Crisis as Opportunity – Critical Incident Stress Management


by Bob Rabe

A college professor once asked the class, “How heavy is a glass of water?” The professor received several answers, but the professor replied, “The weight doesn’t matter, it depends on how long you try to hold it. The longer you hold it, the heavier it becomes. That is, until you put it down and rest.”

Stress is the same way. If we carry stress, especially after a critical incident, the stress can become increasingly heavy, if not dealt with properly. The stress may lead to a crisis.

According to the Chinese symbol for crisis, it is made up from two other symbols, which are danger and opportunity. We can collapse under the weight of the crisis (danger), or we can learn to develop new skills (opportunity), to meet it head on.

Dr. Jeffrey Mitchell is the founder of Critical Incident Stress Management (CISM) and the International Critical Incident Stress Foundation. In the early 1980’s, Dr. Mitchell – a firefighter/paramedic – found that after a critical incident, his peers demonstrated difficulty coping with the stress. He studied their reactions and developed CISM, which is now a worldwide program. The purpose of this article is to help law enforcement personnel better understand and cope with reactions following involvement in critical incidents.

Bob Rabe
Bob Rabe

CRITICAL INCIDENT STRESS MANAGEMENT
CISM is a comprehensive, organized approach for the reduction and control of harmful aspects of stress in the emergency service field. The goal of CISM is to develop new skills to prevent or minimize incident stress reactions, restore an individual’s ability to function and re-stabilize the work place. CISM also includes, but is not limited to the following:

Pre-Incident Traumatic Stress Education
Perhaps the most important element of combating critical incident stress is pre-incident stress education. Providing education before a critical incident occurs, helps to reduce the impact of the incident. Teaching law enforcement personnel before they become involved in critical incidents, generally aids in their ability to avoid, or at least control, stress reactions. It helps personnel recover from stress reactions better because they recognize the symptoms early, and seek assistance more quickly.

Critical Incident Stress Team
A specially trained team of volunteers from police, fire, EMS, mental health, clergy and other professions, who provide CISM services for those exposed to a critical incident. Typically, the team will meet with a group of people who have been exposed to a critical incident in a confidential setting where they can freely talk about their experience and express their reactions. An educational approach is used to inform the personnel of the normal effects of critical incident stress and to suggest ways to conquer it.

Peer Counseling
Peer support officers are trained to recognize problems and make appropriate referrals. Officers learn basic counseling skills that build a climate of trust through empathy, genuine concern, and an unconditional positive regard for the peer person seeking help. Peer support officers do not conduct any clinical therapy, only trained and certified mental health professionals can provide the proper course of treatment. Peer support officers work under the supervision of a mental health professional to ensure that officers, who need help, get it.

Professional Counseling
Providing mental health care to members of the law enforcement community is difficult. Law enforcement personnel often resist counseling for several reasons:

1) Frequently, they have a strong sense of self-sufficiency and insist that they can solve their own problems.
2) Law enforcement personnel possess great skepticism of outsiders and have difficulty trusting them.
3) Mental health counselors sometimes do not understand law enforcement work, nor can they easily grasp the daily stresses face by law enforcement personnel.

To counter such resistance, and to help their personnel, many police departments have established peer support programs.

Debriefing
A group discussion employing both crisis intervention and an educational process, targeted toward decreasing or resolving psychological distress associated with a critical incident. A critical incident can be a police call, during which sights, sounds and smells are so vivid as to cause the officer to feel a significant increase in stress and stress reactions – immediate or delayed. Among the most common are:

• Serious injury or death
• Death or injury of a child
• Workplace violence
• Suicides
• Mass Casualty deaths
• Death of a co-worker

The goals of the debriefing team are:

• Lessen the impact on personnel exposed to critical incidents
• Accelerate the recovery from critical incidents before stress reactions have a chance to damage performance, careers, health and family. Stop it before it starts, and confine it before it spreads.
• Provide information about critical incident stress and stress reactions that law enforcement personnel can use to help themselves and their peers.

The critical incident can be much different from what you usually face. Although law enforcement personnel are well-trained, a critical incident is something they may not be prepared for. Personnel may be confronted by reactions and feelings rarely reported or discussed by their peers. Just as you allow yourself time to recover from a physical injury, it is important to accept your reactions after a critical incident. Allow time to recover from the incident. Remember, time will vary with each individual.

Every year, hundreds of law enforcement personnel experience critical incidents that can have serious, long-term consequence for themselves and their departments. Law enforcement personnel may not suffer any physical injuries, but the emotional trauma can be just as painful.

Every year, hundreds of law enforcement personnel experience critical incidents that can have serious, long-term consequence for themselves and their departments. Law enforcement personnel may not suffer any physical injuries, but the emotional trauma can be just as painful.

In order to better understand your reactions, consider the critical incident in which you have been involved, compare it to the initial splash when a stone is thrown in the water. Your reactions are like the ripples, which may continue long after the stone penetrates the water’s surface. Being aware of the fact that your responses are not unusual may help lessen the level of anxiety these reactions might cause you. There are certain predictors that will also influence how well one responds to critical incidents:

1) The severity of the incident, prior reaction to similar incidents.
2) The level of stress in one’s life at the time of the incident
3) The response of others to the incident itself and your reactions.

Post Incident Training – What to expect after a critical incident
After being exposed to a critical incident, law enforcement personnel may experience noticeable changes in the way they feel, think and behave. This may occur now, or later in the days, weeks or months to come. These changes are simply normal reactions that normal people have to an abnormal event. Here are some common signs and symptoms of the stress reactions triggered by a critical incident:

Physical
Stomach upset
Diarrhea
Dizziness
Sleep disturbance

Thinking
Disoriented
Memory problems
Confusion
Distressing dreams

Emotional
Anxiety
Fear
Guilt
Grief

Research has shown that critical incident stress affects up to 87% of all emergency service personnel at least once in their careers. Each of us experiences trauma in our life. It isn’t just the incident itself that determines our level of victimization; but rather, how we prepare and react to it. That is crucial!

About the Author: Robert “Bob” Rabe, is a Vietnam Veteran (military police), with 38 years of law enforcement experience and 26 years as a firefighter. He has been involved in Critical Incident Stress Management for over 20 years and has developed and taught seminars on stress reduction for over fourteen years. Bob has volunteered his time to over 50 debriefings involving law enforcement officers.

Pierson, T. (1989, February). Critical incident stress: A serious law enforcement problem. The Police Chief, pp.32-33.