Individual and Collective Crisis/Trauma Intervention and Debriefing: Ten Steps & Strategies

In light of events fifteen miles away (Baltimore) to 10,000 miles from my doorstop (Nepal), this essay titled, "Individual and Collective Crisis/Trauma Intervention and Debriefing: Ten Steps and Strategies," clearly has immediate relevance and application.  Actually, the impetus for the article occurred last week when a friend and colleague (originally from Nepal) asked me to talk briefly about stress and trauma on a strategic planning phone conference with other Nepali-born individuals.

 

Always appreciate any ideas or feedback.  If you think it works for any of your publications or for public transmission, please use or share.  Thanks,

 

Mark

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Individual and Collective Crisis/Trauma Intervention and Debriefing:

Ten Steps & Strategies

 

The devastating earthquake, with its mounting death toll, and the life-and-death challenge of speeding relief throughout Nepal, especially in more remote areas, clearly is the immediate national crisis.  The destruction, disruption, and dislocation is generating human, societal, and cultural tragedy and trauma of epic proportions – be they personal, family, societal, cultural, and archeological.  However, today, right now, and as the proverbial dust settles, many will need more than food, clothing, shelter.  Also vital:  psychological counsel, emotional grieving, and gradual healing; so too fostering stress resilience and hope as well as ongoing peer and community support and sustenance.  The critical task:  not just repairing and restoring homes and shrines but also rebuilding and reintegrating hearts and minds!

 

And these physical and psychological resources and responses are not only crucial for those in Nepal.   The trauma and lingering uncertainty, especially for the safety and well-being of family and friends, is right at the doorstep of people of the Nepali Diaspora thousands of miles from ground zero.

 

Before listing key intervention tips, it’s necessary to define two terms – Crisis and Trauma:

1) Crisis: is a critical event or experience that triggers feelings of threat and loss while also challenging the individual’s, family’s, and/or social group-community’s coping resources and capacity for action.  Crisis also involves a time-limited period of “danger” and “opportunity.”  Systems are motivated to regain physical and psychological control; they are more open to reaching out for resources and unconventional problem-solving structures and strategies.  Individuals and groups are more ready to grapple with feelings of loss and grief and receive vital emotional support.  However, a lack of support for engaging meaningfully with such acute pain and problems in a timely manner can lead to regressive or maladaptive coping (e.g., increased drinking or drug use) and stress or trauma-induced mind-body illness.

 

2) Trauma: is a state of both overwhelming emotional and physiological arousal combined with intensely negative cognitive processing.  According to the experts, trauma can occur from a one-time event or an ongoing experience, including trauma based on the nature of one’s role-relationship to the stressor, e.g., ground zero victim, the family members of a victim of violence, the second-hand trauma of witnesses to grisly violence, or the impact on individuals working with trauma victims.  Trauma effects can range from being numb or immobilized to a state of panic, as well as feeling helpless and hopeless.  And sometimes the reaction can be delayed; hence, Post-Traumatic Stress Reaction.Trauma effects can range from being to numb or immobilized to a state of panic, as well as feeling helpless and hopeless.  And sometimes the reaction can be delayed; hence, Post-Traumatic Stress Reaction.

 

And responding effectively to both Crisis and Trauma is complicated by the fact that previous emotional experience with separation and loss, illness and/or disability, helplessness and hopelessness are, sometimes powerfully, at other times subtly, rekindled adding to the intensity of the present-day crisis and/or trauma fires.

 

Ten Individual and Collective Crisis/Trauma Intervention and Debriefing Steps & Strategies

 

1.  Acknowledge Stressful Feelings.  During a crisis, while wanting to immediately swing into action, at some point, sooner rather than later, it’s important to take an honest psychological self-inventory.  Not addressing acutely intense or prolonged stress or depressed feelings is inviting mind-body health issues, even illness down the road.  Of course, a certain amount of stress during trying times is natural and even useful, stimulating focus and determination.  Extended hypervigilance without sufficient support is the problem!

 

2.  Quickly Connect with Others.  Both for support and problem-solving information reach out to trusted or credible resource people and organizations.  By its nature, crisis problem-solving means plunging into unknown or uncertain waters.  Partnering with people more familiar with the experience, or at least with managing crisis or trauma emotions, is vital.  This is no time for Lone Rangers and Rambos or Rambettes.

