A Primer on Critical Incident Stress
“Stress, a ubiquitous part of life, results from the totality of all that humans experience. The decisions that people make both sharpen and dull stress. Stress is part of what makes people both alive and human.”
Dr. Stephen A Pulley, Emergency Room Physician, http://www.emedicine.com
A critical incident is a relatively sudden, untimely and unanticipated event outside the range of
normal human experience that evokes unusually strong emotional reactions. Extreme stress has long
term effects often seen in soldiers, emergency responders, disaster victims. The more intimate a person's involvement with the traumatic event, the greater
the potential impact. An accident is exceptionally troubling if the victim is a close friend or
individuals exceed their abilities to manage stress, they may experience disturbing symptoms. Battle fatigue, Post-traumatic stress,
and burnout both fall under the heading of critical incident stress. Many people will need some
kind of professional support.
When paddlers are involved in a fatal accident, especially a failed rescue, their reactions will be similar to those who have been through a disaster or volent crime. This article is intended to help you understand what symtoms may be experienced, and how to deal with them.
Common stress reactions
1. Emotional (shock, anger, disbelief, terror, guilt, grief, irritability, helplessness, regression to earlier developmental phase)
2. Cognitive (impaired concentration, confusion, distortion, self-blame, intrusive thoughts, decreased self-esteem)
3. Biological (fatigue, insomnia, nightmares, hyper-arousal, somatic complaints, increased startle response)
4. Psychosocial (alienation, social withdrawal, increased stress within relationships, substance abuse, vocational impairment)
5. For paddlers: not wanting to paddle; staying away from certain rivers; avoiding people who were present on the day of the accident
People react differently to traumatic events and progress through the effects of critical incident stress at different rates. The symptoms experienced will vary. Accept your own feelings and reactions to the incident as well as those of others. There is no wrong or right way to feel or think.
Critical Incident Stress Management (CISM) is a program that works to decrease the effects of CIS early on, before reactions become rooted. The goals in CISM are to restore the health of the individuals, decrease traumatic stress effects, and speed recovery. An important feature is helping an individual recognize that the danger has passed and that the need to react also has passed.
The 7 phases of a Critical Incident Stress Debriefing
This work can be done by a CISF team or other mental health professionals. Professional rafting outfitters frequently bring in outside experts after accidents and teams of whitewater boaters should give this option serious consideration.
Afterwards: After the debriefing team members mingle with the group. This allows them to focus on those individuals who are troubled. Also, members of the group can bring up issues that they did not feel comfortable talking about with in the larger group.
Follow-up and referral
CISM is not psychotherapy. It is designed for short-term assistance. After CISM is provided, follow-up is indicated when the issues persist. Some individuals will need formal counseling.
Coping with the effects of critical incident stress (http://www.usyd.edu.au/stuserv/welfare/counselling/onsite_files/critical_incident_stress.shtml)
· These reactions will decrease in time; they are normal reactions to extreme stress.
Most localities have a designated CISM team. They can be reached through the International Critical Incident Stress Foundation, Inc. (ICISF) 3290 Pine Orchard Lane, Suite 106 Ellicott City, MD 21042 | E-mail: firstname.lastname@example.org. Their business telephone number is (410) 750-9600. The ICISF 24-hour emergency number (through the Howard County, Md, Fire and Police Communications Center) is (410) 313-2473. You can also work with a local mental health professional that you know and trust.