Mental Health Association in New York State, Inc.
(Publication Archives)

Community Connections, Fall 2003

Critical Incident Stress Management
By Bernadette Ballezza, Compeer Coordinator, MHA in Ulster County

Critical incidents occur daily to individuals as well as groups of people. Acts of war or terror and natural disasters are critical incidents but so too are witnessing or being in an accident, witnessing or experiencing domestic violence and having surgery. What makes the incident critical is the perception of the beholder. These extraordinary circumstances can make the individual feel terrified, powerless and/or horrified in the face of threatened or actual injury or death.

The need for psychological support after a critical incident has been known since WWII when the term “shell shock” emerged to describe a group of symptoms that could severely challenge an individual's ability to cope with daily life. An estimated ten percent of all personnel who fought in World War II experienced these symptoms, which the American Psychiatric Association called a gross stress reaction. Today, we call this reaction Post Traumatic Stress Disorder (PTSD). Our knowledge of psycho-eurobiology helps us understand that the imbalance in brain chemistry, which causes mental illness, can be further disturbed by overwhelming stress. Thanks to pioneers such as Dr. Jeffrey Mitchell, we also now know some very simple, effective techniques to minimize or prevent the effects of critical incidents. Critical incidents may produce a wide range of symptoms, which can appear immediately, a few hours later, or within days or weeks of the event. The more traumatic the incident, the more powerful impact the stress reaction will have on the individual. Some symptoms include:
COGNITIVE: Poor concentration, memory problems, impaired problem solving
EMOTIONAL: grief, guilt, depression, anxiety/fear, feeling lost and/or overwhelmed, irritability and rage, emotional numbing
PHYSICAL: Muscle tremors, tension, chest pain, headaches, difficulty breathing, gastro-intestinal distress, elevated blood pressure
BEHAVIORAL: excessive silence, sleep disturbance, changes in eating habits, withdrawal from family and friends, changes in work habits. Those who have these NORMAL, though uncomfortable, stress reactions to extraordinary events are often confused by the changes they notice in themselves.

Research shows that the way a person takes care of him or herself during the first few days following a traumatic event will help to minimize the future psychological reactions to the event. Understanding these reactions can help you deal with the trauma of the event.

Because your body is affected by your mind and vice-versa, you will experience both emotional and physical reactions simultaneously. Therefore, it is important to follow
the suggestions listed below:

• Avoid alcohol for at least 24 hours because it works on the way you preserve memories of recent events. It is very important that your brain have the opportunity to deal with all aspects of a traumatic event so that you will less likely to be bothered by it later.
• Avoid caffeine as it is a stimulant. You need to relax and be calm. The stimulation of caffeine plus a traumatic event may make it harder to settle down.
• Talk about the event. Your mind needs to process what happened so that it can resolve your feelings. Bottling up feelings will cause them to appear later in unpredictable ways.
• Use natural methods to relax. A warm bath, massage and/or soothing music. Pamper yourself after a hard day. Exercise helps, too.

For more information and assistance see: www.icisf.org.

posted 9/18/03