The Aftermath of a Critical Incident
When we experience a threatening event, our bodies automatically respond in a way that allows us to protect ourselves or escape from the situation. This fight or flight involves an increase in heart rate, blood pressure, muscle tension, and breathing rate. All these changes help us to physically deal with danger or leave the situation very quickly if necessary. During a critical or traumatic incident with a client this reaction will be very strong, especially if it is the first occurrence and experience the mental health professional has had in working with a challenging client.
The common reactions experienced may include:
Shock
Disbelief
Numbness
Intense fear
Anger
Confusion
Pounding heart
Trembling or shaking
Sweating
Excitement
Nausea
Fast breathing
It is normal for mental health professionals to continue to experience a number of invasive thoughts, feelings, and behaviours for a number of days or even weeks after the traumatic event. These reactions can be distressing and are a sign that you are recovering from severe stress. Some prolonged emotions that a professional may experience after experiencing a traumatic response to a challenging clients reactions or situation include:
Fear:
Of a recurrence
For the safety of one’s family
Seemingly unrelated fears
Being easily startled
Anger:
At what happened and the senselessness of it all
At who “caused it to happen”
General irritability
Shame:
For having appeared helpless
For not behaving as you would have liked
For being better off than others
Sadness:
About the losses
About the feelings of safety and security
Feeling depressed for no reason
Sleep disturbances:
Difficulty getting to sleep because of intrusive thoughts
Restlessness, awake often during the night
Dreams and nightmares about what happened
Feeling tired all the time
Memories:
Flashbacks: “reliving” the event
Thoughts of other frightening events
Preoccupation with and frequent thoughts of the event
Confusion:
Difficulty making simple decisions
Not concentrating
Physical:
Muscle tension, trembling or shaking, headaches,
Diarrhoea or constipation, sweating, nausea.
Social:
Withdrawal from others and a need to be alone
Easily irritated by other people
Feeling of detachment
Avoiding any situation that may remind you of the event
Loss of interest in normal activities
Not wanting to go to work
Habits:
Increased use of alcohol, cigarettes or other drugs
Loss of appetite or increased eating
Loss of interest in enjoyable activities
Loss of sexual interest
Relationships:
Sometimes strains and tensions can appear with workmates, partners, family and friends.
You may find it challenging to talk about what you have been through
You may not want to burden others with your problems
You may not think they are as understanding as you would like them to be
Changes in your behaviour may worry or annoy them
What to do immediately after a traumatic client event
Make sure you are with people. Do not go home to an empty house.
Talk about the incident withe others. Talking will help you get over the reaction.
Remind yourself that the event is over and that you are now safe.
If possible get some physical exercise. This will help “burn off” the adrenalin.
Don’t over use alcohol or other drugs.
Try to eat something, even if you don’t feel like it.
If you can’t sleep, get up and do something until you feel tired.
How to Handle the Next Few Days
Don’t be hard on yourself. Remember your reactions are a normal result of trauma and will pass in time.
Try to get back into your normal routine as soon as possible.
If you feel scared, or anxious, take some long, slow breaths and remind yourself that you are safe.
Be kind to yourself, you deserve it.
Try to accept support from others, even if you feel a bit distant.
Give yourself permission to feel “rotten” for a while.
Accidents are more common after severe stress so take care.
Try to get adequate sleep, a good diet and regular exercise.
Practice relaxation to reduce nervous tension.
Allow yourself time to deal with the memories. Some may be challenging to forget.