Unwinding the mind: re-positioning management of critical incident stress, post-traumatic stress and prolonged duress stress

Abstract

Given estimates that 1% of our communities suffer from post-traumatic stress [1], we need to continue to improve management of trauma. There are conflicting findings over the effectiveness of managed interventions [2-5]. Some reasons for equivocal findings may include how trauma events are perceived by those encountering such events [6] or presence of a family history of psychiatric disorders [6,7]. Most approaches to managing post-traumatic or prolonged duress stress use cognitive behaviour models [1]. These try to help sufferers process the traumatic experience and deal with the fears engendered by recall of the trauma [8]. Sufferers are taught biofeedback strategies to regain some physiological management over their response to the situation. When these approaches fail, thought disruptive approaches such as eye movement desensitisation [9] are suggested. This paper suggests that those managing stress continue to refine their strategies. Some refinements include repositioning conceptual understanding of what may mentally happen after a traumatic event and ensuring that people have basic personal management skills to cope with flashbacks and intrusive thoughts.