyone on a day-to-day basis in preparation for the unexpected is to carry out what we call a flying 40. And a flying 40 is that you have some cash, $40, $20 or whatever that you keep in your car or a safe place or some amount of money in small bills. Because what we saw there, and I'm sure also impacted areas with widespread flooding was that banks were not open. There was no electricity. And when they did open, they had limited cash. And so we would see long lines of folks that were waiting for $20 because there was a certain amount of $20 bills that were gonna be passed out from the bank that day. So even when Walmart, which is traditionally the first store that does open after a disaster, I have to give them a lot of credit. They have quite a plan and procedure to getting goods into a disaster area. So even when things did open, people did not have money to be able to purchase things. And of course, one of the other great impacts in a flood or a hurricane are impact to rituals. So some of those are related to cemeteries. So one of the things that occurred there was cemeteries were flooded. Remains were swept away. They were mixed up. They were lost. And there's some real critical loss that's also felt with that. So let's talk a little bit more about some definitions. So we talked about resilience to begin with. And now let's talk about a crisis. So here you have one definition of a crisis. Events or situation perceived as intolerably difficult that exceed in individuals available resources and coping mechanisms. So what I wanna point out to you and why I have this slide on here and why I'm gonna differentiate this from trauma or disaster is a crisis is very unique. And we as human beings can tend to be a little judgmental sometimes. So sometimes we will meet people who will be experiencing something and will in our minds say to ourselves, I just don't understand why this is a crisis. Doesn't see it wouldn't be a crisis to me. So but it's also very important because as you are interacting with folks, you don't know what stress they brought to the table, what burdens they were already carrying before this particular event occurred. So for example, if I am already going through a divorce and maybe I'm losing custody of my child or I've lost my job or my home is in foreclosure and then this occurred, it's almost as if I'm already at simmer and it's not gonna take a lot of stress to bring me to boil. So a small event may be perceived as a crisis to me at that point in time just because I am so strapped for resources and feeling unable to cope with what's occurring at that time. So my message here is be compassionate but also be aware, where are you in terms of your stress level when you're asked to respond or deploy to an area? What resources do you have available to the table to bring to the table and how will that impact you? I also wanna talk about a disaster. So a disaster is a sudden calamitous event that seriously disrupts the functioning of a community or society and causes human material and economic or environmental losses that exceed the communities or society's ability to cope using its own resources. So that definition you can tell is much broader, much more impactful in terms of its impact but many of the same concepts here in that a community or a society's available resources are inadequate to cope and they feel overwhelmed. I also wanna briefly talk about a couple other terms. So we use a term survivor. We don't tend to use the term victim because that has a negative connotation and survivor is an individual who's been directly impacted by the event. So what I really wanna point out to you is that a responder, a responder who goes to that situation who participates, who is assisting in that situation by definition, even though they are there to help or support because they are there, they in essence are also a survivor. So a lot of the things that we talk about as we move forward, I want you to think about in terms of, okay, so there's individuals that were directly impacted when it occurred but by virtue of being there and participating and assisting, you also are subject to many of these same types of issues or concerns. And then there's trauma and trauma is not an event. Trauma is actually a process. And this is where the psychological first aid will come in later as we're talking about the impact of trauma. It is very unique, again, to the individual. It's the individual's perception of the event. It is not an objective definition. It resides actually in the nervous system and in the body. So the bottom portion of the slide, it happens when an event stuns like a bolt out of the blue overwhelms the individual and leaves us altered and disconnected from our bodies. And what that basically means is that the suddenness, the stripping away of that sense of safety and the resulting thinking and emotions that go along with that really impact us on a biological level. So we say trauma resides in the body as opposed to that it's a cognitive or emotional issue because we experience very strong emotions, very disconnected, sometimes disconcerting thinking, but doesn't necessarily seem very logical and rational to us as a result and is worrisome. And we'll talk a little bit about that. So we can't understand it, we can't make sense of it. And that is part of what psychological first aid does is to help us kind of categorize that and tuck that away. So let's a little talk a little bit about the psychological consequences of disaster. So