 

3.  Appreciate the Time-Limited Nature of Crisis.  During this period of acute uncertainty and threats to survival, people will typically open up to new ideas, approaches, and actions, especially if guided by knowledgeable and purposefully reassuring leaders or guides.  Crisis is a “no exit” challenge:  an individual or group will either take positive or proactive problem-solving steps or they will hide out or freeze into self-defeating and escapist adaptations.  (Hence the previous mentioned “danger” and “opportunity” crossroads of crisis.  And the danger is not just external; see #4.)  Strike when the ego is hot!

 

4.  Be Aware of Unconscious Intrusions.  The acute stress of crisis generates cracks in our psychological defenses.  These defenses normally keep at bay painful memories and feelings.  However, under intense and unrelenting pressure, cracks emerge and subterranean emotions and images, memories and dreams often appear adding to stress levels and heightening a sense of confusion or disorientation.  Sometimes people mistakenly believe they are going crazy; or can’t explain their own coping.  The confusion is a natural component of emotional crisis flooding.  For example, a week after 9/11, a friend, a former artillery officer in Vietnam, was perplexed by his lingering angst.  Certainly he had seen mayhem and destruction before.  I suddenly recalled a tragic piece of his past family history, perhaps a contributing factor to his current dis-ease:  “Hadn’t you lost your first wife in a house fire; and your personal rescue attempts were unsuccessful?”  Momentarily startled, John poignantly said, “I hadn’t thought of that!”

 

5.  Understand the Key Components of Grief and Trauma Debrief.  For both powerful loss and trauma, the classic model of grief has relevance: there are the initial stages of shock, sadness and or despair, rage, guilt, (or, for example, “survivor’s guilt” for those in the Nepali Diaspora), ambivalence, and/or withdrawal, etc.  Then, through time, chemical rebalancing, and emotional support, as energy, confidence, and possibility levels increase, the process typically progresses into refocused attention, focused aggression or determination, individual and collective problem-solving, relief and, hopefully, hard-won acceptance of the loss.  While still painful, memories are no longer paralyzing or inducing panic states.  New lights on the horizon of hope may finally be sighted.

 

During times of crisis, an individual may have the capacity to quickly engage with grieving.  In contrast, someone in the throes of trauma may need to move more slowly through the healing stages.  Of course, for both pathways it’s not a linear evolution.  One may take steps or stages forward and then fall back, needing more than once to rework and reintegrate sobering, troubling or frightening thoughts and feelings.  Also, with Post-Traumatic Stress, effective coping during the crisis period now starts to unravel.  Once our survival guard is down, especially after prolonged and draining vigilance and tragic loss, then exhaustion, high anxiety, rage, despair, and/or depression may take over.  Finally, research reveals that early childhood separations, losses, exposure to violent incidents, and other adverse, trauma-inducing experiences appear to be correlated with adult PTSD-like reactions.

 

6.  Grasp the Individual Nature of Grief and Paths of Healing.  There is not one way to grieve; each person’s process is unique to his or her bio-psycho-social-cultural nature and history.  Consider these approaches or styles:

 

a) Cognitive or head – trying to make immediate intellectual sense or order of the experience

b) Affective or heart – needing to experience and express the array of grief emotions

c) Sensual – needing to be touched or stroked, held and hugged

d) Social – needing to share ideas and/or emotions with others, especially those who can truly relate

e) Action – regaining a sense of purpose and emotional control by taking action plans and steps

f) Reflective – needing time alone to meditate upon and often creatively express pain and meaning; the process may be reinforced interacting with nature, e.g., a number of Veterans have engaged in hiking the Appalachian Trail as part of their trauma recovery process.

 

Ultimately, reconciling or integrating head and heart, body and spirit along with restoring a sense of hope and new possibility, perhaps even new partnerships, and creative outpourings are some of the byproducts of a healing grief experience.

 

Finally, there’s no absolute time frame for moving through the grief stages.  Don’t accept when people say some variation of, “It’s been a couple of months now; stop looking back; stop dwelling on the past; time to move on with your life, etc.”  In fact, some powerful losses are never completely mourned.  Eventually, life again feels worth living, but there will always be “grief anniversary” moments and memories.  The only caveat: a month after the critical incident, if you are still stuck in the same dark emotional hole, (a shorter time frame, of course, if disruptive health or suicidal issues emerge) strongly consider contacting a professional health and/or mental health provider.

