1. REACTIONS TO PERSONAL CRISIS How you may feel emotionally after a traumatic incident.

7. Professional People Used to dealing with crises Able to stand back Self control Role boundaries Human! Emotions Feelings Personal Life Caring people

9. Understandable reactions to abnormal events. Although intense and difficult to put up with, these are the way ordinary people can feel. Normal set of responses to an abnormal occurrence.

10. Definitions: TRAUMA - ‘a powerful shock that may have long-lasting consequences’.[OED] POST TRAUMA STRESS - ‘The normal reactions of normal people to events which, for them, are unusual or abnormal’

11. Definitions: POST TRAUMATIC STRESS DISORDER - ‘The development of certain characteristic symptoms following a psychologically distressing event which is outside the range of normal human experience’ [DSM IVR]

12. Beginning of transition TIME MOOD NUMBNESS DENIAL INTERNALISATION SEARCH FOR MEANING DEPRESSION [ANGER] ACCEPTANCE OF REALITY/LETTING GO TESTING Seven stages of Transition

13. Basic Beliefs Invulnerability - ‘bad things happen to other people’ Meaning & purpose - the reason to live and carry on. Life makes sense. Self-respect (image,esteem,confidence) - ‘I’m OK’, value

14. In the first weeks and months Re-experiencing incident Flashbacks & Dreams Sadness Anger Numbness Helplessness Shame & Guilt Fear. Living on borrowed time

15. Effects on your body Tiredness and exhaustion Racing heart and ‘shakes’ Rapid breathing Profuse sweating Headaches, neck and backache Tightness in throat and chest Gastro-intestinal problems Sleep problems

16. In the longer term Loss of interest Loss of confidence Personality change Avoidance behaviour Inappropriate behaviour Excessive smoking or drinking Relationship difficulties

17. Trauma Support Programme legitimises the impact of trauma; acknowledges organisational responsibility; provides appropriate and effective support.

18. Critical Incident Review - Facts Before the Incident During the Incident After The Incident

19. Critical Incident Review - Feelings Feelings experienced during the incident Sensory Impressions Emotional Reactions Feelings

20. Critical Incident Review - Future Normalisation Information Recommendations When to seek help Support Personal care

21. Appropriate Intervention Critical Incident Review Counselling GP / Force Medical Officer Referral to Psychiatric Service Evaluation and Monitoring

22. ‘Each man must find within himself the various methods to contain and control the pain and confusion within. There are no ready-made answers. It is a slow process of rediscovery, where denial or flight from inward turmoil is the antithesis of self-healing. We go that road alone. We may be helped but we cannot be pushed or misdirected. We each have the power within us to re-humanise ourselves. We are our own self healers.’ Brian Keenan, The Guardian 09/08/91 following the release of fellow hostage John McCarthy