23-year RCMP retired police officer, clinical psychologist, and resilience trainer Jeffrey Morley, PhD, talks about his journey through occupational stress and trauma and his current clinical practice supporting first responders and helping them heal from occupational stress and trauma injuries. Jeffrey shares the rewards and challenges of the different types of police work he did throughout his career working in patrol, plain clothes investigative work, and leadership, as well as the importance of physical fitness and healthy relationships while defining resilience adaptations that first responders can make to cope with very stressful and challenging jobs and the importance of self-awareness and recognizing the early warning signs of physical and mental health risks, as well as maintaining social connections both within and without their profession.
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Resilience Adaptations that First Responders Can Make Transcript
Fleet Maull:
Hi! Welcome to another session on day three of the Global First Responder Resilience Summit. My name is Fleet Maull. I'm your co-host for this session. I'm thrilled to be here today with Dr. Jeff Morley. Welcome, Dr. Morley.
Dr. Jeff Morely:
Thanks for having me.
Fleet Maull:
Great to have you here. I really appreciate you being part of the Summit. I'm going to share a little bit about your background for our audience, and then we'll get started with the interview. Okay?
Dr. Jeff Morely:
Great.
Fleet Maull:
Dr. Jeff Morley is a registered psychologist and board-certified expert in traumatic stress. Jeff spent 23 years as a police officer in the Royal Canadian Mounted Police, retiring as a staff sergeant.
In his practice, he now works with mainly first responders providing assessment and treatment. Jeff conducts training across Canada on trauma and resilience for first responders. I can't think of a more appropriate person to be talking to here for our Summit.
Dr. Jeff Morely:
Great.
Fleet Maull:
Let's start with your background as a first responder. Served as a police officer in the Royal Canadian Mounted Police for 23 years. What kind of challenges did you face over more than two decades as a police officer in the cumulative sense, and how did you work with that?
Dr. Jeff Morely:
That's a good question. As I think about that, I think one of the things that I noticed is that each sort of type of policing I did bring with it its own sort of both positive things, rewards, and also some of its own challenges. And whether that's doing sort of uniform patrol, dealing with the frontline thing, sometimes dealing with violent or aggressive people, attending fatals, suicides, all those sorts of things, and dealing with shift work, and the pressures that come with that are one challenge.
I think it's a different challenge when we take on a role, maybe in a plainclothes unit where we're more apt to be involved in detailed files, working overtime, working in formats, and some of the pressure that comes from higher-profile files. I also think getting promoted and now becoming a leader in an organization where we're responsible for other police officers
and civilians out there doing their jobs. And both the rewards and the pressures that come from that wanting to care and protect for the members that are out there.
The last few years of my career were in HR, being a carpet cop. A lot of people give us a poke for doing that, understandably, but I can tell you, working in HR is often very conflict laden and dealing with complicated personnel situations, internal investigations, workplace conflicts. It has its own stressors as a leader in an organization. Each of those roles has its own unique stressor. I hope that answers your question.
Fleet Maull:
Yeah. Well, you're here with us today and thriving in your career, really adding a lot of value to the community and society. So, I assume you were able to maintain your health and well-being throughout that career in some way.
Dr. Jeff Morely:
I think I did. And there are sort of different ways that were along the way. I know when I was a younger cop, a lot of that came from physical fitness, exercise, and really the social support that came along with being sort of on the road and the connections that come that way.
I think throughout my career, there were different things that helped me. Sometimes doing my own counseling work, going back to school along the way. And just sort of establishing a bit of a, I don't know how you describe that, but just a deeper sense. You started to get used to the effects of police work and learn a bit more about yourself and what you need to do to take care of yourself. So, whether that's focusing on keeping a healthy marriage and friendships in your life or sort of gaining a different perspective on police work and the world around us and how we make meaning of things in new ways. Those have all been steps in the process along the way for me, for sure.
Fleet Maull:
How did it come about that you transition from a career in law enforcement to becoming a clinical psychologist and now working mostly with first responders? I think maybe you mentioned that you sought some counseling along the way. Is that the case? Did that kind of awaken you to the possibility of becoming a psychologist yourself?
Dr. Jeff Morely:
Yeah. I've long had an interest in people, and I considered going into law, going into policing, of course. I thought about psychology back in my university days, but I didn't want to just sit behind the desk right away. So, I came out and really enjoyed the action and the movement and being outdoors and the physical side of policing.
As my career sort of progressed into more of the plainclothes world and got involved in working with informants and doing interviews and interrogation and developing those new skill sets, I realized that my aptitudes and my interests were more around dealing with people. I was never great at the technical stuff. I'd be terrible in the forensic section or being a traffic collision analyst, where I got to crunch a bunch of numbers. I'm better at dealing with people.
I think that's what helped me in my operational policing career. But I also realized I wasn't interested in just the bad guys, or how do I get someone to confess to a crime or, you know, flip somebody as an informant to rat out their friends basically, as important as that is. I really wanted to focus on other police officers and the way the work affected them. So certainly, reflecting on my own life, some of the changes I went through as a young officer, things that affected me. I certainly wanted to contribute back to others.
