Leaving the wilderness alive: How to survive the worst when all you’ve got is you
Lt. Costello (The name and location have been changed. The story is true.) sat behind a large, conspicuously clean desk at the Tarrytown Police Station in NY. He was cool, composed, and seemed as uncluttered mentally as he was physically. The awards on his book cases and certificates on the wall attested to a long, successful career.
“I paid my dues,” he smiled as he scanned the room and the work it all represented. As he saw it, however, his career really started in Vietnam when he was only a teenager serving in the U.S. Army. It was there, assigned to an armored car division sent deep into the jungle, that he learned what it took to survive physically, mentally, and emotionally.
He was on a mission in the Delta, it was summer and the temperature outside had reached upwards of 115 degrees Fahrenheit before noon. Inside the tank, it was at best unbearable under normal conditions. On one particular day, he still remembers with stunning clarity, it was life-threatening.
“It must have been 130 or more inside. It was hot in a way I had never experienced before. I couldn’t stop sweating, couldn’t drink enough, couldn’t just get up and go to the bathroom. I was burning up. I don’t mean that metaphorically. I was literally burning up and I had to lower my body temperature somehow or I was going to die. Funny how it didn’t scare me. It was just as clear to me as the coffee in front of me now. It was a fact. I had no air conditioning. I couldn’t get out of the tank. There was nowhere to go except a POW camp, if I was lucky enough to get caught and not killed right away. I remember thinking that I should have been panicking. Instead, I was utterly, crystal clear. It was in the space of such a small moment that I realized it was completely up to me. Whether I survived or not was between me and my own mind.” The lieutenant sat forward, his body compressed with the intensity of the experience, still vivid in him.
“For some reason, I thought about something I’d heard about some monks in the Himalayas, how they went outside in sub-zero temperatures and howling winds to meditate and never suffered any ill effects. They raised their own thermostats. And I figured if they could do it that way, I could lower it. To this day I don’t know exactly what I did or how I did it, but I imagined cool water inside me and around me, like I was dunking myself into a cooler filled with ice or skinny dipping in the lake back home. And hell if it didn’t work. I’m here. I never forgot that,” he sat back. “This,” he pointed to his head, “was my greatest weapon of all. And it has served me ever since, no matter what or where the battle.”
And that is the way of the mind. The images we hold in our minds seem to be held in our bodies as well. What we think is what we are. What we feel determines how we heal.
Dr. Larry Dossey, best-selling author and one of the foremost proponents of mind/body medicine, has written, “Images create bodily changes—just as if the experience were really happening. For example, if you imagine yourself lying on a beach in the sun, you become relaxed, your peripheral blood vessels dilate, and your hands become warm, as in the real thing.”
If this is even partially true, it is an astonishing statement.
The case to definitively establish the link between mind and body was opened almost 1,500 years ago when Hippocrates wrote that a person might yet recover from his or her belief in the goodness of the physician. Belief, image, thought—these were all clinical “givens” long before the advent of modern technology.
In 1912, one doctor reported that tuberculosis patients who had previously been on the mend, when given bad news (e.g., that a relative had passed away) took sudden turns for the worse and died. It was not called “stress medicine” or psychoneuroimmunology at that time, but the concepts were the same. And today, the data supporting the connection between thoughts and health, indeed between mental images and survival, are mounting.
“We now can measure changes in immune cells and the brain in ways that give us objective scientific proof of the connection between them,” says Mary Jo Kreitzer, director of the Center for Spirituality and Healing at the University of Minnesota.
In psychotherapy circles, it is now considered common knowledge that people under hypnosis can be given suggestions and make them manifest in their bodies immediately. For example, a person who is given the suggestion that he is being touched by a burning cigarette will produce a burn blister even though the object that was actually touching him was neither hot nor cold. People known to suffer from multiple personality disorders have even been documented with allergic responses when presenting in one personality but not in the others.
Muscle movement is no different and, according to researchers, anyone who’s ever watched a movie has personally experienced the physiologic power of thought or imagery. In one study, movie-goers were monitored (via machines which record galvanic skin responses) and found to unconsciously mimic what was occurring on screen with micro-muscle movements. When someone in the movie jumped, the muscles ordinarily responsible for jumping in the person watching the movie made similar movements.