let's talk first about psychological footprint. When a disaster or a broad spread event occurs, what we typically hear about are deaths, injuries and economic losses. What we don't typically hear about is psychological impact. And that may be because it's hard to define and because it does remain stigma related to that. 9-11 I think was a ground breaker in terms of allowing us to normalize people's reactions to abnormal situations, to be able to seek assistance or ask questions about what we're experiencing. Since that time, we really have come a long way. But it's usually responders that are more in tune with the psychological footprint. So this photo or this picture here is basically a representation of the impact. So if you look at it, the small blue circle is the medical footprint of that disaster. So that would be the injuries or that would be the deaths. And then you see how small that is compared to the psychological footprint. So let me give you an example of this, a couple of different examples. So let's say that a tornado comes through town and while school is in and knocks out cell towers, and schools are evacuated and people don't know where their children are. Where is it that they go? Where is it when we can't find someone we're concerned about? And there's been some devastation or some type of disaster event. Where do we go? We go to the hospital. And so we call this the psychological surge of a hospital. This is where people will show up at the hospital looking for other people will ask, asking to have their questions answered. They, to use the clinical term, maybe freaking out, right? It's not really a clinical term that put error quotes around that. But that's kind of what we say, right? I mean, people are very concerned. They can be panicking and they need attention. And it's not unreasonable for them to feel that way. However, their psychological or emotional responses oftentimes do get in the way when there is medical care that needs to be given or there is triage that's going on. So that's how a psychological footprint can immediately impact a situation and also tends to be much more longstanding. Here's another example. If you think about after 2001, excuse me, to the anthrax scare, and you think about how many individuals were afraid or didn't want to touch their mail or were their anxiety peaked related to exposure to anthrax. And then how many direct casualties were there actually were? There were 22 direct casualties related to anthrax, yet it totally shut down our postal service. And people were, again, very concerned, very freaked out, very reactive to any type of white powdery substance. And so that's a good example of medical to psychological ratio in terms of the impact. This is a picture from Haiti following the earthquake. And part of why this is here is to talk a little bit about infrastructure because, again, the impact is widespread and oftentimes not what we anticipate. So because some disasters are very widespread and certainly the flooding from the hurricanes, and if you think about the wildfires that have been occurring, that's a lot of territory, a lot of infrastructure, a lot of economy, and a lot of lives affected. And so we often think about, again, in that typical day-to-day living-your-life kind of thing, oh, yes, well, if this happened, I'll rebuild my home or I'll do this. And it may be that those resources aren't there. And we'll get into that a little bit about our expectations and how that impact us. But again, that sense of security, that sense of the way things should be, the way they ought to work, gets stripped away. Again, in Haiti, so this is trash. This is garbage that due to the devastation had been simply piled into the middle of the road and was rotting in the sun. And so you can imagine then the subsequent impact of that in terms of vermin, in terms of disease and exposure to that. Those umbrellas that you see in the background, we'll use this fancy feature right here. Back here, this is the food market that's going on. And so you can see that inability to put things to rest, to reset them, to get back to normal does not keep people from attempting to do that, but continues to impact their ability to do that. Another thing I saw in Haiti was some medical records that had been washed away and were piled up and there was actually a goat eating them at the time. So that didn't make us feel very good in terms of access to healthcare and records either. This is just a photo of one of the infamous tent cities that occurred. So again, not even resources to be able to reside safely and securely. And then this is water, just access to water. And we hear about this currently in Puerto Rico about those basic needs that still, months and months after the hurricane still have not been put back into place and what a devastating impact that must have for people who just thought, okay, as soon as this is over, I can rebuild my life. So let's talk about the phases of a disaster. This slide came out of some research by Zunin and Myers and subsequent research has really indicated that this is true for communities, agencies and individuals. When we went to Haiti, it was true for Haiti. So really there's not a cultural difference here as well. So let me walk you through this. And I also want you to think about when you respond, when you go to a disaster area, at what point are you arriving? Because I know from working through the Red Cross that and doing debriefings from when people come back that