Re: CDC offers pandemic communication guidance
CIDS may be helpful for those who must re-enter into intensified multiple disaster situation to provide continued critical incident service. It is IMPORTANT to understand that from a THANOSTIC (dying, death and bereavement / grief) POINT OF REFERECE CISD is NOT a way to help with complex and compounded mourning and grief particularly in mass fatality situations. In fact CISD may help during the initial or presenting crisis BUT it may intensify and complicate the post traumatic grief process experience tremendously in that those who must rely on it due to a high level critical incident situation. CISD and the critical incident itself can result in a delayed grief response and thus the individual will be out of 'sync' with those who are grieving additinally beond the critical incident response community which then can cause a complicated, dysfunctional chain reaction as to grief recovery. <o

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That delayed grief response can be one of the reasons for the New York emergency responders situation currently including extremely high levels of disability retirement, spouse / partner & child abuse, violent acting out, substance abuse etc. Due to the situation of 9-11, many were not able the luxury of 'current time grief'. This will happen again should a pandemic occur.
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My understanding is that what happened internationally during and after the 1918 pandemic which caused SEVERE thanostic related dysfunction that has endured for many their entire lifetimes and now impacts generations thanosticly 88-89 years later in so many ways including how we currently deal with grief or should I say how we do NOT deal well and healthy with grief.
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My concern is that those who are not WELL TRAINED in both CISD and CRITICAL INCIDENT THANATOLOGY will use CISD an d possibly other modalities as a quick fix and easy formula for omitting the grief process just like Elizabeth Kubler-Ross?s famous work on Grief Stages was used and still is used inappropriately for everything from divorce to a missed phone call. This can have an impact for millions of people which I can not even imagine what that could do to the complications of social and individual recovery which will also be compounded by other social and health issues. We need to encourage those who are in critical incident leadership and the primary responders ( these would be health care professionals) and secondary responders ( which are classified as journalists, law and order personnel, public utilities workers, etc) to learn both ways to help their teams to cope with critical incidents events as they unfold with different approaches for different facets of the critical incident as well as to help them to cope with the thanostic fall out that will also occur in immediate and extended terms so that all aspects of the spectrum can be addressed. . We also need to continue to be resource educators in where to find qualified and
certified CISD and critical incident thanatologist to help in that process.
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In a critical incident there are so many folk that pop up that become ?instant experts? on everything, just look at 1918 as an example. The literature demonstrates the expanse of such ?instant experts? during that situation. My concern is that ?instant experts? will pop up and do more harm than any good, utilizing methodologies and approaches that they are not qualified to use. There is a certificate program in CISD as well as a rigorous certification process in thanatology. Dealing with individuals and their emotions is a very sensitive, complex and important service and the actions taken can have lifelong and beyond affects for generations to come. When one thinks about it, it is really MIND BLOWING the impact such services have on individuals, families, and the communities at large!!!
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CISD is a specialized method of support service and is offered by International Critical Incident Stress Foundation - ICISF, in certified programs that insures quality of that practice modality. Their services have helped numerous persons. It is much more than what can be leaned over a web page without proper instruction. CISD is also I believe a copyrighted and trade protected non-profit organizational support service that should be kept in mind as well The site for more information is:
www.icisf.org/
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I would be happy to design an information sheet that can explain suggestions on how to cope with a mass fatality situation in ways that may be beneficial and a healthy approach for primary and secondary responders adn the general community member faced with the trauma and devestation of death experience in a critical incident situation. I will be happy to have it posted as an excerpt from my next book slated for publishing Fall 2007 is on this subject in depth. I will have it to you as fast as I can.
Could this posting also be included under the dying,death and bereavement sub forum as well?
T.Modesto, PhD
Critical incident debriefing practices, which are designed to support normal people during highly traumatic abnormal events, may prove useful at all sites. Dedicated flutrackers, health offical, journalists, etc. may be considered 1st responders in the event of a pandemic...not unlike the people on the street who assisted after Oklahoma City, Hurricane Andrew and 9/11. First responders are subject to very identifiable risks, many of which can persist for years. It is very easy to get a type of traumatic stress disorder when you are a 1st responder, faced with the overwhelming chaos and the irreversible and profound losses and excruciating choices which accompany disaster response.
We should add a thread to the Prep section which articulates the principles of CISD (Critical Incident Stress Debriefing) and provides guidance and assistence to individuals who undertake support of greiving public. It is not responsible to allow are members to provide support during a disaster without educating them to the personal dangers and the management of those dangers.
Stated very incompletely and very informally, some of the points made would go like this:
1.) It is normal to have highly abnormal reactions to an abnormal situation. You aren't loosing your mind. Hallucinations, flash backs, derealization (no feelings, the shakes, avoidance, hysterical laughter, profound denial are normal reactions at times of great stress. It is the minds way of processing the inconceivable.
2.) It is safe and appropriate to keep functioning for as long as you can do so reasonably well. If you can stay out of emotion until the crisis is past, do so. Do not encourage individuals to get into their feelings, if avoidable, until the crisis is past and it is safe for them to loose functioning for a while.
3) If an individual is approaching a breaking point, stop them before they break. It is much harder to put humpty dumpty back together than it is to prevent the break in the first place.
4) Sleeping and eating are important to maintaining balance. However, it is important to avoid excessive alcohol consumption in order to sleep. Sleeping very long hours is a normal recupperative process. Very little, highly disturbed sleep is also very normal, but it leaves the individual much less resilent. Sleeping aids are useful in an emergency to prolong the period during which the individual can function.
5) Group debriefing, after the crisis is past, is most helpful because it allows the individual to place his horror, flashbacks and excruciating choices in context with the horror of others and see his emotional reaction in relationship to the emotional reactions of other group members. An appropriate time for group debriefings would be after a wave has passed.
Lots more, but you get the idea....Our members need info on how to protect themselves while acting as 1st responders during the pandemic.
My CISD training was 8 years ago. I need to brush up on the latest practices. Are there any other CISD trained individuals out there?