When Trauma Happens to Someone We Know

It was a nice afternoon.  Quiet.  People were finishing their day’s work and planning their evenings.  The drive home and time with friends lay ahead.  Then the world disappeared in an explosion.

One international worker was killed. Another survived, seriously wounded.  A year later she shows off her skill with an artificial limb and on the good days – which are more and more common – she is excited about creating a new life.

Some of my colleagues were in mission with them.  Though they did not experience the explosion and the direct physical impact, they were deeply affected.  They did sustain a stress injury – a real wound, one needing attention and with the potential to become more serious if not addressed.  Had you and I been there with them, what might we have seen and how could we have helped?

Critical incident stress injuries

A critical incident is any event which causes a very strong emotional reaction in someone, overwhelming their ability to cope.  The reactions may come immediately or some time after the event.   If the reaction is long lasting it may become a trauma injury.

Someone being overwhelmed may have physical symptoms.  They might first seem frozen.  Minutes or hours later we might see shaking, nausea, crying, weakness, hyperactivity or sweating.  In the days after, they may have trouble with sleep and dreams, lose their appetite and be tired.  Stress upsets their immune system and they may be vulnerable to colds or have stomach problems.

They may be in an unusual emotional state.  They might appear to be grieving.  Our previously unflappable friend may be shaken in their self-confidence and feeling hopeless or depressed.  They may be fearful and angry – or even feeling guilty because they didn’t somehow stop the event or do something about it.

They might not be thinking straight.  They could have trouble concentrating, be forgetful and find it hard to make decisions.  They could be suspicious and easily startled.  And through all of these symptoms they may be frightened by their own reactions and worry that they are ‘losing it’.

They need help.  What can we do for them?

1. If you or they are with CANADEM, get in touch right away with Deployment and Duty of Care, who can support both of you.
2. Make sure their physical needs are met. Get them to a safe, calm place.  Be sure that they have clean water and encourage them to drink it.  Arrange for nutritious food in the days that follow and encourage them to eat, even if they don’t feel like it.
3. Reassure them that their reactions are normal, and that things will get better.
4. Stick around. Give them space when they want it, but remain available for when they need some conversation or an embrace.
5. Help them get in touch with friends and family who they worry will be worried.
6. It will help if the people they talk with about the event really understand. When they say “you know what I mean?” … they need people who can honestly respond “I know what you mean.”
7. Protect them from the media, the curious and others who won’t be helpful.
8. Don’t assume they are helpless. Involve them in decisions about work … and understand if things take them longer.
9. Encourage them to rest, even if they are having problems sleeping. Rest will help to heal.
10. Also encourage them to exercise. Perhaps walk together, or ask them to join you in a tennis game.  Exercise and breathing may allow more emotions to come to the surface, and let them express feelings without trying to fix anything.  Assure, again, that what they are feeling is normal.
11. Encourage them not to make major decisions right away. Let some healing take place first.
12. If they or you are worried about their reactions being very strong or prolonged, help them connect with a professional who can help.

Thanks.  You and I would most likely have been rattled by this incident as well.  Our being with them and helping may be good for all of us.  We will look more closely at our own reactions in the next Note.

Resources

Physical first aid training may save a life. Psychological first aid (PFA) training is also important, especially in higher risk or stress assignments.  It gives colleagues the tools with which to respond – and helps inoculate individuals against the impact of stress.

A quick and helpful guide, easy to access and review when someone you know has encountered a critical incident, can be downloaded to your smart phone.  Find it here: https://www.nctsn.org/resources/pfa-mobile.

The World Health Organization has created a manual on Psychological First Aid for field workers.  It is worth downloading and reading.  The link is here: https://www.who.int/publications/i/item/9789241548205. It is very user friendly.