July 30, 2024 • 40 mins
Season 6 - Episode 134
The CopDoc Podcast Summary: Increasing Resilience in First Responders
Guest: Dr. Stephanie Conn, police psychologist and former police officer
Key Topics:
- Dr. Conn's Journey: The daughter of a police officer, Dr. Conn's personal experiences as a dispatcher and police officer, including the tragic deaths of two colleagues, led her to pursue a career in psychology to better support first responders.
- The Need for Specialized Support: Dr. Conn highlights the unique challenges faced by first responders and emphasizes the importance of culturally competent mental health care from clinicians who understand the specific stressors of the profession.
- Check-Ups from the Neck Up: The concept of regular mental health check-ups for first responders is discussed as a way to normalize seeking help and address the cumulative effects of stress before reaching a crisis point.
- Confidentiality and Trust: Dr. Conn emphasizes the importance of confidentiality in building trust with first responders and outlines the steps she takes to ensure their information remains private, especially in sensitive situations like worker's compensation cases.
- The Cumulative Effect of Trauma: The podcast delves into the "death by a thousand cuts" phenomenon, where the accumulation of traumatic experiences over time can lead to significant mental health struggles.
- EMDR as a Treatment Tool: Dr. Conn explains EMDR (Eye Movement Desensitization and Reprocessing) therapy and its effectiveness in helping first responders process and heal from trauma.
- Overcoming the Stigma: The conversation addresses the stigma associated with seeking mental health care in first responder professions and the need for education and open dialogue to overcome these barriers.
- The Future of Wellness in Policing: The podcast concludes with a discussion on the growing emphasis on wellness programs within law enforcement agencies and the importance of ensuring these programs are evidence-based and tailored to the specific needs of first responders.
Overall: This episode of The CopDoc Podcast provides valuable insights into the mental health challenges faced by first responders and offers practical strategies for building resilience and seeking support. The conversation is candid, informative, and highlights the critical role of mental health professionals like Dr. Conn in supporting the well-being of those who protect and serve our communities.
Contact us: copdoc.podcast@gmail.com
Website: www.copdocpodcast.com
If you'd like to arrange for facilitated training, or consulting, or talk about steps you might take to improve your leadership and help in your quest for promotion, contact Steve at stephen.morreale@gmail.com
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:02):
Welcome to the CopDoc podcast.
This podcast explores policeleadership issues and innovative
ideas.
The CopDoc shares thoughts andideas as he talks with leaders
in policing communities,academia and other government
agencies.
And now please join Dr SteveMorreale and industry thought
(00:24):
leaders as they share theirinsights and experience on the
CopDoc podcast.
Speaker 2 (00:32):
Hello again everybody .
Steve Morreale coming to youhere in Boston and we are on a
bi-coastal conversation.
I have Stephanie Kahn, drStephanie Kahn.
She is in Beaverton Oregontoday, so hello there.
Speaker 3 (00:43):
Hi, how are you?
Speaker 2 (00:44):
I am fine, thank you.
I found you on LinkedIn.
It seems to be the way to do it, and one of the ways I found is
that you police officer.
Now you're a policepsychologist.
You've written a book onresiliency and it really drew my
attention, especially,stephanie.
With what's going on in ourworld and the threats that are
pushed upon police officers thethings you see, the things you
can't unsee there are certainlya number of stressors.
(01:05):
So I wanted to get you on andthank you for coming.
I wanted to ask you to tell theaudience about how you got
involved in this, how you camefrom policing to psychiatry?
Speaker 3 (01:18):
Yeah Well, psychology , yeah.
I was the daughter of a policeofficer.
My dad was an officer foralmost 40 years, so I grew up in
a household seeing the impactthat first responder work had on
the first responder and theirfamily members.
Then I became a dispatcher,call taker, did that for three
years, then became an officer,did that for nine.
And when I was an officer and Iwas an officer for Fort Worth
police in Texas one of mycoworkers was shot and killed in
(01:40):
the line of duty and I became apeer supporter.
And because I wanted to be apeer supporter and another
coworker of mine got killed.
Speaker 2 (01:48):
Before we continue in our conversation, we're talking
with Dr Stephanie Kahn.
She is in Beaverton Oregonright now and a police
psychologist.
My mistake about psychiatrist.
I'm sorry about that, but butyou were.
You were talking about twohorrible things that happened in
your life Offic officers whohave been shot and killed.
That's where you were, so talkabout that in Fort Worth.
Speaker 3 (02:08):
So the second officer that was killed in the line of
duty was actually hit by a drunkdriver and tracked and burned
alive in his car.
And so I was a peer supportteam member at the time and
between one officer being killedand then a year later another
one being killed, we had had achanging of the guard from a
police psychologist to a citypsychologist.
So we had someone that actuallyunderstood policing to someone
(02:28):
that understood psychology andcounseling, certainly, but
didn't have any specializedtraining in working with first
responders.
And so when I was supportingpeople as a peer supporter, they
were wanting to have someonethat actually understood them
and the profession and theunique challenges first
responders face, and I couldn'tfind anyone when I looked out
there to try to see who to referthem to, and I had people
(02:48):
wanting very specific help totheir work and not just wanting
to talk to anyone.
So I made the very difficult butwell considered choice of
stepping out of policing to getmy counseling doctorate so that
I could come back and help mybrothers and sisters, not just
in policing but in other firstresponder professions, because I
felt like I had the culturalcompetency to do it.
(03:09):
I dispatcher as a call taker.
As a police officer, you knowyou were engaged to a
firefighter.
You're married to anotherpolice officer, so it gave
(03:30):
people the confidence to see meand so I never got to return to
policing because my practice asa clinician has been so busy
since I opened it.
Speaker 2 (03:39):
Why do you think that is.
Let's just talk about that fora moment.
I understand you know, havingbeen in the business for 30
years the importance of if I'mgoing to take my clothes off.
I want the person on the otherend to understand what I go
through, to understand thestressors, to understand the
difficulties that come from theorganization itself sometimes,
because sometimes we eat our ownand how important that is.
(04:01):
I'll say this One of the thingsI'm beginning to talk about and
hear about across the country isthe move towards a concept
called a checkup from the neckup, in other words, a required
sit down with a psychologist ora psychiatrist on a regular
basis, which sort of melts awaythat negative feeling that so
many people have about mentalhealth counseling.
(04:22):
So talk about that.
Talk about that.
Speaker 3 (04:24):
Yeah, I mean there's two, two pieces there is.
One is you know, if you'regoing to psychologically take
your clothes off, so to speak,you don't want to have to be
explaining your profession toother people.
You need someone to give yousomething you know don't need to
be giving to someone else.
And if you're having to educateother people on your job or
explain why you do what you door how the organization does
whatever it does, then it's more.
(04:44):
It takes more away from thefirst responder than it gives
them, at least initially, and soyou want someone that is
already up to speed or fairly upto speed, so they can kind of
start from where you are andmove forward and help you move
through things.
The checkup from the neck up Ithink there's a lot of value in
that and I do that for a lot ofagencies I work with because it
(05:05):
takes away that threshold whereI got to be a certain level of
screwed up I got to be hurtingin a bad way before I ask
anybody to check in with me, butrather make it more.
Hey, we don't wait till there'ssmoke bellowing out of the hood
of the car before we check theoil or check the other fluid
levels or these kinds of things.
We should probably get ahead ofit and do something, because
(05:28):
it's easier to do that with acar and do that with a person
than it is.
Try to deal with it once itbecomes damaged.
Speaker 2 (05:34):
So let's talk about that if you don't mind.
Confidentiality, I know, isimportant, but when you do a
checkup from the neck up and youwalk into the organization
presumably in many organizationsthe first time that's happened
how much time do you have tospend to talk about why you're
doing it in the first place,what you're trying to allow that
person male or female firstresponder to talk about, to sort
(05:55):
of vent and to purge?
You know, my sense is you and Ispoke about in the beginning.
Here we are talking on 9-12 and9-11, it hits me because I
brought a team down to New York.
I did not suffer half of theproblems that so many of my
colleagues did there, but beingthere unto itself was something
I can never erase.
What I saw, the pain and thesuffering, the death and such.
(06:16):
But I wonder how much time youhave to spend to explain to
somebody that I'm here for you.
We're here to help you.
The cumulative effect of stresscan burn somebody out, so talk
about that.
Speaker 3 (06:27):
Yeah, and I'm pretty lucky Well, I say lucky it's by
design and the agencies that Iwork with as I try to introduce
myself or others introduce me.
Because I work so closely withpeer support team members.
They will introduce me to theirpeers as someone that they
trust, someone that has been oneof them at some point, and so
it takes a lot of the work awayfrom me of building that rapport
(06:50):
, because I've built thatrapport with the peer supporters
.
Or I will go to the roll calland sit beside the sergeant at
the roll call at 11 o'clock atnight which is not banker's
hours or clinician hours, if youwill, and that says something.
I'll come out to the station at11 o'clock at night or six in
the morning, or sometimes bothon the same day, which is
horrible and just introducemyself and just shoot the breeze
(07:13):
with them and that allows themto feel a bit more of a trust
that this is not the normalsituation where you just go see
a clinician and then I spend alot of time talking about
confidentiality, claiming that Idon't keep notes on these
wellness checks.
I don't write notes.
I don't write notes afterwardsIf I bill the agency, and I do,
(07:33):
and I think 100% of the cases ofthese wellness checks depending
on the agency contractsometimes they don't even know
who had the wellness appointmentor in cases where they're
incentivized where they get paid, then I'll be I have to let
their employer know so they canget their incentives paid for it
.
But there's nothing else sharedwith them and I think some of
(07:54):
that takes away some of the fearthat there's going to be
something recorded that's goingto get them at some point or
cost them a promotion or someother kind of scenario.
And so I think there's a bit ofwork put in through the
relationships I build, throughthe transparency of the process,
not acting in manners that areconsistent with their
expectations, which is an oldhostage negotiation trick, if
you will, or tactic.
It's not a trick of justshowing up at odd times to be
(08:17):
there for people or doing ridealong part of how all that works
, that breaks down the barriers.