I actually started being a peer support person in the RCMP. We had a peer support program and got some training there. That really sparked my interest which resulted in my tour back to graduate school, getting a master's and a Ph.D. so I could be a registered psychologist. While I was still in the RCMP, I had a part-time private practice for a few years. But since retiring, it's been my full-time endeavor, and it's been a great honor to work with a lot of police officers but other first responders as well to open my eyes to firefighters and paramedics and soldiers and veterans and search and rescue and Coast Guard.
I think that's the other thing that's really struck me, Fleet, is even when we talk about first responders, we think of some of the classic ones, but I think there's a lot of people that get forgotten and whether sometimes that's a tow truck drivers that are showing up at horrible scenes or crime scene cleanup people.
I got a request to do a talk just before COVID there for funeral home directors. I tease them a little bit there. They're not really first responders. They're kind of last responders, but they too see suffering and people in distress and bleeding. Also, even within my role of policing. That is not just sort of the uniform cops or the plainclothes cops but dealing with our friends at Guidant, our crime scene analyst, our civilian staff. Our 911 dispatchers and call takers, our stenographers sometimes that are transcribing horrible statements and 911 calls, and our victim services people.
I think it's important when we talk about first responders - it's not just badge-carrying folks. All kinds of people in our world can be affected by their work over the years.
Fleet Maull:
Yeah, absolutely. Yeah. So many people are impacted by witnessing that suffering and being under that stress. And under the pandemic, so many people are even broader than those who have kept the essential services online. Even the grocery store clerks sharing their worst parts of the pandemic, who went to work so we could get our groceries. Yeah, absolutely.
So, police officers and other first responders. I do a lot of work in corrections. I think correctional officers have some of the, unfortunately, worst health statistics in general in terms of the risk, but certainly, correctional officers, police officers, and other first responders are at high risk for a lot of negative health outcomes, physical, emotional, mental health issues due to the ongoing exposure to chronic stress to both primary and secondary trauma exposure.
The statistics are pretty alarming in some cases. Some of the most tragic consequences often are the level of suicidality. But also early death from chronic stress-related ailments. So, I wonder if you could talk about kind of the nature of chronic stress. Maybe let us know about what we mean by both primary and secondary or vicarious trauma and how those things contribute to these negative health outcomes.
Dr. Jeff Morely:
Well, I'll say a few things there. I'm glad you mentioned, Fleet, that it's not just PTSD. We're having a good conversation now about PTSD in our world. But it's important to remember that PTSD is not the only diagnosis that follows chronic exposure to trauma and suffering. Certainly, there are physical ailments. And some of the recent research on that is quite scary, actually. I'm showing some research down there in the states that are showing police officers, for example, are at an increased risk for Parkinson's and ALS and some very serious physical things, but also depression, anxiety, sleep problems, addictions. You mentioned suicidality, the effect that it has on our marriage, our kids, our family, our relationships, and other things.
Sometimes like OCD or even ADHD, attention deficit, often, PTSD shows up in those ways. So, it's really important. In Canada, here we use the term operational stress injury, OSI. I don't know if you use that down there. I think it's a more inclusive term. That's actually quite accurate because it's not just about PTSD but the other broader impacts.
And then, you mentioned both primary and secondary, and I'm going to add a third thing there. But when we talk about what I define as primary trauma, to me, that's when we're in harm's way. Car chase, bullets flying, the fight is on. And with primary trauma, our reactions are very physiological, adrenaline response, fight or flight, heart rate, blood pressure, tunnel vision, auditory exclusion. It can be hard for us to speak. Our bowels may evacuate. We get a little shaky sometimes. We go into that fight or flight or freeze. We take cover, seek protection, or we give up and check out if it's really serious.
There are all these different ways that we respond to primary trauma. But it's very interesting to me that I think the general public might presume, "Oh, that must be the hard part of policing." Getting in fights or chases or things like that. But I can tell you most cops are first responders. It's like firefighters. Most firefighters love a good structure fire. To them, that's good quality entertainment. As with cops, cops rarely come into my office to tell me, "Some drunk guy punched me at a domestic." That's not what brings cops in.
So, unless that primary trauma is really bad like we are losing the fight or we're really getting shot out or shooting someone, some really serious stuff. I'm not minimizing it, but that's not the biggest thing in my experience that brings first responders in. By far, the bigger effect on first responders is the effect of secondary and vicarious trauma. There are different definitions out there in the literature and in our world. But to me, I say at its essence. Secondary trauma is about the experience of bearing witness to unfixable suffering. So, it's we're not the one that's in harm's way, but it's bearing witness to the suffering of others. Okay?
Now, whether that's a firefighter showing up to cardiac call, where the person on the floor is not breathing, nor is their heart beating, and they're doing their thing and the family's screaming, "Save grandpa. Saved Grandpa." And there's no saving Grandpa. So, they're not in harm's way. Nothing's on fire. Nothing's going boom. No one's coming at them. But it's the suffering to which they bear witness.
In policing, it's taking statements and people from horrible things that have happened to them or showing up the crime scenes, fatal collisions, suicides, sudden deaths. I mean, I think one of the worst things I can do as a police officer is do, we call it a NOK, a next of kin notification. Having to knock on a door and tell somebody some information that's going to change their life forever.
