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#223951 - 05/20/11 01:02 PM Re: Psychiatric first aid? [Re: dweste]
Mark_F Offline
Old Hand

Registered: 06/24/09
Posts: 714
Loc: Kentucky
Glad DW is a Social Worker. I can handle the survival stuff and she can handle the hysterical antics of those around us.

This does raise an important point though. Mental preparedness is as important as the physical preparedness and having the right gear on hand. What good are all your other preps if you are one of the ones who break down in the aftermath.

Don't discount it. Put yourself in a situation where your significant other, children, parents and/or a lot of other family members have died. Add to that your home has been destroyed. Add to that you are badly injured yourself. Add to that ...

It is easy for us to assume in the aftermath of a disaster we will be the ones who rise from the rubble with our caches of gear and our wealth of knowledge. Put the other shoe on and it changes things drastically.
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#223960 - 05/20/11 03:52 PM Re: Psychiatric first aid? [Re: dweste]
bacpacjac Offline
Carpal Tunnel

Registered: 05/05/07
Posts: 3601
Loc: Ontario, Canada
Back to Dweste's original thought for a moment - When thinking of in-the-moment psychology, we should also give consideration to on-lookers. As a Scout leader, I teach the kids "Safety First." You can't help anyone by becoming a victim yourself. Unfortunately, theory and reality do not always mirror each other.

DH and I once stopped at the scene of an MVA on the side of a major highway. 3 vehicles were involved and 2 of the vehicles had rolled over. There were 10 victims, 6 adults and 4 kids, all injured, a couple of them severely. It was winter and we were in the middle of a snow storm. We weren't the first ones on the scene but we were the first active responders. About a dozen cars had pulled over, most people were out of their cars with several kids left buckled into their car seats.

DH and I immediately set to work triaging and treating the victims. As we worked, we advised everyone who wasn't helping to get back in their vehicles and leave if they weren't witnesses. Nobody moved, except 3 guys who ran over to one of the cars and started yanking on the door trying to open it, rocking the car pretty significantly as they did. I finally got through by yelling at them, and convinced them that they were hurting more than they were helping, and they stopped. I got two of them to hold pressure bandages on, and the other threw-up and went back to his car.

An off-duty nurse soon arrived, but nobody listened to her either. An off-duty, out of uniform cop had little success getting the gawkers to move either. Only when cruiser arrived and that officer told everyone to get back into their cars and leave if they weren't witnesses, did they finally leave the side of the road.

There must have been 20 people standing on the side of the icy, low-visability bend in the highway, WHERE A SERIOUS ACCIDENT HAD JUST HAPPENED BECAUSE OF ON-GOING CONDITIONS, giving no consideration to their own safety, or the safety of the kids that were left buckled in the targets, I mean, cars on the side of the ACCIDENT SCENE. It took a uniformed officer with lights flashing to get them to snap out of it.


Edited by bacpacjac (05/21/11 02:35 AM)
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#223963 - 05/20/11 04:12 PM Re: Psychiatric first aid? [Re: dweste]
bacpacjac Offline
Carpal Tunnel

Registered: 05/05/07
Posts: 3601
Loc: Ontario, Canada
Just read this article about the pyschological impact of the Salve Lake fire and thought it was timely for the post-event portion of this discussion:

http://www.cbc.ca/news/canada/story/2011/05/19/f-psychology-trauma.html
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#223964 - 05/20/11 04:42 PM Re: Psychiatric first aid? [Re: bacpacjac]
hikermor Offline
Geezer in Chief
Geezer

Registered: 08/26/06
Posts: 7705
Loc: southern Cal
There is a reason that public safety people are in uniform. It really makes a significant difference in getting n appropriate response from the onlooking public. Lookie-loos often constitute a significant hazards in themselves. Here in SoCal, just the slowing of passing freeway traffic as gawkers gaze can mess traffic flow up significantly and add to the hazard.
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#223995 - 05/20/11 11:29 PM Re: Psychiatric first aid? [Re: Mark_F]
Art_in_FL Offline
Pooh-Bah

Registered: 09/01/07
Posts: 2432
Originally Posted By: Mark_Frantom
Glad DW is a Social Worker. I can handle the survival stuff and she can handle the hysterical antics of those around us.

This does raise an important point though. Mental preparedness is as important as the physical preparedness and having the right gear on hand. What good are all your other preps if you are one of the ones who break down in the aftermath.

Don't discount it. Put yourself in a situation where your significant other, children, parents and/or a lot of other family members have died. Add to that your home has been destroyed. Add to that you are badly injured yourself. Add to that ...

It is easy for us to assume in the aftermath of a disaster we will be the ones who rise from the rubble with our caches of gear and our wealth of knowledge. Put the other shoe on and it changes things drastically.


Mental preparedness and mental toughness are good in the abstract but I have profound doubts as to how anyone, short of long term psychoanalysis and gaining a very deep understanding of their own mental landscape so they can avoid getting blind-sided, can improve their preparedness in this area.