Speaker 2 (08:21):
I can see that and I recognize why that would be of
great value.
So you've written a book.
I see it behind you IncreasingResilience in Police and
Emergency Personnel Resiliency.
What's that all about?
Speaker 3 (08:33):
Yeah, and that's.
I wrote a mental health columnfor a police magazine for about
three and a half years.
So every month I'd write like apage on sleep or improving
communications or dealing withsecondary traumatic stress, that
kind of business.
And I had many people readersfrom that magazine send me
emails saying, hey, thisresonated with me, that
resonated with me.
You should put this alltogether in one place.
And then my research for mymaster's and my doctorate was
(08:55):
about what helped people dealwith their exposure to trauma,
what helped people maintain alife outside of their work.
And so I thought and then mywork as a peer supporter and
working with peer supporters Ithought I really should put this
all together and treatresilience, as I see it, as an
officer safety tool.
Because when you go to a callwhether you're a police officer,
firefighter, but let's just usethe police example when you go
(09:18):
to a call, you're assessing whatyour risk factors are, what
kind of assists you need, howyou need to respond to things,
because you're constantlyassessing what the threats are
and making adjustments to yourresponse based upon that, but
you're also assessing yourprotective factors.
Do I have an assist with me?
Do I have a perimeter?
Do I have a dog?
What do I have?
And making moment-to-momentdecisions.
(09:38):
If we treat our resilience in asimilar fashion and saying
what's working for me, what'snot working for me, okay, I'm
not exercising, I'm not reallyconnecting with my significant
others, I need to shore that up.
If we treat it like that, wetend to be safer psychologically
, which is our resilience, if weare remaining aware of what's
working and what's not workingfor us in our life just like we
(10:06):
would on a call.
Speaker 2 (10:06):
As you're talking new clients I suppose the fact that
you have a relationship with anorganization in many cases and
you know, the big piece inpolicing is a vouch.
When you get a vouch, you'reokay.
How is this, stephanie?
She's okay, you can trust her,she understands, she knows.
I think in a lot of ways, copslove to cut right to the chase.
I'm not looking for flowerystuff, just here's the story.
You want to hear it?
This is it.
I don't know how it's affectingme, but I'll tell you what I'm
(10:27):
feeling.
Speaker 1 (10:27):
And I'm sure.
Speaker 2 (10:28):
I mean.
Your job is eliciting feelingsand thoughts through questions
in a lot of ways, and so talk methrough that.
Somebody comes to you, not justfor a checkup, but for some
person who might be in crisis,it's me today.
How do we start thatconversation?
And the reason I'm doing thisI'm asking you this, stephanie
is because so many potentiallylisteners have balked at talking
(10:50):
to somebody, and so I'm tryingto, through you, to have people
understand that this is not abad thing, properly executed.
Speaker 3 (10:57):
Yeah, I mean, that's the thing is that again and I
try to draw parallels between mywork as a clinician to my work
as a police officer, in that ifthey come in and say, hey look,
this is what I'm not sleeping,I'm irritable my spouse or
significant other says that I'mwithdrawn or I'm being a jerk or
what have you, then really mywork as an assist to them is to
(11:19):
say OK, so how did this start?
You know what happened here andhow do we figure out what you
do about it?
And to fill in the blanks onthe information they might not
have as to why they would behaving, why their brain keeps
sending them images of that deadkid, they know that the event
is over.
Why is their brain sending themreminders or physical anxiety,
that kind of stuff?
So my work is really trying tohelp them understand why certain
(11:43):
things are happening and whatto do about it and to take the
weakness element out of it, butreally to recognize that it
takes pardon my French a lot offucking strength to face things
that you'd rather just shovedown.
It takes a lot, you know, and Ioftentimes say there is no
courage without fear, and ittakes a lot of courage to do
(12:05):
what you do and to push throughit and it's okay.
That's kind of how it wouldstart out is just trying to
figure out what's going on andwhat do we do about it and why
is it happening.
And help them to understand whyit's happening, because I think
a lot of times the answer, thedefault answer, is it's
happening because I'm weak, it'shappening because I'm broken,
it's happening becausesomething's wrong and I can't
(12:28):
handle it anymore, versus reallyrecognizing that a lot of the
symptoms people have is survivalbrain kicking in and trying to
help them and send them allthese signs and symptoms so they
will address it.
Just like a headache tells yousomething's going on in there,
you need to address it.
Some of these quote unquotepsychological symptoms are doing
the same thing.
Speaker 2 (12:47):
That's an interesting perspective that I've not often
heard.
So thank you for sharing that,and I'm sure the term you used
earlier was a clinical term.
I'm sure you learned it atschool or in policing or
whatever it was.
I appreciate the honesty and Ithink that's so important
because part of what I think itis look, police officers,
firefighters, emts are calledinto situations at the worst of
(13:09):
time and, as I said before, sooften you don't have a choice.
But once you see it, it's veryhard to unsee and I think the
strength in us and in some casesthis is a guy oriented piece,
not that it couldn't be forwomen, but the guy sometimes
will think look, this is my job,I have to do it, suck it up,
buttercup, whatever that is.
But let's talk about thecumulative effect that we start
(13:31):
hearing a lot.
Is there such a thing?
It's almost like you're goingto die from a thousand paper
cuts, the old adage.
Is that real?
Okay, so talk about that.
Speaker 3 (13:49):
Yeah, and it has so many names, and Ellen Kirshner
referred to it as death by athousand cut, and it's also
referred to as the pyramidingeffect, where it's just like at
the bottom of the pyramid.
You know, year one, here's allthese traumas kind of building
up at the bottom of the pyramid,and then year two, five, eight,
10, 25.
And I have some people that arequite surprised that when
something forms the tip top oftheir pyramid in year 20 or 15
or what have you, that it lightsup everything that occurred
(14:09):
underneath and they're like whyam I losing my shiz over this
call that I handled 10 years ago?
Why am I seeing the images ofthis person that had that or
whatever now?
And I said that's because it'sbasically broken open some of
those trauma membranes andbecause it's unfinished business
, right, and it's almost likethat's why we have this
cumulative and we know that thecumulative is the real deal
(14:32):
because it's talked about in ourdiagnostic manual is this
chronic exposure to thesuffering of other people, and
it is more often the case ofpost-traumatic stress or
post-traumatic stress disorderthan that singular event, and
they call it the dose effect.
The greater the dose, thegreater the effect, and so it's
not uncommon for me to see that.
In fact, it's rare that I see asingular event be someone's
(14:54):
reason for coming in, unlessyou're mandated, you know, for
like a critical incident or whathave you.
And so I say, okay, we're goingto go to that first one,
because I do trauma treatment,so I do EMDR.
We're going to go to that firstone and we're going to work on
that with EMDR, and maybe someof the other ones are going to
come up, and that's all right,we're just going to put those on
a shelf, we'll come back tothose and we're going to
systematically knock them out,which sounds really absolute.
(15:16):
But EMDR is pretty impressive.
It's pretty good at taking outthe reminders of specific
traumas, can you?
Speaker 2 (15:22):
talk about that for a moment.
I've heard that a number oftimes, but never from a
clinician.
What does that mean?
Emdr.
Speaker 3 (15:28):
Yeah, that's a lot of psychobabble, it's a lot of
mouthfuls.
So EM stands for eye movement.
So when we go to sleep at nightwe have REM sleep.
If we're lucky, we have to getsome decent REM sleep.
Rapid eye movement, and sothat's when our eyes are moving
back and forth spontaneously andthey're processing the drama
and the trauma of the day.
What happens is we don't alwaysget good sleep when we've had
really significant trauma orwe've got shift work or other
(15:51):
kinds of things going on in ourlife, and so our brain doesn't
get to continue with its processof rapid eye movement, sleep,
so processing drama and trauma.
So stuff gets stuck in ourbrain in an incomplete,
unfinished state.
And so what we do when you'reawake as an EMDR clinician is, I
say okay, steve, I want you tofocus on.
What is the image of the thingthat's most disturbing?
(16:12):
Okay, name it.
All right, that's it.
What's the negative belief youhave about yourself?
And sometimes it, you know, Ididn't do well enough or I'm
weak because of this response,and other times I'm weak because
I continue to have this effect.
So sometimes it's anoperational critique and
sometimes it's a psychologicalone.
All right.
So there's the image, there'sthe negative belief.
What physical sensations do younotice?
You know I've got this pain inmy chest, knot in my throat,
(16:33):
tightness in my jaw, pit in mystomach.
Okay, usually in the midline.
And then what emotions do younotice?
Okay, anger, frustration, blah,blah, blah.
Okay.
So then I just say I don't wantyou to focus on all of those
pieces.
I'm basically taking all thepieces of the trauma and I'm
having them do the eye movementback and forth while they and
just, let us just let your mindgo wherever it goes and I can do
this in person or virtual, itdoesn't, it doesn't make.
(16:58):
When you're doing the eyemovements, then it helps the
brain process the trauma and Dthe EMDR, the D is desensitizes
you to it, so you're no longertraumatized by it, it doesn't
have the same physical effectthat it has before.
And then, as you reprocess it,it becomes something that
becomes more in the past, ratherthan feeling very present for
(17:19):
you and any negative belief youhad about yourself, about being
weak or not having donesomething properly on an
operational level, you reprocessit as I did the best I could,
or you know I can be better now,or I can heal from this or
something else that is moreadaptive and it is so incredibly
effective and so fast comparedto, say, talk therapy, because
(17:40):
it goes into the subcorticalregions of the brain where the
trauma is stored.
But it's become the treatment ofchoice for first responders and
people in the military.
There's actually books on it,emdr for first responders that
outlines the protocols forspecifically working with it.
I've been doing this for 11years, day after day, and have.
Yet, whether you believe itworks or you don't believe it
works, your brain knows that itworks and so it works.
Speaker 2 (18:03):
I appreciate the lesson because that's pretty
important.
I've heard some people who havehad some very good experiences
in that, so thank you forsharing.
And now I know what EMDR means,and so do the listeners.
And as you were talking, atrauma cap it's the first time
I'd heard that, because I speakin terms of boxes that we put
little things in lock boxes,which is probably the same thing
and sometimes, at the strangesttimes, these little things leak
(18:27):
.