Again, not in harm's way. No one's hitting me, screaming, or doing anything. But seeing that kind of grief and screaming and crying and distress that can come from horrible situations takes a toll on us. I think primary traumas are far more physiological - adrenalin. I think that secondary trauma is far more psychological. It can affect our hearts, our souls, how we see the world, how we make meaning of this. It can lead to depression, anger, and rage. It can lead to all these effects on our physical health that you've sort of noticed as well. It weighs us down.
I think one of the main PTSD symptoms is numbing. I think that's where a lot of first responders are like, "I don't want to think about what I had to do today or remember that, so we want to drink or gamble or do things to get rid of our pain." I think so much of that secondary and vicarious trauma. As you know, sometimes there are really bad ones, but what's the bigger risk for first responders is that chronic exposure over 20 or 30 years.
I had a friend at Guidant. He was a police officer some time ago. He sat down on my couch and looked white as a ghost. He basically said, "I can never see another dead body." And I said, "Oh, were you at a recent murder?" He said, "Yes, I was." And I said, "Well, what was it about that one?" And he said, "Nothing different than the other 180 that I've been to." It's that cumulative effect that gets us over time.
Fleet Maull:
I think that it's really important to talk about the cumulative effect of ongoing exposure to high stress, sometimes chronic stress if it's insufficiently managed, and then all these various kinds of trauma exposure. It really can be the silent killer in a sense.
We're all empathic to one degree or another. We feel what other people are feeling. We're exposed to suffering. It impacts us. And so, you're talking about that empathic distress that we can be in as a result of exposure to human suffering. And, you know, if we don't have some way to work with that, it can then lead to empathy fatigue and burnout, and worse consequences.
I'd like to explore with you a couple of other maybe ways of thinking about secondary or vicarious trauma. So, from my understanding, and especially in agencies, when there is an incident of some kind, everybody hears about it pretty quickly. News travels fast. And so, when we hear about an incident that someone else is in, somewhere in our brain conscious or unconscious, probably mostly unconscious, we're going, "That could have been me." So, to one degree or another, we're having the same neurochemical experience as the person who's in the incident, to a much lesser degree, but again, it's the cumulative impact.
We all experienced this to a degree in modern life. You can imagine parents of school children when they see on the news about another school shooting. They're going, "That could have been my kids." Right? So, I wonder about that impact. And then, the other one is that we are empathic beings. We take on from the world around us.
When we're not very awake or mindful, we tend to soak things up like a sponge, which is why I think mindfulness training is really helpful. But when we work around people who are holding a lot of trauma in their nervous systems, especially for corrections officers, I think we're there 8-12 hours a day with an inmate population who are holding a tremendous amount of trauma in their nervous systems while then working around your appearance. We've been at it for 10-20-30 years, and they're holding that. So, I wonder if you could talk about those two other types, possibly of secondary trauma that can accumulate over time.
Dr. Jeff Morely:
Well, one of the notions that you brought up that I think is really curious is this whole business around empathy. I think, look, is empathy a good thing in first responders, police, fire, corrections? I mean, do we want empathic corrections officers? Do we want empathic police officers?
I mean, it's interesting. I had a very high-ranking police executive say to me some time ago, "Jeff, how can I hire cops that won't get PTSD?" I said, "Oh, ma'am, that's easy. Hire psychopaths. They won't be affected by anything they see." And I was only being a little bit of a smartass. Like, empathy is a great thing. Daniel Goleman would say empathy is the prime inhibitor of human cruelty.
Yep, we also know that empathy is a predictor of PTSD. Like, the more I feel, the more I connect with the suffering of others, the more impacted I am. So, it's this dilemma. I think that empathic cops are what makes them very good at dealing with victims. It's also what keeps them ethical because if I truly appreciate the impact that my behavior has on others, I'm not going to harass you, bully you, or talk about you behind your back. But it takes this toll. So, I think Fleet, what we have to do is find a way to frame our empathy.
Richie Davidson there, I think he's in Wisconsin, does some interesting work on mindfulness, which I understand is a passion of yours. He talks about the difference between empathy and compassion. They sort of sort out the dilemmas. But to me, empathy is this felt sense, which can be a good thing on how we can act. Compassion is this mindset of, "I see your suffering. I'm here. I'm bearing witness to it. What can I do for you?" without it sort of taking a toll on us.
So, there's some very cutting-edge research that I think we need to have this ongoing discussion as first responders. How do we keep our hearts and at the same time protect them so that they don't just get exhausted too quickly because of overexposure to the trauma and unfixable suffering?
Fleet Maull:
Yeah, absolutely. I think there is good research showing that we couldn't have relationships if we didn't have empathy, right? It's a basic human skill to be able to tune into each other and understand what each of us is feeling and needing. But if we take on, take on, take on, and take on, at some point, our system just starts shutting itself down, and we go into that empathy fatigue, burnout. That's not a character issue. It's just our system is shutting itself down to take care of itself.
And so, there is research showing that when we're more awake and we kind of have good boundaries, a strong sense of self and appropriate boundaries and at the same time, we're empathic, then we can handle that better. It doesn't stick in. But then also compassion. We used to use the term compassion fatigue. That's considered a misnomer today because compassion is in of itself transformative.
When we're able to respond altruistically, and when we're able to wish the best for others, it does sort of transform. At that point of empathic distress, instead of going into empathy fatigue and burnout, being able to act compassionately or even feel compassion actually transforms the experience and gives us really, in a sense, more resilience in the face of that empathic distress, I think.
