Incidents such as the death of a colleague, friend, client or family can have a major impact on well-being and emotions. Such incidents are often labelled as ‘critical’ and cumulative stressful situations may also have a similar impact.

Critical Incident Response Debriefing is a group activity that provides information about normal responses to abnormal experiences. It helps to form a clear picture of the incident, mobilise problem solving strategies, and receive personal support.

Guidelines

You need to recognise that you have been through a highly stressful experience and acknowledge that you may have a psychological reaction to it. If you refuse to accept your feelings or deny them excessively, this is likely to delay your recovery process.

Seek out support from others – both physical and emotional. Talk about your feelings to those who will understand, particularly those who have had a similar experience.

Try not to block out thoughts of the incident or avoid reminders of it. Thinking and talking about it, confronting the reality bit by bit, helps you to come to terms with the experience.

It is important to look after yourself, as people are vulnerable to accidents or physical illness following a trauma. You may feel unmotivated and apathetic – but trying to do some of the things listed under ‘look after yourself’ will motivate you and assist the recovery process.

Reactions

People who experience critical incidents may experience strong physical and emotional reactions. These reactions are common and part of the process of coming to terms with a horrible event. They may occur immediately after the incident, a few hours or days later, or sometimes weeks or months afterwards.

Common Physical Reactions

Fatigue
Nausea
Upset stomach
Diarrhea
Constipation
Trembling
Headaches
General aches and pains
Chest pain *
Sweating
Irregularities to heartbeat*
Muscle tension
AND many other physical signs and symptoms

* These symptoms are best checked by a doctor if ongoing.

Common Behavioural Reactions

Restlessness
Apathy
Sleep disturbances
Isolating self from others
Easily irritated by other people
Feelings of detachment from others
Loss of interest in normal activities and hobbies
Increased use of alcohol/tobacco/other drugs
Inappropriate use of macabre humour
Work – absence/not wanting to go/wanting to be there more than usual
Poor motivation
Poor concentration and attention
Avoidance of TV/newspapers
Acting differently for example, putting things in unusual places/forgetting where you put things
AND many other behavioural reactions

Common Cognitive Reactions – (Thoughts)

Nightmares/dreams about what happened.
Flashbacks/reliving the experience
Focusing on the event
Inability to remember the event
Inability to name common objects
Difficulty concentrating
Difficulty making decisions
Mental confusion
Thinking that you are losing control
Unable to understand your own reactions
Thinking that you are going crazy

Common Emotional Reactions

Sadness
Loss
Shock
Disbelief at what happened
Anxiety
Fear – of a recurrence/for the safety of others/other apparently unrelated fears
Anger – at the injustice of it/how it was managed/directed at particular people
Panic attacks
Irritability
Frustration
Depression
Guilt
Helplessness
Vulnerability
Numbness/as if things are unreal
Withdrawal
Disorientation
Paranoia

Common Existential Reactions

Wondering if it is worth your continuing in your current work
Reactions about the injustice of the situation
Concerns about your personal safety and how to protect that
Making people the priority

Look after Yourself

Physical

Get plenty of rest even if you can’t sleep.
Try to get regular and well-balanced meals.
Regular exercise, such as walking, cycling or jogging, helps reduce the physical effects of stress and trauma.
Reduce your use of stimulants such as coffee, chocolate and cigarettes – your body is already ‘hyped up’ and these substances only add to the stress your body is experiencing and increases your level of arousal.
Do not try to numb the pain with drugs or alcohol – this will lead to more problems in the long term.
Make time for relaxation – you may wish to learn and use a technique such as progressive muscle relaxation, meditation, yoga, or breathing exercises.

Lifestyle

Try to resume a normal routine as quickly as possible but take it easy; do not throw yourself into activities or work in an attempt to avoid the unpleasant feelings and memories.
Sometimes you will want to be alone but try not be become too isolated – contact friends, and, if necessary, have someone to stay with you for a few hours each day.
Do things you enjoy and be nice to yourself – try to schedule at least one pleasurable activity each day.
You may wish to try and help out others who have been through similar situations – your support and understanding may be very important to them.
Don’t make any major life decisions (such as moving house or changing jobs) in the period following the trauma – equally, do make as many smaller, daily decisions as possible. This will help to re-establish a feeling of control over your life.
Some people find keeping a journal or diary is helpful. Writing down your feelings can be almost as good as talking about them.
Give yourself permission to feel rotten – you’ve been through a traumatic experience. You are having normal reactions so be wary of labelling yourself as abnormal.

How Friends and Family Members Can Help

Listen carefully
Spend time with the traumatised person and reassure them that they are safe
Offer your assistance and support even if they have not asked for help
Don’t take it personally if they want to be alone sometimes or even seem angry

Dealing with distressing incidents and situations