Judith Kimball PhD OTR - Dial It Down: A Wellness Approach for Addressing Post-Traumatic Stress in Veterans, First Responders, Healthcare Workers, and Others in This Uncertain World

DEDICATION

To my family members who served in the armed forces:

My father: Lt. Col. Edgar J. Giencke, USAF Retired

My brother: Capt. Robert E. Giencke, USAF veteran, Biomedical Sciences Corps

My Son-in-Law: W. Lane Carpenter, US Army veteran, Expeditionary Force 1999-2000

To my two very special teachers and dear friends:

A. Jean Ayres, who did the pioneering work on Sensory Integration and inspired and challenged me to learn more about and do research on sensory integration issues.

Patricia Wilbarger, who did the pioneering work on sensory defensiveness and inspired and informed my clinical practice.

And to Charlie and our three daughters, Amy, Heather, and Emily, who lived with an Occupational Therapy Sensory Integration Clinic in our house and spent many hours helping me learn.

FOREWORD

I first had the opportunity to work with Dr. Judith Kimball in the 1990s when I was a medical student and she was the director (and founder) of the award-winning occupational therapy curriculum and clinic at the University of New England. My previous background as a trauma survivor, and as a professional dancer who experienced significant physical injury, had given me what was to become a lifelong passion for understanding and working to heal the incredibly complex intersections of the physical and emotional components of trauma and post-traumatic stress. Dr. Kimball was among the most skilled, knowledgeable, and compassionate practitioners I encountered in this field during my education, and she has remained so during my thirty years as a physician affiliated with Maines leading hospital systems and its osteopathic medical school, and in my private practice.

Over the years, I have had the privilege of treating patients with Dr. Kimball, including veterans with diagnosed PTSD and people suffering from chronic pain, and I was struck from the first by her unique ability to balance her rigorous research-based grasp of the neurophysiology and psychology of post-traumatic stress with a direct and deeply empathic connection to each patient. Judys combined knowledge and warmth stand out on every page of this extraordinary book. Dial It Down is a much-needed resource on the effects of post-traumatic stress for both patients and medical providers. It combines a focus on practical daily strategies for healing with an open and accessible tone for general readers, as well as a solid research foundation with additional resources for those who may wish to explore this topic in more depth.

Dial It Down offers excellent self-assessment tools and guidance for individuals and families whove experienced trauma and its complex aftermath, along with an assurance grounded in the stories told by patient histories that healing and wellness are possible. As an occupational therapist, Judy has always been intensely focused on meeting her colleagues and patients where they are in their individual journeys toward healing, and her book similarly offers not a one-size-fits-all prescription but rather a broad range of possibilities for exploring, experiencing, and talking about post-traumatic stress. For clinicians like myself who treat those suffering from post-traumatic stress, Dial It Down offers a kind reminder of the questions we often dont think to ask our patients about the often-subtle after-effects of trauma, when we need to be mindful of its small and large daily impacts on individual sensory experiences, intimacy, and family life.

This book is truly a gift for those whove endured trauma, and a testament to Judys singular understanding of the value of connections : the physical, mental, and emotional connections that each individual must navigate in their own unique way on their path toward better health; the importance of repairing the connections to support networks of family and close friends that are all-too-often damaged by misunderstandings in the aftermath of trauma; and finally, the crucial connections to society as a whole that often suffer due to a lack of understanding of trauma among the general public and even the medical establishment. Dr. Kimball provides us ways to explore, share, and talk about these matters.

As I write this in February 2021, all of us have recently experienced unprecedented levels of traumatic stress in our daily lives: the loss of routines and personal connections resulting from the COVID-19 pandemic; the economic uncertainties generated by this health crisis; and the political upheaval and crisis of the 2020 election cycle. The target audience of this bookfirst responders, military personnel, and frontline medical workershave suffered greatly from these and other traumatic experiences and will benefit from the wisdom in these pages. But I also highly recommend this book as a path toward post-traumatic growth and healing for anyone who is struggling to repair personal, familial, and social connections in these difficult times.

Stephen Goldbas, DO
Whole Health Osteopathic Medicine
Portland, Maine
February 7th, 2021

PREFACE

The COVID-19 pandemic leapt to the forefront of the news and of all our lives across the United States just as I was completing my final draft of this book, which was originally intended to support veterans and first responders (police, firefighters, and EMTs) in finding ways to manage the trauma resulting from their prolonged exposure to life-and-death situations, a trauma that often disrupts not only their perceptions of personal security but also their most intimate connections with family and close friends.

The new national and global realities of COVID-19 tragically and exponentially increased the number of individuals experiencing trauma: frontline healthcare workers (doctors, nurses, medical technicians and assistants, and respiratory, physical, and occupational therapists); essential workers operating daily in unsafe or uncertain environments (postal and delivery service workers, grocery store and warehouse employees); and, in different ways, all of us, from COVID-19 patients and their families, to senior citizens and individuals with underlying health conditions, to unexpectedly unemployed workers, to school-aged children and toddlers (and their parents) who crave but suddenly faced the loss of in-person connections to extended family and peers. We have all, in different ways, been on the front lines of a war that has taken us far away from our former lives. We will all, even after the widespread distribution of effective vaccines and treatments, still carry some of the emotional, psychological, and physical impacts of this time.

The research- and treatment-based techniques for recovering from trauma described in this book can be applied across all ages (many of these were in fact first developed to aid children diagnosed with sensory issues) and professions. As the pandemic has demonstrated on a devastating scale, we all share the same biology and inherent vulnerabilities. But we also all share the same potential strengths that can help us, in both large and small ways, to regain a sense of security and connectedness.

I have expanded the language of this book to include COVID-19 frontline healthcare workers as well as the originally intended veterans and first responders. The traumas faced by these active-duty and medical personnelliving under threat for extended periods, whether the threat of gunfire or of potentially fatal infection, and being directly responsible for the lives of othersare comparable, and frontline medical workers deserve and can benefit from the same supports and treatments that are available to military personnel and first responders.