at what time period or what phase that they're responding, very much impacts the experience that they have because we all want to go help. And sometimes that's well received and sometimes we're faced with something else. So this is pre-disaster functioning. So this is basically a graph of functioning. So the community, the person, the agency is doing fairly well, fairly normal. This would be their normal state, right? And then we have a threat of disaster if that is possible. Sometimes it's not. And then we have the actual impact. And so now you have the low point of functioning, right? Then comes what we call as the heroic phase. And this is when people respond. This is when the country responds, when Salvation Army, Red Cross, there's fundraising, there's groups coming to assist, people are helping rebuild homes or clean out devastation. And there's some really heroic things. I think this is an adequately named phase in that there are some really heroic things. Neighbors are rescuing neighbors and helping out. And you really do see some of the best in people as they come together in those day-to-day details that typically take up our lives and stress us out or stripped away and we're refocused on things that we feel really matter. Now at some point there's a honeymoon, right? So it tops out and then we have this decrease in functioning. And you can see that this actually falls below the level of functioning here. So people are used to getting some help and feeling supported and encouraged and they start to believe that things are going to be all right and it will quickly return to quote normal. And then they discover that there's another disaster or groups have to get back to their regular lives or jobs and they leave, the focus is taken off and those resources that came in leave. And so people actually in communities feel this sense of disillusionment that really, really is devastating. So this is an emotional devastation here that occurs following a physical devastation. If you are responding during this time, you will likely be greeted as saviors helpful, very thankful, all right? Respond during this time. This is a time where people are really angry and sometimes they feel that the world or the community or the nation has left them behind or that they just don't care anymore. People tend to be more irritable and angry here. And then there's this really long extended and this says one to three years down here at the bottom and it really does extend beyond that where there's really a working through of grief and people over a very long term then begin reconstructing their lives and their communities and developing what we call a new normal, right? And this is punctuated by times of anniversary reactions or trigger events. So for example, another hurricane is a potential threat or some flooding, there's smaller flooding in another area and people have some real emotional reactions to that legitimately. So how are we directly impacted? Well, these are the people that typically are immediately impacted, right? So this, it makes sense that our family members our friends, our coworkers, people that are there with us are impacted, but it's kind of like that six degrees of separation, right? Because you can go further away and so your family members that don't live there may be very concerned. Also the exposure to the disaster is very telling here. So it gets back to that individual response. So the closer that a person is to that event then that exacerbates the impact of that. So if you are working in a community that you also live in that is impacted by a disaster and so this occurred to me in response we had some flooding in 2008 in Indiana and my community was affected. And so I was working 14 to 16 hours a day. I was meeting with friends and neighbors and people I love that had been impacted. There's a whole nother emotional toll that is present when you are working in your own community. Some of the mediating factors, things that might mitigate that psychological distress is that you may have some prior experience with a similar event. Maybe it's been a while since the event has occurred. Those things are mediating factors. Someone may have some individual perceptions about that event that causes them to maybe not be so impacted as they may have been. Okay, so everyone has is impacted by a disaster to some degree. Some of those reactions will cause enough distress to interfere with adaptive coping and recovery. And these are the broad categories related to that. Now I wanna take a moment to just talk about neuroscience which sounds complicated but it's basically we're impacted by it every day. And the more we understand about the way our brains work without getting into really big detail the easier it is for us to understand what's happening. So what happens unconsciously and unwillingly is that when we are faced by a threat or a perceived threat our attention is basically hijacked by that perceived threat and our bodies become prepared for fight, flight, or freeze, right? So we have a flood of endorphins and other cortisol and stress hormone preparing us for that reaction for whatever we need to do. But what our brains do is it, our brains narrow our attention to the perceived threat which makes sense in a evolutionary aspect. It's much safer to assume a threat is there and avoid it than to assume the threat is not there and then be a fall victim to that, right? So our natural reaction without us even realizing it is we will begin focusing