Sometimes it's fatal, sometimesit is a suicide, sometimes it
is a murder, it's a rape,whatever it might be, sometimes
it's 9-11.
And so it seems to me I meanjust from my own experience and
your own experience for thelisteners that I think coming to
the realization that these dohave impact on you, whether
you'd like them to or not.
(18:49):
They have a long lasting impactand they'll show up sometimes
when you least expect it.
So what am I saying as I'mtalking?
What are you hearing as I'msaying that?
How would you explain that tosomebody coming to you?
Who would say that to you?
Speaker 3 (19:05):
Yeah, I would say there's some level of that.
That makes sense because and weknow this from looking at what
happens in retirement issometimes we're so busy being
outwardly focused, handling that, call the situation, that
family demand, whatever thatwhen you shove stuff down, there
is no space for it to come backup.
But then other times, whenyou're off on admin leave
because you've been involved ina shooting, you're off on injury
leave or that kind of stuff, italmost like you create an
opening for these things to beable to pop up and or something
(19:28):
will activate it, like a date,an anniversary of something or a
memory of something.
And so then it pops open andyou're like, oh crap, what is
that?
Why is that coming up now?
And so, again, we know that thathappens and so I don't want
people to be freaked out by itto think, okay, this must mean
I'm coming unraveled, because wehave so many ways of saying you
(19:49):
know I'm losing it, or thisbroke down or that kind of stuff
, and it's like you didn't breakdown, you didn't come unraveled
.
Trauma popped up either becauseit had the opportunity to, or
something popped open.
Popped open that, yeah, thatmember in it.
People hate the word triggerbecause they're like oh,
everybody's triggered abouteverything and needs a
tri-closet.
No there's actually yeah,there's validity to these things
(20:10):
being activated and so, insteadof being mad that it happened
or being alarmed or making itworst case scenario, okay, so
that just needs, that needs tobe dealt with.
That is something that you needto deal with.
It's almost like if, been sobusy doing something else, you
didn't notice your elbow hurtand then finally you're not busy
doing something.
You're like, oh gosh, my elbowdoes actually hurt.
(20:31):
It's been there all along,you've maybe just not, it's not
come to the surface until it didand then deal with it.
I don't mean to downplay howhard it is to deal with it.
I just even remember my owntraumas as an officer.
You know an auto ped of apregnant, visibly like seven,
eight month pregnant, woman andshe's.
You know I wasn't evendispatched to it, I just rode up
on it one week on my own, justbarely out of training.
(20:54):
And I just ride up and there'sthis woman dying on the ground
and her 11 month old wasold wasa few feet away, been thrown
from the stroller she waspushing when she was hit and her
mom screaming the most horrible, blood-curdling screams.
I had images of that, right, Ihad.
I'm not saying meaning todownplay the horrificness of.
That's a word, but there'sremedies, there's ways to
(21:14):
address this if you have someonethat's trained in trauma.
Speaker 2 (21:17):
So we're talking to Stephanie Kahn.
She is a police psychologistand she's out in Oregon former
police officer and I apologizeif the audio isn't perfect.
My board is not working 100percent, so we're using this
through the technical drills ofcell phones.
So all of the players that youengage with that, I suppose,
would be clients at this point,patients, whether it's fire,
(21:39):
police or EMS how do we overcome, how do agencies overcome, the
stigma of mental healthcounseling?
Because I think for so many thefear is, if I admit, I'm going
to lose my gun, I could lose myjob because of it, and it seems
to me that we need to do a muchbetter job of overcoming that
stigma, helping people andletting them back on track.
(21:59):
So I'm sure you're playing arole in that, but what's your
thought on that as a formerofficer?
Speaker 3 (22:04):
Yeah, and I think again it comes down to the
relationships I have with thepeer support teams that I'm
attached to, that I see on aquarterly basis and talk to on a
regular basis, you know,because they can text me anytime
or call me anytime.
Obviously, when I'm withclients my phones are silent but
and so it's the relationship Ihave with them that they in turn
are able to share with the peerthat's struggling.
But then it's also the ridealong's the myths about
(22:26):
confidentiality and the thingsthat would cause a first
responder to fear, because a lotof them think that because of
the confidential nature of whatit is we do, they think other
people aren't getting help orthat other people that are.
(22:47):
I'm like gosh, if I could justbreak confidentiality and tell
you five of your peers were in abad way and came to see me and
maybe were even suicidal at somepoint or abusing substances or
whatever, and got help and neverlost their job.
But the secrecy of that becauseof confidentiality is a bit of
(23:08):
a disservice to the stigma oflike.
I remember there was one agencyI was at and they were just like
, oh, this person really neededhelp and blah, blah, blah and no
, but nothing happens.
And for these people orwhatever.
And I was at and they were justlike, oh, this person really
needed help, and blah, blah,blah and no, but nothing happens
for these people or whatever.
And I was just sitting therethinking, yeah, actually they
did get help and I happened toknow what happened and they were
taken to the hospital andthrough the back doors and
received support and then whenthey were released they came to
(23:30):
me.
So that's the thing is thesecrecy of all this doesn't help
.
It's an interesting thingbecause there are some first
responders who are trying totake an active role in debunking
those myths by saying, hey, Igot help, I didn't lose my job,
I got help.
It not only did I not lose myjob, but it actually made me
better at my job and I promotedand it saved my marriage.
And so some first respondersare taking an active role in
(23:52):
that.
And then I remember one of thelast ride-alongs I did before
COVID.
I got to sit with officers atdinner on the ride-along and
answer questions they had aboutconfidentiality, because they
thought that sessions wererecorded and stuff was reported
back to their agency.
There's just a lot ofmisinformation.
I was like I actually startedlaughing and I said oh my God,
no, no way.
Speaker 2 (24:13):
Can you talk about the pink sheets?
You use the pink sheets.
What I don't in our state I maybe wrong.
In our state any psychologicalor psychiatric discussions are
on pink sheets, so any notationsare on pink sheets.
You don't do that in oregon, sowhat?
happens, is I want to explainwhy.
Because when I was with hhs, Iwas in with the inspector
general's office and we hadwalked into a place and I had to
(24:36):
seize there was a fire.
There was a fire.
It killed nine or ten people,all medicaid recipients, right,
and the smell of the smell ofburned bodies was horrible.
But I brought my troops thereand the first thing I wanted to
do is to seize all rec and thenurses intervened, said you
can't seize the pink recordsbecause those are psychiatric
and psychological records.
And I said, indeed I can, butyou'll be here when I go seize
(24:57):
them, when I seal them, and theywill be.
They will be going to a judge.
The judge will determinewhether or not we can see it.
Maybe we have to hire apsychiatrist to do that, but
anyway, that protected that.
That's what I'm saying.
There was that extra layer ofprotection, and so I think
that's important, thatconfidentiality side that you
experienced and, as a clinicianyourself, you're not going to
give that up.
You're not going to give upyour records.
(25:19):
You're shaking your head.
I can see you, so talk aboutthat.
Speaker 1 (25:22):
You know, I mean I hope it will allay fears.
Speaker 2 (25:23):
just to explain that it's important.
Speaker 3 (25:25):
Yeah, I mean we have HIPAA, so you know the Health
Information Protection and soPortability Act.
Yeah, there are significantprotections for that information
.
I have even had people and it'svery, very rare, it's usually
in a workers' compensation casewhere they have subpoenaed
records, and the case law isthere that says even in a
subpoena case which again theclient usually consents to the
(25:48):
release of this information Ican come back and say well, some
of this isn't work-related, sowe can redact some of it that
isn't specifically work related.
So let's just say, fake nameclient Bob had been sexually
abused as a child.
He disclosed that when hetalked about his history and he
recently was involved in ashooting where he was shot or
(26:09):
whatever.
Well, his sexual abuse as achild has nothing to do with him
having been shot later on inthe line of duty or being in
shooting or whatever the casemight be.
And so I have the ability in thecase law to redact that and say
that is actually not pertinentto this and so there are those
kinds of protections.
But even when I get involvedwith things like workers' comp
(26:31):
cases, I educate clients fromday one.
I mean very first session.
This is not confidentialbecause you've asked and you've
signed that away.
You have to do that, so I wantyou to bear that in mind as we
talk about and think about whatyou're talking about, because I
want you to be in control ofwhat information is contained
here, so you'll attempt to limitwhat they talk about.
Speaker 2 (26:52):
So does that mean that's an interesting thing that
I'd never heard?
Does that mean I come to you ona workers' comp and I come to
like your style, your approach,your likability, your
approachability, and so we startkind of walking in a different
area about what makes me tick?
You're saying I don't want todeal with that.
You don't have to Remember thatyou're signing it over.
(27:13):
Is there any way for you tosever that?
Or would I then have to go toanother clinician to talk about
what makes me tick, as opposedto why I'm sick or why I'm out?
Speaker 3 (27:21):
And I'm not saying no , I wouldn't say you need to go
see someone else.
But even workers comp won't,doesn't want to foot the bill
for your relationship issues,right, so it all has.
I mean that just kind of makessense.
So even not just protecting theclient, but then also being
aware of what I'm hired to betreating as well and so, but
it's really all again,transparency is super important
(27:42):
for the trust for them tounderstand, because I did have
an instance where a person hadbeen sexually abused as a child
and he was quite embarrassed byit and I said and then he wanted
to later talk about signing arelease for stuff, and I said,
no, you put that in writing.
Do you understand?
If you sign this stuff that'sgoing to be released, I'll do
whatever you want me to do.
(28:02):
But is that?
You know I do have to give theinitial intake paperwork that's
requested, and so he could makean informed decision on what was
best for him.
So, yeah, it's all about, butalso being thoughtful about okay
, I still need to know,understand the person in context
.
We can't we can't, sever thepersonhood from the event either
.
And so you know, just knowingthat a workers' comp case, or
(28:23):
has the potential for that.
I'm just very thoughtful.
I don't mean to sound like I'mdoctoring records or that kind
of business, but I'mconscientious about how records
are kept.
Speaker 2 (28:33):
And what can be released and what might be
released, and how it might harmsomebody.
