Critical Incident Stress
by Arlene Weslowsky
Jeff wasn’t usually still on the road at 2 a.m. He’d lost time in the yard waiting for a trailer repair and wanted to cover a few miles before he called it a night. When Jeff first noticed the headlights in the distance, he sensed something wasn’t right about them. Their movement was too erratic, not the fluid sweep of light on asphalt. As Jeff rounded the next curve he realized why.
The driver was slumped in his seat, his head against the side window, sleeping like a baby. His female passenger was asleep too, her head bobbing with the motion of the car. Jeff laid on the air horn, praying it would wake them up. There wasn’t enough room or time to swerve.
The sound of metal tearing on metal seemed to last an eternity while Jeff fought to keep his truck on the road. It came to rest with the passenger side of the cab firmly planted in the cliff face. An eerie silence filled the night as Jeff sat in shock and disbelief.
He didn’t want to look, but had no choice. If anyone had survived, it would be up to him to keep them alive until help arrived. He knew better than to try his cell phone. The radio was out of commission too. With no form of communication, he’d have to wait for the next vehicle to go by. At this time of night, that was going to be awhile.
Jeff didn’t have to check for a pulse to know that neither occupant was still alive. Their pale motionless bodies reminded him more of wax mannequins than ‘real’ people. The driver was still asleep, permanently. He’d never known what hit him. Something struck Jeff about the passenger though, whom he assumed was the man’s wife. When he realized what it was he was seeing, Jeff ran from the car, waves of nausea wracking his body until he dropped to his knees by the cab of the truck.
Her lifeless eyes were slightly open, as if she were staring into an unseen distance. But it was her hand – the index finger extended, pointing, that had unnerved Jeff. She had seen the truck coming at the last possible moment, awakened no doubt by the horn. Jeff cursed himself for using it, for being on the highway so late, and for a million other things that made sense only to him.
Once he was home, Jeff was plagued by nightmares and flashbacks – he saw the couple every time he closed his eyes. Alcohol seemed to be the only thing that numbed his mind and let him sleep. His wife’s concerns were met with hostility and silence; Jeff was certain she’d neither understand nor be able to handle the gory details. He avoided the office staff too. He didn’t know any of these people well enough to confide in. It was just a place to drop off paperwork.
The few days off that the company gave him to ‘recuperate’ stretched into a week, then a month. Jeff could feel his life spiraling out of control, but didn’t know how to stop the train. When his wife threatened to leave, he finally agreed to see a counselor. There, Jeff learned he was suffering from acute Critical Incident Stress.
Alone and Overwhelmed?
CIS is a condition caused by an exceptionally disturbing event – a psychological “shock” in the workplace. CIS is a normal reaction to an abnormal event. Left unchecked, it can be life altering and destructive. It’s long been recognized as an employment hazard of emergency service workers, but they’ve got the support mechanisms to deal with it.
When awful things happen to ordinary people like truck drivers, support may be difficult to come by. Because they know nothing about CIS, many “civilian” workers are ill equipped to deal with it.
In a perfect world, companies with employees that may be exposed to difficult situations would have at least a working knowledge of CIS, its causes, and its symptoms. Unfortunately, that is a rarity. It’s important then, for drivers and their families to learn about CIS before they are adversely affected by it.
Many different situations can produce CIS. Events we find difficult to cope with can be traumatic, emotionally upsetting or both. Common types of incidents associated with CIS are:
1) Life threatening experiences (i.e. collisions, armed robberies, fires, etc.)
2) Human angst (i.e. death or injury of a co-worker, witnessing a profoundly emotional event)
3) Mission failure (when our efforts to help are unsuccessful)
4) Numerous casualties (i.e. multi-vehicle collisions, train derailments)
5) Overwhelming sensory experiences (traumatic or grotesque incidents that shock our senses)
No two people react exactly the same way to the same event. Personal history or background, pre-incident stress levels, general health, and personality traits are all factors in how we can handle a given situation. Someone who is ‘hands on’ at an accident scene is more likely to be severely impacted than a person who experienced it indirectly by driving past.
Symptoms of CIS include physical (nausea, chest pains, headaches, insomnia), emotional (anxiety, guilt, fear, anger), cognitive (flashbacks, confusion, poor memory) and behavioral (substance abuse, restlessness, changes in routine). The symptoms that manifest will be as individual as the person who is experiencing them. There is no right or wrong way to feel after an event. In fact, not feeling anything at all can also be a symptom. Depending on the circumstances, milder occurrences of CIS will begin to dissipate within a few days, whereas more acute cases are prolonged and may require professional intervention.
When A Friend’s in Need
There are a few steps you and your family can take to minimize CIS’s impact. The most important one is talking. If you’re not comfortable discussing it with your family or co-workers, find someone you can talk to. Defusing or venting your feelings and experiences allows your brain to process the event and speed recovery. Attempting to ‘tough it out’ by remaining silent and internalizing your thoughts will only delay the healing process.
Stick with routines, and allow yourself time for fun and leisure activities. Though some of the emotional symptoms may leave you feeling that you ‘don’t deserve to have fun,’ it’s crucial that you recognize this for what it is. Spending time with friends and family, and putting a healthy dose of enjoyment back in your life will return you to a sense of normalcy faster.
Tempting though it may be, don’t self-medicate with alcohol and/or drugs. The temporary relief you might get from a few beers will actually make things far worse. Alcohol is a depressant and if you’re already in a depressed state, it will magnify your symptoms. Substance abuse of any kind will only add to your problems.
If you are the friend or family member of someone who is experiencing CIS, be prepared to just listen, saying nothing. They don’t need reassurances that everything is ‘okay’, or your personal views on why this has happened. Even if you’ve been through a similar event, don’t assume or suggest that you know how they feel. Stay in touch and offer your support. How often have we heard “I would have called, but I wasn’t sure what to say”? Now is a good time to pick up the phone.
Watch for changes in behavior or the onset of symptoms. Often, the person experiencing them won’t realize it, and may need an objective, outside opinion. Don’t be afraid to suggest counseling if the symptoms seem severe or last longer than a few days. Your concern may be rewarded with denial and hostility, but keep gently reminding them that there are resources available to them.
Keep in mind that a caregiver of someone with CIS can also develop symptoms. The imagery and emotional turmoil can easily be absorbed by anyone close enough. Don’t be shy about seeking counseling yourself should this happen.
With the increasing traffic on our highways, demanding schedules, mechanical failure and human error, it’s not so much a case of ‘if’ but rather ‘when’ you or someone you know will be afflicted with Critical Incident Stress. Take the time to educate yourself, your family, and your co-workers so that when it hits, you’re prepared. Become familiar with the resources your community and your company have available before you need them. Your career and well-being could depend on it.