on things that we find potential threats or potential stresses. And what that is doing is also excluding our brain is automatically excluding information that may mitigate that, that may be positive information that may be contradictory information. So all that, any that potential positive information gets filtered out and we oftentimes don't even take that in. We lose our ability to problem solve and to be creative because our brains have basically been hijacked to keep us safe. So I encourage you that when you are in an area where there is a disaster or even on a day-to-day basis be aware of the fact that what you hear on the news or on the radio or whatever it is that you're reading if we are convincing ourselves that we are always under threat that is always, that is always how we will respond. And that causes an ongoing stress. So let's talk a little bit about some of the some of the impact psychologically and behavior rolling. So irritability and anger, self-blame or blaming others isolating ourselves from other folks or withdrawing, feeling stunned or overwhelmed or helpless. Unexplained mood swings. So oftentimes people will feel like they have a surge of emotion that isn't necessarily rationally related to what it is that is going on at the moment. And that is a common reaction to such a situation. Certainly sadness and grief, problems concentrating, problems following simple instructions or remembering things are really common. And so we take great care to be able to be very clear in our communication. Relationship problems, marital discord comes up quite frequently, excuse me. People will have physical symptoms if they've had an illness or they have some type of physical disorder, it is common that that suddenly kind of reemerges or can get worse. People will can sometimes experience nightmares, fatigue, inability to sleep or want to sleep all the time, gastrointestinal problems, headaches and tremors. Sometimes people will feel that again, you're being flooded with cortisol. People will begin over time to engage sometimes in risk behaviors and that can include sexual behaviors, risk taking, drug and alcohol. And sometimes around about four months, sometimes we see an increase in suicide. Everyone has some reaction that does not mean that it is not outside the norm. So we say that these are normal reactions to an abnormal situation or it could be common reactions to an uncommon situation. So part of what we do is help people understand that. So psychological first aid is a way to help do that. So psychological first aid is a approach to working with people who have been impacted by a disaster or a traumatic event. And you may have heard in the past and still to some extent, critical incident stress debriefing, a lot of people were trained in that. That was originally designed for first responders and continues to be favored in that, in those communities and organizations. What the research did find is that sometimes critical incident stress debriefing, which is a very formal procedural approach to debriefing, did not over the long term reduce the onset of post-traumatic stress disorder and in some ways actually created more exposure to trauma, kind of secondary exposure to individuals who may not have been firsthand witnesses to some events. So psychological first aid was developed. It is currently endorsed by the World Health Organization and is also used by the Red Cross. And so it's, again, designed to reduce the initial distress caused by traumatic events and to foster short and long-term adaptive functioning. One of the nice things about psychological first aid, it is so adaptable. So you can adapt it to age groups, to developmental levels, to different cultures. You can use it in a group setting with families and communities. So it is very flexible in that sense. And it's also very flexible in the sense that you do not have to be highly trained to be able to do psychological first aid. It does require some training. And those links at the bottom of your screen are online trainings for free that you can do, complete that training. The psychological first aid was really designed for neighbors, for church members, for non-mental health folks to help each other and to help the people in the areas that they're responding to. So I mentioned this a minute ago that this is applicable to all these methods or groups. And then here are some of the core actions related to that. So this is basically it. There are eight core actions related to psychological first aid. And this is making contact and engaging. And I'll tell you right now that this is the hardest one. Number one is very much the hardest one. And I'll tell you a story. So I did train when we had the floods in Indiana that I referred to a little while ago. I was responsible for melding basically, collaborating between our mental health center and the Red Cross to respond. And so I did put together my mental health team. We did have a family service area where people can go kind of one stop if you've heard of that, where people can go and get their licenses. They can file their insurance claims. They can do a variety of different things, you know, file with FEMA, things like that. And I asked my mental health folks to go down there and do some psychological first aid. And then I would be there a little later in the morning. So when I got down there, they were down there and they had set up a table in the one stop. And they had a big sign that said mental health. And they