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After a Critical Incident (Emergency Responders)

Dr. Don Bosch
Director of Clinical Services, Headington Institute, August 2, 2013.


Even though exposure to critical incidents is a part of your job, that does not make them any less stressful or difficult. After a critical incident many people encounter a wide range of symptoms and feelings. Some of these may be positive, such as deep sense of clarity about what is most important to you. You may also experience deep feelings of determination and commitment to loved ones. On the negative side, it is very common to experience a wide spectrum of feelings that may or may not be typical to you.

After a critical incident you may feel:
  • A sense of confusion about what happened
  • A sense of it being unreal
  • Feeling out of touch with yourself
  • Intense feelings of anger, anxiety, shame, or guilt
  • Uncontrollable crying or laughter
  • Numb
  • Like you want to run home or find home somewhere
  • Hate towards those that caused it
  • Compassion toward those who caused it
  • Exhausted
  • Unable to eat or wanting comfort food
  • Let down by colleagues or leadership
  • Unable to sleep with scenes from the incident replaying in your mind
  • Like you should have handled it better or done something different
  • Desire to be with others
  • Desire to be alone
  • Interest in talking about it
  • No interest in talking about it
  • Any or all of the above in a confusing mix

If you experience any of these, don’t worry that something is wrong with you. All of these are commonly reported reactions that will typically subside over the coming weeks and days. People are unique and your reactions may be very different than someone else who experienced the same incident. Allow yourself to recover at your own pace. Be gentle with yourself in your thoughts and expectations.

What is helpful?
  • If you can, write or journal about the situation and what you encountered.
  • Try to get as much rest as possible and eat well.
  • If you are able, exercise vigorously during the next several days after. Your body will have been on high alert during the crisis, but now will need help in getting rid of the stress hormones and chemicals in your system. Exercise will help your body do this.
  • Do activities that involve spatial reasoning such as organizing your room, playing Tetris or Scrabble with a friend. This type of activity can help distract your brain from negative processing and provide a needed break.
  • Most individuals need to tell their story, but only when the timing feels right to them.
  • If the incident resulted in loss, give yourself time and space to grieve the loss.
  • Pray, meditate, sing or listen to calming music.
  • Do things that increase your sense of safety.
  • Resume a routine, but give yourself permission to do tasks at a slower pace. Take frequent breaks.
  • Look for examples of courage, resilience, and good work. Acknowledge it when you see it.
  • It is often helpful to speak to a professional to understand your particular response.
What is not helpful?
  • Using alcohol or drugs to relax.
  • Using violence or conflict.
  • Talking about the situation before you are ready.
  • Using information that you only know after the fact to critique your actions or blame yourself for the outcome.
  • Making major decisions. After a critical incident you need to give yourself time to regain perspective.
  • Downplaying or minimizing the incident because you feel it would be easier for “seasoned” emergency responders.
Other considerations:
  • Let someone in your organization (who is in a position to be helpful) know how you are doing and what would help. This may be a manager, a partner, or an advocate within the organization.
  • If you have symptoms that are severe enough to cause you significant distress, interfere with your daily routine.

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