Coping with Traumatic Events
You have been involved in a situation much different than those you usually face. Perhaps this situation elicits an uncomfortable response. Although well trained, you are not prepared for this. You may find yourself confronted by reactions and feelings rarely reported and discussed by other emergency services personnel who have had similar experiences. This information sheet is provided to help you and your family better understand and cope with the reaction following your involvement in the traumatic situation.
A Major Stress
In order to better understand your reaction, consider the situation in which you have been involved to be like the initial splash caused when a pebble is thrown into a pond. Your reactions are like the ripples which may continue long after the pebble penetrates the surface. As a consequence, you may have specific physical, psychological, and emotional reactions as well as family concerns. Being aware of the fact that your responses are not unusual may help lessen the level of anxiety these reactions and concerns might cause you and your family.
You are a normal person having normal reactions and experiencing the normal consequences of those reactions. The only thing that is abnormal is the situation you have just encountered! The reactions you may experience can be either physical, psychological, or, most probably, both. Experiencing any of the responses contained in this information sheet does not mean you are going off the deep end. The reactions are the normal and natural result of the situation you have just been through.
Major trauma is frequently followed by one or more emotional reactions. Although any of the following might occur, individuals vary in terms of the variety, intensity, and frequency of such reactions. Possible emotional reactions include:
Becoming insulated from the external world. For example, being unable to enjoy things that were pleasurable before the incident.
Having a memory impairment and/or trouble concentrating, being absent-minded, and having visions of the situation unexpectedly.
Experiencing depression that might be evidenced by fatigue, restless sleep, loss of appetite, or social withdrawal.
Experiencing moodiness, becoming irritable, and having aggressive outbursts with little or no provocation.
Experiencing general feelings of anxiety and being frightened without knowing for certain what is causing the fear.
Experiencing guilt at surviving when others perished, or guilt over the actions taken to survive.
Suffering intensification of symptoms when exposed to events, situations, or activities which symbolize the original trauma.
Feelings of guilt, anger, apprehension, or sadness may be experienced as related to the incident. There may also be renewed feelings related to previous personal traumas.
Questioning your chosen profession and your views of your aggressiveness. The lack of support you may receive from others may make you ask, "Does anyone care about what happens to me?"
Becoming distrustful of your department and your co-workers.
Finding that you are embarrassed and concerned about your reputation. It is possible that you will be more aware of how others respond to you and more sensitive to the treatment you receive from others.
Physical Reactions The physical reactions you may experience may include, but are not limited to, the following:
- Digestive Trouble
- Sexual Problems
Post-Incident Stress Management
Following a critical incident such as the one you have just experienced, there are certain things you can do to assist in coping with any reactions you may experience. Some of these are:
Physical Exercise—Helps remove stress-produced chemicals and relieves built-up tension.
Proper Rest—Helps the body and mind regain strength.
Proper Diet—Take in foods and liquids that are high in carbohydrates and low in fats and sugar. No alcohol immediately following a critical incident!
Normal Activities—Quickly resume daily work and family schedule.
Open Discussion—Talk about the incident and your reactions with fellow emergency workers who responded to the incident with you, other firefighters or EMS personnel who have gone through similar incidents, a chaplain, a CISM-trained peer, or a psychologist if necessary. Even with outside assistance provided to help you successfully cope with the critical incident you have experienced, what you do to care for yourself will have a significant impact on the final intensity of your reactions and the speed of your recovery.
Individuals who experience a major trauma may attempt to protect themselves from the unpleasant aspects of the situation by denial; that is, refusing to acknowledge the negative consequences. Recognizing that the event might have had an impact on you will enable you to more effectively come to grips with the situation. Avoid impulsive decisions such as resigning from your department until you have worked through the situation. Refrain from self medication with drugs or alcohol as this serves only to feed the denial and can cause additional problems. Although you may wish to be alone, now is the time to turn to someone else for support. Good friends, family, clergy, and counselors may all be helpful in restoring balance to your life by providing support and feedback. Finally, be aware that while the feelings you are experiencing may not be comfortable, they are typical for one who has been through a major trauma.
Helping Your Family
A major approach toward helping your family cope with possible reactions is to realize that they are going through the trauma with you. Although you might want to protect them by not telling them what has happened, your reactions make it clear that there is something bothering you. It would help all involved if you share this information sheet with them. Although you might want to ignore your reactions, it is advisable to deal and cope with concerns as they arise. If not allowed to be expressed, feelings have a way of surfacing inappropriately. Discussing this with your spouse helps him or her prepare for possible reactions. This preparation will help decrease possible confusion and tension which might result from involvement in the trauma. Telling children what has taken place is advisable as they are typically questioned by, or find out from, other children about the incident. Sharing the information and feelings about the incident helps promote a clearer understanding and provides an open avenue for communication. A child who finds out about a traumatic situation from others is quickly involved in second-guessing, i.e., "Why didn't he tell me...I guess I shouldn't talk about it...Well, Jimmy says that what really happened was..." Such second-guessing leads to communication breakdowns and additional reactions to the situation. Children fill in the blanks when the information is not provided. After you've experienced a highly traumatic critical incident is not the time to play the loner. Your friends and family are an important emotional and spiritual resource that needs to be brought into your life during this time, not shut out. They may not understand everything you are feeling, but they will know you are hurting, and can help provide needed comfort.
Where To Go For Help
This information was developed to assist you in dealing with the effects of the traumatic event and your possible reactions. The management of your organization cares about you. They may help make a CISD debriefing available to you. They are concerned that you receive all the help you need during this particularly uncomfortable period. If you or your family want additional help, please contact any CISM team member or the state CISM program director.
Emergency Services Stress, Jeffrey T. Mitchell, PhD and Grady Bray, PhD, Prentice-Hall, Inc., 1990.
Stress Management, Federal Emergency Management Agency, United States Fire Administration, Washington, DC, 1991. "Chronic and Traumatic Stress in the Fire Service," Lawrence H. Bergman, PhD and Timothy Barnett-Queen, M Div, MSW
Chapter 7 of Managing People, edited by Kenneth C. Henry and Morton D. Shurtleff, International Society of Fire Service Instructors, 1987.
"Stress Reactions to Traumatic Events," pamphlet, Dr. Eugene Schmuckler, State of Georgia Public Safety Training Center
"Recognizing Critical Incident Stress," Barbara Spurlin, Firehouse Magazine, February 1988.
"High Tension: Keeping Stress Under Control," Jeffrey T. Mitchell, PhD, Firehouse Magazine, September 1984.
"Post Traumatic Stress Disorder and the Firefighter," Francis X. Holt, Fire Engineering, November 1985.
DSHS MHSA Disaster Behavioral Health Services