 

7.  Consider these Two “Grief Dynamic” Passages and Reach Out for TLC:

a) There’s a real difference between feeling sorry for yourself and feeling your sorrow.  When you are feeling sorry for yourself you typically blame others.  When feeling your sorrow you have the courage to face your pain.  And there are times in life when we all need to face our sorrow! And

 

b) Whether the loss is a key person, a desired position, or a powerful illusion, each deserves the respect of a mourning.  The pit in the stomach, the clenched fists and quivering jaw, the anguished sobs prove catalytic in time.  In mystical fashion, like spring upon winter, the seeds of dissolution bear fruitful renewal.

 

During highly uncertain or stressful times, try finding a “Stress Buddy.”  (The concept was derived from working with military spouses.  They would find a supportive partner, a fellow spouse, when their soldier went overseas, especially “down range, in harms’ way.”)  However, a “Stress Buddy” should provide a variation on traditional TLC:  Tender Loving Criticism and Tough Loving Care!

 

8.  Create a Safe Space whether In-Person or in Cyber.  When trying to console or counsel others, as much as possible, find a private place to share.  Assure the person of your confidentiality, unless the individual threatens self-harm or harm to others.  In light of the disorienting nature of crisis, try to be open to a wide range of emotional ventilation (along with cultural variation) without critical judgment.  In my estimation, listening carefully to someone demonstrates real respect.

 

Virtual support systems are especially vital when trying to communicate with and connect people separated by wide distances.  Of course, as more and more counseling services are provided technologically, through phone, email, or Skype, extra effort must be made to assure “message sent is message received.”  And to expedite effective and efficient group communication, whether involving supportive or strategic planning services, whenever possible, an experienced facilitator is wise.

 

9.  Keys for Comforting Others.  While most appreciate an attentive ear or a sturdy shoulder during times of confusion, chaos, or crisis, reaching out or supporting others takes both some science and art. Perhaps the most important quality is being non-judgmental.  Some make this mistake with the best of intentions, e.g., when trying to reassure another claiming, “Oh, you shouldn’t feel that way.”  Or we can unintentionally trivialize someone’s pain by saying, “I know how you feel.”  Unless you have truly walked in another’s particular painful path, better to say, “I don’t fully grasp your experience, (or ‘I can only imagine’), please help me understand.”  Or, if you want to share, try saying, “I don’t know if this is relevant, however, for me your story brought up this thought or memory…”  Again, after sharing your idea or story, make sure you refocus ears and eyes, head and heart back on the person in crisis or trauma.

 

The communication key, of course, is not quickly offering advice, unless asked, (in general, avoid, “Here’s what you should do!”); rather, ask sensitive questions and listen reflectively.  Check out understanding by paraphrasing back to the person what you’ve heard.  When emotions are particularly charged, check out whether “message sent is message received.”  Finally, if giving advice, spoon it out in clear and concise, bite-sized chunks for easier intake.

 

10.  Help People Find Purpose and Passion in Pain.  Almost all of us want a sense of meaning and purpose in our lives.  This can seem hopelessly lost in times of tragic loss and destruction.  However, whether rapidly or patiently, enabling those in the throes of crisis and trauma to begin to embrace their pain -- to either open the emotional floodgates or to explore slow yet steady, gradual grief-steps – often means helping individuals, families, and communities discover unrecognized and untapped sources of strength.   People may even regain or evolve a new sense of passion, especially wanting to help others in their community; one emerging from the trauma or crisis crucible may well seek a purpose larger than their own safety and well-being.  (And remember, the root of “passion” is suffering, as in the “Passion Play,” that is, the sufferings of Jesus or, more generically, the sufferings of a martyr.)

 

As I once penned:

 

For the Phoenix to rise from the ashes

One must know the pain
To transform the fire to burning desire.

 

Closing

 

Along with traditional disaster rescue, resource, and recovery efforts, grief and trauma intervention and engagement, especially during double-edged, “strike when hot” times of crisis, can substantively assist overwhelmed individuals and families, groups and communities.  Despite the immediate assault on a victim’s senses and sense of identity, with timely and knowledgeable support we can learn and evolve individual and collective stress resilience skills and strategies.  We not only can survive the chaotic present but often develop psychological attitudes and aptitudes – head and heart muscles – that have us better prepared to survive, learn from, and creatively adapt to future hazardous events and challenges.

