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Critical Incident Stress

CRITICAL INCIDENT STRESS IN A HUMANITARIAN CONTEXT

What is Critical Incident Stress?

One enters what is called a state of traumatic stress when a traumatising situation or event is experienced: i.e. a situation or an event which is:

  • Sudden
  • Unexpected
  • Violent
  • Life threatening, physically or psychologically, for oneself or close family and friends

Examples would include being witness to a natural disaster, a bombing, a massacre, or having basically survived a hostage-taking situation, threats, violence, an attack on your convoy, etc…

Whatever the event, one would be intensely conscious of having escaped the worst and of being a survivor of the event. Life is felt to be precarious and one feels vulnerable. Any person who experiences such an event is never the same again, and when he or she returns home they feel different from their family and friends.

This is a normal reaction to an abnormal situation.

What are the signs of Critical Incident Stress?

At the time of the incident, or just following it, you may:

  • Feel very tired
  • Shake an tremble
  • Break out in cold sweats
  • Suffer from nausea, vomiting, diarrhoea
  • Have raised your blood pressure and heart rate and even suffer chest pains similar to that of coronary angina

You may also have strong feelings of guilt and anguish about the fate of the other victims

  • Feel sad, downhearted and inert
  • Feel angry, be irritable and wrongly accuse those around you
  • Feel vulnerable or overexcited

Mentally, you may suffer from:

  • Temporary confusion
  • Slowness: in thought, in concentration and in your ability to make decisions
  • Or, on the contrary, your thought and speech patterns may have become abnormally rapid.

Your behaviour may change:

  • You tend to drive dangerously
  • You are becoming hyperactive
  • You work late in the evenings and at weekends
  • You explode for no reason, argue endlessly or burst into tears.

All these reactions constitute a normal reaction and should clear up in the weeks following the traumatising event.

Post Traumatic Stress Disorder (PTSD)

Everyone reacts differently to stress. You may for example:

  • React immediately in the hours or days following the event in which case the recovery prognosis is good
  • Or react only after some months, or even some years, and the consequences for your well-being will be more serious as this can lead to PTSD (Post Traumatic Stress Disorder).

The symptoms of PTSD are more serious than those of Critical Incident Stress:

  • The victim experiences “flashbacks”, i.e. emotional and sensorial (like hallucinations), of the scene which has affected him or her the most. At night, this causes nightmares which, in the long term, can lead to chronic insomnia.
  • There is a tendency to avoid anything concerning the traumatising event (thoughts, emotions, situations…), which, in the long run, can make interpersonal relations difficult.
  • It can cause hyper-arousal of the nervous system: the least noise causes jumpiness, there is difficulty going to sleep, or frequent waking-up during the night, digestive problems become chronic, skin problems, immune system chronically low, etc.

The condition is serious if these signs last more than a few weeks without diminishing.

If you feel you’re suffering from PTSD, you should know that it is considered more and more as an illness, and therefore covered by health insurances in most Western countries now, on condition that it is diagnosed by a medical doctor.

Do you recognise a majority of the signs described? If so, you are suffering from Critical Incident Stress or PTSD.

What can you do if you believe you are suffering from PTSD?

  • First: you must realise that you need to stop and rest.
  • Next, don’t suffer in silence and don’t be ashamed or afraid to ask for help. What you are suffering from is, in reality, an “emotional wound”. You are not a hero or heroine. Don’t think: “The victims are suffering more than me, I shouldn’t complain”.
  • To support your own needs, if you suffer from flashbacks and nightmares and your behaviour is becoming “bizarre”, do what you can to be brought home or away from the conflict or disaster zone. Once more, remember returning home does not mean you have failed.
  • If a traumatic event occurs, it is vital that you talk about the situation and about what you’re feeling. This is called debriefing. To be effective it must be carried out:
    • Immediately
    • At the scene of the incident
    • In a simple manner

If your superior is not available, discuss the event with a colleague you trust. Otherwise send an e- mail or call your organisation.

  • If one of your colleagues is suffering, following a traumatising event, offer him or her your presence and your listening skills. This may prevent him or her developing PTSD. Never be afraid to offer support. It’s not so hard. There is no need to be a specialist in compassion to do that!
  • Finally, if none of the above is possible and circumstances allow it, you may talk to our team at support@humanitarian-psy.org or call the CHP at +41 22 800 21 15.

Never forget: you’re just human and your future depends on it…
© CHP 2009