Speaker 1 (28:37):
We're talking to.
Speaker 2 (28:37):
Stephanie Kahn.
She's in Beaverton Oregon.
She is a police psychologist,but really not just a police
psychologist, I would say afirst responders psychologist,
and so we talked a lot aboutpolice but fire and EMS.
Are there as many problems Idon't mean problems with coming
to see you?
Is there as much reluctance infire and EMS as opposed to
police?
Speaker 3 (28:56):
Is there as much reluctance in fire and EMS as
opposed to police?
Yeah, fire, ems, correctionsand dispatch all the same, and
less about.
I'm going to lose the abilityto carry a weapon, but I'm still
.
I'm going to lose my job, orthis is a sign of me being weak,
this is a sign that I can'thandle the job.
You know, because there's thishistorical mantra this is what
(29:24):
you signed up for, Right and so,even though there might not be
the same level of pre-psych orfitness for duty, in the other
categories of first respondersthere's still a stigma of being
weak and so I see, is almostalways overlooked but they have
a very difficult job and theyhave their own issues that they
deal with and the things thatthey see cannot be unseen.
Speaker 2 (29:42):
So I'm glad you raised that.
What do you think about theco-responder models in so many
places where there's a clinicianwith a police officer showing
up on mental health calls?
Speaker 3 (29:52):
a great tool if done appropriately.
I was pleased to be able to bea part of that very early on,
actually, because I was a crisisintervention trainer for my
department.
They sent me to Memphis tolearn it and to come back and
train other police officers todo crisis intervention.
And then I partnered with themental health law liaison and so
(30:14):
I went out with the mentalhealth person to people in
crisis and those kinds of thingsand forged those relationships
and got to know those folks sothat when they came in and did
any training in our agency I wasable to say, hey, I've been
going out with these folks,they're not delusional, they
don't think you just go aroundhugging everybody and
everything's going to be okay.
They're actually quite aware ofthe challenges of helping
(30:36):
people with mental health andthe reward of it too.
I'm not here to paint everybodywith mental health as being
violent, but oftentimes if thepolice are co-responding, then
there's some propensity for aperson being harmed of
themselves or someone else.
So I believe it can be donewell.
I've seen the memes where it'sthe new SWAT, which is social
workers and therapists, wherethey're saying let's just send
(30:59):
that SWAT team out and I'mfearful of that becoming a
replacement for police, becauseI don't believe.
Social workers and therapistsare usually trained to handle
that level of danger on theirown, and nor should they be.
That's not their line of work.
Speaker 2 (31:16):
So as we wind down again.
We've been talking to StephanieKahn and she's a police
psychologist and we're talkingwith her in Beaverton, Oregon.
And I wanted to know where youthink policing is going with the
wellness push, in other words,the wellness of officers, and
I'm sure that some of the thingsthat you do training on
everything, everything fromgetting proper sleep and proper
(31:38):
diet and you tell us what makesup this whole wellness effort.
Speaker 3 (31:44):
Yeah, I think it is very interesting because I
didn't.
When I wrote my book and it wasactually in 2018 was when it
was published.
I wasn't and I started writingit in 2015, 2014, something like
that.
I don't guess I predicted thatwe would have this swell of
resilience training and push andall this other kind of wellness
programs and these kinds ofthings that we've had.
(32:05):
So it was interesting timingthat it was launched.
And what I'm seeing as I watchthe trainings that are out there
is there tends to be kind oftwo camps of the training and
the wellness.
One is I'm going to go out andtell war stories and you're all
going to.
All of my war stories are goingto resonate with you and we're
all going to hurrah, hurrah, thewar stories.
And then the other is we'regoing to talk about some of your
(32:27):
hardships and some of yourchallenges and we're going to
give you some real concreteadvice on how to deal with it
and real concreterecommendations and some
resources.
And I'm not saying there's notvalue in stories, there should
be stories in the other one aswell.
And so I'm seeing kind of twocamps where I've had some people
say, well gosh, they just camein and complained a lot about
some of the horrible stuff thatwe didn't get anything out of it
and you're like, and theycharged a fortune for it and
(32:49):
you're like, well, that's toobad.
So I think that agencies aresometimes throwing money at
wellness programs because theydon't know what they don't know.
It's not their line of work.
The line of work isfirefighting or police or
corrections.
Their line of work isn't inresilience, and so they really
sometimes get lost in knowinghow to build a wellness program,
how to train, how to vetclinicians to be good resources
(33:14):
for them, whether it be fortraining or for wellness program
development or what have you.
Because there are some peoplein this profession that do it
because their heart's in it andthey come from that background.
And then there's some that Ihate to say it see money to be
made and a name to be had, andthey don't always look very
different on the outside.
Speaker 2 (33:32):
Well, I think that happens all of the time that I
love what you said.
You don't know what.
You don't know Everything fromtechnology to training and what
wellness means, what communitypolicing means when you talk
about that.
There's so many variations ofthat, too, and we can't seem to
get a handle on it.
So let me wind down by askingyou a question and giving you
(33:52):
virtually the last word.
As a clinician, as somebody whohas seen countless numbers of
people in crisis, or people justtrying to figure out what's
going on with themselves inpolice, fire corrections and EMS
and dispatch.
What's the benefit of reachingout to somebody like yourself,
in your view, and what couldhappen if you choose not to?
Speaker 3 (34:13):
I want to end on a positive note.
So I'm going to start with ifyou choose not to what you
resist, persist as they say.
So you can resist, you canpretend like you're not hurting,
you can pretend like you're nothaving trouble sleeping or your
relationship isn't failing, andit will continue and it will
likely worsen.
I don't know unless you.
I mean and I'm not saying it'sseeing a clinician is the end
(34:34):
all be all, Perhaps somethingyou'll read some health, some
self-help book or get involvedin some other kind of thing and
find a way on yourself Right,and so talk to a chaplain and do
something else.
So it's not impossible for thatto happen.
But if you ignore it, it's notgoing away.
So, coming to see someone likemyself, you know, and I think
one of the first things and I'veheard I've had this feedback
(34:56):
from people before is one of thefirst things you get is hope,
and embedded in the hope is thebelief and the expectation that
you will get better if you.
That's what hope is.
I think that's the first thingyou get, and I've had people say
once I had a name for it andunderstood it, I believed I
could do this and I expected Iwould get better if I did that.
I can get on board with thatVery powerful stuff.
(35:17):
There's a book on the anatomyof hope that talks about how
that works.
And then you get systematicsupport and guidance where you
just go, be yourself in aconfidential setting to try to
navigate things you can't unsee,as you said, you can't unhear,
you can't not know, so that younot just aren't fighting your
demons anymore, Also be happy inlife, you can thrive and be
(35:40):
well, and I think every firstresponder deserves that, so the
last question.
Speaker 2 (35:45):
I guess I thought that was the last question.
But, listening you make mewander in different areas?
How does a first responder finda first responder knowledgeable
clinician?
Speaker 3 (35:55):
That is my big mission.
That's some of the work I'mdoing with the National FOP
Fraternal Order of Police, wherewe're creating what's called
the approved provider bulletin,the APB.
So nationwide it will be a listof first responder clinicians
that are vetted according to thecriteria that I co-created with
another psychologist inCalifornia, dr David Black out
(36:16):
of Cortico.
So that's what we're creating.
I'm the first clinician on thelist in the nation of probably
hundreds of us, if not more.
There are some Serve and Protectactually maintains a list.
They're out of Nashville.
You can find themserveandprotectorg and they also
maintain a list.
They vet people on the phonethemselves and sometimes just
(36:38):
Googling it and looking forthings like the APB or the FOP
stamp of approval or theNational Emergency Responder and
Public Safety Center trainingcertificate will indicate those
kinds of things.
Psychology and the IACP psychservices section also has, I
think, 200 of us that specializein this.
(36:58):
So there's a few groupings thatthey're kind of fragmented and
we want to pull them alltogether into one national
database which is again kind offull circle from.
My original mission when I wasa peer supporter is how do we
connect people with culturallycompetent help so they don't
have to go to someone and whoasked them why they had their
gun out.
Speaker 2 (37:17):
Yeah, I understand that all too well.
Again, one of the things I dowonder is COVID changed
everything and COVID forced anawful lot of us to do exactly
what we're doing, where we'retalking to each other on Zoom,
even though I'm using audio.
And now you have telehealth andthat's becoming more prominent.
How would somebody overcomeit's so much easier in a lot of
(37:41):
ways, but how would somebodyovercome?
I don't want to be taped, Idon't want one of those kinds of
things.
In other words, that trust thatneeds to be.
I'm talking to you on the otherend, I like you, but I don't
know what you're doing overthere because I can't see
whether you're writing orwhether you're recording.
How do you overcome that?
Speaker 3 (37:50):
Well, one, I let them know.
Just like in the top left-handcorner it says recording.
You can see if it's recordingand they have to acknowledge it.
And then when I say I'm nottaking note because I'm doing
like an OIS follow-up orcritical incident follow-up, I
literally sit there with myhands in the screen of the video
so that where they can see I'mnot writing anything down.
And then if they say, hey, canyou send me a handout on that,
I'll say I'm going to write downthat I'm going to.
(38:11):
And then I'll go over and writedown that I'm going to send
them a handout.
And then I put my hands back upand do you again that
transparency and that trust isit's like air.
You don't have it.
You absolutely notice, youdon't have it.
Speaker 2 (38:23):
So have you found success in telehealth in your
practice?
Speaker 3 (38:27):
Too much, actually, because it's opened me up to
first responders all over thestate versus the ones that were
within driving range.
Yeah, too much, and I'm notcomplaining, it's just it's hard
to sometimes meet the demand.
So, yeah, I think it's made ithelpful for people that have
shift work, people that havekids, people that live in remote
areas and might not want toaccess services for fear that
(38:47):
they'd see someone walking intoor out of the clinician's office
on Main Street when there'sjust two streets in the town.
I think it's helped a lot ofpeople, even people that didn't
think they would like it meetwith me initially in person,
come to build that rapport andsay, hey, you know, thursday
would be easier if I just didvirtual, is that okay?
