161: Resilience Without The Buzzwords, with Kemia Sarraf

What if we stopped treating trauma like a forbidden topic and started treating it like a leadership skill set? 

That’s the spark for a candid, practical conversation with physician and public health expert Kemia Sarraf on how to show up for others—and ourselves—when life overwhelms. 

We unpack a core distinction that changes everything: traumatic stress exposure is inevitable; trauma is what happens inside us afterward. That gap is where agency lives.

We talk about why two people can share the same moment and walk away affected in very different ways, and how good intentions can still cause harm when we rush to fix, offer platitudes, or go silent. The alternative is deceptively simple: presence over prescription. Admit uncertainty. Replace grand gestures with small, steady check-ins that actually land.

The throughline is hopeful and actionable: capacity can be built, leaders can protect their teams without losing themselves, and organizations can reduce burnout, turnover, and moral injury with trauma‑responsive practices. 

Kemia Sarraf is a doctor, public health expert, founder of Lodestar, and a thought leader on the impact of traumatic stress exposure on professionals and first responders. She also serves as adjunct faculty at Southern Illinois University School of Medicine. 

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Chapters

• 0:00 Opening And Guest Introduction
• 2:40 A Mother’s Diagnosis Moment
• 6:30 Inevitable Exposure, Not Inevitable Trauma
• 10:20 Why We Misread Others’ Pain
• 14:45 Presence Over Platitudes
• 18:31 Grief, The Casserole Brigade, And Care
• 22:06 Boundaried Vulnerability For Leaders
• 26:01 Building Bench Strength And Trust
• 29:41 First Responders, Compartmentalizing, And Repair
• 32:51 Action Creates Hope And Next Steps

Transcript

Kemia Sarraf: 0:01

We don't approach it because we are afraid of what it means to approach it. And the price that we pay with that refusal is a very high price. It is a price of recruitment and retention. It is a price that is paid in burnout and exhaustion. It is a price that is paid in significant moral injury.

Manya Chylinski: 0:23

Hello, and welcome to Notes on Resilience. I'm your host, Manya Chylinski. My guest today is Kemia Sarraf. She's a physician, public health expert, and a thought leader on the impact of traumatic stress exposure on professionals and first responders. Today we talked about exposure to traumatic events, when that results in a trauma, how we all have different resources to deal with these kinds of experiences, and what it takes to lead through a crisis or difficult experience. I had such a great time talking with Kemia. I know you're going to enjoy this conversation. Kemia, I am so excited to talk to you. I'm glad we finally got this on our calendars. Thanks for making time.

Kemia Sarraf: 1:07

Yeah, me too. Well, we got it on, and then you were very gracious to give me a do-over because I think the day came and went with some uh some actually uh some trauma that I had to go and and help disrupt.

Manya Chylinski: 1:21

So yes. One thing the work that I do, and I know the work that you do and this podcast have taught me is life happens and we've got to roll with the punches, whether you want to be doing it in that moment or not. Absolutely. This year, the question I'm asking all of my podcast guests.

Kemia Sarraf: 1:42

Oh, that was such a loaded this year. May I just draw both of our attention to that? What a loaded simple little phrase you opened with. Yes, please go ahead.

Manya Chylinski: 1:56

What would the title of a book about you be if your worst enemy wrote it?

Kemia Sarraf: 2:04

I'm gonna give this a title written by my worst enemy that actually I would appreciate, which is blank she's awake.

Manya Chylinski: 2:16

There is a really good story behind that.

Kemia Sarraf: 2:18

And the subtext to that is the top 10 reasons you don't poke the bear. I love it. That makes me sound way cooler than I actually am. You gave me creative license, so there you have it. Absolutely.

Manya Chylinski: 2:34

I love that title, and I'd love to read it when you get a chance or when your worst enemy gets a chance to write that about you.

Kemia Sarraf: 2:40

I shall reach out to my worst enemy right away and ask them to get started. Let's see if we can get them to do it for us. Exactly.

Manya Chylinski: 2:47

Absolutely. All right, so as we're thinking about resilience and trauma and these things that you and I spend so much time thinking about every day, everyone's had a moment in their life that changes how they think about maybe leading other people or taking care of the people around them.

