Psychological first aid: We don't always know what to say

By Erin Ellis, Canadian Red Cross volunteer
 
Taking psychological first aid training as a Red Cross volunteer reinforced a lot of familiar ideas about being a calm presence and a good listener to people in need.
 
I understood the instructions to not obtain details of a person’s trauma. It makes sense to avoid stirring up strong emotions by asking probing questions when you’re not necessarily qualified to deal with the outcome. This can cause more harm than good.
 
A close-up of a Psychological First Aid course booklet with people standing in the distance, blurredBut what if someone wants to talk? As a journalist by trade, I’ve interviewed many people who want to recount a horrifying incident, often to warn others, but sometimes because it seems to make them feel better to not bottle it up inside.
 
I turned to Jodie Boyle, Safety and Well-Being manager with the B.C. branch of the Canadian Red Cross in Victoria, for a fuller explanation.  Communicating or expressing your feelings is helpful and important but recanting the details about what harmed you is not recommended without professional support. We can be most helpful when we provide practical care and emotional support, and make sure that people have access to counselling as needed.
 
“[The] short answer is, you don’t try and do brain surgery unless you’re a brain surgeon and the same goes for psychological trauma,” says Boyle.
 
“It can do harm. It takes specialized training and extensive understanding of the biological, social, psychological, economic and political factors to understand the complex nature of trauma and our response to it.”
 
This is what a trauma counsellor does, and right after a disaster is the place for psychological first aid (PFA).
 
Psychological First Aid (PFA) provides emotional and practical support to individuals, families, or communities who are having difficulty coping through trauma. It is about establishing a connection with people in a compassionate, non-judgmental manner to bring calm and comfort. It also helps to reduce stigma associated with mental health crises and can reduce negative health outcomes through general public and community-building strategies on self-care and promoting conversations about wellness.
 
First aid for the mind and social networks is just as important as first aid for the body, and the Red Cross offers PSA training for its volunteers to support this work, as part of the services it offers within community.
 
Much research around trauma suggests not revisiting the troubling details in the weeks immediately following an event.
A better approach is to talk to people about how they’re coping and feeling, now, in the present moment, following a disaster. That encourages self-healing. And while most people are able to cope and recover on their own with basic supports, someone who needs more help should be referred to professionals.
 
Boyle encourages volunteers to steer people away from recounting a troubling story in the early days, particularly if it’s obviously creating distress.
 
“You could say, ‘I can see this is really upsetting for you to talk about. Can I ask what you are doing to cope?’ ”
 
It’s more important to make sure people are safe, have their basic needs met and know where their loved ones are. Then make sure they have accurate information about the situation as it unfolds.
 
Humans have a need to connect and that could mean a volunteer provides a calm and compassionate presence and helps them reunite with their support network or community. Active, non-judgemental listening will help a volunteer find out what an individual needs.
 

“Remind them of their strengths, and things they can do. Remind people that they are safe and connect them to others. Most people will be OK given basic supports,” Boyle adds.



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