Like, oh, yeah, you know, andso they can kind of go back and
forth as their schedule allowsand their childcare allows and
(39:11):
that kind of business, and so Ithink it's been a significant
help for some, and then forothers they're just like nope, I
want to.
I want to have my eyeballs onyou.
I understand.
Speaker 2 (39:20):
Well, listen, this has been amazing.
It's been a lesson for me and,I hope, a lesson for all of the
listeners.
You have added so much, so manydimensions to wellness and to
the help mental health for firstresponders, and I appreciate it
.
So we've been talking toStephanie Kahn.
Thank you for being here,stephanie, you're welcome.
(39:40):
Thanks for having me.
No problem, so that's anotherepisode of the Cop Doc in the
books.
We've been talking to a policepsychologist and I hope you have
found it interesting.
Stand by for more episodes andthanks for listening.
Speaker 1 (39:50):
Thanks for listening to the Cop Doc podcast with Dr
Steve Morreale.
Steve is a retired lawenforcement practitioner and
manager, turned academic andscholar from Western State
University.
Please tune into the CopDocpodcast for regular episodes of
interviews with thought leadersin policing.
Welcome to the CopDoc podcast.
This podcast explores policeleadership issues and innovative
ideas.
The CopDoc shares thoughts andideas as he talks with leaders
in policing communities,academia and other government
agencies.
And now please join Dr SteveMorreale and industry thought
(00:24):
leaders as they share theirinsights and experience on the
CopDoc podcast.
Speaker 2 (00:32):
Hello again everybody .
Steve Morreale coming to youhere in Boston and we are on a
bi-coastal conversation.
I have Stephanie Kahn, drStephanie Kahn.
She is in Beaverton Oregontoday, so hello there.
Speaker 3 (00:43):
Hi, how are you?
Speaker 2 (00:44):
I am fine, thank you.
I found you on LinkedIn.
It seems to be the way to do it, and one of the ways I found is
that you police officer.
Now you're a policepsychologist.
You've written a book onresiliency and it really drew my
attention, especially,stephanie.
With what's going on in ourworld and the threats that are
pushed upon police officers thethings you see, the things you
can't unsee there are certainlya number of stressors.
(01:05):
So I wanted to get you on andthank you for coming.
I wanted to ask you to tell theaudience about how you got
involved in this, how you camefrom policing to psychiatry?
Speaker 3 (01:18):
Yeah Well, psychology , yeah.
I was the daughter of a policeofficer.
My dad was an officer foralmost 40 years, so I grew up in
a household seeing the impactthat first responder work had on
the first responder and theirfamily members.
Then I became a dispatcher,call taker, did that for three
years, then became an officer,did that for nine.
And when I was an officer and Iwas an officer for Fort Worth
police in Texas one of mycoworkers was shot and killed in
(01:40):
the line of duty and I became apeer supporter.
And because I wanted to be apeer supporter and another
coworker of mine got killed.
Speaker 2 (01:48):
Before we continue in our conversation, we're talking
with Dr Stephanie Kahn.
She is in Beaverton Oregonright now and a police
psychologist.
My mistake about psychiatrist.
I'm sorry about that, but butyou were.
You were talking about twohorrible things that happened in
your life Offic officers whohave been shot and killed.
That's where you were, so talkabout that in Fort Worth.
Speaker 3 (02:08):
So the second officer that was killed in the line of
duty was actually hit by a drunkdriver and tracked and burned
alive in his car.
And so I was a peer supportteam member at the time and
between one officer being killedand then a year later another
one being killed, we had had achanging of the guard from a
police psychologist to a citypsychologist.
So we had someone that actuallyunderstood policing to someone
(02:28):
that understood psychology andcounseling, certainly, but
didn't have any specializedtraining in working with first
responders.
And so when I was supportingpeople as a peer supporter, they
were wanting to have someonethat actually understood them
and the profession and theunique challenges first
responders face, and I couldn'tfind anyone when I looked out
there to try to see who to referthem to, and I had people
(02:48):
wanting very specific help totheir work and not just wanting
to talk to anyone.
So I made the very difficult butwell considered choice of
stepping out of policing to getmy counseling doctorate so that
I could come back and help mybrothers and sisters, not just
in policing but in other firstresponder professions, because I
felt like I had the culturalcompetency to do it.
(03:09):
I dispatcher as a call taker.
As a police officer, you knowyou were engaged to a
firefighter.
You're married to anotherpolice officer, so it gave
(03:30):
people the confidence to see meand so I never got to return to
policing because my practice asa clinician has been so busy
since I opened it.
Speaker 2 (03:39):
Why do you think that is.
Let's just talk about that fora moment.
I understand you know, havingbeen in the business for 30
years the importance of if I'mgoing to take my clothes off.
I want the person on the otherend to understand what I go
through, to understand thestressors, to understand the
difficulties that come from theorganization itself sometimes,
because sometimes we eat our ownand how important that is.
(04:01):
I'll say this One of the thingsI'm beginning to talk about and
hear about across the country isthe move towards a concept
called a checkup from the neckup, in other words, a required
sit down with a psychologist ora psychiatrist on a regular
basis, which sort of melts awaythat negative feeling that so
many people have about mentalhealth counseling.
(04:22):
So talk about that.
Talk about that.
Speaker 3 (04:24):
Yeah, I mean there's two, two pieces there is.
One is you know, if you'regoing to psychologically take
your clothes off, so to speak,you don't want to have to be
explaining your profession toother people.
You need someone to give yousomething you know don't need to
be giving to someone else.
And if you're having to educateother people on your job or
explain why you do what you door how the organization does
whatever it does, then it's more.
(04:44):
It takes more away from thefirst responder than it gives
them, at least initially, and soyou want someone that is
already up to speed or fairly upto speed, so they can kind of
start from where you are andmove forward and help you move
through things.
The checkup from the neck up Ithink there's a lot of value in
that and I do that for a lot ofagencies I work with because it
(05:05):
takes away that threshold whereI got to be a certain level of
screwed up I got to be hurtingin a bad way before I ask
anybody to check in with me, butrather make it more.
Hey, we don't wait till there'ssmoke bellowing out of the hood
of the car before we check theoil or check the other fluid
levels or these kinds of things.
We should probably get ahead ofit and do something, because
(05:28):
it's easier to do that with acar and do that with a person
than it is.
Try to deal with it once itbecomes damaged.
Speaker 2 (05:34):
So let's talk about that if you don't mind.
Confidentiality, I know, isimportant, but when you do a
checkup from the neck up and youwalk into the organization
presumably in many organizationsthe first time that's happened
how much time do you have tospend to talk about why you're
doing it in the first place,what you're trying to allow that
person male or female firstresponder to talk about, to sort
(05:55):
of vent and to purge?
You know, my sense is you and Ispoke about in the beginning.
Here we are talking on 9-12 and9-11, it hits me because I
brought a team down to New York.
I did not suffer half of theproblems that so many of my
colleagues did there, but beingthere unto itself was something
I can never erase.
What I saw, the pain and thesuffering, the death and such.
(06:16):
But I wonder how much time youhave to spend to explain to
somebody that I'm here for you.
We're here to help you.
The cumulative effect of stresscan burn somebody out, so talk
about that.
Speaker 3 (06:27):
Yeah, and I'm pretty lucky Well, I say lucky it's by
design and the agencies that Iwork with as I try to introduce
myself or others introduce me.
Because I work so closely withpeer support team members.
They will introduce me to theirpeers as someone that they
trust, someone that has been oneof them at some point, and so
it takes a lot of the work awayfrom me of building that rapport
(06:50):
, because I've built thatrapport with the peer supporters
.
Or I will go to the roll calland sit beside the sergeant at
the roll call at 11 o'clock atnight which is not banker's
hours or clinician hours, if youwill, and that says something.
I'll come out to the station at11 o'clock at night or six in
the morning, or sometimes bothon the same day, which is
horrible and just introducemyself and just shoot the breeze
(07:13):
with them and that allows themto feel a bit more of a trust
that this is not the normalsituation where you just go see
a clinician and then I spend alot of time talking about
confidentiality, claiming that Idon't keep notes on these
wellness checks.
I don't write notes.
I don't write notes afterwardsIf I bill the agency, and I do,
(07:33):
and I think 100% of the cases ofthese wellness checks depending
on the agency contractsometimes they don't even know
who had the wellness appointmentor in cases where they're
incentivized where they get paid, then I'll be I have to let
their employer know so they canget their incentives paid for it
.
But there's nothing else sharedwith them and I think some of
(07:54):
that takes away some of the fearthat there's going to be
something recorded that's goingto get them at some point or
cost them a promotion or someother kind of scenario.
And so I think there's a bit ofwork put in through the
relationships I build, throughthe transparency of the process,
not acting in manners that areconsistent with their
expectations, which is an oldhostage negotiation trick, if
you will, or tactic.
It's not a trick of justshowing up at odd times to be
(08:17):
there for people or doing ridealong part of how all that works
, that breaks down the barriers.
Speaker 2 (08:21):
I can see that and I recognize why that would be of
great value.
So you've written a book.
I see it behind you IncreasingResilience in Police and
Emergency Personnel Resiliency.
What's that all about?
Speaker 3 (08:33):
Yeah, and that's.
I wrote a mental health columnfor a police magazine for about
three and a half years.
So every month I'd write like apage on sleep or improving
communications or dealing withsecondary traumatic stress, that
kind of business.
And I had many people readersfrom that magazine send me
emails saying, hey, thisresonated with me, that
resonated with me.
You should put this alltogether in one place.
And then my research for mymaster's and my doctorate was
(08:55):
about what helped people dealwith their exposure to trauma,
what helped people maintain alife outside of their work.
And so I thought and then mywork as a peer supporter and
working with peer supporters Ithought I really should put this
all together and treatresilience, as I see it, as an
officer safety tool.
Because when you go to a callwhether you're a police officer,
firefighter, but let's just usethe police example when you go
(09:18):
to a call, you're assessing whatyour risk factors are, what
kind of assists you need, howyou need to respond to things,
because you're constantlyassessing what the threats are
and making adjustments to yourresponse based upon that, but
you're also assessing yourprotective factors.
