What are traumatic incidents?

A traumatic incident is any event that can be considered to be outside of an individual’s usual experience and causes physical, emotional or psychological harm.

We all respond in different ways to any event, but this handout highlights the usual responses of individuals and may offer some help in relieving the anxiety such incidents cause, assist in the healing process and give some assistance in identifying further sources of help.

The determining factor around the emotional responses for anyone involved in, or responding to, an incident can centre on challenges to core beliefs about ourselves or how we see the world. For instance, we may acknowledge that we could die within the next 24 hours (be run over by a bus, involved in a crash or an explosion) but if we really believed that our life might not last beyond tomorrow, we might well be revising what we intended doing – rather than me writing, or you reading this!

It is important to remember that other factors in your life may contribute to your vulnerability to any incident, and its impact upon you.

Reactions to a critical incident are likely to be worse if …

• There has been a death.
• There is a feeling of wanting to have done more.
• There is little or no perceived support from colleagues, family or friends.
• The incident follows closely on top of stress creating events in your life.

Reactions may include:

Sadness for deaths, injuries or losses of every kind;
Guilt for not having done more; for having survived;
Anger   at what has happened, at whoever caused it; or let it happen; at the injustice of it all; at the lack of understanding of others; at the inefficiencies in the “system”; Why me?
Shame for not having reacted as one would have wished; for having been seen as helpless, “emotional” or needing      others;
Fear of “breaking down” or “losing control”; of a similar event happening again;
Memories of feelings of loss or of concern for other people in your life; of past, similar events;
Disappointment which can alternate with Hope.

Physical and mental reactions

You may have some physical reactions, with or without the feelings described above. Sometimes they may develop long after the event.

Physical reactions include tiredness, sleeplessness, palpitations, nausea, headaches, neck and back aches, muscular tension, tightness in the chest and throat, changes in eating habits and sexual interest.

Mental reactions may be loss of concentration and/or motivation, poor memory, nightmares, flashbacks (feeling that it is happening all over again), hypervigilance (always on your guard), or being easily startled.

Irritability, loss of sense of humour and impatience with self and others are extremely common, and can put relationships with  family and friends under strain. Try to remember that they too may be suffering additional stress, may feel left out, or do not    understand how best to support you.

You may find yourself withdrawing from those closest to you, unable to express your feelings, rejecting what is offered.

Stop – and try to ask for what you want.

Remember this

• Our bodies and minds will look after themselves – reactions are a natural process.
• Nature will heal if you allow feelings to come out into the open.
• Concealing feelings can prolong the recovery period.

Sometimes there is a sense that too little or the wrong things are being offered, or that you cannot live up to others expectations of you. Alcohol and drug intake may increase.

What’s this got to do with me?
More than you think, or may want to admit to, even to yourself.

Let’s put it into a personal context …

… how many times have you responded to an incident? Do you get a hollow feeling in your stomach in
those few seconds before arrival at the scene of an incident, engaged in combat or after the alarm bells have
sounded. Accept it or not, most emergency workers do.

When it’s all over, think hard for a moment about how you feel.

We have the advantage of training, skills and techniques that can minimise the danger to ourselves and others, but it is a fact that traumatic incidents do happen. These incidents can happen with very little warning. Colleagues can be hurt, some badly.

Perhaps you know someone who has been exposed to one of these traumatic incidents, perhaps you have been affected yourself. How do you feel about that? When you respond to the incident, you have no idea what you are running into. Fortunately most incidents are dealt with quickly and without traumatic effects but there is always the risk of finding colleagues that have been very badly injured or killed.

An incident may not involve physical injury to self or colleagues. The sudden death of an individual (particularly when it is a friend or a child) can have a great impact on those who find and try to revive the person.

Usually the incident is discussed over a coffee or a drink. That’s fine, it’s one way of easing the stress, but how many of us are totally honest with ourselves, let alone our colleagues about how we really felt at the time. If you were terrified, would you admit it? The truth is that the risk of injury to ourselves and others is always present. Stressful, isn’t it?

After the incident
There are some strategies you can use to make things easier to bear post incident. Your mind’s defence mechanism may not let you feel the full impact of an incident straight away, often you are in shock. Your feelings will slowly unfold as the days go by.

• You may feel numb if your feelings are blocked and the event may seem unreal, almost dream like, and you may even wonder if it ever happened at all.
• Keeping yourself occupied with other things may help, your hobby, PT, additional work, etc. However, when combined with the numbing effect, this can be over used and delay your recovery.
• Talking to friends or colleagues, who were also involved, about the incident and how you feel.
• Returning to the scene of the event is one way of confronting the reality of it all.
• Dreaming about the event possibly repeatedly, is not uncommon. This is nature’s way of helping you to collate and absorb the information.
• Having the support of others can be invaluable. Don’t say “no”, if it is offered. It may come from others who have had a similar experience. It is important not to isolate yourself. If you are feeling this way, then it is safe to assume that others have done so too under similar circumstances.
• There are times when you may need to be alone with your thoughts and feelings. Again, this is natural. Equally, you may need the company of your colleagues, family and friends.
• Pain, unfortunately may be part of the healing process