Author: Erik De Soir
In this book, the author presents a number of psychological theories for crisis situations that are always preceded by a real-life story. This book discusses both the victims and the impact they have, with what they experienced, on the first responders. The latter is something that people reading the newspaper pay far too little attention to. How can they also be helped, after what they experienced during a rescue operation? This book tells more about it.
Chapter 1 discusses the CRASH model. Victims are triaged according to three dimensions:
Types of victims (primary, secondary, and tertiary victims)
Types of events (traumatogenic, depressogenic, exhaustogenic)
Types of intervention (prevention, approach, aftercare)
Afterwards, the author delves into the approach to a number of types of events in ‘sessions’.
Chapter 2 is dedicated to psychotrauma, in which a survivor of Ghislenghien tells his story about the event and the time after the gas explosion. He tells his story very clearly in ten ‘shocks’. Then, the author continues to discuss psychotrauma from a psychodynamic perspective, including an approach from various theories.
Chapter 3 is dedicated to traffic accidents and the support of next of kin. It mentions the Squirrel Method, a psychological approach method that significantly increases the victim’s chances of survival. What becomes clear from the testimonies is that seemingly small things can be of great importance.
Chapter 4 is about emergency and intensive medical care. The chapter begins with the story of Geert, a head nurse in emergency care with a passion for his job, which is all-consuming. The second story is that of Guy, an emergency doctor with 20 years of experience who exposes his experiences with emergency medicine and the impressions and consequences for him and his colleagues. It appears that caregivers can receive emotions from the victims they help as if they are connected like communicating vessels.
Chapter 5 discusses humanitarian disasters, using the earthquake in Port-au-Prince as an example, and the experiences of Jeroen, a nurse specialized in obstetrics with additional training in hospital nursing. Later, he joined BE-FAST and ended up in Port-au-Prince. It is an example of compassion fatigue among rescuers. Using this example, the author discusses Figley’s trauma transmission model.
Chapter 6 deals with the direct psychological and physiological stabilization of severely injured victims. The author starts with the story of Dirk and Mia, who experienced a traffic accident, and Dirk could be saved partly by luck, but also by the help of the Squirrel Method, which was already mentioned in Chapter 3. At the end of the chapter, the author provides guidelines for psychological stabilization, with each guideline followed by lessons from practice.
Chapter 7 is about delayed psychological support. It discusses so-called psychological debriefing. The task that accomplishes this is detaching. There appear to be multiple variants of psychological debriefing. Psychological debriefing involves several steps: immediate support, defusing, and a full debriefing. The latter consists of an introductory phase, facts phase, and thoughts phase. This is followed by a reflection moment and a reactions/feelings phase, a change phase, a learning phase, and finally a conclusion. The guidance of such a psychological debriefing cannot be learned from a book; it requires special training.
Chapter 8 deals with managing and following up on grief: delivering bad news… The example in this chapter is the story of Katrien experiencing the stillbirth of her daughter. The author provides a series of examples of how NOT to conduct a bad news conversation. Afterwards, he gives a number of dos on how to ‘deliver the blow’ in a bad news conversation and in a second phase how to help it sink in, and how to provide support in the acute aftermath of the blow. In the third phase, you can offer help in solving immediate problems.
Chapters 9, 10, and 11 discuss Pukkelpop 2011, the psychosocial intervention plan, and among others, the importance of rituals. Therein, the very powerful story of Marijke’s parents in Chapter 11 comes across very movingly.