Do I have an assist with me?
Do I have a perimeter?
Do I have a dog?
What do I have?
And making moment-to-momentdecisions.
(09:38):
If we treat our resilience in asimilar fashion and saying
what's working for me, what'snot working for me, okay, I'm
not exercising, I'm not reallyconnecting with my significant
others, I need to shore that up.
If we treat it like that, wetend to be safer psychologically
, which is our resilience, if weare remaining aware of what's
working and what's not workingfor us in our life just like we
(10:06):
would on a call.
Speaker 2 (10:06):
As you're talking new clients I suppose the fact that
you have a relationship with anorganization in many cases and
you know, the big piece inpolicing is a vouch.
When you get a vouch, you'reokay.
How is this, stephanie?
She's okay, you can trust her,she understands, she knows.
I think in a lot of ways, copslove to cut right to the chase.
I'm not looking for flowerystuff, just here's the story.
You want to hear it?
This is it.
I don't know how it's affectingme, but I'll tell you what I'm
(10:27):
feeling.
Speaker 1 (10:27):
And I'm sure.
Speaker 2 (10:28):
I mean.
Your job is eliciting feelingsand thoughts through questions
in a lot of ways, and so talk methrough that.
Somebody comes to you, not justfor a checkup, but for some
person who might be in crisis,it's me today.
How do we start thatconversation?
And the reason I'm doing thisI'm asking you this, stephanie
is because so many potentiallylisteners have balked at talking
(10:50):
to somebody, and so I'm tryingto, through you, to have people
understand that this is not abad thing, properly executed.
Speaker 3 (10:57):
Yeah, I mean, that's the thing is that again and I
try to draw parallels between mywork as a clinician to my work
as a police officer, in that ifthey come in and say, hey look,
this is what I'm not sleeping,I'm irritable my spouse or
significant other says that I'mwithdrawn or I'm being a jerk or
what have you, then really mywork as an assist to them is to
(11:19):
say OK, so how did this start?
You know what happened here andhow do we figure out what you
do about it?
And to fill in the blanks onthe information they might not
have as to why they would behaving, why their brain keeps
sending them images of that deadkid, they know that the event
is over.
Why is their brain sending themreminders or physical anxiety,
that kind of stuff?
So my work is really trying tohelp them understand why certain
(11:43):
things are happening and whatto do about it and to take the
weakness element out of it, butreally to recognize that it
takes pardon my French a lot offucking strength to face things
that you'd rather just shovedown.
It takes a lot, you know, and Ioftentimes say there is no
courage without fear, and ittakes a lot of courage to do
(12:05):
what you do and to push throughit and it's okay.
That's kind of how it wouldstart out is just trying to
figure out what's going on andwhat do we do about it and why
is it happening.
And help them to understand whyit's happening, because I think
a lot of times the answer, thedefault answer, is it's
happening because I'm weak, it'shappening because I'm broken,
it's happening becausesomething's wrong and I can't
(12:28):
handle it anymore, versus reallyrecognizing that a lot of the
symptoms people have is survivalbrain kicking in and trying to
help them and send them allthese signs and symptoms so they
will address it.
Just like a headache tells yousomething's going on in there,
you need to address it.
Some of these quote unquotepsychological symptoms are doing
the same thing.
Speaker 2 (12:47):
That's an interesting perspective that I've not often
heard.
So thank you for sharing that,and I'm sure the term you used
earlier was a clinical term.
I'm sure you learned it atschool or in policing or
whatever it was.
I appreciate the honesty and Ithink that's so important
because part of what I think itis look, police officers,
firefighters, emts are calledinto situations at the worst of
(13:09):
time and, as I said before, sooften you don't have a choice.
But once you see it, it's veryhard to unsee and I think the
strength in us and in some casesthis is a guy oriented piece,
not that it couldn't be forwomen, but the guy sometimes
will think look, this is my job,I have to do it, suck it up,
buttercup, whatever that is.
But let's talk about thecumulative effect that we start
(13:31):
hearing a lot.
Is there such a thing?
It's almost like you're goingto die from a thousand paper
cuts, the old adage.
Is that real?
Okay, so talk about that.
Speaker 3 (13:49):
Yeah, and it has so many names, and Ellen Kirshner
referred to it as death by athousand cut, and it's also
referred to as the pyramidingeffect, where it's just like at
the bottom of the pyramid.
You know, year one, here's allthese traumas kind of building
up at the bottom of the pyramid,and then year two, five, eight,
10, 25.
And I have some people that arequite surprised that when
something forms the tip top oftheir pyramid in year 20 or 15
or what have you, that it lightsup everything that occurred
(14:09):
underneath and they're like whyam I losing my shiz over this
call that I handled 10 years ago?
Why am I seeing the images ofthis person that had that or
whatever now?
And I said that's because it'sbasically broken open some of
those trauma membranes andbecause it's unfinished business
, right, and it's almost likethat's why we have this
cumulative and we know that thecumulative is the real deal
(14:32):
because it's talked about in ourdiagnostic manual is this
chronic exposure to thesuffering of other people, and
it is more often the case ofpost-traumatic stress or
post-traumatic stress disorderthan that singular event, and
they call it the dose effect.
The greater the dose, thegreater the effect, and so it's
not uncommon for me to see that.
In fact, it's rare that I see asingular event be someone's
(14:54):
reason for coming in, unlessyou're mandated, you know, for
like a critical incident or whathave you.
And so I say, okay, we're goingto go to that first one,
because I do trauma treatment,so I do EMDR.
We're going to go to that firstone and we're going to work on
that with EMDR, and maybe someof the other ones are going to
come up, and that's all right,we're just going to put those on
a shelf, we'll come back tothose and we're going to
systematically knock them out,which sounds really absolute.
(15:16):
But EMDR is pretty impressive.
It's pretty good at taking outthe reminders of specific
traumas, can you?
Speaker 2 (15:22):
talk about that for a moment.
I've heard that a number oftimes, but never from a
clinician.
What does that mean?
Emdr.
Speaker 3 (15:28):
Yeah, that's a lot of psychobabble, it's a lot of
mouthfuls.
So EM stands for eye movement.
So when we go to sleep at nightwe have REM sleep.
If we're lucky, we have to getsome decent REM sleep.
Rapid eye movement, and sothat's when our eyes are moving
back and forth spontaneously andthey're processing the drama
and the trauma of the day.
What happens is we don't alwaysget good sleep when we've had
really significant trauma orwe've got shift work or other
(15:51):
kinds of things going on in ourlife, and so our brain doesn't
get to continue with its processof rapid eye movement, sleep,
so processing drama and trauma.
So stuff gets stuck in ourbrain in an incomplete,
unfinished state.
And so what we do when you'reawake as an EMDR clinician is, I
say okay, steve, I want you tofocus on.
What is the image of the thingthat's most disturbing?
(16:12):
Okay, name it.
All right, that's it.
What's the negative belief youhave about yourself?
And sometimes it, you know, Ididn't do well enough or I'm
weak because of this response,and other times I'm weak because
I continue to have this effect.
So sometimes it's anoperational critique and
sometimes it's a psychologicalone.
All right.
So there's the image, there'sthe negative belief.
What physical sensations do younotice?
You know I've got this pain inmy chest, knot in my throat,
(16:33):
tightness in my jaw, pit in mystomach.
Okay, usually in the midline.
And then what emotions do younotice?
Okay, anger, frustration, blah,blah, blah.
Okay.
So then I just say I don't wantyou to focus on all of those
pieces.
I'm basically taking all thepieces of the trauma and I'm
having them do the eye movementback and forth while they and
just, let us just let your mindgo wherever it goes and I can do
this in person or virtual, itdoesn't, it doesn't make.
(16:58):
When you're doing the eyemovements, then it helps the
brain process the trauma and Dthe EMDR, the D is desensitizes
you to it, so you're no longertraumatized by it, it doesn't
have the same physical effectthat it has before.
And then, as you reprocess it,it becomes something that
becomes more in the past, ratherthan feeling very present for
(17:19):
you and any negative belief youhad about yourself, about being
weak or not having donesomething properly on an
operational level, you reprocessit as I did the best I could,
or you know I can be better now,or I can heal from this or
something else that is moreadaptive and it is so incredibly
effective and so fast comparedto, say, talk therapy, because
(17:40):
it goes into the subcorticalregions of the brain where the
trauma is stored.
But it's become the treatment ofchoice for first responders and
people in the military.
There's actually books on it,emdr for first responders that
outlines the protocols forspecifically working with it.
I've been doing this for 11years, day after day, and have.
Yet, whether you believe itworks or you don't believe it
works, your brain knows that itworks and so it works.
Speaker 2 (18:03):
I appreciate the lesson because that's pretty
important.
I've heard some people who havehad some very good experiences
in that, so thank you forsharing.
And now I know what EMDR means,and so do the listeners.
And as you were talking, atrauma cap it's the first time
I'd heard that, because I speakin terms of boxes that we put
little things in lock boxes,which is probably the same thing
and sometimes, at the strangesttimes, these little things leak
(18:27):
.
Sometimes it's fatal, sometimesit is a suicide, sometimes it
is a murder, it's a rape,whatever it might be, sometimes
it's 9-11.
And so it seems to me I meanjust from my own experience and
your own experience for thelisteners that I think coming to
the realization that these dohave impact on you, whether
you'd like them to or not.
(18:49):
They have a long lasting impactand they'll show up sometimes
when you least expect it.
So what am I saying as I'mtalking?
What are you hearing as I'msaying that?
How would you explain that tosomebody coming to you?
Who would say that to you?
Speaker 3 (19:05):
Yeah, I would say there's some level of that.
That makes sense because and weknow this from looking at what
happens in retirement issometimes we're so busy being
outwardly focused, handling that, call the situation, that
family demand, whatever thatwhen you shove stuff down, there
is no space for it to come backup.
But then other times, whenyou're off on admin leave
because you've been involved ina shooting, you're off on injury
leave or that kind of stuff, italmost like you create an
opening for these things to beable to pop up and or something
(19:28):
will activate it, like a date,an anniversary of something or a
memory of something.