Dr. Jeff Morely:
Well, what you're saying there, I would just say a big amen to. It's also the importance of when we are exposed to a great deal of trauma and suffering in our work, and we have a lot going out, to make sure we also have a lot coming in, to make sure that our self-care is high.
I remember an ethics class in my grad school. There were five ethical principles. Beneficence and non-maleficence - do good, do no harm. Justice and fidelity - be fair, keep your promises. And the fifth ethical principle was self-care. I remembered it because, one, it didn't have a fancy word attached to it, but it was like, self-care is an ethical principle. But even for me, if I showed up here to our time this morning, hungover and not rested and fed, I'm not going to be able to do my job as effectively as I can. So, self-care is an ethical requirement.
I think so many first responders get exhausted by their work. You also mentioned burnout, Fleet. You're covering a lot of things. That's another word that I think sort of gets, not misused, but like, "Yeah. I am burnt out. I'm burnt out." Like, burnout is quite serious. Burnout can have profound effects on our physical health. As we've noted, our psychological health, spiritual health, emotional health. I think many first responders call on their 12-hour shift and then doing overtime and dealing with crisis, run home, walk the dog, feed the kids, and get back at it the next day.
I think they get the primary trauma, the secondary trauma, those burnout factors. It can be hard to maintain the needed level of self-care. So, that's what I'd say to people. Self-care is not selfish. The more you got going out, the more we have to up our self-care when most of us knock it down a bit because we're too busy to go to the gym or go for a hike. So, just really hammering home the importance of self-care, resilience, and mental health is huge.
Fleet Maull:
Absolutely. And naturally, one of the primary missions of this Summit. I'm glad you brought it up actually as an ethical principle. It is ethical to take good care of ourselves, so we can show up in the world. Show up as parents, show up as spouses, show up as friends, and show up as professionals and whatever our work and career and livelihood is, and so forth.
Self-care does sometimes get a bad rep as being selfish or something like that. I've started, and some others have started using the term self-stewardship, which I kind of liked, but I don't know that's going to catch on. But I think we also need to just really reaffirm that self-care is not selfish, right.
The other thing besides trauma exposure, high-stress professions, we tend to end up living in that stress zone. We don't get enough time down in the rest and recovery zone, right. And so, we got too much cortisol in our bloodstream, too much adrenaline, noradrenaline all the time. That affects all of us in modern life. We're all kind of living up there. And as Dr. Herbert Benson talked about in the late 70s, we've unlearned the relaxation response. We don't know how to get back into that recovery zone.
Self-care is really about building in those rest and recovery loops. Not only at night. Hopefully, to get a good night's sleep but throughout the day. Finding ways to do that throughout the day.
Dr. Jeff Morely:
Well, one of the things that you just said there really caught my ear. It's about the role of chronic exposure to adrenaline and how it takes away our ability to relax. I think at its essence it's what trauma does. It takes away our ability to connect, relax, and even to play with our kids or in our lives. We come home, and we were just that some horrible, triple, fatal whatever. And, you know, how was your day, Honey? Or trying to listen to our kids talk about some incident at school that, by our standards, is nothing compared to what we went through today. And we've still got all that adrenaline in our system.
A big part of dealing with our work is not just the psychological but the physical. Because even a lot of the symptoms of PTSD, by the way, again, we focus on the numbing, avoidance, hyperarousal, re-experiencing, but often if we don't sleep, we get headaches. People grind and clench, chest pain, irritable bowel.
So often, for first responders, I find that the body is the barometer. Myself included. Arguably I can keep my head screwed on reasonably well most of the time during the day, but you know, it's my body that won't let me sleep, or I'm grinding my teeth at night, or chest pain if things are high. So, really paying attention to our physical bodies and our physical health is also a big part of resilience that I think we're just focusing on more and more.
Fleet Maull:
Yeah, absolutely. And so, continuing with self-care and resilience, let's talk about that. So, you do a lot of resilience training for first responders. Before we talk about kind of what you do, what does resilience mean to you? What is resilience? What's your understanding of resilience psychologically? Neurobiologically?
Dr. Jeff Morely:
Well, it's a good question. In the technical sense, there are different definitions out there in the literature. There's no one agreed-upon definition. Some people think of it as hardiness. "I'm not affected by things." Others, it's bending but not breaking, or the bouncing back, which is the one that I liked the best. But, I quite frankly, almost think we need to redefine the notion of resilience for first responders because I don't think it's about our work never affecting us or not changing us. Our work does change us. And that doesn't always need to mean in bad ways.
Maybe we'll touch on that later if we have time. It's things around post-traumatic growth. But look, with resilience as first responders, it's often normal. I think every cop has some degree of hypervigilance, for example. I don't always mean that in the clinical sense, but they're just aware of their surroundings, maybe the way that's different than others. Corrections officers. When I work with corrections officers and they're in the grocery store, and they see some coming down the aisle who's all tattooed up and things like that, they might see that differently than civilians would, right.
I think we need to redefine that. I stick with the bounce back. And essentially, resilience to me is that our coping exceeds the stress level. We can make meaning of ourselves. We're maintaining our physical health and the ability to relax, connect, and enjoy our lives.
