International Critical Incident Stress Foundation, Inc.
International Critical Incident Stress Foundation, Inc.
By: Lennis G. Echterling, Ph.D.
During this time of the COVID-19, citizens are encouraged to stay at home and keep their distance from others. However, first responders are always on call, ready to answer every single emergency in the community. As the members of the CISM Team of the Central Shenandoah Emergency Medical Services in Virginia, we are reaching out to remind first responders that we have their backs as they deal with these critical incidents. Our volunteers remain available to offer peer support and debriefing during this especially stressful time.
We offer support in a variety of ways while also ensuring safety and well-being:
The COVID-19 pandemic has reminded us that human connection can spread illness. But human connection also promotes wellness. Our CISM Team values the importance of relationships for enhancing the well-being of our first responders.
Taking Care of Yourself After a Critical Incident
A Handout for First Responders
A critical incident can cause physical and emotional distress. As a first responder, it is essential that you take care of yourself so that you can continue this vitally important work.
When you begin to feel overwhelmed by particularly stressful events or circumstances, you may notice personal signs of distress. First, you may observe any of these physical symptoms: faster heartbeat, dry mouth, and increased sweating. You may also develop indigestion, feel nauseous, have headaches, and sense pain in your neck and shoulders. You may discover that you are sick more often with colds and viruses. Then you may feel more irritable, fatigued, sad, or apprehensive. You may laugh nervously or have the urge to cry. More often, you may have more difficulty concentrating and making decisions. Finally, you may notice that you act more impulsively, are more prone toward accidents, or feel tempted to medicate yourself. You may find it difficult to relax or sleep.
The more of these signs you notice in yourself, the more quickly you will need to take better care of yourself. Life is filled with events, both large and small, joyful and tragic. Any of these can lead to stress or, when multiplied together, distress. When you have been exposed to seismic events like the violent deaths of loved ones or the devastation of your communities by war and poverty, you are faced with trauma, the soul wound that dominates your thoughts, threatens to destroy your dreams, breaks your heart, and rushes in when you least expect it during the regular routine of daily life.
You can develop a wide range of skills in coping with critical incident stress. Consider the following suggestions. As you read through this section, assess your own stress response strategies.
When under stress, you may be tempted to grab quick foods on the run or to skip meals altogether, but eating nothing or foods with little nutritional value will not provide you with critical energy when you need it most. Also, carefully monitor your consumption of drinks with caffeine and alcohol, which you may be using to become alert in the morning and to calm yourself at night. Moderation and balance are the key. How do your nutritional habits measure up?
You can make a point of being with people who add laughter to your life, but even more important than appreciating humor is actually creating it yourself. You have the potential to see the humor in the daily aggravations and nuisances you encounter. How’s your humor quotient?
COPING STRATEGIES AFTER A CRITICAL INCIDENT
Everyone deals with stress after a critical incident in his or her own way. That is the way we physically, mentally, physiologically and spiritually are able to cope with an event or events that cause stress which is a NORMAL reaction that a NORMAL person would have to an ABNORMAL event. The following techniques are some coping mechanisms that have proven to be helpful in post-incident stress situations.
Express Emotions. Share your thoughts and feelings with someone you trust, though it may be painful. Make sure the other person understands you’re not asking for a solution, just an opportunity to express how you feel.
Face Your Pain. Painful, fearful memories can come back without warning. This is normal, but our first reaction is to prevent this. Instead, let the memory or thought come back so that some release of tension can take place, and then decide when you want to stop it. You can even say to yourself, “Okay, that’s enough!” Gradually, you will gain more control over these intrusive thoughts and feelings.
Dreams and Nightmares: Nightmares are very common reactions to traumatic stress. Although they can never be controlled completely, some people have learned to diminish them for themselves, “Okay, that’s enough. Now I am going to dream about something else more pleasant.” If you have trouble sleeping, try reading or watching TV. Insomnia should resolve in a few days, but if not, you may want to consult your physician.
Recognize Self-Blame and Survivor’s Guilt. It’s normal to feel some blame for just surviving a traumatic incident, especially if others were severely injured or killed. The “Why me?” questions and “I could have done more” self-accusations can mentally take a toll on a survivor. Recognize this normal reaction for what it is—an irrational thought, one that cannot change what has occurred. It is okay to have survived.
Change the Memory. Remember, what’s upsetting after a traumatic incident is not the incident itself, but your memory of it. You, and others you talk to, may keep discussing aspects of the event that are particularly distressing, stirring up those upsetting memories. Try to substitute other more affirmative aspects of the event, such as remembering someone who was saved, or someone who got to safety. Also remember how well the rescue team worked together to make the situation better. Substituting the positive thoughts for the negative is a healthy way to cope and does not discount the significance of the event.
Exercise. Stress affects us physically as well as mentally. Strenuous exercise afterward is very useful, especially if you are already in good shape. Don’t overdo it, however, and cause more harm than good! If you have chest pain or difficulty breathing while working out, stop the activity and consult your physician.
Get Back to Work. If you take time off work to cope, get back to work when it is appropriate. Expect the apprehension of your duties to remain with reminders of the incident. These responses are perfectly normal and should diminish with time. Getting back to the routine of your job aids in healing.
Decrease Alcohol Consumption. Drinking alcoholic beverages rarely helps in coping with stress and may compound the problems. It hinders our ability to deal with stress, and blunts our responses. Try substituting with juices and healthier drinks.
Accept Enjoyment and Diversion. Although you may believe it will be a long time before you will laugh and feel better, it is OKAY to enjoy yourself and forget the incident. Getting involved in pleasant activities, such as going to the movies, playing sports, reading a good book, or exercising your mind, will be helpful in the days after a critical incident.
Ask for Professional Help. Sometimes professional help is needed to work through traumatic stress. Remember, the CISM teams are primarily peers helping peers, not professionals offering treatment. Seeking the help of an employee assistance program is a sign of strength. It takes courage to work with a professional and face your pains and fears. Be proud that you take this step.
Don’t Expect Too Much. Working through post-traumatic stress is not something that happens overnight, and the process may take some time, and it may never return you to a pre-incident level of function. You will likely remember the event for a long time. Try to accept this element of yourself and put it in proper perspective.
If traumatic stress can be faced squarely and dealt with in some positive fashion, you are winning half the challenge!
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International Critical Incident Stress Foundation, Inc is a 501(c)3 Non Profit