Many of those I've met who are most concerned about it often have, IMHO, a deep and abiding need to be worried. I'm not referencing anyone here on this forum.

I do think there are ways to mentally buffer shocks. Feeling well supported and secure helps. Things that help include: having someone you can talk to without fear of scaring them off, friends and family who accept you for who you are (warts and all), a history of loving and being loved, an established roll in life that gives you a feeling of being needed, and, last but not least, a highly developed sense of humor. All of them seem to act as psychological seat belts. They won't stop all damage but they bolster resilience and seem to allow people to recover more quickly when/if they do lose it.

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#224000 - 05/21/11 02:41 AM Re: Psychiatric first aid? [Re: dweste]
bacpacjac Offline
Carpal Tunnel

Registered: 05/05/07
Posts: 3601
Loc: Ontario, Canada
When I was younger, my best friend's dad was a cop. I went to work with him on one of those Bring a Kid to Work days. When we were in his cruiser, he showed me a black and white photo of a decapitated head laying on the side of the road. He told me it was a guy who witnessed an accident and wouldn't get back in his car. Said he kept it in his cruiser to show the lookie-lous who didn't want to listen. I don't think I'll ever erase that image from my head. In this day and age, he'd probably need full colour high-def video with surround sound to have the same effect.
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#224392 - 05/26/11 11:17 PM Re: Psychiatric first aid? [Re: dweste]
Jeanette_Isabelle Offline
Carpal Tunnel

Registered: 11/13/06
Posts: 2956
Loc: Nacogdoches, Texas
The only technique I know of deals with anxiety. Have the person experiencing anxiety sit down and sit down next to that person directly facing him or her. Look at that person and have that person look at you. Tell that person to breathe with you Take deep, slow breaths.

I have never practiced this technique. This was taught at the Citizen's Fire Academy.

Jeanette Isabelle
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#224393 - 05/26/11 11:27 PM Re: Psychiatric first aid? [Re: Leigh_Ratcliffe]
Jeanette_Isabelle Offline
Carpal Tunnel

Registered: 11/13/06
Posts: 2956
Loc: Nacogdoches, Texas
Originally Posted By: Leigh_Ratcliffe
Take this as an absolute:

If it has not happened to you then you will never understand what and why, or even with the best will in the world, be able to really help. Yes, you can blunt the physical harm but the mental is beyond your powers.

I am not fully convinced that this is an absolute. From my observation a person who went through one type of trauma can be a help to a person who has went through another type of trauma.

Jeanette Isabelle
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I'm not sure whose twisted idea it was to put hundreds of adolescents in underfunded schools run by people whose dreams were crushed years ago, but I admire the sadism. -- Wednesday Adams, Wednesday

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#224397 - 05/27/11 12:54 AM Re: Psychiatric first aid? [Re: Jeanette_Isabelle]
NAro Offline
Addict

Registered: 03/15/01
Posts: 518
Originally Posted By: JeanetteIsabelle
The only technique I know of deals with anxiety. Have the person experiencing anxiety sit down and sit down next to that person directly facing him or her. Look at that person and have that person look at you. Tell that person to breathe with you Take deep, slow breaths.

I have never practiced this technique. This was taught at the Citizen's Fire Academy.

Jeanette Isabelle


Might help, might not. People have different respiratory profiles in panic/anxiety attacks. Probably the majority will feel a bit calmer after a little (a little!) slow, deep breathing. Others, however, will feel worse. In a crisis situation you don't really have time to carefully explore this, so I'd recommend that you might try it briefly - but if it doesn't help in a minute or two (or if it seems to make the person more uncomfortable) don't persist.

My experience is that what helps the most universally is to just let them talk about what their physical sensations actually are. This "processing" seems to lighten the discomfort pretty reliably. I've never seen it have an adverse response, and I certainly have seen adverse responses to any of the typical breathing techniques (Benson Breathing, Diaphragmatic breathing, etc.).

I suggested trying the above slow-deep breathing briefly because even if the person feels worse you haven't done any harm: they'll usually just stop complying with your instructions.

The "face to face" helps some... makes others feel worse. Again: try it, but pay attention. If the person feels worse, perhaps have them shut their eyes.

The bottom line is to not wed yourself to a particular tool: watch, and change what you're doing if it isn't working.

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#224412 - 05/27/11 02:31 AM Re: Psychiatric first aid? [Re: NAro]
Jeanette_Isabelle Offline
Carpal Tunnel

Registered: 11/13/06
Posts: 2956
Loc: Nacogdoches, Texas
You bring up valid points. I have a general anxiety disorder and while I EDC as needed medication, for minor attacks all I need to do is hold the bottle of medication as this has a calming effect. I don't even need to take a pill. For more severe attacks, I need a pill.

Jeanette Isabelle
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I'm not sure whose twisted idea it was to put hundreds of adolescents in underfunded schools run by people whose dreams were crushed years ago, but I admire the sadism. -- Wednesday Adams, Wednesday

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