By Gregory Mitchell - Copyright © 2003
Appendix 1. Psychological First Aid
The following techniques can be used to quickly help people who are upset. We do not claim or intend to imply any medical authority, or that these procedures substitute in any way for professional medical treatment administered by qualified practitioners. They are to be used as first aid only, and professional help must be sought if further aid is seen to be necessary.
1. Increasing Body Awareness through Touch
As usual, the Communication Cycle is followed. Here, the helper assists the person being helped to become more aware of his body, and the person should first be willing to co-operate in this process.
When people are upset or ill, they tend to withdraw and become introverted, either mentally or physically, causing increased tension. By drawing their attention back onto reality, i.e. onto parts of the body by using supportive body contact, this tension can be reduced. The helper will use pressure from the fingertips against easily pinpointed areas of discomfort, or the palm of the hand on wider areas. It is important to ask the person if the pressure being used is appropriate or if they would prefer a softer or firmer touch.
The person receiving help may be sitting or lying, depending on the problem. Their eyes should be closed. Subjects are asked to let their awareness focus on any sensations that arise around the point of fingertip or hand contact, or any shifts in thoughts or feelings, and to express these as they occur.
The helper would deal with such originations using questioning skills, for example: "Would you like to tell me more about that?", "Is there more to it?", etc. If the subject is not forthcoming he should request, "Is something happening?" or "Do you wish to talk about anything?"
In using this technique, the helper would start some distance from the site of a physical difficulty, moving toward the painful area gradually. Alternatively, in the case of a general problem or upset, the spine, head, fingers and toes would be addressed. The helper would touch one side of the body and then the other side, in a balanced way, maintaining a good cycle of communication - especially, listening to and acknowledging the expression of the person being helped. With a headache, for example, the helper may touch one of the subject's fingers and then the corresponding finger on the other hand. Having touched all the fingers, the helper may touch the elbows, shoulders, sides of the neck, base of the skull and gradually reach the forehead, touching first one side and then the other.
The helper should look out for repressed thoughts and feelings, which may be detected as changes in facial expression or color; changes in breathing rhythm; shifts in posture; movements of the hands or feet.
The helper would then gently ask, "Have you just had a thought? or "Have you become aware of a feeling?" If so, "Would you like to tell me about it?"
When treating a particular area, the helper would touch the person being helped at places closer and closer to the area of physical discomfort but would not touch the actual injury or bruise.
The session should end when there are the following signs:
No change for several minutes;
The person being helped is more aware and relaxed;
The person being helped brightens up;
The person being helped has a realization;
The discomfort is gone.
The person applying this technique should then ask, "Is it is OK to finish now?" If the person being helped agrees, then the session is ended.
2. Reducing emotional charge by re-experiencing
This is a technique for dealing with a recent upset, such as when the injury described above occurred, or an experience that the subject has been reminded of and become upset about. Basically the person being helped tells the helper about the traumatic experience and actually re-lives it in his mind.
The helper listens, using the Communication Cycle. He does NOT:
, that is, tell the person being helped what to think about what happened and what it means, or to give advice or sympathy, etc.
Interrupt the person being helped.
Invalidate the person being helped, for example, by saying the person is being stupid, or mistaken, etc.
The person being helped is asked to relate a traumatic experience several times, to reconstruct exactly what happened, from the beginning through to the end. The helper should listen attentively but unobtrusively. An acknowledgement is usually all that is required.
The procedure is continued, running through the incident over and over, experiencing more and more of the feelings and perceptions of the time, until the emotional energy starts to fall away and the person being helped no longer talks as if he is a victim trapped in the incident, but shows signs of release, brightens up and begins to laugh and have realizations.
Should the person being helped find it difficult to face up to the incident, then the helper can ask about less stressful parts of the experience, for example: "Tell me about the journey to that location," etc.
When the person being helped is more relaxed about these parts of the incident, the helper can ask again about the more stressful parts.
The incident can also be acted out. The person being helped is asked to act out the exact circumstances of the incident. For example, if he received a minor shock, the helper would re-enact touching the electrical object and encourage the person being helped to repeat exactly what he or she did in the incident. Often the original pain or upset is felt again as the incident is confronted and the charge released.
3. Restoring reference-points in present time
When a person is upset, he often has his attention inside himself and not on the outside world. He may be too overwhelmed or agitated to control his thoughts and co-operate with the above procedures. Such a person can be helped by being encouraged to recover direct contact with the real world.
Helper: "Look at that book!"
Helper: "Thank you. Look at (object)!", etc.
Here the person who is upset is asked to look at, touch, etc., various objects, giving him some reference points on which to anchor his attention, thereby reducing his confusion.
This procedure is continued until:
- There is no change for several minutes;
- The person being helped is more aware and relaxed;
- The person being helped brightens up;
- The person being helped has a realization;
- The discomfort is gone.
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Copyright © 2004 Gregory Mitchell - Published by Trans4mind