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Understanding Psychological First Aid for PTSD Recovery

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Chapter 1: Introduction to Psychological First Aid

Psychological First Aid (PFA) encompasses a set of strategies employed by trained professionals to support individuals following a disaster. Its primary objective is to alleviate emotional distress and behavioral responses that emerge immediately after a traumatic incident, providing short-term psychological relief.

The foundation of PFA is built on eight essential components:

  1. Establishing initial contact
  2. Ensuring safety and comfort
  3. Calming and orienting individuals
  4. Identifying immediate needs
  5. Offering practical help
  6. Connecting individuals to resources
  7. Providing coping mechanisms
  8. Linking to collaborative services

Most techniques within PFA utilize cognitive-behavioral approaches aimed at enhancing the individual's mindful awareness, helping them feel secure and grounded. These methods may include breathing exercises, mindfulness practices, bilateral stimulation, and the restoration of hope.

However, effective PFA also depends on the professional's ability to maintain composure and become a safe space for the emotions that may arise, even amidst ongoing crises.

While PFA does not prevent the onset of post-traumatic stress disorder (PTSD), it can significantly mitigate early symptoms, giving those affected a better opportunity to seek therapeutic support later.

It's important to note that PFA and psychological debriefing are insufficient without follow-up care. Thus, PFA should be viewed as emergency aid for severe psychological trauma. Just as immediate medical care is crucial to stabilize a patient, subsequent therapy is vital for long-term recovery after experiencing a traumatic event.

My Experience with PFA

Since completing my PFA training, I have had the opportunity to apply these principles in three distinct crises. Two instances involved wildfires, while the most recent was a train accident that resulted in 57 fatalities and numerous injuries. During the first two events, I was physically present, whereas in the latest incident, I provided support remotely due to the incident's distance from my location.

I have also utilized PFA strategies on myself. A while back, I was on a bus that suddenly halted to avoid colliding with a vehicle that ran a red light. Thankfully, no one on the bus was seriously injured, although several passengers were jolted and sustained minor injuries.

Feeling shaken, I quickly implemented the eight principles of PFA. However, for the subsequent week, I experienced heightened anxiety whenever the bus approached that intersection. Acknowledging my feelings during that time greatly aided my recovery. I reassured myself with thoughts like, “It’s normal to react this way; my brain is processing an association. I am safe now.”

Having a therapy session scheduled a few days later also facilitated my healing, allowing me to discuss the event with my therapist.

Applying PFA's Principles on Yourself

Ideally, after experiencing trauma, one should seek professional support. However, individuals can initially apply the eight core principles of PFA to themselves before assisting others, much like the instruction to secure your own oxygen mask before helping others on an airplane.

Familiarity with relaxation techniques is crucial; attempting to implement unfamiliar strategies during or immediately after a traumatic event may not be effective. Here’s how the eight principles can be adapted for self-application:

  1. Connect with yourself; acknowledge what happened.
  2. Ensure your own safety and comfort.
  3. Calm yourself and regain your bearings (e.g., look for a familiar point of reference).
  4. Assess your immediate needs (e.g., are you injured? Do you need medical help?).
  5. Engage in self-assistance techniques (e.g., breathing exercises).
  6. Reach out for resources (e.g., is there someone you can contact for help?).
  7. Implement coping strategies (e.g., if breathing exercises aren’t sufficient, consider bilateral stimulation or cognitive reappraisal).
  8. Seek professional services afterward (e.g., do you need to schedule therapy sessions? Is there a helpline available?).

This summarizes my actions following the bus incident:

  • I reminded myself, “The driver braked to avoid a collision. I am safe.”
  • “Nothing is threatening my safety; the bus is intact, and I am out of danger.”
  • “We’re close to home; I am familiar with this area.”
  • “My wrist is sore from gripping tightly; I can manage that later.”

By engaging in square breathing while evaluating the situation, I noted, “I could call my partner for support, but it’s not urgent now.” This practice helped me remain present; I assured myself, “I’m okay at this moment, and I can process everything during my upcoming therapy session.”

Being well-versed in mindfulness and PFA techniques allowed me to rapidly execute the first four steps. This underscores the importance of preparing oneself with calming strategies in advance.

If you find yourself in a safe environment, take your time to process your feelings. However, if you are still in danger, prioritize your safety before moving forward.

If you’re not feeling calm enough, it’s advisable not to attempt to soothe others. Their distress or any physical injuries may intensify your own feelings of anxiety.

Below are two informative videos that detail exercises I find beneficial. I incorporate them into my practice and assist others in using them during PFA interventions.

Post-Traumatic Stress Disorder (PTSD): Symptoms, Treatment

This video from Mass General Brigham provides an overview of PTSD symptoms and treatment options. It covers the critical aspects of recognizing and managing PTSD effectively.

Identifying and Treating Post-Traumatic Stress Disorder

Chivonna Childs, PhD, discusses methods for identifying and treating PTSD in this insightful video. It offers practical insights for both professionals and individuals seeking help.

I hope this information proves useful. Please feel free to leave any questions in the comments!

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