CISD (critical incident stress debriefing)

[Highlander]

In EMT-Basic and Paramedic school the training is fast-paced and the amount of materials to learn in a short period of time can be daunting. To spice things up, we are given both in power-point presentations and the many textbooks we must study full color photos of the most gruesome nature.....broken limbs with bones sticking out, ghastly burns, vehicles with twisted metal and blood on the ground and worse. We would eagerly flip ahead in our books to find every "shocking" one. The very best books had the most such pictures. This was, I suppose, to prepare us for the world "out there"......desensitization. But for those of us who sometimes had trouble coping with what we experienced "out there" we had access to CISD and a hot line to call any time, day or night. CISD, critical incident stress debriefing, to help one deal with really tough traumatic events, is a great step forward to help those people who are at the front lines. And for those of us who are preparing for possible pandemic or even life in general when things get really difficult, a modified CISD plan could make the difference between maintaining hope and sanity or descent into despair. For me, though, it is "the little things" that save me......a really great hug from someone I love, a radiant smile on a child's face, a terrific piece of chocolate. These "little" things are not so little. But what holds a person together during times of almost unbearable stress is highly individualistic. Figure out what things do that for you and "stock up" on them, cultivate them. You'll be way ahead of the game.

[Niko]

Thank you Highlander.

Could you post the names of 2-3 books for preppers who wish to pursue this further?

[T. Modesto,PhD]

Highlander
Thank you so much for this information. In talking to a number of professionals, one of the issues presently is professional pandemic awareness fatigue. It is hitting lots of f people ( including myself right now BIG Time).This message is so helpful. If possible I hope you would consider placing this in as many places as possible including as as stickly for the FT site. One of the biggest dangers in leadership is the phases or phases of preparation fatigue when there is anticipation of a long sequence of a disaster. This may be a prime example with BF and what you have written is so important to keep in mind.

Terrie

Originally Posted by Highlander

In EMT-Basic and Paramedic school the training is fast-paced and the amount of materials to learn in a short period of time can be daunting. To spice things up, we are given both in power-point presentations and the many textbooks we must study full color photos of the most gruesome nature.....broken limbs with bones sticking out, ghastly burns, vehicles with twisted metal and blood on the ground and worse. We would eagerly flip ahead in our books to find every "shocking" one. The very best books had the most such pictures. This was, I suppose, to prepare us for the world "out there"......desensitization. But for those of us who sometimes had trouble coping with what we experienced "out there" we had access to CISD and a hot line to call any time, day or night. CISD, critical incident stress debriefing, to help one deal with really tough traumatic events, is a great step forward to help those people who are at the front lines. And for those of us who are preparing for possible pandemic or even life in general when things get really difficult, a modified CISD plan could make the difference between maintaining hope and sanity or descent into despair. For me, though, it is "the little things" that save me......a really great hug from someone I love, a radiant smile on a child's face, a terrific piece of chocolate. These "little" things are not so little. But what holds a person together during times of almost unbearable stress is highly individualistic. Figure out what things do that for you and "stock up" on them, cultivate them. You'll be way ahead of the game.

[Highlander]

I want to preface what I say with the caveat that I am not a psychology professional.....I am only sharing my experience. The training we received in CISD was with lectures and "hand-outs"....no books, although there now may be some. The main thrust was to be aware of changes in ouselves and those with whom we worked to recognise signs and symptoms of depression or shock resulting from a highly stressful event or even the accumulation of many long-term moderate to low-stress events. The hope was that, if recognised and addressed in a timely manner, the psychological damage could be lessened or even turned around. Many of these signs and symptoms were the very same as with depression or suicidal ideation:
loss of pleasure in activities, social isolation and withdrawal, subjective cognitive impairments, anxiety, worry, excessive guilt, preoccupation with thoughts of death or suicide, insomnia or hypersomnia, changes in appetite and weight, loss of energy and feelings of helplessness, hopelessness, and worthlessness, etc.
I know what you're thinking....good grief!...I already feel some of these things to some extent sometimes. Except with the "preocupation with thoughts of death or suicide", we all experience some of these things, but usually not on a constant basis. As for me, I always feel better if I can "do something"......cultivate a sense of empowerment. And here's where working on provisions in all categories comes in. At least to that extent, and the extent that I exercise responsibility and put-out the intellectual effort to stay abreast of the issues and daily barrage of new information, I can establish control over my own life. What a great feeling!
On the subject of finding "little things" that keep one whole, healthy and alive, I know of no EMS or emergency room personnel who, when wanting to boost their morale, put on a Mozart Requiem to listen to. I head straight to Motown, or CCR or whatever "lights my fire" and really crank up the volume.

[Mellie]

Take a look here for my table of symptoms:

http://www.wildlandfire.com/docs/200...ss_debrief.htm

12 Things to Try:

1. Within the first 24 to 48 hours, periods of strenuous physical exercise alternated with periods of relaxation will alleviate some of your physical reactions.
   
2. Talk to people - talk is the most healing medicine. Spend time with others, both those within emergency services and those in ordinary life.
   
3. Do things that feel good to you.
   
4. Beware of numbing the pain with drugs or alcohol. You don't need to complicate this with a substance abuse problem.
   
5. Structure your time - keep busy. Keep your life as normal as possible. As much as you can, keep the commitments you have made.
   
6. You are normal and are having normal reactions. Don't label yourself crazy.
   
7. Reach out - people do care. Accept offered help.
   
8. Realize that those around you are also under stress. Remember that others were also affected by this incident. Help those around you as much as possible. You can help them by sharing your feelings or simply checking out how they're doing.
   
9. Give yourself permission to feel rotten.
   
10. Keep a journal - write your way through those sleepless hours.
    
11. Eat nutritious, well-balanced meals high in carbohydrates and low in sugar. Avoid excessive use of caffeine.
    
12. Don't make any big life changes, until things have settled.

More later...

Mellie

[Mellie]

When a "bad thing" happens (Critical Incident Stress), the brain creates an immediate network of neuronal connections (via the amygdala) that says "Danger, Danger" and triggers the flight or fight (adrenalin) reaction. This may or may not lead to Post Traumatic Stress Disorder (PTSD).

Experience of "bad thing" that creates this kind of a neural network can be mitigated if you can "make friends with the memory". Talking about it, writing about it, sharing with people who participated in the same experience or a similar one, etc can help with that process. The person who was traumatized needs to do it in their own rhythm and at their own speed so their experience can be integrated in the best possible way.
.

[c3jmp]

folks might want to hit:

http://www2.us.elsevierhealth.com/in...rchform&id=jem

and do a search on "critical incident stress" across all the journals there... the search can be narrowed depending on what aspect of CIS folks are interested in.. relevant to EMS, JEMS was around back to at least '85 - don't know about the others. while the search capability only goes back to 2001, it remains a useful resource.

note: it appears the "free" text is restricted to subscribers. my intent was not to provide advertising -- moderators are welcome to pull this post. it might be useful if the local library has archives.

[sharon sanders]

Welcome c3jmp.

[Highlander]

Thanks to all for pitching in on this very important subject.
Mellie brought up a critical point, and that is to define what is normal. Many other points help one to, when in trouble, take different actions to return to optimal psychological health when faced with stress. Of course, we are not disembodied zombies......keeping the body healthy helps keep the mind healthy, too.