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Carrie Ruggieri, LMHC, BCETS

Licensed Mental Health Counselor ~ Board Certified Expert in Traumatic Stress

Rhode Island AEDP Therapy


Critical Incident Intervention

I. What is a critical incident?

"Critical incident" is the term used to define a catastophic public event.  School shootings, workplace violence, public suicide, and natural disasters, are some examples of critical incidents.  

Critical incident intervention is intended to help survivors, witnesses and first responders, process the event in order to prevent post traumatic stress disorder. 

II. What is normal to experience in the aftermath of a critical incident event?


Reliving the event:

The sensory experience of the event- images, sounds, smells, will likely remain vivid for several or more days.  It will feel more like re-living the event, rather than simply remembering.  The images may intrude into one's mind when trying not to think about the event.  People describe the event as replaying over and over in their heads.  Re-living the experience is most likely to occur when there are no external distractions, such as when one is trying fall asleep.  

While it is important to talk about the event in the immediate aftermath, it is also important to help the normal process of time to allow the sensory experience to fade, by using methods to dim the images.  Making an intentional effort to replace the image with a positive experience associated with the event is most helpful. Finding a meaningful replacement image is one of the ways I can be helpful. 

Survivor's guilt:

Even though we know it is not rational to blame oneself for events outside of one's control, it is a normal human response to wonder what one could have done to prevent, mitigate or help in some way.  These thoughts can feel punishing and lead to depression.  This occurs because our instinctive reaction to a traumatic event is to want to intervene. Our brains prepare our bodies to react in some way.  However, when we cannot act on our brain/body's readiness to act, we are left feeling helpless and defeated.  It is normal for our minds to interpret such helplessness as somehow our "fault." This feeling may be stronger for people who have experienced other traumatic events where they have felt helpless.

Talking to a professional trauma therapist can help eliminate this guilt, and to begin the process of transforming this negative self-experience, with a self-experience that is resilient as a result of exposure to the traumatic event.  

Feeling unsafe and over-protectiveness toward loved one's:

When, in a split second, a life is horrifically taken or traumatically altered, one feels that a sense of control over one's safety is destroyed.  Restoring one's felt sense of saftey must occur in the context of the random traumatic event. Each person will find their own way back to stability and felt safty.  This process can be helped by learning to regain control over one's overwhelmed nervous system in the aftermath of the event. 

Feeling numb, or having no feelings:

Feeling numb or having no feelings is also normal. Numbness may alternate with feeling overwhelmed.  Numbness, or feeling emotionally shut-down" is simply the brain's way to protect your nervous system from becoming overwhelmed.  However, a professional can help to you to experience emotions in a carefully managed way.  It is important to avoid a delayed reaction so that you can participate in the community aspect of the healing process.

III. Building social bonds:

It is essential to talk with and express emotions with those who also experienced the traumatic event.  Doing so helps the process of feeling safe, connected and quickens the return to normal functioning. There may be a tendency isolate because one feel's that one's reaction is not normal, or one does not want to be a burden to other's - it is essential to not give in to these tendencies.  Talking with a professional will help break through inhibitions.  

Social bonds deepen by sharing feelings and helping one another to challenge the normal but irrational beliefs.  It is also important to help one another to not focus upon the traumatic sensory imagery.  

IV. Ritual

An essential part of the healing process is for the community of witnesses to honor the victims of the tragedy in some manner.  It is essential to reinforce the memory of the victims as they were in life and in well-being.  

It is also essential to mark the occasion as an event in which people survived and also became stronger, closer, wiser.  

 The world breaks everyone and afterward many are strong at the broken places

                                                     Ernest Hemingway 

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