were all behind the table. And everybody else was out and sitting in chairs or waiting in lines and doing whatever it is that they were doing waiting to get assistance. So I asked them what my staff, what are you doing back here? And they said, well, no one's coming up to talk to us. And I said, well, yes, because who would want to come up when you're already feeling overwhelmed and stressed out to the table that says mental health, where you are all hiding behind. And so this is a good example of why mental health folks sometimes don't make the best responders in terms of the psychological first aid. We're used to a fairly formalized approach. This is really about just going out and talking to people. So I sent them out to ask people if they wanted water, to sit next to somebody and just introduce themselves and have a conversation. And suddenly they were having those conversations. So it's really just about introducing yourself and asking somebody about, hey, what's going on? Helping provide safety and comfort. So what we're talking about is people can't talk to you. They can't process things if they don't feel safe in that moment. Do they need a drink of water? Do they need some food? Do they need to go to the bathroom? And if you could just stand in line for them, then they could attend to that. Just some of that basic kinds of stuff. And then down through the different steps. So just assisting in stabilization, helping identify who needs more assistance, who just needs somebody to talk to for a minute, helping gather appropriate and accurate information. So after disaster, when people are very stressed, they're very concerned, they're afraid. The sense of safety has been stripped away. They want information. And if there's no information, we as human beings tend to make up information if they're called rumors. And we're really good at it. And they rarely are very positive. So providing accurate information or searching that out is very helpful. Offering practical assistance, reconnecting people to their social supports, helping them remember how they've dealt with stressful situations in the past and linking them with anything else that they need. Those are basically the core actions of psychological first aid. So what does that mean for you? It means that you're gonna listen to someone that you are going to be with someone. We're in a society, we live in a society where people feel like if we're not doing something, if we don't have something to show for what we did, then it's not real. And what we forget is that one of the most powerful things that we can do is take time to give someone our attention and to just really listen to what they have to say. And it's not about what we wanna hear. It's about what is the story that they want to tell? And it's being respectful about that and listening. And we know that from the research that allowing people to tell their story in their own time, in their own way allows them to take those emotions and those thoughts that feel very disconnected in their body and in their experience and start to find a place for those that makes sense to them. And lots of times we won't see that or know that. Kids do this inherently, they're very natural at it. If a child experiences an event that stresses them out or that scares them, what you often hear is over and over and over again that same story over and over and actually parents and adults tend to get very frustrated with this, like drop it already or just move on to a different topic. But they naturally know that this is the way of processing. They play, they'll tell the story. I had kids in the waiting room after 9-11 that were building the towers and airplanes out of Legos and repeatedly crashing them. And the adults in the building were very upset with this until we reminded them that this is how kids tell their story, they do it through play. This is not therapy. This is simply being there with someone. And being there also means that we're sensitive to different aspects of diversity. So in Haiti, we were able to use psychological first aid because we were listening. We weren't telling. We were providing some information but we were letting people tell their story. And so because psychological first aid is so adaptable, it really does not, there's nothing about it that you're imposing your own beliefs, your own culture, your own religion onto someone else. So what do survivors and responders need? First is to feel safe and secure. Without that, I mean, we're just not gonna move forward to be able to have their basic needs met and then to be able to tell their story because that is their way of making sense. And again, trauma is a process and so is reacting and healing from trauma. It's a process, it is not an event. To reconnect with coping skills because again, that's the first thing that we forget in a crisis is how we've been successful in the past because we feel so overwhelmed in that moment. So asking people questions about ways that they've dealt with things in the past or things that they've overcome can sometimes help them regain that sense of purpose and strength or to remember, yeah, you know, you're right. I have handled some really incredible things in my life and I can get through this as well. So the guiding principles of psychological first aid. So we're creating an environment. Remember, we're not doing so much and being. So we're being calm. We're helping people stay safe or feel safe. We're connecting and human beings are, we are