Brain scans have similarly shown that when we imagine an event, our thoughts “light up” the areas of the brain that are triggered during the actual event. Sports psychologists have been responsible for extensive work in this area. In one study, skiers were wired to EMG machines and monitored in a manner similar to the movie-goers except that they were being monitored for electrical impulses sent to the muscles as they mentally rehearsed their downhill runs. The skiers’ brains sent the same instructions to their bodies whether they were doing a jump or just thinking about it.
What does this mean for a person out in the mountains who suddenly finds himself stuck in a downpour and unable to get out before dark when the temperature is expected to fall nearly forty degrees? How does this help someone with an asthma attack in the middle of a lake or a person with a broken leg one hour from the nearest ranger station? How does this help a rock scrambler or skier have the performance of a lifetime and keep themselves calm and healthy?
What some people claim is that it can mean the difference between life and death. J. Prager is the co-author with J. Acosta of The Worst is Over. Both authors teach what they call “Verbal First Aid” to medical personnel, parents, school teachers, military, and law enforcement around the country. Based on the simple notion that the words we say (to ourselves and to one another) do matter, that they affect us both physically and mentally, there are ways to speak that make those words healing, no matter what the situation. “By saying the right words in the right way we are able to speak directly to the body, reduce an inflammatory response, help to slow down or stop bleeding, change the way an event is interpreted so that it is experienced differently in the body,” Prager states.
Over the last fifty years, the evidence supporting the claims of mind/body researchers has been steadily growing. Stress apparently makes us more than just tired. It inhibits the immune system, increases the production of epinephrine, norepinephrine, and cortisol. It is linked with heart disease and other chronic diseases, as well as infertility.
Not too long ago, one study found that the stress levels of a woman struggling with infertility are similar to those of someone who’s just been told they have HIV. In another study, Alice Domar, Ph.D. (Harvard Medical School) showed the positive effects of stress-reduction on women who were trying to get pregnant.
By changing the negative thoughts (“I’ll never have a baby”) to positive thoughts (“I’m doing everything I can to get pregnant”)—just words repeated internally—they were able to change the body’s response. The data spoke for themselves: Fifty-five percent of the women in the experimental group (those who used relaxation, yoga, imagery, and cognitive restructuring) got pregnant, in contrast with only twenty percent of the women in the control group.
This is especially noticeable with people who suffer from chronic pain. One occupational therapist in private practice in a NY suburb commented, “People in pain get into a ‘set’ and they don’t hear what they need to or open up to healing well. Half of my work with them is changing their thinking and helping them to relax and detach from their disease."
Stress is a short-term and long-term killer. It has also been shown to affect the aging process and our susceptibility to disease in general. The average life expectancy of a man living in the United States is 73. The average life expectancy of a male police officer is 59.
While adrenaline helps us to prepare for emergency action, the chemical cascade it initiates inhibits our ability to repair ourselves, to digest food properly, or even to reproduce. Epinephrine (a secretion of the adrenal glands) has been shown to constrict blood vessels. When this occurs in the uterus, it interferes with conception. Epinephrine also increases heart rate. A normal heart rate is eighty beats per minute (bpm), a dangerous stress level is 180 bpm, and police officers have been found with three hundred bpm after a shooting. One study showed that traumatic stress can affect a person’s neuroendocrine and immune systems for twenty years.
Clearly, what we do with stress not only has immediate consequences, but long-term and sometimes invisible implications. Experts have agreed that how we “hold” stress, the language we use to one another as well as to ourselves in our private thoughts, and our attitudes have a great deal to do with the impact stress has on our bodies. Dr. Hans Selye, the father of modern Stress Medicine, even broke stress into two separate entities: Simple Stress, or the stress which depletes us and Eustress, or stress we experience as challenging and exciting, which enhances our immunity.
The question then becomes: How do we use this in the field? How can we utilize these ideas to get ourselves out of a bad situation alive?
WHAT CAN WE DO, WHAT CAN WE SAY: VERBAL FIRST AID IN REAL LIFE
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.
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 Assistant Chief of Placitas Volunteer Fire Brigade, paramedic, former Assistant DA, 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 [we] 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.
Judith Acosta, LCSW, CHT is a licensed psychotherapist, hypnotherapist, and homeopathic consultant in private practice in Placitas and Albuquerque. Her areas of specialization include the treatment of anxiety, depression, and trauma. She has appeared on both television and radio and is a regular lecturer throughout the U.S. She is the co-author of the book, The Worst Is Over, which has been dubbed the “Bible of crisis communication.” This article also appeared in Duke City Fit, reprinted here with kind permission from Ken Orth, Editor in Chief.