Fleet Maull:
Yeah. We will talk about the idea of post-traumatic growth in a moment. Some people are talking about the idea of not just bouncing back, but maybe bouncing forward, right. But before we go there, so you do a lot of resilience training. What kind of skills, practices, or strategies are you offering to first responders for them to build resilience to heal from accumulated trauma and mitigate those health risks that they face come along with the nature of the job?
Dr. Jeff Morely:
Well, of course, I'll try and give you the highlights of a full-day presentation here in a short version. But I guess the essence of resilience to me is, one, learning to recognize the early warning signs. Not waiting until we're totally amassed with massive PTSD and depression and addiction issues on our third marriage before we figure out, "Hey, maybe I should go and talk to somebody about this, right?"
Recognize the early warning signs. Get in and deal with them early on. And then, some of the key principles I like to talk about when I work with first responders and resilience, what's the biggest factor for most of them? Social support, connections, friends, family, staying connected. Because I think so often, that's what first response work is. We're on shifts. We don't have the same days off as everybody else. Then, we start to settle into our own group, and our friends become other first responders. And then there's them in a nice sort of attitude. And then we sit around and have a few drinks or go for dinner, and what do we talk about? Work and all the trauma that's going on.
I think it's really important that we both have friends on the job that can understand and relate but also friends that are normal out there to keep us grounded and balanced in our life. So, peer support, outside support, professional support. Look, I'm a bit biased because I'm in the field, okay? Counselling works. Eighty percent of people that come in get better. I can't erase your memory, nor do I want to, but we can sure help reduce some of those symptoms and bolster up those resilience factors.
Social support, professional support. Other just practical things like really making sure you're getting proper sleep. I mean, it's hard enough with shift work, but it's one of the biggest factors, and that's what I'd say. If you went through a bad call, you're not sleeping for a night or two, so be it. Practice some other skills. But you're going on with chronic sleep deprivation? Go and get some help!
We've got much better meds that are less addiction and tolerance and all that kind of stuff that can help. We've got cognitive behavioral therapy for sleep. So, that's a big one, our physical fitness. I don't lecture about it for your physical health. I mean, for your mental health. Right? With the US military. It's one of their four pillars down there, right? Social support, diet, exercise, and sleep. But that fitness piece is huge for our mental health. Time and nature are good for our mental health. I know you've got an interest in mindfulness or more than an interest from what I know of you, quite a skill set. But that's the other thing because we know with PTSD, a lot of the current research that Van Der Kolk and some of these other folks are speaking about and coordinating is how trauma can actually change our brains, how it changes the grey matter.
I can tell you, as a psychologist, it's like, "Oh, my goodness. What are we going to do?" Right? This person, their brain is actually different. But one of the things we're learning through the principles of neuroplasticity is that the brain can also heal and change in good ways. And again, you probably know the research better than me, Fleet, but the role of mindfulness training in actually changing the grey matters, thickening the cerebral cortex, calming down that blessed amygdala, the fight or flight brain is huge.
I strongly encourage all first responders not to just read a book or download an app, find a class and a teacher to really get some formal training in mindfulness because it's one of the best things. It helps our sleep, our emotional self-regulation. It calms down the amygdala. So, that's huge. I know you might want to comment on that.
The last thing I'd also say is just the importance of making meaning of our work. We sometimes see very difficult things and go through very difficult things in the course of our careers. So, finding that capacity to make meaning of what we see and go through. And for some people, that's in a spiritual tradition. Other people, it's through conversation, or self reflection, or mindfulness. But we need to have that capacity to appreciate that our work and our lives matter even when there are difficult parts. See that big picture because it helps orient us and grounded in terms of the meaningfulness of our lives and our work.
Fleet Maull:
Wow, you covered a lot of territories there. So many important things. I mean, first responders, we're experiencing all these challenges we've been talking about before the pandemic. And with the pandemic, it's all just escalated and been exacerbated in so many ways.
You mentioned the importance of social support. We've really been restricted around our social connections and our ability to connect with others. Generally, we've heard the term social distancing in many people. Richie Davidson, you mentioned. Other known psychologists like Dan Siegel. No, we should be talking about physical distancing. We need to stay socially connected, right? But we are restricted. You're wearing a mask. You can't even get the facial cues that bring your social engagement systems online, and so forth. Right?
I mean, everyone's been impacted, and our first responders even more so. And you mentioned the sleep issues. Kind of connected with mindfulness, but it is almost a world in itself is the whole notion of breathwork and regulating your own autonomic nervous system to very simple breath regulation practices. There's been a renaissance in this kind of work around the world. People may have heard of Wim Hof. He's one of the most famous out there, but there are many, many teachers of breathwork. I'm finding again and again that we can introduce people to something as simple as straw breathing or 478 breathing. In the military, they call it tactical breathing or box breathing. And somebody within a couple of nights is sleeping all through the night without any other assistance, just using these simple breath regulation tools.
Dr. Jeff Morely:
One little tip I use for that, Fleet. In my world, I think some first responders, arguably maybe, some of the old school would see this all meditation, this hippie, BS, or you know, breathwork. Like, that's for some yoga person or something. But I like to say, "Look, you know, I like to frame things like breathwork. I use the term tactical breathing. That is something that they can relate to.