social. We are built socially. We learn socially. We experience socially. Self-efficacy, which is basically that sense of that I can and will do it. And that is built on past successes and reminders of those past successes, successes. We're empowering and helping people have hope. And, you know, I very early on, one of my professors said, if you do nothing else when you meet someone for the first time for a session, at the very least, help them have a sense of hope. Because if we do not have hope, there is no purpose in moving forward. You don't believe that it's going to get better. I mentioned earlier that some of the things that, some of the reactions that people have include some cognitive distortion, right? So really having memory impacted. And people get really concerned about this. It's like, you can have a comment and people and responders get very frustrated with this. So you may be working with someone who has been there for some time or maybe been directly impacted. And you have given, you know, you've had a conversation and you've agreed to do something or you have a set of steps that need to be done in order. It would be very common for someone to, that it's been impacted by a disaster to not be able to remember that or to not be able to follow multi-step instructions, to not remember acronyms. So we use as clear language as possible. We are very direct, short, short simple sentences, short instructions, patience, a lot of patience. I sat there with an individual and this was a therapist down in Gulfport and she was a therapist in the community. She was directly impacted and she was drinking. You know, at that point in time, Walmart had opened, the liquor stores had reopened and she was drinking about a bottle of wine a night. And so I, in my own mind, of course did this brilliant intervention and talked to her about that and reminded her about what she worked with with other people prior to the disaster about alcohol abuse and things like that. And so I thought we had this great conversation. And then at the end of it, she said, now tell me again why I shouldn't drink. I mean, so it was like that whole conversation didn't happen. I thought that we were having this great moment and I was being really effective. In reality, I missed being with her, okay? I missed, I was telling, I was doing, I wasn't listening. As human beings, we frequently don't want to engage because we don't know what to say. And then when we do engage and we feel uncomfortable, we have a tendency to say some things that aren't that great. And so this is just kind of a list of things that people commonly say that we suggest that you don't. Because it's, for the person on the receiving end, it can feel like a platitude, like you're not really validating how they feel. So it's really more about just listening. And it's perfectly okay to say, I just don't know what that would be like or I can't imagine what that was like for you. It's for telling someone that it will all be okay or I know exactly how you feel, well, we don't. And we don't know it's gonna be all okay. I don't know how that person feels because I'm not done. So this is just a little note in here to be careful of what we say. So let's talk a little bit about self-care for responders because as I noted earlier, as responders, you are also survivors and subject to all of those same reactions that we described before for someone who was actually directly impacted. So in addition, responders have some other things that we do to ourselves, which is that we sometimes have a little sense of grandiosity and it is really difficult to not help or to feel like it's okay to leave because it's not done or to take that moment for self-care because there's so much that needs to be done. And the bottom line is that if you choose to respond, please have done a self-evaluation. Are you in a position that you feel like you emotionally, physically, financially can do this? Because here's a good example. So here is some, I responded to 9-11 and I'm showing up to check in and here's a woman who just had a hip replacement and she is there to respond. She cannot carry her own baggage or luggage. She's very limited in her activities. We have spontaneous responders that show up. This happened in Hurricane Katrina. People showed up and said, oh, hey, so can we join your camp or do you have a place I can stay or do you guys have supplies? Be aware of where you are emotionally, physically, financially, like I said, because if you are unaware and you go, you may very well become a drain on those resources as opposed to an assistance. And I don't think anybody intends for that to happen. So have a plan, have identified resources, have these discussions and this awareness beforehand. Know what is going on. Don't, please don't avoid meetings or information that is going to be valuable to you. Be open to the fact that other people may notice that you're not firing on all cylinders for lack of a better term, right? You might be stressed out. You may be experiencing some of those reactions. Be open to the idea that someone may be able to give you feedback about that because as a responder in the middle of it, that and experiencing it, I'm not the best person to be objectively identifying what's going on with me, right? I'm in the middle of it. I need to be able to eat, drink, get my exercise. I need to maintain my connections. I need to be social, but I also need to take time for myself and the amounts of that vary per person. When I am