Kemia Sarraf: 3:05

What's one of those moments for you? They're about 10 that'll pop into my mind, and uh numbers one, two, and three are the day and the moment that I got the phone call confirming uh the diagnosis I had made in my son of leukemia. So Joseph, who dear listeners, is absolutely fine. My child is fine. Joseph was 13 at the time and the eldest of four boys. We could sometimes jokingly refer to them as my four semi-feral sons. At which point, my closest friends, not even my worst enemy, push back and say, Oh, you're kidding yourself, they are fully feral. Joseph was 13, it was a Monday morning, and he was uh running through the house before school, as my boys always are, which is two-thirds naked, right? Like in their underwear, five minutes before the bus. And uh and I caught this glimpse of the blur as he went running by and saw that one whole side of his body was just black and blue, and called him over and examined the bruises as he's telling me, Mom, it's fine, it's fine. I was wrestling with Tommy, it's all fine, and uh did all the things that as a physician you're not supposed to do with your own family, which is laid him down, palpate his liver, palpate his spleen, realized all the things, and just knew in that sort of both physician training, but also that mama gut sense that I was looking at leukemia. And within a couple hours, had the labs drawn, and within a couple hours after that, had received a phone call from his pediatrician saying, Yeah, this is acute lymphoblastic leukemia. Um, and within two hours of that, we were in the ICU because it's a medical emergency. And so that was one of those moments that just sort of crystallizes things, right? Everything else falls away. Everything else falls away in that moment, right? All the things that you think are important, you realize are absolutely meaningless. So it's a it's a moment of crystalline clarity that we never wish on anyone. I want to be clear about that, and that I look back on and carry with me very I carry that moment as an ever-present moment on purpose because it is it serves as such a good reminder of the things I want to draw my attention, of the places I want to put my energies and my efforts. So I deliberately carry that.

Manya Chylinski: 5:44

Right. Wow. Well, thank you for sharing that story and and thank you for letting us know that your son is okay as well, because that is that just hits at the heart of so many of us just thinking of a child and thinking of what that must have felt like for you when you realized what was happening, that that sinking stomach feeling. And as you mentioned, in a way, we don't want people to be able to understand what it's like to feel one of those moments, because it means you've gone through something just so difficult. Um, and this podcast, I guess for me, is one way to help other people understand what it's like when you go through a moment like that. And so thank you for being so honest and sharing that story. When things go wrong like this story, you know, people, the people in our lives, whether they're coworkers or friends or family, they often really mean well, but still say or do something that actually makes it harder. And what have you seen get in the way of recovery or progress, even when someone you know they fully had good intentions?

Kemia Sarraf: 6:59

Yeah, that is a question that I want to answer in three parts, if I might. Because you you are exactly right. You're exactly right. And I see people and have experienced myself and and frankly have done it wrong. I mean, so I let's I I just want to own that on the front end. I I have gotten it wrong. Sometimes I've gotten it wrong in what I actively did or said. Sometimes I've gotten it wrong because I was so afraid of getting it wrong, I did or said nothing. Yes, right in there. I mean, both ends of that spectrum require that we tend to them. And and it really feels important to normalize that for listeners because none of us want to get it wrong. And we especially don't want to get it wrong with the people we love, we care about when we're when we're approaching this with good intentions. I want to drop back for half a second though, because something that you said really sparked a thought in my head, which is around this idea that we don't wish those moments on anyone, and everyone's gonna have those moments. All of us are going to experience those moments at some point in our life. None of us get out unscathed, right? Will it be a moment that looks like mine, a moment that looks like yours? I hope not. And it'll be a moment that impacts every one of us, it will have a moment that impacts us. It is a truth. And so then what becomes really helpful once we accept that truth. And this is, I want to be clear, this is coming to recognize and accept this as truth is a really important stage of normal, healthy adult development. So now I'm gonna Dr. Geek a little bit, right? Which is that oftentimes we don't realize that adults go through normal, healthy, predictable stages and phases of a development in the same way children do. We don't talk about it in adults, but coming to accept this without becoming cynical, that's the key. Because traumatic stress exposure is truly inevitable. And I'm gonna say that again for anybody who didn't catch it the first time, because I think this is important. Traumatic stress exposure is inevitable. Trauma is not. Trauma is what happens to us inside of us after the exposure. And traumatic stress exposure comes at us in a lot of different ways. What most of us think about when we think about is we think about events, that moment in time, the diagnosis, the phone call, the sentinel event that we experience out in the world. But we think about it in terms of traumatic event. It is also that cumulative and compounding exposure to secondary and vicarious trauma and the traumas of moral injury, which come from a completely different place, right? So they these this is this exposure to the things that happen to us. It's also the exposure that happens over time to the people we love, the people we care about, the patients we take care of, the communities we serve. And it's also that cumulative and compounding dose of vicarious exposure, the stories we listen to, the things that we see. Now, that's not how the story ends. That's half of the story. The other half of the story is the skills we develop, the mindset we strive for, the capacity we build to successfully navigate when not if that happens. And so for me, it becomes about planning for that, building capacity towards that, towards that when not if.