 

 

Mark Gorkin, MSW, LICSW, "The Stress Doc" ™, a Licensed Clinical Social Worker, is a national keynote and webinar speaker and "Motivational Humorist & Team Communication Catalyst" known for his interactive, inspiring and FUN programs for both government agencies and major corporations.  The Doc is a training and Stress Resilience Consultant for The Hays Companies, an international corporate insurance and wellness brokerage group.  He has also led “Resilience, Team Building and Humor” programs for various branches of the Armed Services.  Mark, a former Stress and Violence Prevention Consultant for the US Postal Service, is the author of Resiliency Rap, Practice Safe Stress, and of The Four Faces of Anger.  See his award-winning, USA Today Online "HotSite" – www.stressdoc.com – called a "workplace resource" by National Public Radio (NPR).  For more info on the Doc's "Practice Safe Stress" programs or to receive his free e-newsletter, email stressdoc@aol.com or call 301-875-2567.

The Community Awareness and Impact Program: Bridging and Healing the Violence, Trauma & Grief Divide

We live in a real and social media world saturated with sources of aggression, weapons, and violence, – whether random or “home-grown.”  Almost daily, media headlines affirm this grave reality…with another and another, and yet another tragic loss of life.  In addition to societal forces and pressures, the “home-grown” battlefront may involve:

a) intense family stress or breakup along with reintegration of a family member, e.g., a returning Veteran,

b) peer bullying – whether in a schoolyard or workplace, or gang-related activity,

c) cyber-bullying: with greater isolation and anonymity, with the loss of genuine human connection, empathy decreases, aggression increases,

d) substance and/or domestic abuse and its spiraling tension on family members, friends, colleagues, etc.

In such a volatile culture and work-life-cyber space, it becomes increasingly difficult to distinguish vulnerable from “it can’t happen here” communities, schools, playgrounds, shopping malls, workplaces, etc.

What is truly critical in such volatile, TNT – Time-Numbers-Technology – Driven & Distracted times is for individuals, couples, families, businesses, organizations, institutions, and communities to dismantle these “us vs. them” perceptual walls.  Such mind-culture barriers prevent seeing our vulnerable space-time as a “human ecology” problem that transcends cultural diversity, ethnicity, or financial disparity.  (Alas, sometimes with more money we just build higher and more rigid, seemingly “impregnable” walls.)  These mental blocks make it harder to empathize with our neighbors – whether “inside or outside a beltway” or on the “right or wrong side of the tracks.”  Such ideas also feed the illusion that one community’s “life and death” struggles can be quarantined or isolated from surrounding communities.  And sadly, such a mindset, as Lincoln noted many score years ago, impedes our reaching “the better angels of our nature.”

So, if you are wondering whether this is a time of breakthrough or breakdown…There’s a multifaceted team on call:  Dr. Charles Hicks, acclaimed Baltimore Psychologist and Personal Empowerment Life Coach and Mark Gorkin, MSW, LICSW, the “Stress Doc” ™, acclaimed Speaker, Workshop Leader, and Critical Incident/Trauma Intervention-Debriefing Consultant.  Let this Dynamic-Diverse Duo help you and your social and work groups, institutions and neighborhoods engage in “Community Bridge-Building as a Healing Response to Violence, Trauma and Grief.”  In this workshop, engage with lively "Get FIT" -- FUN-Interactive-Thought-provoking – “on-point” presentation, powerful social-psychology-communication concepts, tools, and techniques, along with real, “hands on” group exercises/role plays, and care-griever/caregiver strategic discussion.  Expanded awareness, dialogue, and collaborative action planning, will help us design a “One Human Touch Relationship:  Community Bridge-Building & Healing – Model and Method”:

Ø  Be part of the emerging and integrative community conversation

Ø  Collaborate and develop tools with individuals and families, colleagues and groups

Ø  Develop stress resilience and trauma/grief/anger management and creative adaptation skills for emotional intelligence maturation and personal-organizational recovery and growth

Ø  Build psychological and cognitive agility to respect tradition and think out of the box

Ø  Learn how other families, organizations, companies and leaders grapple with emerging challenges and opportunities

Ø  Identify and begin to repair and overcome communication-culture barriers

 

Ø  Experience challenges and benefits of conflict thru creative thinking: building bridges and designing your personal Grief Rejuvenation/Stress Resilience Tool Kit.  (Remember, your mind is the most creative psycho-social medium!)