looking for team members, I will always say that the first thing I'm looking for is flexibility because it will never go the way you expect. It is very, very likely that you want to get there and you want to help and you get there and you end up sitting on your hands for an extended period of time because that's what happens in disasters. The information is coming in. The decisions need to be made and the deployments need to be decided upon and sometimes we just have to wait for that and to be frustrated or angry is not helpful and actually is exacerbating that situation. When you come back, again, this is a time to take care of yourself. You want to participate in the debriefing because that is also helping you to be aware of what's going on. To put those things, those feelings, those emotions into a place that makes sense for you to recognize that while you were gone, other people's lives went on and they have feelings about that too. It's, we like to say to responders, give someone permission to give you feedback when you come back on how they see you functioning, how they see you doing. Do not make it a spouse or a partner because then there's other dynamics that get involved in that and make the agreement that they can come and tell you to give you feedback or express concern. You don't have to agree with it. You just have to consider it, all right? And you'll be amazed that you may be acting or being in a manner different than you think you are, but that honesty and that openness can help you get back to where you want to be. These are common stress reactions in responders. Again, you'll notice that these are some of the same reactions that occur in people that were directly impacted. So just to summarize, because we are at time basically, psychological first aid and again, the links there are at the bottom of the screen to do some online training. It doesn't take a very long time and actually it's very good training. You can, there's been yets and it's very interactive. I've done it, I've actually enjoyed it. So I highly encourage you to do that. This is a method to help people deal with the results of disasters and traumatic events. It's also a method of helping responders deal with the effects and aftermath of responding to those events. So I hope this was helpful to you and I highly encourage you to go online and explore that if you haven't already. Some of you may already be trained in psychological first aid. So I'm gonna say thank you and then I'm gonna turn it back to Jessica to ask any questions. Great, well thank you so much Jodi. It's just a presentation filled with really helpful information. And before we jump over to the questions, there's been a few that have come in so far. I realized I neglected at the beginning of the presentation to ask a poll question that we wanted to field with this group. And I know that many of you were involved with response to Hurricane Harvey, but just to kind of get some conversation going, if you all could just quickly answer this question if you've ever been involved with responding to a large scale disaster. So whether it be Harvey or any other storms prior to that or any other regions that you lived in where you had responded, just help put a get a sense of who had some of these first hand experiences. And for those of you who did, I encourage you to draw on those experiences and thinking about your own psychological state and if you have any questions relating to this program that you can share with the group. Okay, so Jodi, I'm sure you're seeing this too. It's about 50-50 with this group. Yeah, yeah, that's awesome. Which is really being kind of, yeah. So, well let's go ahead and turn over to the questions. So the first one we have is from Jennifer who was wondering how we as responders can help inspire hopefulness if we shouldn't say that things will get better. How do you walk that, Jodi? That's a great question, Jennifer, thanks for that. So I wanna make sure I answer this appropriately. So the difference is really in what we're saying or how we're saying it. So when we just say, oh, you know what? It'll all get better. That statement in and of itself is really not all that helpful because people aren't feeling like all of a sudden it's going to get better. And when we say that, and it oftentimes doesn't resonate with what their current experience is. So they kind of cast it aside, like you don't understand me. You don't understand what's going on. And so then we've lost that connection with them. On the other hand, I mean, I really like that question because we do wanna inspire hopefulness. So helping people understand that what they're doing and that what they're finding is a new normal. It is not what they experience up to this point that things are different, that validating of how people are feeling is really important because that's what really impacts that connection. Helping people remember things in the past that they've successfully overcome. Helping them understand that what they're experiencing is not a bad thing. It doesn't mean there's something wrong with them. It doesn't mean that they're going crazy because that's what people oftentimes think. It's like, if I'm experienced this, like I can't remember things. I can't follow simple directions. There's something really wrong with me. And if they don't talk about it, then they get more anxious about it. And then that makes it worse. So that sense of hopefulness can really come from normalizing those responses to helping