If there’s one thing that’s fairly predictable in caregiving or first responder work, it’s that the unpredictable will happen. A crisis situation is an incident that goes beyond the everyday stresses of the caring for people or animal and involves intense danger or difficulty. Often times it is an emergency that requires an immediate response, throwing us into a heightened state of fight or flight so that we can spring into action and do what needs to be done to handle the crisis. So why does our world feel like it’s been turned upside down even after the crisis is resolved?
Normal Reactions to Acute Stress and Trauma
When we involved in, hear about, or witness a traumatic event, it’s common to experience a variety of emotional and physical responses. This is called “acute stress reaction.” You can expect symptoms to last anywhere from a few days to a few weeks.
Symptoms may include the following:
- Recurring flashbacks or nightmares
- Trouble concentrating
- Avoidance of people or places that remind you of trauma
- Stomach issues
- Anhedonia (the inability to enjoy activities you once found pleasurable, including sex)
- Change in world-view (intense fear of danger, difficulty trusting others, etc.)
- Questioning your faith in God or other higher power
If you’ve experienced (or are currently experiencing) any of the above symptoms, the good news is that you’re completely normal. This is simply the brain’s way of trying to process the crisis or traumatic incident. But if your symptoms last longer than a month, are causing you extreme distress, or are interfering with your daily life, you should consult a mental health professional to help you process, cope, and heal from the trauma.
Finding Healing After a Crisis
Although taking time to debrief may seem like a luxury to many busy caregivers or first responders, it is absolutely crucial to make the time. Not doing so may actually backfire; employees’ symptoms may be prolonged and productivity will likely go down. Avoiding the feelings surrounding the incident is a sure-fire way to contribute to compassion fatigue, burnout, and even acute stress disorder or PTSD (posttraumatic stress disorder).
Critical Incident Stress Debriefing (CISD) is an immediate, brief intervention to help first responders and caregivers process their feelings associated with the trauma – be it a death, injury, accident, shooting, natural disaster or other incident that causes distress to employees. CISD is not a substitute for psychotherapy, however it is recommended that your debriefing sessions be facilitated by a trained mental health professional. In fact, you may want to check with your organization’s EAP (employee assistance program) to see if they offer counselors to come in and facilitate CISD meetings. Remember, a debriefing meeting is not the appropriate place and time to talk about what went right, what went wrong, what needs to change, etc.; rather it’s a time for encouraging staff member to talk about their feelings and how the even has impacted them.
Critical Incident Stress Debriefing 101
- Understand common reactions to trauma. Short-term symptoms of crisis situations may include shock, denial, sadness, anger, confusion, guilt, fear, blame, irritability, change in sleeping or eating patterns, anxiety (heart palpitations, sweating, shaking, racing thoughts, hyper-vigilance), difficulty concentrating, nightmares, physical problems, paranoia, flashbacks, and suicidal/homicidal ideation. Long-term symptoms may include serious depression or anxiety, relational problems both personally and professionally, substance abuse, work-related problems, and “survivor’s guilt.”
- Within 72 hours, but preferably as soon as possible, allow everyone to process the traumatic event and how it has affected them. Assess the impact on the team as well as support staff.
- Within 72 hours, but preferably as soon as possible, encourage people to vent their thoughts and emotions associated with the traumatic event. Validate each individual’s experience.
- Manage any immediate safety of security issues.
- Based on the common reactions to trauma, conduct a systematic review of the critical incident. Assess any unhealthy behaviors or responses.
- Determine what is needed to start the process of rebuilding, healing, etc. Provide education, assistance, or support services to facilitate healthy recovery for staff members and/or volunteers.