And even mindfulness. I encourage my first responders to say, "Look, there's a long tradition of mindfulness practices in the warrior professions." whether that's the samurai or the Zen months. I ask cops, "When is the first time you practice mindfulness?" Or the last time. I don't know. I don't know much about that. I would say when you're at the range. Front sight, breath, stance, focus concentration.
There's a scene in that movie American Sniper, where he's at the SEAL training center, and as his instructor walks by, he says to him that you will learn to find the space between heartbeats. Right? That, to me, is a combat version of mindfulness that I think is incredibly powerful in healing for first responders.
Fleet Maull:
Absolutely. That space between the heartbeat, that space between the breaths. Right? It can be a focal or an active point into a really a tremendous sense of peace, and we can learn to elaborate that and work with that. All the elite military units trained in tactical breathing these days, the navy seals, I don't know what the Canadian version of that is. I should, but I don't.
High-performance athletes, elite military units are all training in various forms of breath regulation because the breath is really the golden doorway, and it's regulating our own autonomic nervous system because the in-breath up-regulates the out-breath down-regulates. And so, by working with breath, we can learn to navigate our own autonomic nervous system instead of letting the world regulate it for us.
Dr. Jeff Morely:
And it's interesting, by the way, even the word psychology, psyche. Some people think it's the mind, soul, but the early iteration of the psyche is actually breath. Curious.
Fleet Maull:
Very interesting. Very interesting. So, Jeff, one of the primary goals of this Summit is to really transform or overcome the stigma around mental health and mental illness issues for first responders and any other obstacles that would prevent people from seeking help when they need help and support. And so, I'm wondering what you see. Do you see that changing in law enforcement and first responder culture in general? Because it has really probably prevented a lot of people in the past from getting the support they needed. It has probably led to quite a few deaths.
Dr. Jeff Morely:
Yeah, I agree. I think the good news is, I would say, yes, I do notice it's changing. I think more first responders are willing to come in, come in early on, and talk more openly about it, sort of in the office, or the fire hall, or at the jail.
I mean, most of the clients that come to see me come in through word of mouth. "Oh, I was talking to my partner on the watch. And he said, You know, he comes to see you." So, I noticed it's just spoken about far more openly. I think, by the way, when we get credible first responders, maybe that got a few years on the job, lived through some stuff, and they're willing to talk about what they went through, or maybe they dealt with some PTSD and had to get some treatment and work through it. But when those folks can come back and, "Hey, no. That guy's a good corrections officer. That's a good firefighter. A good police officer. And they had to work through PTSD, and they're back and good and strong and fed it doing their job. I think that goes a long way to reducing the stigma. So, education helps. I think credible people talking about it helps.
I think the more we can just normalize it. You know, if you work in construction, low back injuries might be part of the risk of the job. "Hey, in our world, we're exposed to trauma and fixable suffering." There are normal reactions that people have. Sometimes those get backed up. So, just like you go see your chiropractor, you go for a massage to keep your body physically healthy. Coming in to see a psychologist or a counselor keeps your mind and your psyche healthy as well. I hope it just becomes a part of how we do business in the coming decades.
Fleet Maull:
Yeah, absolutely. I love the way my friend and colleague, Rich Goerling, talks about it. More than 30 years in Coast Guard and then retired as a police lieutenant in Hillsboro, Oregon. He's out there bringing this kind of work to first responders.
He says, like, "I know, as a first responder, I'm exposed to all this stuff. I'm at risk for all this stuff. That's part of my job. It comes with the territory. So, I know I got to work smart. It's just working smart to take care of myself." He calls his counselor or psychotherapist a mental health coach. "I see my mental health coach on a regular basis to stay tuned up. Just like I go see my chiropractor. I get my teeth cleaned. I get my car maintained on a regular basis. It's just working smart. It's just being smart." I really hope that, as you said, we can get it normalized to that degree. Absolutely.
You mentioned post-traumatic growth before. A lot of what we know about trauma or the work around trauma began to some degree with the well-known aces study on abusive childhood experiences studies. In those days, they saw that some children actually, post trauma, would thrive. Not just be able to heal or return to normal, but actually thrive. There may have been some genetic components to that. But I think since then, we have actually learned that we can work with our mindset, maybe to encourage post-traumatic growth.
And also, there's a well-known TEDtalk out there. I encourage people to see Kelly McGonigal. She's a health psychologist from Stanford University. She's also got a great book called The Upside of Stress. In that Tedtalk, she talks about she used to teach that stress was the enemy until she saw the research pointing to the fact that really our mindset around stress has a huge impact on how it impacts us. So, they did a lot of research showing people think stress was bad for them versus people who did not think stress was bad for them.
The people who felt stress was not bad for them were not having negative outcomes from a stressful job or experiencing a lot of stress, whereas the people who believe stress is bad for them did. And they said, even the people in a low-stressed job had worse outcomes than the people at a high-stress job who didn't feel stress was bad for them.
Now, if they didn't feel stress was bad for them, they probably had good stress management mechanisms as well. But that whole importance of the mindset, and that actually, at the end of that talk, the host asked her a question, and she said, "In choosing a profession, better to chase meaning than comfort." In other words, go after what's meaningful for you and trust that you'll be able to handle the challenges that come with it because actually seeking something that's low stress or comfortable is not really a prescription for human growth.