And so then it pops open andyou're like, oh crap, what is
that?
Why is that coming up now?
And so, again, we know that thathappens and so I don't want
people to be freaked out by itto think, okay, this must mean
I'm coming unraveled, because wehave so many ways of saying you
(19:49):
know I'm losing it, or thisbroke down or that kind of stuff
, and it's like you didn't breakdown, you didn't come unraveled
.
Trauma popped up either becauseit had the opportunity to, or
something popped open.
Popped open that, yeah, thatmember in it.
People hate the word triggerbecause they're like oh,
everybody's triggered abouteverything and needs a
tri-closet.
No there's actually yeah,there's validity to these things
(20:10):
being activated and so, insteadof being mad that it happened
or being alarmed or making itworst case scenario, okay, so
that just needs, that needs tobe dealt with.
That is something that you needto deal with.
It's almost like if, been sobusy doing something else, you
didn't notice your elbow hurtand then finally you're not busy
doing something.
You're like, oh gosh, my elbowdoes actually hurt.
(20:31):
It's been there all along,you've maybe just not, it's not
come to the surface until it didand then deal with it.
I don't mean to downplay howhard it is to deal with it.
I just even remember my owntraumas as an officer.
You know an auto ped of apregnant, visibly like seven,
eight month pregnant, woman andshe's.
You know I wasn't evendispatched to it, I just rode up
on it one week on my own, justbarely out of training.
(20:54):
And I just ride up and there'sthis woman dying on the ground
and her 11 month old wasold wasa few feet away, been thrown
from the stroller she waspushing when she was hit and her
mom screaming the most horrible, blood-curdling screams.
I had images of that, right, Ihad.
I'm not saying meaning todownplay the horrificness of.
That's a word, but there'sremedies, there's ways to
(21:14):
address this if you have someonethat's trained in trauma.
Speaker 2 (21:17):
So we're talking to Stephanie Kahn.
She is a police psychologistand she's out in Oregon former
police officer and I apologizeif the audio isn't perfect.
My board is not working 100percent, so we're using this
through the technical drills ofcell phones.
So all of the players that youengage with that, I suppose,
would be clients at this point,patients, whether it's fire,
(21:39):
police or EMS how do we overcome, how do agencies overcome, the
stigma of mental healthcounseling?
Because I think for so many thefear is, if I admit, I'm going
to lose my gun, I could lose myjob because of it, and it seems
to me that we need to do a muchbetter job of overcoming that
stigma, helping people andletting them back on track.
(21:59):
So I'm sure you're playing arole in that, but what's your
thought on that as a formerofficer?
Speaker 3 (22:04):
Yeah, and I think again it comes down to the
relationships I have with thepeer support teams that I'm
attached to, that I see on aquarterly basis and talk to on a
regular basis, you know,because they can text me anytime
or call me anytime.
Obviously, when I'm withclients my phones are silent but
and so it's the relationship Ihave with them that they in turn
are able to share with the peerthat's struggling.
But then it's also the ridealong's the myths about
(22:26):
confidentiality and the thingsthat would cause a first
responder to fear, because a lotof them think that because of
the confidential nature of whatit is we do, they think other
people aren't getting help orthat other people that are.
(22:47):
I'm like gosh, if I could justbreak confidentiality and tell
you five of your peers were in abad way and came to see me and
maybe were even suicidal at somepoint or abusing substances or
whatever, and got help and neverlost their job.
But the secrecy of that becauseof confidentiality is a bit of
(23:08):
a disservice to the stigma oflike.
I remember there was one agencyI was at and they were just like
, oh, this person really neededhelp and blah, blah, blah and no
, but nothing happens.
And for these people orwhatever.
And I was at and they were justlike, oh, this person really
needed help, and blah, blah,blah and no, but nothing happens
for these people or whatever.
And I was just sitting therethinking, yeah, actually they
did get help and I happened toknow what happened and they were
taken to the hospital andthrough the back doors and
received support and then whenthey were released they came to
(23:30):
me.
So that's the thing is thesecrecy of all this doesn't help
.
It's an interesting thingbecause there are some first
responders who are trying totake an active role in debunking
those myths by saying, hey, Igot help, I didn't lose my job,
I got help.
It not only did I not lose myjob, but it actually made me
better at my job and I promotedand it saved my marriage.
And so some first respondersare taking an active role in
(23:52):
that.
And then I remember one of thelast ride-alongs I did before
COVID.
I got to sit with officers atdinner on the ride-along and
answer questions they had aboutconfidentiality, because they
thought that sessions wererecorded and stuff was reported
back to their agency.
There's just a lot ofmisinformation.
I was like I actually startedlaughing and I said oh my God,
no, no way.
Speaker 2 (24:13):
Can you talk about the pink sheets?
You use the pink sheets.
What I don't in our state I maybe wrong.
In our state any psychologicalor psychiatric discussions are
on pink sheets, so any notationsare on pink sheets.
You don't do that in oregon, sowhat?
happens, is I want to explainwhy.
Because when I was with hhs, Iwas in with the inspector
general's office and we hadwalked into a place and I had to
(24:36):
seize there was a fire.
There was a fire.
It killed nine or ten people,all medicaid recipients, right,
and the smell of the smell ofburned bodies was horrible.
But I brought my troops thereand the first thing I wanted to
do is to seize all rec and thenurses intervened, said you
can't seize the pink recordsbecause those are psychiatric
and psychological records.
And I said, indeed I can, butyou'll be here when I go seize
(24:57):
them, when I seal them, and theywill be.
They will be going to a judge.
The judge will determinewhether or not we can see it.
Maybe we have to hire apsychiatrist to do that, but
anyway, that protected that.
That's what I'm saying.
There was that extra layer ofprotection, and so I think
that's important, thatconfidentiality side that you
experienced and, as a clinicianyourself, you're not going to
give that up.
You're not going to give upyour records.
(25:19):
You're shaking your head.
I can see you, so talk aboutthat.
Speaker 1 (25:22):
You know, I mean I hope it will allay fears.
Speaker 2 (25:23):
just to explain that it's important.
Speaker 3 (25:25):
Yeah, I mean we have HIPAA, so you know the Health
Information Protection and soPortability Act.
Yeah, there are significantprotections for that information
.
I have even had people and it'svery, very rare, it's usually
in a workers' compensation casewhere they have subpoenaed
records, and the case law isthere that says even in a
subpoena case which again theclient usually consents to the
(25:48):
release of this information Ican come back and say well, some
of this isn't work-related, sowe can redact some of it that
isn't specifically work related.
So let's just say, fake nameclient Bob had been sexually
abused as a child.
He disclosed that when hetalked about his history and he
recently was involved in ashooting where he was shot or
(26:09):
whatever.
Well, his sexual abuse as achild has nothing to do with him
having been shot later on inthe line of duty or being in
shooting or whatever the casemight be.
And so I have the ability in thecase law to redact that and say
that is actually not pertinentto this and so there are those
kinds of protections.
But even when I get involvedwith things like workers' comp
(26:31):
cases, I educate clients fromday one.
I mean very first session.
This is not confidentialbecause you've asked and you've
signed that away.
You have to do that, so I wantyou to bear that in mind as we
talk about and think about whatyou're talking about, because I
want you to be in control ofwhat information is contained
here, so you'll attempt to limitwhat they talk about.
Speaker 2 (26:52):
So does that mean that's an interesting thing that
I'd never heard?
Does that mean I come to you ona workers' comp and I come to
like your style, your approach,your likability, your
approachability, and so we startkind of walking in a different
area about what makes me tick?
You're saying I don't want todeal with that.
You don't have to Remember thatyou're signing it over.
(27:13):
Is there any way for you tosever that?
Or would I then have to go toanother clinician to talk about
what makes me tick, as opposedto why I'm sick or why I'm out?
Speaker 3 (27:21):
And I'm not saying no , I wouldn't say you need to go
see someone else.
But even workers comp won't,doesn't want to foot the bill
for your relationship issues,right, so it all has.
I mean that just kind of makessense.
So even not just protecting theclient, but then also being
aware of what I'm hired to betreating as well and so, but
it's really all again,transparency is super important
(27:42):
for the trust for them tounderstand, because I did have
an instance where a person hadbeen sexually abused as a child
and he was quite embarrassed byit and I said and then he wanted
to later talk about signing arelease for stuff, and I said,
no, you put that in writing.
Do you understand?
If you sign this stuff that'sgoing to be released, I'll do
whatever you want me to do.
(28:02):
But is that?
You know I do have to give theinitial intake paperwork that's
requested, and so he could makean informed decision on what was
best for him.
So, yeah, it's all about, butalso being thoughtful about okay
, I still need to know,understand the person in context
.
We can't we can't, sever thepersonhood from the event either
.
And so you know, just knowingthat a workers' comp case, or
(28:23):
has the potential for that.
I'm just very thoughtful.
I don't mean to sound like I'mdoctoring records or that kind
of business, but I'mconscientious about how records
are kept.
Speaker 2 (28:33):
And what can be released and what might be
released, and how it might harmsomebody.
Speaker 1 (28:37):
We're talking to.
Speaker 2 (28:37):
Stephanie Kahn.
She's in Beaverton Oregon.
She is a police psychologist,but really not just a police
psychologist, I would say afirst responders psychologist,
and so we talked a lot aboutpolice but fire and EMS.
Are there as many problems Idon't mean problems with coming
to see you?
Is there as much reluctance infire and EMS as opposed to
police?
Speaker 3 (28:56):
Is there as much reluctance in fire and EMS as
opposed to police?
Yeah, fire, ems, correctionsand dispatch all the same, and
less about.
I'm going to lose the abilityto carry a weapon, but I'm still
.
I'm going to lose my job, orthis is a sign of me being weak,
this is a sign that I can'thandle the job.
You know, because there's thishistorical mantra this is what
(29:24):
you signed up for, Right and so,even though there might not be
the same level of pre-psych orfitness for duty, in the other
categories of first respondersthere's still a stigma of being
weak and so I see, is almostalways overlooked but they have
a very difficult job and theyhave their own issues that they
deal with and the things thatthey see cannot be unseen.
