As both a paramedic and a trained yoga teacher, I’ve been working to promote yoga to EMS responders for the last six years. As you might expect, there are some mountains to climb in selling something like yoga to the emergency responder culture.
Typically the mental health and physical fitness programs in place for police and fire are not yet seen for EMS providers. When an EMS crew is exposed to a particularly devastating situation, the average response is to allow them an hour of down time to get a cup of coffee and restock the truck. They may be allowed to go home for the remainder of their shift, but generally no further mental health or emotional coping assistance is offered. In fact, if someone feels the need to ask for help coping, they are often viewed as weak by their coworkers. This need to survive is where our stereotypical tough exterior comes from. The emergency responder world is one where acceptance, validation, and respect are based on how much one can handle under pressure, and the time we get with loved ones is stolen by stressed and distracted minds.
I unofficially polled some friends and coworkers as to why they think our field has been so resistant to yoga, since the need for this tool is widely known. Every person generally said the same thing: “Yoga is foofoo. We have an outside toughness we need to uphold, and yoga brings out emotion.” But this answer in itself is the very reason yoga is needed so desperately in our field: to help us break through that barrier of toughness. We need a tool to help us deal with the repressed emotions after terrible calls and the cumulative stress of years on the job.
What we think of as yoga here in the Western part of the world isn’t how yoga was originally intended to be practiced. In many other countries yoga is used as a way to train the warrior professions: police, fire, EMS, and military. It is a way to instill a skill set for responding mentally and emotionally during and after high-stress situations. The United States tends to teach our first responders how to respond physically, tactically, and clinically in emergencies but often drops the ball on what to do mentally and emotionally. Due to high incidences of post-traumatic stress, compassion fatigue, and suicide among emergency responders, there is now a push toward mental health and stress awareness. Conversations are happening around the subject, but for the emergency responder culture to seriously consider learning a tactical skill to handle stress and pressure on a deeper level has never been quite so vital as it is now. This skill set can be found through yoga, and the effectiveness is science-based.
Sympathetic vs. Parasympathetic
The easiest way to control our mental and emotional feedback is to learn to control our sympathetic response during an emergency and balance out our parasympathetic response for after-action regulation. Our parasympathetic response means we are relaxed and our systems are balanced. The parasympathetic response conserves energy, slows the heart rate, lowers our blood pressure, slows our respiratory rate, and allows us to digest with ease. This is where we should be spending most of our time.
On the flip side, our sympathetic response is our “fight, flight, or freeze” response, which increases stress hormones such as cortisol; increases heart rate, respiratory rate, and blood pressure; dilates pupils; increases blood flow to our skeletal muscles; and more to ensure survival for ourselves or others. Basically it gets our body ready for a Saturday night fight at the bar. This response is necessary for survival and designed for infrequent life-threatening situations. Due to the high rates with which emergency responders are required to activate their sympathetic response, it can become dysfunctional, or “stuck.” But consciously controlling your breathing patterns can work as a remote control to your central nervous system.
The science behind it is simple: Deep breathing increases the volume of air we pull into our lungs; many of us would understand this as increasing our tidal volume. When we increase our tidal volume, our lungs press on the diaphragmatic wall. The diaphragm then pushes on the abdominal cavity, causing the abdominal cavity to press on the vagus nerve and stimulate it. Our vagus nerve is our 10th cranial nerve and interfaces directly with the parasympathetic nervous system response. With only 30 seconds of deep and controlled breathing, your respiratory rate begins to slow, heart rate slows, and blood pressure starts to decrease.
Success in Training
How can this affect emergency responders on and off the job if we aren’t going to walk around all day manipulating our breath? Through training, just like we train anything else. Yoga for First Responders classes always start with a specific kind of deep breathing technique called three-part breath. We consistently go back to this breathing technique, especially when students are in challenging postures or physical drills on the mat. Through this training technique, your mind and body ultimately become accustomed to processing stress in a manner that allows the system to be in necessary activation, yet stay calm, focused, coherent, and in control while in a stressful yet safe situation on the yoga mat. This is followed by proper recovery and regulation of the nervous system. This training then translates intrinsically to a skill set that controls the mental, emotional, and even physical response to handling and processing stressful situations on the job.
The key to the success of YFFR training is breath work, and the three-part breath is the foundation. Watch this short video to learn YFFR's three-part breath.
Jenna Ferlazzo is a paramedic for two large health systems in New Jersey. She has practiced yoga for nearly 20 years and is a certified yoga teacher and an ambassador for Yoga for First Responders. Jenna is also the CEO and founder of a first responder-based wellness company that brings comprehensive and integrated wellness programs to first responder agencies across the country.