So, I'm wondering if you can talk about really for first responders, that your choice of career can actually be the platform for their personal growth as human beings and high performance, higher states of human evolution and human progress and human growth, if they have that growth mindset and can experience what we sometimes call post-traumatic growth?
Dr. Jeff Morely:
Well, I agree with everything you're saying. The only thing I would just gently say, "Yes, part of it is the mindset, and that does help." That said, by the way, if something's really traumatic enough, or there's enough of it, any of us can.
Fleet Maull:
Sure, absolutely.
Dr. Jeff Morely:
But I think that idea of the mindset chasing meaning matters. Stress in itself isn't bad. It's like adrenaline. Is adrenaline bad? Maybe when the fight is on, and I'm losing, we've got all these adrenaline responses. But on the weekend, we go skydiving and ride our motorcycles and go surfing because we like adrenaline.
Stress in of itself isn't bad. It's finding our way through that. And when those really stressful things happen, the traumatic things, finding that path to growth sometimes takes time. Sometimes it takes support. Not all of us do it. Some things are easier to make meaning of than others.
I talked, for instance, about primary and secondary trauma, policing, and first responders. I think that's a big thing. The other big stressor, by the way, I just won't have time to talk about a lot, but it's the organizational stressors.
Fleet Maull:
Absolutely.
Dr. Jeff Morely:
Whether that's conflict in the office, a difficult boss, being under an internal investigation, the media, the public, all these sorts of things. It's one thing to cope with a primary trauma, doing a next of kin notification, or dealing with that internal strife, but all of those things still require that meaning-making process. And we do know that for most of us, as we go through after trauma, it can make us wiser.
We see how the world works. We see how people cope and land on their feet. It can make us kinder. We can run the risk of empathic distress and compassion fatigue, or it can actually give us more compassion for ourselves and others. So, it can make us wiser and kinder. It can give us a sense of gratitude that even my worst day doing a webinar today, it's not the worst day compared to what a lot of people are going through today.
So it can help just give us a context here, right? I'm not at the morgue. I'm not at Children's Hospital. So, not to minimize things, but I think also embracing and seeking that path to post-traumatic growth is a real source of wisdom for many, many first responders.
Fleet Maull:
Yeah. Obviously, it has to be married with good self-care, right? So, it's that marriage between good self-care and then being willing to challenge ourselves because what do we call putting stress on the muscles and bones? Exercise. If we don't exercise, our muscles and bones atrophy and become weak. We need to challenge ourselves physically, mentally, emotionally, spiritually to grow as human beings, but at the same time, we got to be taking good care of ourselves, or that it's going to lead to distress and be debilitating.
I know that there's been a resurgence of interest in the possible use of various psychoactive, sometimes called psychedelic substances, to assist therapy with some things that have been really treatment-resistant. Some addictions, some forms of depression, PTSD. There's a lot of research going on. In fact, they're starting to bring it out clinically. There are clinics to provide, I don't know what the current term is, but something like psychoactive drug assisted therapy.
And so, I think there's even some work being done around PTSD treatment for first responders, but perhaps with MDMA or other of these types of drugs originating with what are sometimes called plant medicine. So, could you talk a little bit about what's going on in that research and practice?
Dr. Jeff Morely:
Look, in the field of trauma therapy, it's evolved from the old Freudian psychoanalysis to behavior schools and cognitive behavior schools in the last 25 years. Probably one of the newer techniques is EMDR, for example. And now, as you've noted, there's been a resurgence in the psychedelic medicines and the role that they could have in treating PTSD. Whether there are the more potent psychedelics like Psilocybin mushrooms and LSD, there's some very good scientific, well-controlled research there.
The big focus right now is on MDMA sort of street drug would be called ecstasy. But of course, when we're talking about the role of MDMA psychedelics in the treatment of treatment-resistant PTSD, we're talking about pharmaceutical-grade medicine here under the supervision of usually at least two trained people, often psychiatrists or psychologists. And what we're finding is really powerful effects of eliminating or dropping PTSD scores by profound amounts.
For a drug to get approved by the FDA, I think it needs to basically be placebo in the high 30% to get approval. What we're learning with the MDMA studies right now is that after about three sessions of MDMA work, then about two-thirds of people are no longer clinically experiencing PTSD.
Fleet Maull:
Wow.
Dr. Jeff Morely:
So, the FDA in the states and Health Canada here in Canada are labeling as breakthrough treatments. So, we're at now phase three of clinical trials. We know it's safe. We know it works. Now, they're looking at the broader population things.
I think a lot of first responders when they think about ecstasy cops, for sure, we spent many years going after drug dealers and charging people and seeing the effects of these types of drugs on people and society and the harms that they can do. I take those seriously. I have a 17-year-old daughter at home. Do I want her going to some kid at school and buying ecstasy or what she thinks it is or going through a rave? Absolutely not. But to work with first responders in a controlled setting with pharmaceutical grade medicine, that you don't have to keep taking SSRIs antidepressants. Most medications that we use to treat PTSD now, they're palliative, they help ease some of the symptoms, but they're not curative. Right? Aspirin won't cure your sprained ankle. It might help with the symptoms.
We're exploring this, but it's looking like the psychedelics have the potential to actually be curative. You don't need to take ecstasy every day. You take it one, two, or three times in a supervised, controlled environment as part of good therapy. It can be profoundly healing.