And, of course, this half-day workshop is only the first step.  There will be a follow-up program to discuss, plan, and launch community action initiatives.

Program Objectives

A.  Community Bridge-Building as a Healing Response:  Overview

1.  Provisional Vision/Mission Statement:  educate and sensitize, increase and inspire the public's knowledge and awareness of those persons, families, and organizations that have been impacted by the random and societal acts of violence, trauma, and grief!

2.  Trauma and Post-Traumatic Stress:  Is it a personal illness and/or a societal issue?

3.  Do we know enough about "human behavior" to advocate a frame work of understanding that generates opportunity to provide programs/services of relief-help-healing-resiliency-recovery?

4.  How do mental, emotional, psychological, (age), developmental (including early childhood/family experiences), environmental, and social maturity factors, along with access to supportive and healing resources, influence one's vulnerability to violence and rage or one’s capacity for managing anger, trauma, and grief?

5. Who are the caregivers?  Who are the care-grievers?  How best to support each group?

6.  The criticality of professional and public as well as communities wide-recognition of the impact of social-cultural violence and aggression, trauma and grief on individuals, families, schools, workplaces, churches, and an array of institutions

7.  The collaborative challenge of building interpersonal-group bridges within and between communities and social-cultural-religious institutions for “Bridging and Healing the Violence, Trauma & Grief Divide.”

B.  Rage, Trauma, and Grief:  A “Crisis” Model

1.  Definition of “Crisis” and “Crisis Stages Model”

2.  Key components of the “Vulnerable State”:  Threat, Loss & Challenge

3.  Time-limited “Crisis Window of Danger and Opportunity”

4.  Different types of trauma/grief situations:  “Fight & Flight, Freeze & Flow”

5.  Link between past and present pain and loss in traumatic stress reactions

C.  Violence, Loss, and Trauma (VLT):  Overview

1.  Defining the VLT Sandwich (and each of its ingredients)

2.  What are key personal-situational precursors to Violence? Self-Defeating Conflict? Domestic Violence, Bullying? Workplace Disruptions? Road Rage? and Suicide, etc;

3.  The special cases of Violent Death and Loss of Young Life

4.  Stress-Trauma Assessment:  Holmes-Rahe Life Change-Stress Index

5.  The critical issue of sense of control of one’s emotions and one’s environment; “You Can’t Make Me” and “You Fumbled the Data” Exercises

D.  Nature of Trauma

1.  TNT Trauma:  Overwhelming Crisis or Chronic Condition; Illness or Socio-Cultural Issue?

2.  What is the nature of trauma? Why is it so devastating?  Can the process be reversed?

3.  Situational Trauma:  "homicide trauma," "war trauma," "rape trauma", "discrimination trauma," "socio-economic/job loss trauma," "domestic violence trauma," "oppression trauma," etc.

4.  “Bad Kids or Traumatized Kids”:  Understanding the person-situation context

5.  Dr. Hicks’ “Trauma:  Twenty Questions”:

6.  Witnessing Violence or Second-Hand Exposure:  PTSD contexts and reactions

 

 

E.  The Nature of Grief and the Grief Process

1. “Unfinished Grieving,” “Grief Ghosts,” and the multifaceted types and dynamics of loss and grief

2.  Classic Stages of Loss and Grief, including Shock, Denial, Rage, Helplessness, Guilt, Ambivalence, etc.

3.  Cognitive, Affective, Behavioral, and Social-Cultural Methods of Grieving

4.  Difference between “Feeling Sorry for Yourself and Feeling Your Sorrow”

5.  The Magical Healing Path of Grief

6.  The Stress Doc’s Recipe for Group Grieving the Loss of a Vital Member

F.  Violence, Loss, & Trauma Interventions

1.  Once the rage or anxiety (or depression) trigger has been engaged…how can I press the pause button?  How can I steadily moderate my intensity?