Manya Chylinski: 10:38

Absolutely. And you're right, it the when none of us get out of this unscathed, it's the shape of the the traumatic experience or the trauma is different depending on what the thing is. And so, in some senses, we all share the experience, but because the cause is different, it often feels that we don't understand each other.

Kemia Sarraf: 11:06

Absolutely correct. You are a hundred percent because let's take it out of these big experiences, yes, right, that you and I have each individually had. Let's let's take it to the two of us walking down the street at the same time, and something occurs around us. It doesn't cause either one of us any physical harm, and it's startling, it's frightening, it's whatevering, but it's most of all, it's overwhelming. It overwhelms, right? Or at least it overwhelms me. So this is where it becomes really important, and have the exact same exposure at the exact same time, and the moment passes, and I look at you, and I am flattened by it. And you're like, what is your problem? Right? What feels overwhelming, what lands as overwhelming to one person may be a nothing sandwich to the person standing right next to them. Why? We have different exposure histories, we have different experiential histories. We are differently resourced, both in terms of like what we have that we can access, but probably our internal resources that may say, Oh, yeah, you're gonna be fine, you know what to do, right? We may be able to frame the moment differently because of our training, because of past experiences. So all of this is to say that when you say we we get it wrong when we approach each other, I think we get it wrong because what we fail to fully understand and appreciate is that trauma is subjective. And it is this really complex interplay of a lot of things. Yes, genes and biology and upbringing and all that, and also resourcing and experience and education and prior exposure and what we know in that moment we can tap to navigate that that experience, that exposure we're having. It's super complex. And so when working with each other, when teaching each other how to show up for one another in those moments, well, I think we we pick the either or either we get it really wrong or we get it really wrong. Either we think we're supposed to show up and do say something very specific, explicit, I need a PhD in trauma disruptive skills, or we're so afraid that we don't have that PhD that we don't show up at all. Or we fall back to what we think would be, what we think or believe would be comforting to us in a similar moment. When we recognize the truth lives at neither one of those ends, right? And we recognize that it what is needed is our presence, is our capacity to hold, sometimes to hold still, even in the face of overwhelming pain in another, the capacity to tell the truth and say, I am really unsure what to do, and I need you to know I'm here. Those are the kinds of things that and the skills that we we aren't taught necessarily, and out of our own fear, oftentimes we fall back to the things that would be comforting to us, and that's where we trip and fall, right? That's where we make mistakes and say things like, you'll learn from this, this will be meaningful someday, this will right. We say those things out of these really good places, right? Or we fall back into talking about how we feel about the other person's pain that can be really harmful sometimes. There's a there's a great um philosophy that was first put forth by Dr. Susan Silk and her husband. It's called ring theory, and we can talk about that. So we sort of fall back to how we feel about what's happening to this person who's having this experience, or we fall into I'm so afraid I'm gonna get it wrong that I'm just gonna go silent. And then that leaves the person feeling quite abandoned.

Manya Chylinski: 15:30

Right. And I imagine that many of our listeners, as they were listening to you share this, were doing the thing that I was doing, which is thinking about those times that I didn't say a word because I was so afraid, and the times I barged in fully knowing that I a hundred percent know how to fix you now that this thing has happened. And just thinking back to then the times where I know I just allowed myself to be present and how different that time felt from these other times where it wasn't about me, it was just about let me sit next to you. And that's very hard because your brain is wanting to do these other things for all of the reasons you were talking about. And can I just want to flash back to you shared, you know, you and I are walking down the street and this thing happens. And thanks to your earlier uh book title, the first thing I imagined is that you and I are walking down the street and a bear jumps out in front of us. I am the bear. So you would have been fine with it. I would have been hyperventilating. Not knowing what it is.

Kemia Sarraf: 17:19

Possibly, and when I am providing an example, that was actually quite deliberate on my part. So I'll I'll just draw your listeners' attention to it. It's quite deliberate on my part to position myself in sort of that that power down, more reactive, more harmed position, because we don't ever know what it is, what the fullness of anyone else's experience. I know the tiniest sliver of yours, right? So I am not ever, ever when I am, and that was a bit of a teaching moment, right? I'm not ever going to put myself in a position that is in a power up. It was is very deliberate choice in that moment. Right.

