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The Psychological Aftermath of Critical Incidents
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  1. The Psychological Aftermath of Critical Incidents Joel Fay PsyDSan Rafael Police DepartmentWest Coast Post Trauma 721-9789

  2. One Way of Understanding the Brain Cortical Brain Limbic Brain Reptilian Brain

  3. Cortical BrainConscious Thought / Action / Planning. Spoken and/or written language. PlanningOrganizing, Problem SolvingSelective Attention Personality Behavior Visual Memory

  4. Limbic SystemExternal World / Internal Response • Controls Emotions • Emotional Responses • Hormonal Secretions • Mood • Motivation • Pain and Pleasure Sensations No language involved / necessaryin Limbic system responses

  5. Reptilian BrainPhysical Response. • Controls the body'smost basic functions such as heartbeat and breathing

  6. How It Works • Thalamus – is a routing station for all incoming sensory impulses except smell

  7. How It Works • Thalamus – Routes information from eyes and ears to the brain

  8. Amygdala • Small almond shaped structure near the middle of the brain. • Attaches meaning to memory • Places the experience into the context of an emotion.

  9. The Amygdala is the command center of the brain’s fear system.

  10. A rat lacking an Amygdala will not respond to a threat.

  11. “The absence of fear is not courage – the absence of fear is some kind of brain damage.” M. Scott Beck

  12. When the Amygdala goes on the Pre-Frontal Cortex “goes off”

  13. Brain’s Response • Prefrontal Cortex – Reins the Amygdala is the threat is deemed to be insignificant.

  14. HippocampusResponse • Evaluates threats by placing them in the context of a previous experience.

  15. What Happens Next? • Amygdala – If threat is sufficient the body shuts down non-emergency services (I.e., digestion and immunity) • Triggers body wide emergency response within seconds

  16. Hypothalamic-Pituitary-Adrenal System (HPA) • Release of Cortisol to activate the bodies defense systems • Release of Catecholamines -dopamine, norepinephrine, and epinephrine

  17. Catecholamines • Suppress activity in areas at the front of the brain concerned with short-term memory, concentration, inhibition, and rational thought. • This allows a quick reaction to the threat

  18. Response Heart and lungs receive a glucose dump

  19. Heart’s Response • Heart rate and blood pressure increase instantaneously • Blood flow may actually increase 300% to 400%

  20. Skin's Response • Diverts blood flow away from the skin to support the heart and muscle tissues • This causes cool, clammy, sweaty skin

  21. Circulatory Response • Spleen increases red blood cells into bloodstream to promote oxygen supply. • As blood moves into muscles, blood vessels tighten causing vasoconstriction.

  22. Immune System's Response • Infection fighting systems (white blood cells, etc) are redistributed • Immunity boosting agents are sent to the skin, bone marrow and lymph nodes

  23. Mouth and Throat Response • Fluids are diverted from nonessential locations, including the mouth • Can make it difficult to talk.

  24. Heightened alertness in the brain – which in effect tells the memory centers, “Remember what occurred.”

  25. What is Memory? The use of past experiences to affect future behavior.

  26. We use memory to anticipate the future – It is how we stay alive.

  27. So, the really cool thing is… All of this occurs in a couple of seconds or less

  28. “What Do All These Chemicals and Hard Wired Reactions Mean To Me?” So You Might Ask…

  29. Post Traumatic Stress Disorder –An Assault on the Mind, Body and Spirit

  30. PTSD • PTSD is a total person experience • Symptoms effect • Mental Health • Physical Health • Family and Friends • Work • Spirit

  31. PTSD – Diagnostic Criteria Must be exposed to a traumatic event Person's response to the event must involve intense fear, helplessness, or horror

  32. The event must be re-experienced by distressing recollections, dreams, flashbacks, etc.

  33. Avoidance of locations, persons, etc • Sense of isolation • “No one else knows what I am going through” • “I can’t burden other people with this.”

  34. Persistent Problems With Increased Arousal • Withdrawal • Irritability • Irritability • Insomnia • Hyper-vigilant

  35. Symptoms of the Spirit • Hopelessness • Helplessness(Locus of Control) • Meaning of life • Questioning faith

  36. Treatment

  37. Treatment Options • Sometimes it just goes away on its own • Talking w/ friends and family • Chaplains • Local clinicians - EAP • Medication • Therapy • Residential treatment

  38. So, What’s the Point • The brain works in the same way in Police Officers and it does Citizens with mental illness. (CI vs. MI) • A lot of what the brain does or doesn’t do is beyond your control. • What your brain does or doesn't do, isn’t necessarily your fault.

  39. Our Goal is to Reduce the Impact of Critical Incidents in a First Responder’s Life and to Empower the Responder to Retake Control Over His/Her Life