2.  Basic self-regulation and constructive conflict resolution mindsets and communication skills and strategies; the “Four ‘R’s of PRO Relating:  being Respectful-Real-Responsible-Responsive

3.  Building the the TnT Relationship:  The Power of Trust & Transparency

4.  Gaining a basic understanding/application of “Emotional Intelligence” for self-regulation and empathic emotional connection

5. The Power of Psycho-Drama:  enabling participants to act out these emotions/reactions in a safe environment, more effectively managing emotional and cognitive-behavioral responses and social interactions through support, guidance and shared experiences

6.  The “Power of “Creativity” and “Engaging with Nature” for expressing grief and healing trauma

 

G.  Save the Retreat Wrap-up

1.  Brainstorming “Community Building & Healing” next steps

2.  Forming action plan/task groups

3.  Choosing a “Stress/Battlefield Buddy” and the Power of the Stress Doc’s TLC

4.  Go round:  What will I take home, what workshop seeds will I plant:  on a personal-professional, family, organizational, and/or community level?

5.  Stress Doc will close with a “Healing Humor” Shrink Rap ™

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Presenter Bios

Dr. Charles Hicks

Charles’ professional career started as a Public School Teacher, evolved into Teaching in Academic Departments at various Universities – Howard University, Duquesne University, Morgan State University, Towson State University, the University of Baltimore, and The Johns Hopkins University.  Dr. Hicks was also a staff member in the Student Affairs Department at the California Polytechnic State University where he served as a Career Counselor and Career Center Coordinator. He was an Industrial Social Psychologist in the Human Resources Department of Gulf Oil Corporation, a Sr. HRD Consultant at Blue Cross and Blue Shield, and a Staff Consultant at Personnel Decisions, Drake Beam Morin, Lee Hecht Harrison, and Right Management - Career Outplacement Firms. In addition, he has been an executive coach with the Center for Creative Leadership (CCL®) for 25 years and has staffed programs at the Greensboro facility and also at the National Leadership Institute – a CCL Affiliate at the University College, University of Maryland. Roles have included facilitator of experiential team activities in the program modules and as also as a developmental assessment feedback coach, delivering 1 on 1 client assessment feedback, and follow-up coaching services. In addition, Charles has extensive adjunct affiliation (25 years) with the Federal Executive Institute in Charlottesville, VA. Currently he is affiliated as a Personal Empowerment Coach with the Inspirit Counseling Services of Baltimore, Maryland.

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Mark Gorkin, “The Stress Doc” ™

Mark Gorkin, MSW, LICSW, "The Stress Doc" ™, a Licensed Clinical Social Worker, is an acclaimed keynote, kickoff and webinar speaker as well as "Motivational Humorist & Team Communication Catalyst" known for his interactive, inspiring, and FUN programs for both government agencies and major corporations.  The Doc is a Training and Stress Resilience Consultant for The Hays Companies, an international corporate insurance and wellness brokerage group.  He has also led “"Stress and Communication,” as well as “Managing Change, Humor, and Team Building" leadership retreats for a variety of units at Ft. Hood, Texas and for Army Community Services and Family Advocacy Programs at Ft. Meade, MD and Ft. Belvoir, VA as well as Andrews Air Force Base/Behavioral Medicine Services.

A former Stress and Violence Prevention Consultant for the US Postal Service, the Doc is the author of Practice Safe Stress and of The Four Faces of Anger.  The Stress Doc blog appears in such platforms as HR.com, WorkforceWeek.com, and MentalHelpNet.  His award-winning, USA Today Online "HotSite" – www.stressdoc.com – was called a "workplace resource" by National Public Radio (NPR).  For more info on the Doc's "Practice Safe Stress" programs or to receive his free e-newsletter, email stressdoc@aol.com or call 301-875-2567.

Critical Intervening and Creative Writing: Parallel Processes for Soothing the Heart, Sustaining the Soul, and Searching Anew for Purpose and Passion – Part l

The Stress Doc illustrates parallel “hybrid” – focused and flexible – processes in preparing for an emotionally challenging Critical Incident Intervention and attempting to relive and capture the “grief debrief” experience on the page or screen.  The paradoxical goal:  to soothe the heart and sustain the soul...and to make order from chaos and even generate some chaos from order!

