Addressing the emergent psychological needs of others during a traumatic event can be a draining experience. Working with individuals who are in acute emotional distress requires an intensity that, for the provider, is both mental and physical. It is imperative that you consider your own state of mind prior to engaging in the provision of ATSM. If you are currently experiencing a time of emotional distress in your life, it would be wise to have another responder assist the victim. In this way, you lessen your chance of becoming victimized yourself by the event.
As an emergency responder, you will likely be exposed to the very events that you are called upon to help others. For example, after arriving at an automobile accident, a police officer had the responsibility of preserving the scene. While holding back bystanders, he provided psychological support. Yet he too had seen a gruesome, dismembered body on the roadway. As an emergency responder, you will be exposed to seemingly overwhelming physical events as well as the psychological impact that these events have on others.
There will be times when you will identify personally or “link with” an individual with whom you are working—or perhaps with some aspect of the situation. For example, a young detective was called upon to deliver a death notification to the parents of a 10 year-old girl. After sharing the news, she and her partner offered support for the grieving parents. Her feelings of discomfort shifted very quickly to feelings of being overwhelmed when she saw a photograph of the deceased child—the girl looked very much like her own daughter.
Despite drawing upon a specific strategy that will help you to remain “professionally detached” (e.g., empathic communication—as described in the upcoming section, “Provide Support”), powerful thoughts and feelings have a way of piercing professional detachment. This is a normal response to an abnormal situation. If you find yourself feeling emotionally overwhelmed during the provision of ATSM, try the following:
• Maintain an awareness of your state of mind, as well as your physical reactions. Consider the effect the person is having on you. Acknowledge to yourself that your involvement with the individual is creating various physical and psychological reactions.
• If you find that the discussion is causing you to react physically (i.e., rapid heart rate, breathing increase, sweating, etc.) take a slow deep breath and tell yourself to relax—take a second deep breath and relax. If possible, separate from the event, grab a cup of decaffeinated coffee, and share your feelings with a peer.
• If you find that you are unable to concentrate, focus on the individual and the specific words they say—work to actively listen to what they are communicating. Slow down the conversation and try repeating what you have just heard.
• If you find yourself feeling emotionally overwhelmed, it is okay to acknowledge the impact the event is having on you as a human being. For example, you might say, “What we’re seeing out here is really tough for all of us....” However, make every effort to avoid self-disclosure of specific, personal information (e.g., “This reminds me of when my sister was involved in a car accident.”). Remember that it is OK not to be OK, and that displaying your emotions can reinforce for the victim your genuine concern. Finally, realize that traumatic stress may compromise your ability to make good decisions and can therefore place you in danger. Monitoring your own reactions, while working with others during a traumatic event, is critical.
If you find yourself feeling emotionally overwhelmed following the provision of ATSM, try the following:
• Acknowledge that the experience has been difficult for you.
• Realize that the connection you established with the person can have a lasting impact on you. Words they have spoken and the emotions they displayed may become imprinted in your mind.
• Reflect upon what has just occurred. Be aware of your emotional, cognitive, behavioral and physiological reactions. If necessary, engage in some physical exercise to dissipate the stress energy that has been generated. Find a trusted friend to talk to about your experience. However, remember to keep in confidence things the victim may have shared with you. Talk about your reactions to the experience. Sharing the experience will help you to assimilate what has occurred and to gain a sense of closure.
• If you find it difficult to sleep because of continual thoughts of the person’s words or emotional display, realize this is a normal reaction. Do not fight the sleep difficulty, this will usually pass in a few days. Try the following. Eliminate caffeine for four hours prior to your bedtime, create the best sleep environment you can, consider taking a few moments before turning out the lights to write down your thoughts, thus emptying your mind. Try reading or listening to peaceful music.
• Take some time to step away from the action. If possible, give yourself permission to rest, relax and engage in some non-threatening activity. Unwind.
• Spend time with your family and friends; stay connected with them. Resist the urge to retreat into your own world. You need their support following an emotionally charged event.
• If you have the opportunity, take advantage of a Critical Incident Stress Debriefing in the days following the traumatic experience.
• If necessary, seek the assistance of a professional. If you find that the experience is powerful and is staying with you for an extended period of time, allow yourself the advantage of professional support and education. Remember that you are a normal person who has experienced an abnormal event.
• Have the strength to let go. It requires courage to face the powerful emotions within you.
Reprinted from Acute Traumatic Stress Management™ by Mark D. Lerner, Ph.D. and Raymond D. Shelton, Ph.D. by The American Academy of Experts in Traumatic Stress, Inc.