I think MDMA, in particular. We talked earlier, Fleet, about empathic distress and compassion fatigue. We know some of these medicines, LSD. We say they're fuel. They open us up to the divine or deeper parts of our psyche. MDMA is an empathogen. It's a heart opener. I think it helps people sort of process the grief and the trauma and suffering that they see with a big flash of serotonin and compassion in our system. So, what helps us see ourselves and sometimes others in a deeply compassionate lens that allows for healing and a change in the brain?
I think it's very exciting - the work we're doing in this area. Both in the US and certainly here in Canada. I just would encourage people to keep an open mind. I mean, I think there are legitimate risks. I'm not suggesting we all go out and choke down some MDMA from one of our friends. But just to be aware that there are good, legit clinical trials going on in this. And for people with treatment-resistant PTSD, it can be a really powerful tool in the right circumstances.
Fleet Maull:
Yeah, absolutely. It's fascinating research that's going on. And this kind of research was going on back in the 60s.
Dr. Jeff Morely:
That's right. Yeah.
Fleet Maull:
But then it exploded out into the counterculture street drugs. So, then it all became illegal for 50 years. Now, fortunately, good research is going on. I know I have some friends that work as counselors at clinics outside of the country using some plant medicine, where they're working with heroin addicts, and people are coming in for treatments assisted by counselors and coming out free of heroin addiction, which is literally amazing because that's about the treatment of addiction as you can find. A lot of promise, yeah.
Dr. Jeff Morely:
There are medicines like Ibogaine.
Fleet Maull:
That's the one that I'm referencing. Yeah.
Dr. Jeff Morely:
Quite rare. It's an African root, but things like Ibogaine, Ayahuasca, and some of these plant medicines are incredibly powerful, and they're not for everyone. Cognitive Behavioural Therapy is not for everyone. Mindfulness isn't for everyone.
I think as we find our way through the effects that our work has on our life or soul or psyche, or body or health, it's finding these combinations of things, the social support, or the mindfulness, or the fitness or medication. I'm not against SSRIs. And for some people, different psychedelics offer different healing paths. Just keeping those on the table and appreciating that they're not just fringe and choking down some drug at a party. They are beneficial when they're used in the right way.
I often say it's like a knife. Is a knife good or bad? In the hands of some gangster on a roadside, it's a threat. In the hands of a surgeon, it can be incredibly healing. So, we have to treat these medicines with respect and also keep researching them, so we know the risks and also the benefits.
Fleet Maull:
Yeah, that's great. That's a great analogy. So yeah, this has been incredibly rich and really so helpful. The final day of our Summit, day six, is called leading healthy change in public safety. You've been involved in the public safety field for a long time as a police officer and now supporting police officers and other first responders.
If you had the opportunity to be up in front of a room, a large group of public safety leaders, both policymakers and operational leaders, what would your core message be? What do we need to focus on? Where are we going? What's important? What are the priorities to see the kind of healthy change we need in public safety?
Dr. Jeff Morely:
Again, big question. I'll say two things to this. One, I think it's important that all your leaders right from your junior NCOs right up to your senior leaders, be trained in what we call trauma informed leadership so that we're educated and understand the impacts of the job and trauma and how that can show up, not just in terms of PTSD but in terms of job performance, in terms of conflict, in terms of the ability to get your paperwork done on time, and not just always, for example, treating it as a performance or a conduct issue, but also being trauma-informed.
And also, even after a traumatic event's gone down in the workplace to not just, "Okay, we need to investigate this and boom, boom, boom." but to come out of it with, "Do your job. Be skilled. Investigate." but to come at it with a trauma-informed lens so that people are not just dealt with professionally but also with that sense of education, awareness, and compassion. That's really important. So, trauma-informed leadership training, I think, is very important. I think that's a growth area for organizations.
And the other one is, here in Canada, we have a national psychologically healthy workplace standard. I'm not sure if that's down there in the States or other countries around the world, but it's a voluntary standard that many organizations are adopting. In Canada, there are 13 core competencies for a psychologically healthy workplace. So, what I recommend to leaders is that you have a psychologically healthy workplace plan for trauma, secondary trauma, organizational stress, all these sorts of things.
And that not only is just there a plan in place and policies to back it up, but you measure it, that you go in there, and you look at your detachment or your units in your team that doesn't just measure their performance, "How many fires did you attend? Or how many people did you arrest?" But also with your people. What's their level of workplace engagement? Of feeling valued and rewarded? Of feeling supported? What's the level of trauma and distress that's going on there? It's sort of the old basic stuff, right? If you want to change something, measure it, right? We need to measure it.
I think just paying attention, having a trauma-informed approach, and really focusing on the bigger psychologically healthy workplace issues that are unique to first responder organizations, have a plan, measure it, set goals, and accomplish them. I think that's really how we change organizations over time in the right direction.
Fleet Maull:
Wow, that's really great. I think that's a very encompassing, high-level important strategic direction. So, thank you very much for that.
Well, thank you so much for getting us to your time today and being part of this Summit. And for your career in public safety and for the work you're doing now to support first responders. It's been great to have this conversation with you today, Jeff.
Dr. Jeff Morely:
Thanks for having me. It's great.
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