Critical Intervening and Creative Writing:  Parallel Processes for Soothing the Heart, Sustaining the Soul, and Searching Anew for Purpose and Passion – Part l

At first, the intention of this essay was to provide a “content-process recipe” for a time-limited Critical Incident Debriefing involving the number of folks who crowd into the information-control central area of a typical hospital ward.  (Let’s say about twenty or so.)  And the recipe will be outlined in due course; actually in Part II.  However, as I let my fingers, mind, and words unfold on the keyboard and screen, parallels began percolating between preparing to write this piece and getting ready to lead and facilitate a critical intervention.  Certain events, like public speaking or facilitating a Critical Incident Intervention in the aftermath of some individual tragedy and organizational trauma, helps generate a hybrid mind space and set:  initially hyper-alert yet receptive and, hopefully, responsive as well as goal-driven, there often rises a need and desire for my own personal debriefing. Emotional catharsis and integration is facilitated by a post-intervention transitional space for reflection and written expression.

Linking the Cognitive and the Meditative
 

More specifically, each speaking and writing experience involves some mental rehearsal of key psycho-situational elements and strategies.  Almost simultaneously there’s a meditative-like contemplation of new relations among the ingredients – in real time the unfolding interactive and internal data and theories, tools, and techniques – along with the methods for cooking this informational gumbo.  An “R and R” – Rehearsal and Reflection – process allows swirling elements to slow and settle enough so that a point of entry emerges from the steamy mist.  Naturally, both arenas engage various ideas and memories derived from this and other intervention experiences.  From trial and error (sometimes terror; see below) experiences as a presenter and scribe I’ve gleaned hard earned wisdom:
a) a clear and concise initial focus along with,
b) a subsequent blend of rough logical outline and intuitive-trust your gut (while still seeking feedback) flexibility,
c) tends to be essential for a rational-reflective-responsive performance tool kit.
 

Performance Angst and Analysis, Adaptations and Art
 

In addition, the two settings stir performance anxiety, especially when alone, face-to-face with that computer scream, I mean screen.  To move beyond this “on the edge” self means silencing the “I’m not ready to do this” angst, and then leaping into the abyss.  Okay, I’m being a tad dramatic; it means throwing this cognitive-affective mix onto an electronic canvas – and then exploring next steps.  Sometimes the process is feverish; alas, sometimes I’m seemingly paralyzed, fortunate to be moving at a snail’s pace.

Nonetheless, I’m convinced, in Yin/Yang fashion, the courage to remain vulnerable during this crisis window of “danger and opportunity” heightens the grief learning curve both for presenter and participants.  Being at a loss, angry with or despairing of the status quo, thirsting for authentic connection and new possibility lays the groundwork for emotionally insightful, expressive, and creative vitality and connection.  For me, both speaking and writing are performance arts.  (It’s also possible that periodically watching the Winter Olympics – from preparation to performance, from elation to profound dejection – has helped prime my current thought process.)
 

The challenge is making sense over a period of time of a large and complex data configuration – whether doing a group grief session or, after the fact, trying to analyze the same.  With public presentation or group facilitation, once playing the opening move, a myriad of verbal and nonverbal emotional and communicational data points begin firing back at you.  And the trick is to make adjustments on your feet while still trusting your basic “walk the talk” path.  Also, to mix metaphors, as a writer, knowing when to deviate from the path and make your own finger prints; or expecting keyboard throwing to set the stage for predictable and surprising cutting and pasting, rewriting and editing maneuvers, including seeking input from outside sources.  Of course, as a conference speaker or a hospital grief consultant, I’m making my opening moves and editorial adaptations both in my mind and in front of an audience, an audience that may range from the receptive to the hostile.  And everything is happening Right Now!
 

Speaking and Writing in Rich Air and Ambiance
 

As a writer, I am most focused and impassioned shortly after actively experiencing and authentically engaging with an emotionally, physically, and/or interpersonally challenging situation or crisis state…even, at times, by reliving a provocative or disturbing dream.  Doing Critical Incident Work, interacting with people on the edge of tears and trauma, when words and nonverbal communication truly have the capacity to compassionately touch or turn off minds, hearts, and souls…this unpredictably sensitive yet vital surround enables me to breathe enriched oxygen.  Let me set the stage…
 

