Crisis Situations Manifestations Intervention strategies Crisis What does

Crisis Situations Manifestations Intervention strategies

Crisis • What does the term crisis mean for you?

Crisis • • • State of emotional turmoil Serious interruption in equilibrium Emotion overcomes thoughts Emotional pressure becomes too great Can happen to anyone, at any stage of life Brady: Emergency Response to Crisis Mitchell/Resnik pp 3

Wikipedia on Crisis • crises are "specific, unexpected, and non-routine events or series of events that [create] high levels of uncertainty and threat or perceived threat to a persons or organization's high priority goals. "

Delicate Balance • Most of the time we live in a steady state. • We fluctuate between thoughts and emotions. One normally fluctuates around the baseline of equilibrium. When one’s own balancing system fails and one’s equilibrium disrupted, Crisis can occur. When that equilibrium is shifted far enough or rapidly enough a problem occurs.

“The breaking point” • Everyone has a “breaking point” • We are all unique, therefore our breaking point is unique and different • Remember; anyone can reach the breaking point – even you! • A person in crisis is a person who has reached their breaking point

• OMAHA, Neb. –The gunman who killed eight people in a mall shooting "just snapped, " he wrote in a suicide note that combines love for his friends and family with contempt for his random victims. Toronto Star, Dec. 8/07, Sophia Tareen, Associated Press

Four Characteristics of crisis 1. 2. 3. 4. Crisis is sudden Normal coping mechanisms fail Crisis short in duration Result in dangerous, unacceptable or self destructive behaviour Brady: Emergency Response to Crisis Mitchell/Resnik

1. Crisis is sudden • The breakdown in equilibrium is an isolated incident, not a usual pattern of life • It is unforeseen and unexpected

2. Normal coping methods have failed • The person tries to cope but is unsuccessful • The person is unable to draw on his emotional resources, his self motivation, his internal strengths or outside support

3. The crisis is short in duration • A true crisis rarely lasts more then six weeks • Most are resolved in 36 hours • Why? People find it unbearable to be in a crisis state for very long • A person will do something to end the pain and suffering

4. Crisis may result in dangerous, unacceptable or self destructive behaviour • Crisis can bring with it feelings of panic or defeat • If not resolved, may lead to suicide or homicide

From a different perspective Crisis has four defining characteristics. 1. event is unexpected (i. e. , a surprise) 2. creates uncertainty 3. is seen as a threat to important goals. "crisis is a process of transformation where the old system can no longer be maintained. " 4. There is a need for change, if change is not needed, the event could more accurately be described as a failure.

Three classifications of crisis types of crisis 1. Predictable 2. Maturational 3. Unpredictable

1. Predictable • Part of the natural order of life • Result from normal and expected life experiences • Any change can be stressful (positively or negatively) and may lead to a crisis

2. Maturational • • • Puberty Adolescence Old age

3. Unpredictable • Sudden • Completely unexpected

Stages of crisis 1. 2. 3. 4. Impact Crisis Resolution Reconstruction

1. Impact • The occurrence of the crisis /stressful event • Equilibrium is destroyed • Body prepares for the traditional ‘fight or flight’ • All of the person’s energy is concentrated on the present and on the stressful event • Person may be disoriented and distracted or may be full of energy – why?

2. Crisis • Crisis occurs within minutes to hours of the event • You are concerned with the person’s reaction to the event • There may be a range of emotions from hostility to uncertainty and detachment

3. Resolution • As the crisis period passes, the period of resolution or adjustment begins • The person regains control and begins to think more clearly, explores alternatives, makes plans and sets goals • Motivated to make change • May take weeks to months

4. Reconstruction/Post crisis • Once the resolution is complete, the person resumes normal activity • There may be some lasting effects, however, most of the signs and effects of the crisis are over and may even be forgotten • Some suffer permanent emotional injury

Recognizing a person in crisis • Remember; each person is unique • There is no ‘checklist’ for psychological crisis BUT do not underestimate your role • Assistance provided by EMS has deep and lasting effects upon victims

Consider the following when trying to determine if a person is in crisis • The person may have lost some or all contact with reality • May not be acting normally • When talking to them, you may feel you are talking to a brick wall • Unable to work at a normal level

More… • May seem withdrawn • Avoid sensory overload • Extraordinary fear and/or anger YOU MAY SEE ALL, SOME OR • Extreme anxiety NONE OF THESE SYMPTOMS • Confusion • Depression • May become impulsive • Overly dependent on others • May reject offers of help

When things were out of “whack” how have you felt? What was your response to the crisis ?

Emotional reactions to crisis As we explore the following behaviour consider what kinds of calls would elicit the response

1. Emotional shock “high anxiety” • • • May be hysterical or stunned Combative Panic Agitated, out of control Tend to act irrationally Can be dangerous

2. Denial • The person is trying to protect themselves • Trying to limit what is happening to them, so they deny the crisis is happening • Management?

3. Anger • Once the person has passed through the denial stage and admits that the crisis is happening they will often become angry • May direct the anger inappropriately – often at you! Management?

4. Remorse • May become overwhelmed with guilt and sorrow • Twist events out of proportion • Place the burden of events onto them self • “if only statement” Management ? ?

5. Grief • Begins the first stage of healing Usually happens much later – not generally seen by paramedics

6. Reconciliation • The person passed through the crisis • Resumes his normal lifestyle • No longer preoccupied by the crisis

Our Role • Intervene in the Crisis • Could be at any of the aforementioned stages • Earmarked by narrow goals of short duration • Aimed at helping a person regain equilibrium and return to normal functioning To be continued… 2/5/2022