Manya Chylinski: 17:59

Yeah. I'll be fine. You of course are gonna really struggle with it.

Kemia Sarraf: 18:04

Right, right. Well, and and and so it's it's a it's a little hint at, right? What does it, what goes into this approach? And I I there's one other thing I want to normalize around grief and walking with someone in moments of enormous grief because we we don't honor grief the way grief ought to be honored, and grief can come in a lot of different places and and can come for a lot of different reasons. And let's again go to an extreme, right? You are you are uh face to face with a friend who is experiencing or a loved one who is experiencing loss grief, right? I think the thing in this to really remember is that in the acute phase, whatever that grief will be, let's, I mean, we can go back to to my son, even, right? So there's there's some grief immediately around the derailing of career, the the loss of of this idea that everything was going to be okay, this loss of sense of safety and security. I mean, so there's grief around loss there, even though I didn't lose my son. There was that immediate grief that came up along with this diagnosis. There is a rush, whatever the grief, the loss of someone we love, the permanent loss of someone we love in particular. There's an immediate rush of resources that come in those times, right? I call it the casserole brigade. God love the casserole brigade. There, no offense to it. It's just a term that everybody recognizes, right? And that's normal, right? And everyone is sharing in that grief, experiencing that grief, and they are all peripheral. They are not the center of the grief. And about two weeks or three weeks after, what almost without exception occurs is the person who is at the center of that grief, that grief storm looks up and wonders where the hell everyone went. Is this because friends, family, colleagues no longer care? Of course not. It is because it's not their primary grief, and life gets busy, and we, we, I, dear listeners, I'm pointing at myself, we forget. And so a really important way of honoring and continuing. This is set a reminder in your phone. I mean, let's get practical about this. You're gonna forget it doesn't make you a bad person. So set a reminder every two days. Light touch. Light touch. The biggest predictor of relationships that are successful over time are the small things done consistently. The light touch, thinking of you, love you, checking in. Here's a funny meme if you know the person well enough. Sending you a thing, right? And the timing's appropriate and important and all these things, but those light touch moments and the voicemail that says, just wanted to hear your voice, know that I love you. I'm gonna keep bugging you until you tell me to take a walk, right? Those things are absolutely essential, and you will forget to do them if you do not set a reminder. I've been at this a very long time. I still set reminders because I forget.

Manya Chylinski: 21:31

Absolutely. And I'm so glad to hear you say that because I also do set reminders because I know I want to honor something, acknowledge something, and I'm not going to remember it in the moment. Well, you know, we are getting so close to the end of our time. And I feel like we just started. I know we just we did just start. Um, but you know, you work with leaders who are sort of maybe going through all of these kinds of emotions or dealing with people who are going through something difficult. What do you see works in that environment? Works for helping leaders be supportive or take care of themselves. And where are we making it harder than it needs to be?

Kemia Sarraf: 22:14

The pause is because I want to make sure that I get this all into the short time we have left. These are human skills. So I think that our tendency to parse ourselves into this is my work persona and what I have to do and show up at work, and this is my personal persona, and I think that's a mistake. Now, I want to be very explicit about this, right? I am not talking about the type of vulnerability where you show up as a leader and you you dissolve from structure to soup in front of everyone. Okay. I'm talking about boundaried vulnerability. The type of vulnerability that says, okay, I've had this, you've seen me actually model boundaried vulnerability in this podcast, right? Which is I offered you, you asked me a very important question, and I offered you a very well-metabolized story, right? There's vulnerability to it, yes. And I didn't fall apart in the retell. Why? Because I've done my work to allow them the metabolizing and the conversion of that wounded place in me into a source of wisdom, teaching, however you want to frame it. So that type of boundary vulnerability is absolutely essential leadership capital. And here's where it gets really tricky. Because if you are the tip of the spear, if you are the leader, you don't get to dump in on your team. You show up with boundary vulnerability because that humanizes us, because that allows people to make the approach to you and come closer. And you do not dump in the pain, the harm, the vicarious trauma, the secondary trauma, the primary trauma. You know, you're not dumping that in. They may be dumping some of that out. Certainly the behaviors are showing up oftentimes. And that doesn't mean you don't need the places to dump out to. So this is where we begin to talk and teach about bench strength, right? I have a thing I often say, which is sooner or later, you know, all of us are gonna need a deeper bench. We don't know when hell's gonna visit, right? We just said it does that it will. All of us are going to need a deeper bench. And so we begin to build bench strength. We recognize this as a very human and leadership need, and we begin building network where we can pick up the phone and say, here's what's happening, here's the story I'm telling about it, here's how it's showing up, right? And we have someone where we can dump out very safely without causing harm, without harming our team, without dissolving from structure to soup, without doing all of those things. Because the same process of this is a decentering of leadership, right? We talk about decentering in a lot of different ways. This type of decentered leadership is the kind that allows us to show up and and resonate with and allow people to come closer to us because trust and safety, right, on teams, these are um and connection, those three things are absolutely essential for high-performing teams in these huge meta-analyses that have been run by Google and other um enormous multinational corporations, right? Those three things, if they are absent, any one of those three things are absent from a team, it is not a high-performing team. These are not soft skills. And I would like to go back in time and find whoever coined that term. Connection, safety, trust, these are prerequisite. They are not soft, right? They are challenging and they are often overlooked, underutilized, undervalued. And sometimes it's simply because we're not sure where to begin. Because we have been trained to disconnect from our own humanity in professional settings. And I want to caveat even that, because there is a lot of value, particularly in certain professions, particularly in first-responder professions. So we do a lot of second-responder work. In first responder professions, we always tell folks, right, your job is to run towards the fire. Your job is to run towards danger. There is absolutely nothing I can say or do that is going to decrease your traumatic stress exposure because that's the job, right? And compartmentalization while doing one's job is absolutely essential. If I'm running a code, you do not want me feeling my feelings. And there's the end to this. And if I do not skill myself in what to do with those very human feelings afterwards, it builds up.