Speaker 2 (29:42):
So I'm glad you raised that.
What do you think about theco-responder models in so many
places where there's a clinicianwith a police officer showing
up on mental health calls?
Speaker 3 (29:52):
a great tool if done appropriately.
I was pleased to be able to bea part of that very early on,
actually, because I was a crisisintervention trainer for my
department.
They sent me to Memphis tolearn it and to come back and
train other police officers todo crisis intervention.
And then I partnered with themental health law liaison and so
(30:14):
I went out with the mentalhealth person to people in
crisis and those kinds of thingsand forged those relationships
and got to know those folks sothat when they came in and did
any training in our agency I wasable to say, hey, I've been
going out with these folks,they're not delusional, they
don't think you just go aroundhugging everybody and
everything's going to be okay.
They're actually quite aware ofthe challenges of helping
(30:36):
people with mental health andthe reward of it too.
I'm not here to paint everybodywith mental health as being
violent, but oftentimes if thepolice are co-responding, then
there's some propensity for aperson being harmed of
themselves or someone else.
So I believe it can be donewell.
I've seen the memes where it'sthe new SWAT, which is social
workers and therapists, wherethey're saying let's just send
(30:59):
that SWAT team out and I'mfearful of that becoming a
replacement for police, becauseI don't believe.
Social workers and therapistsare usually trained to handle
that level of danger on theirown, and nor should they be.
That's not their line of work.
Speaker 2 (31:16):
So as we wind down again.
We've been talking to StephanieKahn and she's a police
psychologist and we're talkingwith her in Beaverton, Oregon.
And I wanted to know where youthink policing is going with the
wellness push, in other words,the wellness of officers, and
I'm sure that some of the thingsthat you do training on
everything, everything fromgetting proper sleep and proper
(31:38):
diet and you tell us what makesup this whole wellness effort.
Speaker 3 (31:44):
Yeah, I think it is very interesting because I
didn't.
When I wrote my book and it wasactually in 2018 was when it
was published.
I wasn't and I started writingit in 2015, 2014, something like
that.
I don't guess I predicted thatwe would have this swell of
resilience training and push andall this other kind of wellness
programs and these kinds ofthings that we've had.
(32:05):
So it was interesting timingthat it was launched.
And what I'm seeing as I watchthe trainings that are out there
is there tends to be kind oftwo camps of the training and
the wellness.
One is I'm going to go out andtell war stories and you're all
going to.
All of my war stories are goingto resonate with you and we're
all going to hurrah, hurrah, thewar stories.
And then the other is we'regoing to talk about some of your
(32:27):
hardships and some of yourchallenges and we're going to
give you some real concreteadvice on how to deal with it
and real concreterecommendations and some
resources.
And I'm not saying there's notvalue in stories, there should
be stories in the other one aswell.
And so I'm seeing kind of twocamps where I've had some people
say, well gosh, they just camein and complained a lot about
some of the horrible stuff thatwe didn't get anything out of it
and you're like, and theycharged a fortune for it and
(32:49):
you're like, well, that's toobad.
So I think that agencies aresometimes throwing money at
wellness programs because theydon't know what they don't know.
It's not their line of work.
The line of work isfirefighting or police or
corrections.
Their line of work isn't inresilience, and so they really
sometimes get lost in knowinghow to build a wellness program,
how to train, how to vetclinicians to be good resources
(33:14):
for them, whether it be fortraining or for wellness program
development or what have you.
Because there are some peoplein this profession that do it
because their heart's in it andthey come from that background.
And then there's some that Ihate to say it see money to be
made and a name to be had, andthey don't always look very
different on the outside.
Speaker 2 (33:32):
Well, I think that happens all of the time that I
love what you said.
You don't know what.
You don't know Everything fromtechnology to training and what
wellness means, what communitypolicing means when you talk
about that.
There's so many variations ofthat, too, and we can't seem to
get a handle on it.
So let me wind down by askingyou a question and giving you
(33:52):
virtually the last word.
As a clinician, as somebody whohas seen countless numbers of
people in crisis, or people justtrying to figure out what's
going on with themselves inpolice, fire corrections and EMS
and dispatch.
What's the benefit of reachingout to somebody like yourself,
in your view, and what couldhappen if you choose not to?
Speaker 3 (34:13):
I want to end on a positive note.
So I'm going to start with ifyou choose not to what you
resist, persist as they say.
So you can resist, you canpretend like you're not hurting,
you can pretend like you're nothaving trouble sleeping or your
relationship isn't failing, andit will continue and it will
likely worsen.
I don't know unless you.
I mean and I'm not saying it'sseeing a clinician is the end
(34:34):
all be all, Perhaps somethingyou'll read some health, some
self-help book or get involvedin some other kind of thing and
find a way on yourself Right,and so talk to a chaplain and do
something else.
So it's not impossible for thatto happen.
But if you ignore it, it's notgoing away.
So, coming to see someone likemyself, you know, and I think
one of the first things and I'veheard I've had this feedback
(34:56):
from people before is one of thefirst things you get is hope,
and embedded in the hope is thebelief and the expectation that
you will get better if you.
That's what hope is.
I think that's the first thingyou get, and I've had people say
once I had a name for it andunderstood it, I believed I
could do this and I expected Iwould get better if I did that.
I can get on board with thatVery powerful stuff.
(35:17):
There's a book on the anatomyof hope that talks about how
that works.
And then you get systematicsupport and guidance where you
just go, be yourself in aconfidential setting to try to
navigate things you can't unsee,as you said, you can't unhear,
you can't not know, so that younot just aren't fighting your
demons anymore, Also be happy inlife, you can thrive and be
(35:40):
well, and I think every firstresponder deserves that, so the
last question.
Speaker 2 (35:45):
I guess I thought that was the last question.
But, listening you make mewander in different areas?
How does a first responder finda first responder knowledgeable
clinician?
Speaker 3 (35:55):
That is my big mission.
That's some of the work I'mdoing with the National FOP
Fraternal Order of Police, wherewe're creating what's called
the approved provider bulletin,the APB.
So nationwide it will be a listof first responder clinicians
that are vetted according to thecriteria that I co-created with
another psychologist inCalifornia, dr David Black out
(36:16):
of Cortico.
So that's what we're creating.
I'm the first clinician on thelist in the nation of probably
hundreds of us, if not more.
There are some Serve and Protectactually maintains a list.
They're out of Nashville.
You can find themserveandprotectorg and they also
maintain a list.
They vet people on the phonethemselves and sometimes just
(36:38):
Googling it and looking forthings like the APB or the FOP
stamp of approval or theNational Emergency Responder and
Public Safety Center trainingcertificate will indicate those
kinds of things.
Psychology and the IACP psychservices section also has, I
think, 200 of us that specializein this.
(36:58):
So there's a few groupings thatthey're kind of fragmented and
we want to pull them alltogether into one national
database which is again kind offull circle from.
My original mission when I wasa peer supporter is how do we
connect people with culturallycompetent help so they don't
have to go to someone and whoasked them why they had their
gun out.
Speaker 2 (37:17):
Yeah, I understand that all too well.
Again, one of the things I dowonder is COVID changed
everything and COVID forced anawful lot of us to do exactly
what we're doing, where we'retalking to each other on Zoom,
even though I'm using audio.
And now you have telehealth andthat's becoming more prominent.
How would somebody overcomeit's so much easier in a lot of
(37:41):
ways, but how would somebodyovercome?
I don't want to be taped, Idon't want one of those kinds of
things.
In other words, that trust thatneeds to be.
I'm talking to you on the otherend, I like you, but I don't
know what you're doing overthere because I can't see
whether you're writing orwhether you're recording.
How do you overcome that?
Speaker 3 (37:50):
Well, one, I let them know.
Just like in the top left-handcorner it says recording.
You can see if it's recordingand they have to acknowledge it.
And then when I say I'm nottaking note because I'm doing
like an OIS follow-up orcritical incident follow-up, I
literally sit there with myhands in the screen of the video
so that where they can see I'mnot writing anything down.
And then if they say, hey, canyou send me a handout on that,
I'll say I'm going to write downthat I'm going to.
(38:11):
And then I'll go over and writedown that I'm going to send
them a handout.
And then I put my hands back upand do you again that
transparency and that trust isit's like air.
You don't have it.
You absolutely notice, youdon't have it.
Speaker 2 (38:23):
So have you found success in telehealth in your
practice?
Speaker 3 (38:27):
Too much, actually, because it's opened me up to
first responders all over thestate versus the ones that were
within driving range.
Yeah, too much, and I'm notcomplaining, it's just it's hard
to sometimes meet the demand.
So, yeah, I think it's made ithelpful for people that have
shift work, people that havekids, people that live in remote
areas and might not want toaccess services for fear that
(38:47):
they'd see someone walking intoor out of the clinician's office
on Main Street when there'sjust two streets in the town.
I think it's helped a lot ofpeople, even people that didn't
think they would like it meetwith me initially in person,
come to build that rapport andsay, hey, you know, thursday
would be easier if I just didvirtual, is that okay?
Like, oh, yeah, you know, andso they can kind of go back and
forth as their schedule allowsand their childcare allows and
(39:11):
that kind of business, and so Ithink it's been a significant
help for some, and then forothers they're just like nope, I
want to.
I want to have my eyeballs onyou.
I understand.
Speaker 2 (39:20):
Well, listen, this has been amazing.
It's been a lesson for me and,I hope, a lesson for all of the
listeners.
You have added so much, so manydimensions to wellness and to
the help mental health for firstresponders, and I appreciate it
.
So we've been talking toStephanie Kahn.
Thank you for being here,stephanie, you're welcome.
(39:40):
Thanks for having me.
No problem, so that's anotherepisode of the Cop Doc in the
books.
We've been talking to a policepsychologist and I hope you have
found it interesting.
Stand by for more episodes andthanks for listening.
Speaker 1 (39:50):
Thanks for listening to the Cop Doc podcast with Dr
Steve Morreale.
Steve is a retired lawenforcement practitioner and
manager, turned academic andscholar from Western State
University.
Please tune into the CopDocpodcast for regular episodes of
interviews with thought leadersin policing.
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