Members of the Metro CISM team provided 23 local people this week with two days of training in how to help first responders cope with trauma they experience in the line of duty.

CISM stands for Critical Incident Stress Management. Participants included mental health workers, EMS and fire personnel and a dispatcher.

“We’re the helpers to help the helpers,” said co-instructor Kathy Abram, a coordinator with Metro CISM and a retired sheriff’s sergeant from the Twin Cities area.

The other trainer was Sue Johnston, a licensed social worker who does therapy with first responders and refugee communities.

“First responders are used to being the helpers,” Abram explained. “We go out and deal with all these awful things, and we’re fine.”

In most cases, she said, first responders really are fine. “But there are the occasional events that are more traumatic,” said Abram. “Really bad incidents, the ones where you’re dealing with children that are injured or die; the one where it’s a co-worker who dies … or, especially in more rural areas, you might be going to a call where it’s someone you know or a relative of yours.”

CISM developed in the 1980s, but it took a while to gather steam, Abram said. Among first responders, especially at the upper echelons, there was an attitude of “Our people are fine; they don’t need this.”

What changed? “I think it’s the realization that, no, you’re not always really fine,” said Abram. “We all tend to have this Plexiglass shield that we put up, and that allows us to do our jobs. But then you get these events that break through that Plexiglass, and that hurts. So, this is a way of helping first responders stay healthy, by being able to talk about that event, and help them understand some of the reactions they might be having from it.”

Crucial 24 to 72 hours

Monday and Tuesday in the community room at Northwoods Bank, trainees worked toward certification in the Mitchell Model of CISM, which Abram explained as “how to step in immediately after an incident and help people involved, also through the next 24 to 72 hours, and to help them understand their reactions” to traumatic events.

People naturally react to horrific experiences in a variety of ways, including, Abram said, tunnel vision, anxiety, anger, lost sleep and recurring thoughts about what happened.

“They go home, and their brain kind of sleeps on it – or doesn’t sleep,” she said. “We talk a lot about learning the life story you take out of this event, the one piece that will become a good piece of who you are.”

Abram compared the brain to a file cabinet. Traumas are hard to assimilate because the brain doesn’t have a big file of similar experiences. So, when you can’t stop thinking about an unpleasant event, she suggested, just go with it.

“Your brain’s trying to find a way to put it in there,” she said, “and in the future it might pull it out when your on the way to another call and go, ‘Does this help?’ That might help you be a better first responder.”

Hoping to start a local team

Instrumental in putting together the training was Pastor Joshua Hawn, who serves as a chaplain with the Hubbard County Sheriff’s Office.

“I participated in five or six (CISM) debriefings that they’ve had,” he said, noting that they had to call in a debriefer because no one in the area was trained in the method. “I thought it would be really great to have some people from our own area trained to do this.”

He added that he wanted to be able to do it, too. “Now I have the training to lead a debriefing and help where I can.”

Hawn said this week’s training was a first step toward setting up a CISM team in the area, possibly in combination with other groups in northwestern Minnesota.

Connecting with peers

Hawn said the reason they reached out to mental health, fire and EMS personnel was so that “they can speak to their peers.”

“I will be watching out for our department after calls,” said trainee Dwayne Mattson, a firefighter and training officer with Nevis Fire and Rescue. “Until we get a full team established, we’re going to work with our own departments.”

He agreed on the importance of the peer connection.

“Not everyone is going to attach to the chaplain,” said Mattson, “but they’re going to be able to respond to someone who works in the same field.”

Firefighters, for example, will accept counseling from someone like him, he said, “because they know I’ve seen the same things that they go through.”

Mattson said interest in CISM training evolved out of several critical incidents (CIs) during the past couple years.

“It’s just time,” he said. “Even without a team, it’s a good thing to have so we can watch out for each other. In the industries that we work, we’re going to have a lot of CIs. That’s just part of our job. So, we’re able to watch out for each other that way.”

‘Awesomely necessary’

Metro CISM’s services are free, Abram said, supported by grants from fire relief associations, civic organizations and private donors.

“It’s a very cost-effective organization,” she said. “Everybody’s a volunteer. It’s mostly just paging equipment and some printing, to put up flyers.”

Abram called it “awesomely necessary that first responders understand that things that happen to them don’t have to be career enders, that you don’t have to get PTSD. The stress itself is very normal, but it doesn’t have to go to the point where you need therapy.”

Instead, she said, early intervention, like the Mitchell Model, can “stop that from happening, and normalize (the experience) for people.”

This need is evident, she said. “I get these phone calls from northwestern Minnesota, saying ‘We need help,’ and it feels awful to tell people, ‘There’s nobody up there. Sorry, I don’t know what to tell you.’”

The community’s response is a good sign, Abram said. “I think the amount of people that have shown up shows just how wonderful the awareness is, and how accepted (CISM) is now. To get this many people trained is going to be super.”