Before commencing the critical grief engagement, waiting in the wings to be introduced, the senses are finely tuned; my brain is on high alert.  I’m psycho-physiologically aroused yet, surprisingly, there’s an idling quiet, maybe a tad edgy calm.  The memory banks are open but on standby as I have few preconceived expectations.  My mind-body is in a focused-fluid space, both absorbing the scene with “soft” eyes and ears while scanning the environment for anomalies and possible noteworthy cues.  And this relaxed yet hyper-alert condition records and encodes emotional images and ideas will be accessible for review and reflection, if not imaginative reverie and wordplay, for some extended time period.  (Of course, recall is aided by jotting down brief yet salient points and images shortly after the charged or critical event.  However, if another experience, even more compelling or disruptive, captures or jams my mental radar, then the challenge becomes restoring some dynamic equilibrium.  I have to psychologically work my way back to that relaxed and attuned, “word artist” state; once again attempting to induce a hopefully pregnant, flexibly focused mind ready to plunge into that blank screen, that compelling, Siren-like writer’s web.)  As mentioned above, fortunately, this enriched atmosphere has a fairly long shelf life, enabling me to transport and harness this pulsating O₂ for the keyboard arena.

Finding Order in Chaos and Even Stirring Some Chaos in Order

As a grief consultant, a primary goal is helping employees make some sense of the incomprehensible tragedy of a life suddenly (and sometimes brutally) swept out of their personal lives and communal work space.  I also want to them to better understand the array of emotions and memories often triggered in the face of shocking news; to facilitate some heartfelt sharing while mutually designing a resilient border around the silently smoldering, streaming, or fuming chaos.
 

Clearly, as a grief consultant and writer, I too strive for deepened self-awareness.  Such understanding is enhanced by reflectively sketching, shaping, and sharing ideas and images, intuitions and insights gleaned in the lion’s den.  At the same time, both as writer and speaker, when the timing is right I occasionally induce some chaos (or creative confusion, e.g., through novel conception, unexpected expression, thought-provoking challenge, etc.) from order or convention.  I’ll even inject some “healing humor” when the moment seems apt.  As the pioneering film genius, Charlie Chaplin observed:  A paradoxical thing about making comedy is that it is precisely the tragic which arouses the funny.  We have to laugh due to our helplessness in the face of natural forces…and in order not to go crazy.
 

For example, I recently performed a “Shrink Rap” ™ during a group grief debrief.  Not only did participants begin to relax for the first time in days, staff also began laughing and swaying to my questionable rhythm.  People now realized it was okay to share a light-hearted moment within a dark background and laugh collectively.  Generating order from chaos and stimulating some chaos from order is a high priority objective, whether as a speaker, grief consultant, work-life coach, or writer.
 

Content-Process Guidelines for a Critical Incident Intervention
 

We are finally ready for my strategic intervention recipe, where the meal has to be prepared, served, and digested in twenty minutes.  (I’m beginning to feel like a contestant on some performance-based reality show.)  Actually, the serving a meal metaphor may not be so farfetched.  Shortly after completing the two 20-mintue interventions, the Hospital Chaplin approached me.  She thanked me for coming and then said:  “You had them in the palm of your hands.”  Taken aback, I was truly touched by her words.  Apparently, I was not only offering “food for thought,” but a balm for the heart, sustenance for the soul, and hope for the future.

In closing, the event to be examined is a blend – both Critical Incident Intervention and public presentation.  And, hopefully, my speaking-writing parallel gumbo has sufficiently whetted your appetite so you’ll stay for the rest of the dinner, which will be served in Part II.  Until then, just remember…Practice Safe Stress!

 

Mark Gorkin, MSW, LICSW, "The Stress Doc" ™, a Licensed Clinical Social Worker, is a national keynote and webinar speaker and "Motivational Humorist & Team Communication Catalyst" known for his interactive, inspiring and FUN programs for both government agencies and major corporations.  A training and Critical Incident/Grief Intervention Consultant for the National EAP/Wellness Company, Business Health Services in Baltimore, MD, the Doc also leads “Stress, Team Building and Humor” programs for various branches of the Armed Services.  Mark, a former Stress and Violence Prevention Consultant for the US Postal Service, is the author of Resiliency Rap, Practice Safe Stress, and of The Four Faces of Anger.  See his award-winning, USA Today Online "HotSite" – www.stressdoc.com – called a "workplace resource" by National Public Radio (NPR).  For more info on the Doc's "Practice Safe Stress" programs or to receive his free e-newsletter, email stressdoc@aol.com or call 301-875-2567.