What Can We Do, What Can We Say: Verbal First Aid in Real Life
Deepak Chopra begins to answer that last question when he uses the metaphor of two people in a roller coaster. The following example is an adaptation and elaboration of his story:
Two people are getting into a roller coaster. One is a young cowboy--hardly moving off the platform yet, but his arms are already in the air and he's hootin' and hollerin' with anticipation. His heart is pounding. He's smiling. The woman next to him has her hands clamped down onto the metal rod in front of her. Her heart is pounding but she is not smiling. Both are in the same seat, on the same ride, but they are clearly not experiencing the same thing. The difference? Their thoughts.
The young cowboy in the roller coaster sees that the woman next to him is nervous. He turns to her. She looks to him, her eyes wide. She says, "How can you be so relaxed?" He smiles, points to his hat, "It's my magic hat." He takes it off his head and hands it to her. "You hold on to it while we ride, okay? It's easier to enjoy the ride when you know you've got magic with you." Her hands loosen their grip. She takes the hat. Tentatively, she smiles.
According to medical experts, anxiety (or fear) and pain are inextricably woven together for the vast majority of people. A great deal of human discomfort comes from our anticipation of it and our perception of it. Unfortunately, there is nothing marketed as vigorously in this country as is fear. If we're not scared to death by a headline, it's a radio report, a movie, a video game, or a television show. We're literally bombarded by images and ideas that promote fear. We are propelled by it and sold by it.
If the science is correct, the good news is that we can change it on every level--from the conscious to the autonomic. When we alter our thoughts, are soothed by a kind authority, or are assured that we are in good hands, we can begin to feel the changes in our bodies--the softening of muscle fiber, the opening of bronchial tubes, the quieting of pain, the start of healing.
This is why so much of Verbal First Aid in the field is directed to the alleviation of anxiety through the development and utilization of rapport. In rapport, a person will feel, "She understands me." "He is going to help me." "I'm safe, now." When we feel understood, our anxiety is reduced. And when anxiety is reduced, pain is relieved. Even if we are entirely alone, clinicians and scientists agree that what we say to ourselves matters and we can direct our thoughts so that our chances for survival are enhanced.
The Power of Rapport
Whether you're speaking to yourself or to someone else on the trail, how you approach someone mentally and emotionally is at least as important as the medical expertise you have, according to Winnie Maggiore, former Asst. Chief of Placitas Volunteer Fire Brigade, paramedic, former Asst. D.A., and now a malpractice defense attorney.
"We saw the same things in the wilderness that we saw locally--snake bites, mountain bike wrecks, breaks, falls, cardiac conditions--but the injuries in the wilderness feel worse to the patient in that he's away from familiar surroundings. Most of what we had to do in rescues was anxiety management. The first step is to let the person know you have the expertise to help. This conviction allowed us to say "do this' in a way that motivated compliance."
The other major ingredient in dealing with crises on the trail, according to Maggiore, is giving people some sort of control over what is happening to them. "When we were just learning emergency medicine, we were given a course in hypnosis so it could be used in pain control, because it could be all we'd have to work with out there. The worst part for patients was being out of control so put them back in control as much as we could, gave them something positive to focus on. Panic is a patient's worst enemy."
People normally want to reassure with blanket statements, e.g., "you're fine." When this is obviously untrue, it's the sort of statement that breaks rapport. It's better to say, according to the experts, that the worst is over and you're there to help. Your caring presence is the cornerstone of the healing process. If you don't know what to say, say nothing and listen as you wait for help or do standard first aid. Your care can do more than you might imagine.
Mental survival--regardless of where a person is, whether that's in the extremes of battle or a backpacking expedition--is often a matter of recalling or being made aware of the resources one already has. As Lt. Costello learned the hard way, the mind is the greatest weapon of all.
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