A critical incident may cause confusion and disorientation, as people do not know what to do with themselves in such an unusual situation. They may be reluctant to leave the scene, feel locked into it or attached to the people involved. It is important not to tell them what to do without first trying to understand what they need.
The following 10 suggestions may help people who have experienced a sudden critical event:
- Accept that you have been through a highly stressful experience, things will be different for a while and you will have strong reactions; acceptance is the first stage of recovery.
- Allow time for the memories, dreams or flashbacks to fade; when they intrude, give them attention and then put them aside, don’t try to fight or suppress them, confronting the reality bit by bit helps come to terms with it.
- If memory, concentration and planning are affected, use aids, writing things down and do things in short bursts.
- It is normal to have changing moods after critical incidents, respect your emotions even if they are not normal for you; feeling bad usually passes quite soon, tolerate it and see what it means rather than take it away with distractions or numb it by alcohol or other means, these only make it worse by stopping real resolution, which will come in time.
- If emotions are unstable try to plan the day so that you are not overstimulated or exposed to upsetting or unhelpful stimuli.
- If sleep is affected, plan for quality rather than quantity of sleep, wind down at night and spend time preparing to go to sleep; arrange to take catnaps during the day.
- Find people you trust to talk to about the event and your reactions; talking helps to defuse feelings and make sense of things and builds bridges with others.
- Adjust your lifestyle to your need as they are now and don’t just do things out of habit or because you planned them some time ago if they no longer feel appropriate.
- Avoid making important life decisions until you’re recovery is well in hand and you can be objective; but make many small decisions on a day to day basis to ensure you have control over your life.
- Participate in an Individual or Group Debrief which can lead to a structuring of the critical event.
Treating critical event stress symptoms
The following list identifies a range of practical techniques and strategies for alleviating or managing stress symptoms.
They can be provided as part of the educational phase of a debriefing. It is important to assist people to identify and clearly label the stress symptoms so that they’re clear why they are experiencing them. The specific suggestions need to be linked to the symptoms so they do not continue to suffer them without some attempt to actively do something about them.
Diet: High protein, complex carbohydrates, low sugar, fats. or stimulants. Emphasise routine and frequency even if no appetite (i.e. many small snacks rather than a single big meal).
Exercise: Low impact, relaxing and sustained activity to metabolise brain chemicals, such as swimming, walking, cycling.
Health: Care for lowered immunity, treat psychosomatic conditions, headaches, general stress ailments, accidents, recurrence of past ailments. Maintain good medical care. It may be a good time to have a check-up and get the GP to monitor your health.
Sleep: Naps – quality rather than quantity, prepare for and relax into sleep more deliberately and with more planning than normal.
Lifestyle: Reorder and assess current needs, breaks and leisure, social contact time, recovery time. Preserve routine and rhythm of life, keep in touch with former lifestyle.
Relationships: Balance contact with time to be alone. Avoid isolation, talk about the experience to those who will listen sympathetically.
Relaxation: Breathing, meditation, and progressive relaxation, yoga, music, nature. Take extra time to rest and relax.
Thoughts: Give thoughts their space, don’t fight them, but at the same time don’t let them take over. Think and then stop thinking. Understand what to expect and what is normal.
Emotions: Accept the feelings and time necessary to recovery. Bad feelings are OK, they will pass, accept your need to feel bad and respect feelings, they are justified. Fluctuating emotions and problems of control can be helped by patience and protecting oneself from unnecessary emotional interactions and taking time to calm down.
Life Management: Avoid major decisions and plans. Review priorities and plans in light of the current needs. But take control of life make small decisions about daily needs and recovery requirements.
Work: Return as soon as possible and take on light duties. Re-negotiate activity and responsibility levels to permit time to process the event. Respect limits of the stressed state, e.g. memory, attentions, concentration responsibility, stress tolerance. Review needs of leave and time off.
When to seek additional help
Sometimes it is important to provide some guidelines for people to know when their own recovery requires additional help. For example, if the recovery has stalled or does not seem to be improving, if physical or other symptoms are causing concern, if relationships are being affected by the stress, or if there is emotional numbness, depression or continuing anxiety, then talking to a mental health professional may be the best course of action.
If you, or someone you know, is struggling after a critical event, call 1300 687 327 where one of our friendly team is available to provide around-the-clock care.