Manya Chylinski: 27:13

Right?

Kemia Sarraf: 27:13

I call it getting shellacked, right? It's like putting layers of varnish or whatever that really hard stuff is on over and over and over again. And what happens over time, what happens over the years is I become less good at what I do, less efficient, less effective, and sometimes even less human in how I show up for very human moments. It is supposed to hurt when I lose a patient. It is supposed to hurt to bear witness to, to accompany, to um be proximate to pain and other people. It is supposed to hurt. It also is, by my training, not supposed to summarine me in the moment. And so finding and developing the skill to recognize that this has this exposure has occurred, and now these are the things I do with it is very important. And this cross-cuts all leadership development, right? Because leaders are going to be exposed to it. They're going to be exposed to it in secondary stories they hear from the teams they lead. They're going to be exposed to it in the traumatic stress of the organizations that they are leading. And the job is not to fall apart, right? The job is to be able to do the job, whatever it may be. The job is also to develop strategies, skills, networks, and very deliberate resiliency strategy that allows you to stay in the job without becoming someone you didn't mean to be.

Manya Chylinski: 28:48

Wow. It's such important work. Thank you for the for paying attention to these things. And so we are at the end of our time. And as you know, we could go on for more hours. But can you please share with our listeners a little bit more about yourself and your work and how they can reach you?

Kemia Sarraf: 29:06

Well, thanks for that opportunity. So I don't know what you will provide at your intro. Here's what I will say is I am a physician and public health professional by training. I have been developing and working in trauma responsive skills and strategies and programmatic development for 20 years now. Um have seen the effectiveness of these when applied to individuals, to organizations, to leaders, and see how quickly things can change. I think that the word trauma sometimes puts people back on their heels. And it is, it's, it is because there's a misunderstanding that if I approach that place in me, or if I approach that place in my team or my organization, it is going to require that we all lay down on the floor and in the fetal position because there's so much harm, right? So we don't approach it because we are afraid of what it means to approach it. And the price that we pay with that refusal is a very high price. Um, it is a price of recruitment and retention. It is a price that's paid in burnout and exhaustion, it is a price that is paid in significant moral injury. And what is probably the most remarkable outcome that I see and hear consistently across tens of thousands of people we have trained now is how even very seasoned leaders who come into uh, let's just say one of our three-day intensives with a fairly low degree of hope about the future of their profession leave. In fact, the data show a jump from 30% to 80%. And now you've listened to me. This is not because I'm in there rah-rawing. I mean, what I open with, all of us are gonna get exposed to trauma. Very realistic, right? And what that shows us is that hope follows action. And that's the thing that I hope your listeners really walk away with, if nothing else. It is that if you want hope, take action. Learn the skills that allow you to take action, and the hope will follow.

Manya Chylinski: 31:29

Absolutely. Oh, thank you so much for sharing. And thank you again for this conversation. I've so much enjoyed speaking with you today. Me also.

Kemia Sarraf: 31:38

I appreciate the opportunity to be here with you.

Manya Chylinski: 31:40

And thank you to our listeners for listening in today, and we will catch you next time.