them understand that, yes, of course, things are gonna be different. How have you been successful in the past? Who can you reconnect with? I can help you with that. Great. Wonderful answer. Yeah, Jennifer just chimed in saying thank you for that response, Judy. Then we had another question from Mary Beth who's wondering about, early on in your remarks you talked about the importance of keeping cash. And she's wondering where you keep that if anything could potentially be destroyed, your car, your house, your office. Right, so that's a really good question too. So there's two different answers to that. So one is I encourage everyone I know, all my friends and colleagues, to carry $40 in their cloth. And I can't tell you how many people have just said, you know, I left the house, I didn't have my wallet, I ran out of gas, and I'm so glad I had that $40. So just on a day-to-day basis, I just really encourage people to do that. What I typically do is I have a fireproof safe and I keep some money in that. Now you can't, you know, I can't guarantee, right, that I'll be able to recover it. People do a variety of different things. If you have time to prepare for a disaster and you know it's coming, you can always keep that on you in some manner, but at least have that resource so that you have access to some of that cash. It doesn't have to be a lot, but just in order to get by. Yeah, and Melissa had chimed in saying maybe you can get one of those travel money belts to wear underneath your clothes. So I think that might be a helpful idea, especially if you have some advanced notice just so that you know you have things like your cash, your IDs on hand, and it's harder to lose than anything else. So, oh, my Mary Beth just chimed in saying she does have a small safe at home with birth certificates, so. Right, exactly. That's a good thought. Great, so then there was also just a question about whether or not we could have the PowerPoint slides from Mary Beth as well. So I'll just tell you, Mary Beth, we will make the recording available for anyone who is interested in seeing the presentation again. And we'll also be sharing the links on a webpage too so that you can always access the recording and the links. Great, did anyone have any other questions related to the content? I will say that this is very helpful information for you all because although you may be responding to an event outside of your home area, for example, could be based in Austin and go help in Houston or vice versa across the state, it is really important to think about what might happen if the event is in your own home area and how dealing with a disaster on a personal level will affect your ability to respond. So just thinking about checking in on yourself and checking in on your fellow responders too and just keeping in mind some of the signs that Jodi has let you all know about will be the key for working effectively as a team. And also I just want to emphasize to, Jodi mentioned towards the end of her remarks about and selecting teams of flexibility is key and that's what we've really found in working with the National Heritage Responders Team and anyone else who's been involved with working in this field. Just recognizing that in yourself, it's not gonna be an ideal situation so you have to be able to be the most flexible version of yourself in order to effectively work in these kinds of environments. So thank you for bringing that point up Jodi. Okay, well I'm not seeing any other new questions coming in. So I'm just gonna go ahead and move this back over again the schedule of all of the upcoming presentations. A reminder that this will be available on the website that I shared with you all previously that has all of the information about the self-study portion of your training which I can share in the chat window again momentarily. But our next program is gonna be on March 7th. We had that up in the air when I first emailed about the series. So it has been scheduled for the 7th. So just in a few short weeks, again on a broader topic of health and safety issues in a disaster situation. So keep an eye out for the invitation for that program. And then I also wanted to share with you all the risk of blocking the upcoming schedule. Let's see if we can put it up here. Just a quick link to a survey for this webinar. It's very helpful for us to have information about your feedback on this program. So it should take less than five minutes if you're able to just again use this box as the web links box below. So just click on the text in blue and click on browse to and that should take you to the survey. So Jodi, is there any other closing remarks that you wanted to make before we wrap up the session? Just to thank you. I really, I really enjoy talking about this topic and I love that people are so interested in responding and understanding the psychological dynamics of that. And just the last reminder that to take care of yourself, that self-care is really important here because if you're going to be an asset to your team and able to really assist as well as come back successfully and reintegrate then through the challenges of getting back to your normal life, then you really do need to be aware of what's going on with you and taking care of yourself. Wonderful. Well, thank you so much Jodi. We're all so grateful for taking the time to share your wisdom with us all. So. Thank you. And thanks to everyone who joined us here today and I will be in touch with you all soon. Thanks again.