Critical Incident Stress Management
Imagine you are an emergency services worker who has experienced a traumatic event or critical incident. This refers to any incident that causes emergency services personnel to experience unusually strong emotional reactions, which have the potential to interfere with their ability to function, either at the scene or later.
Even though the event is over, you may now be experiencing or may experience later, some strong emotional or physical reaction. It is very common, and in fact quite normal, for people to experience emotional aftershocks when they have passed through a horrible event.
Sometimes the emotional aftershocks (or stress reactions) appear immediately after the traumatic event. Sometimes they occur a few hours or a few days later. And, in some cases, weeks or months may pass before the stress reactions appear.
The signs and symptoms of a stress reaction may last a few days, a few weeks or a few months and occasionally longer, depending on the severity of the trauma.
With understanding and the support of loved ones, the stress reactions usually pass more quickly. Occasionally, the traumatic event is so painful that professional assistance from a counselor may be necessary. This does not imply craziness or weakness. It simply indicates that the particular event was just too powerful for the person to manage by themselves.
Positive ways you can respond to the Stress Reaction
- WITHIN THE FIRST 24 - 48 HOURS, periods of appropriate physical exercise, alternated with relaxation will alleviate some of the physical reactions
- Structure your time; keep busy
- You're normal and having normal reactions; don't label yourself as crazy
- Talk to people; talk is the most healing medicine
- Be aware of numbing the pain with overuse of drugs or alcohol, you don't need to complicate your situation with a substance abuse problem
- Reach out; people do care
- Maintain as normal a schedule as possible
- Spend time with others
- Help your co-workers as much as possible by sharing feelings and checking out how they are doing
- Give yourself permission to feel rotten and share your feelings with others
- Keep a journal; write your way through those sleepless hours
- Do things that feel good to you
- Realize those around you are also under stress
- Don't make any big life changes
- Do make as many daily decisions as possible that will give you a feeling of control over your life, i.e., if someone asks you what you want to eat, answer him even if you're not sure
- Get plenty of rest
- Don't try to fight recurring thoughts, dreams or flashbacks - they are normal and will decrease over time and become less painful
- Eat well-balanced and regular meals (even if you don't feel like it)
For Family Members and Friends
- Listen carefully
- Spend time with the traumatized person
- Offer your assistance and a listening ear if (s)he has not asked for help
- Reassure him that he is safe
- Help him with everyday tasks like cleaning, cooking, caring for the family, minding children
- Give him some private time
- Don't take his anger or other feelings personally
- Don't tell him he is "lucky it wasn't worse;" a traumatized person will probably not be consoled by those types of statements. Instead, tell him you are sorry such an event has occurred and you want to understand and assist.
Common Signs and Signals of a Stress Reaction
Physical
Chills, thirst, fatigue, nausea, fainting, twitches, vomiting, dizziness, weakness, chest pain, headaches, elevated blood pressure, rapid heart rate, muscle tremors, shock symptoms, grinding of teeth, visual difficulties, profuse sweating, difficulty breathing etc.
Any of these symptoms may indicate the need for medical evaluation. When in doubt, contact a physician.
Cognitive
Confusion, nightmares, uncertainty, hyper vigilance, suspiciousness, intrusive images, blaming someone, poor problem solving, poor abstract thinking, poor attention/decisions, poor concentration/memory, disorientation of time, place or person, difficulty identifying objects or people, heightened or lowered alertness, increased or decreased awareness of surroundings, etc.
Emotional
Fear, guilt, grief, panic, denial, anxiety, agitation, irritability, depression, intense anger, apprehension, emotional shock, emotional outbursts, feeling overwhelmed, loss of emotional control, inappropriate emotional response, etc.
Behavioral
Withdrawal, antisocial acts, inability to rest, intensified pacing, erratic movements, change in social activity, change in speech patterns, loss or increase of appetite, hyper alertness to environment, increased alcohol consumption, change in usual communications, etc.
Spiritual
Anger at God, questioning of basic beliefs, withdrawal from place of worship, faith practices and rituals seem empty, loss of meaning and purpose, uncharacteristic religious involvement, sense of isolation from God, anger at clergy, etc.
