Nationally and internationally, the most endorsed response in the early aftermath of a disaster is Psychological First Aide.  Used by those responding to disasters, it is a set of guidelines that you can learn to use for yourself and others.

Just as knowing certain aspects of Medical First Aid can help you minimize injury and reduce future medical complications, knowing and using certain aspects of Psychological First Aid can help you reduce the emotional impact of a disaster and its consequences.

Here are Five Steps for Using Psychological First Aid

 I. Establish Physical Safety

• Given the body-mind connection, it is necessary to secure physical and medical safety as a first step to psychological safety.
• In securing what is needed to maintain physical safety (food, shelter, water, heat) it is often helpful to access options and then make a temporary or working plan that can be updated. This often mobilizes people to safety, as they know they are not making permanent decisions.  

 Families have moved in together in arrangements they never would have dreamed possible-as a way of keeping each other safe.

II. Establish Psychological Safety

• Accept and normalize your feelings.Recognize that feelings of disbelief, fear, terror, helplessness, and anger are very common to the situation you have faced. For most people they may persist as difficulty sleeping, intrusive thoughts and memories, or a sense of numbing for a week or two and then dissipate.
• In those cases where someone displays a sense of disorientation, unremitting panic or inability to cope, emergency medical care is warranted.
• You have often heard the expression “ What doesn’t kill you makes you stronger.” – Well, Not So Fast.
• Consider that while people differ, for most of us, it takes a while to adapt to a crisis situation. Even as people are busy surviving and helping others survive, survivors are often feeling a mix of relief, pain and uncertainty. It makes sense.
• Recognize that in disasters – SMALL THINGS ARE BIG in making us feel less helpless.
• Look for those things you can control. Set up achievable goals- be it playing a game with the children; finding a place to make a few phone calls; finding a way to connect with your workplace; making a hot cup of coffee.

III. Maintain Connections

Connections are crucial to both physical and psychological safety. Being a compassionate presence to others and feeling compassion and care from others is what sustains us. Being a compassionate presence basically means just “ being there.”  Given the importance of attachment bonds on our neurophysiology, it is reparative and restorative in small doses.

• It could mean sitting next to someone crying.
• Listening as someone talks about what happened to them – what they lost.
• Exchanging hugs as you and a family member stare at the gutted house.
• Sleeping next to your favorite pet.
• Sitting with an elderly parent, young child or partner because being next to each other makes it feel better.

Helping Connections- Something that provides support, reduces helplessness, and mitigates isolation is the capacity to help others.  Helping others and letting them help you not only speaks to “the power of giving” in generating happiness; but can restore a sense of personal competence and community vitality.

Children’s Connections- Experts tell us that the greatest trauma for children is the abuse or betrayal by those who are supposed to love and protect them. Natural disasters are actually something children can cope with when they are able to stay connected with loving caregivers.

I have often told parents that in the face of evacuation, shelters, loss and damages – if you are present, make some sense of what is happening and convey that you are ok and that it will be ok – the children will feel safe.

IV. Use Stress Reduction

• In order to be the best you can be for yourself and others in challenging circumstances, it is important to identify and care for your needs.
• A major need in the aftermath of disaster is stress reduction. Often in the turmoil and demands of coping, we can lose sight of what we   “ always” did to calm down.
• Reinstating some version of your stress reducing routine is extraordinarily helpful to body and mind. Be it a few minutes to be alone, a vigorous walk, a cross-word puzzle, reading a mystery book, listening to your favorite music, or throwing a ball – finding a way to make it happen will help you.
• Clarifying your needs will often facilitate meeting them.

 V. Recognize Coping Skills

In the aftermath of disaster, the nature of the situation can make time stand still. It seems as if the life you knew stopped on the day before the disaster and since then you are caught up in a context that is hard to fathom, much less deal with.

A few days after Hurricane Sandy, without power, light, heat or phone contact, I remember saying to my husband, “ I feel like I can’t think myself out of this.”

Given that there is a shutdown of the ” thinking” part of the brain to optimize the fight-or-flight response to a crisis, it takes some calming down to remember and draw upon your coping skills.

You can appreciate the benefit when you hear partners, families,and First Responders reminding each other of their coping capacities.

• If we made it through that ice storm – we can make it through this.
• I have been to Iraq – I can handle this.
• We always find a way.
• The best is that we problem solve together.
• We never give up – we just keep adjusting the plan

Coping skills vary and unfold from the personal gifts and resiliencies we have. They can be physical strength, intelligence, problem solving ability, social skills, artistic talent, spirituality, love of nature, creative thinking, independence, generosity, etc.

In the best of situations, our coping skills blend, support, compliment and are affirmed by those around us.

No matter how big or small, we can take steps to protect ourselves and those we love in the aftermath of disaster.

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    Last reviewed: 10 Nov 2012