When I was just starting out as a social worker, I read a book by Stephen Bergman (under the pseudonym Samuel Shem) called House of God. It was about a medical internship in the ‘70s – a satire that was as hysterical as it was inappropriate. The intern in the book reveals several “laws” for doctors, most of which are concerning to say the least. One however, stuck with me: “At a cardiac arrest, the first procedure is to take your own pulse…”
If only I had been able to follow that law during my career in children’s behavioral health. When a crisis hit (and it hit a lot), I would withdraw into this strange mental place in which my emotions were deadened. I looked for the most efficient (in my mind) resolution, and, as a result, I became absolutely controlling. There were many points in my career in which I saw this as a value, a super-power, and a real benefit – my employers generally reinforced this for obvious reasons – “He’s good in a pinch…”.
In fact, I became less attuned to my own emotions and the impact they were having on my body and my behavior (let alone others). Frankly, I became almost completely unaware of those impacts on a day-to-day basis. Only during certain nexus-moments (vacations, conflict in personal or professional relationships, 3am on sleepless nights, & etc.) would I be able to reflect and connect the trauma with the consequences of trauma on my own life.
I suppose I am offering this as a cautionary tale about the need for reflective practice at all levels in behavioral health and special education. If we don’t “take our own pulse first” in a crisis, we may stop taking it altogether and enter into the so-called “culture of toughness” – a culture that is the polar opposite of a trauma-informed approach.
Too often have I seen organizations subtly encourage a “culture of toughness” and a disregard for the impact of your work on your own well-being. They don’t do this because they are cruel, they do this because they are desperate. We are a people-intensive industry and the delivery of workers to the job is essential for uninterrupted operations. The more we get into the mindset of folks taking “mental health days”, the more chaotic the operation becomes. It’s easier to manage a controlling milieu than one which truly values the needs of each individual. “Keep calm and carry on” appears to be the mantra of our industry. But this is flawed thinking.
The problem is, it’s unsustainable. Without the encouragement of reflective practice, without a “trauma-informed” perspective on the workforce as well as on the clients, without real and meaningful pressure-valves to release the tension that is the very nature of what we do, our programs become compromised. Strangely, that shift in mindset is beginning in many first-response organizations – EMT squads are increasingly connected to a behavioral healthcare professional, as are police departments, and emergency room personnel. The most recent season of the television show “The Pitt” brilliantly captures this tension; Robby knows that his purpose as a person is fused with his professional identity, but also is fully aware that it is killing him and he is trapped in a feedback loop. But, is that renewed focus on mental health happening in the schools and provider organizations that manage behavioral crises regularly? We as the “behavioral healthcare experts” seem to be the last to develop systems and processes to support reflective practice and a truly trauma-informed approach to the workforce.
I don’t say this from a place of despair; I call it out as an opportunity for the future. Ukeru is compelling for me, as it addresses not only the needs of the clients, but the needs of the workforce, and provides real and concrete tools that can be used to maintain safety without incurring additional trauma. We need to build on this and create real and sustainable resources for staff in schools and in provider organizations that help them debrief, contextualize and recover using the tried-and-true techniques that we ourselves employ on behalf of our clients. We need to commit to resourcing this, even though resourcing it is hard, carries cost, and disrupts the “front line”.
As for me, everything turned out okay in the end (I think), thanks to professional colleagues and supportive family. But, I’ve had to do a lot of forgiving of myself for the things I did in response to a crisis when my repertoire of responses was small. And I have no doubt that the experiences I have had in this field, both good and bad, are indelibly inscribed in my brain, my psychology and my relationships. I hope for a future in which all organizations doing this work make the well-being of the workforce a primary focus.
– Scott Zeiter, Outreach Strategist
Scott Zeiter has been a clinical social worker since 1996, working across inpatient, outpatient, crisis, and residential settings. He joined Grafton in 2011, where he witnessed the early growth and impact of Ukeru across the organization. After serving as Chief Clinical Officer, he moved to Vermont in 2024 to fulfill a lifelong dream, and rejoined Ukeru in 2025 to continue supporting the expansion of the movement.
