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Dealing With Trauma Using Critical Incident Stress Management

By Edited Nov 13, 2013 2 1

Use a tried-and-true technique for dealing with life's stress.

A paramedic shares his experience on dealing with traumatic incidents.

It’s hard to make it through life without a variety of traumatic experiences, some are momentary and become nothing but a fleeting memory in a short period of time, others linger with us for years and never completely leave us, becoming a part of our history and character for the rest of our lives.

I spent eight years working as a paramedic and was exposed on a semi-regular basis to some pretty traumatic events.  I won’t go into specifics here, but I saw the worst of what people are capable of doing to each other as well as natural and accidental causes of great trauma.  The only way to survive a job like that for a long period of time is to find a way to deal with your feelings, and in emergency medicine providers often found support in a Critical Incident Stress Management (CISM).  May of the techniques that proved effective for me over the years can be applied to any type of trauma.

The theory behind CISM is to enable you to confront the trauma and reduce the incidence of Post-Traumatic Stress Disorder (PTSD).  The process may begin with pre-incident preparation in cases where a traumatic incident is likely to occur in the near future, like in the case of a chronically ill relative who is not expected to recover.

One critical element of effective CISM is having a non-judgmental support system, which can be comprised of as little as one person.  Family, friends, chaplains, counselors, psychiatrists and other trained crisis managers can be a great help in getting through a difficult time.


CISM is designed to deal with traumatic incidences one at a time by providing an environment to talk about the incident without being judged or criticized by others.  All conversations should be kept confidential, with the exception being that the person suffering from the traumatic incident is considered a threat to themselves or others.  The goal here is to put people in a safe environment and allow them to return to normal levels of functionality as quickly as possible.

A typical CISM follows a three-step process:

1.  Defusing – This should be done as soon as possible after the traumatic incident and is intended to allow the victim to “blow off steam”, be assured that their feelings are normal, and also to provide someone to ensure that they are not a threat to themselves or others.  The idea is to assist individuals in dealing with the short-term problems created by the traumatic incident.


2.  Debriefing – In a civilian setting, this would entail bringing together a support group of people affected by the incident, along with a professional to guide the discussion.  Allowing people to speak freely, provide support to each other, and feel a sense of togetherness is often a great comfort during difficult times.

3.  Follow-up – A follow-up may include a recommendation for professional counseling or other support.

If you or someone you know is undergoing a traumatic life experience, you can be of great assistance by offering your time, referring them to someone you know that can help them, or alerting the authorities if you suspect them to be in a situation that may cause them or another person harm.  Going through traumatic experiences is an unfortunate part of life, and one that no one should have to go through alone.



Jun 20, 2012 4:02am
Excellent advice to keep handy!
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