It is inevitable that during or after a national crisis, traumatic injuries and medical emergencies will occur. The nature of the disaster will limit the availability of conventional medical services as we know them today. The extent to which medical services will continue to remain available depends on the scope and severity of the disaster.

As part of being prepared to face disaster one should make some sort of medical preparation. The extent to which one can provide medical services in a disaster is going to be proportionate to the level of training acquired and the available equipment.

Due to limited medical help during a disaster, many of the routine injuries and emergencies which are successfully treated by today’s medical facilities will move into a terminal category. The general health of the population will be weakened due to breakdowns in sanitation and malnutrition caused by food shortages. Malnutrition weakens the body’s immune system that increases susceptibility to uncontrolled infections. If the disaster is nuclear, immune systems will be further suppressed by exposure to dangerous levels of radiation.

Triage, or the sorting of patients, will become a more common practice in this type of disaster environment. Triage is usually done when medical resources are limited, and thus sorting concentrates available resources on the most salvageable patients.

Alopathic Considerations

Subjects covered:

Pre-hospital Care

Basics of patient assessment

Shock
Pulse rate
Blood pressure
Oxygen therapy

Prehospital training is valuable, but in a major disaster we are talking about a situation where there is not a hospital to take the patient to. The situation suddenly involves more than just stabilizing and transporting the patient. It now involves the actual treatment of the patient. The only person certified to do this is the doctor. But if it means the patient dies or you try, it is much better that you try!

Beyond Pre-hospital Care(information covered in book)

Antibiotics (information covered in book)

Stockpiling Medications (information covered in book)

Veterinary drugs(information covered in book)

Anesthesia (information covered in book)

Storage of perishable drugs(information covered in book)

Naturopathic Considerations

A person can’t cure serious gunshot wounds, open fractures or a ruptured appendix with natural remedies, but many infections can be effectively controlled with the use of herbal preparations and homeopathic remedies.

Natural measures will help maintain health and improve the body’s immune resistance. In extreme life threatening situations, natural treatments cannot substitute for synthetic drugs and surgical intervention. There is a fine line between the legitimate boundaries of allopathic medicine and naturopathic medicine or the health field. I have seen abuses by both camps when they overstep their boundaries.

Bach Flower preparations (information covered in book)

Homeopathy(information covered in book)

Herbal Preparations(information covered in book)

Chinese Medicine(information covered in book)

Strengthening the immune system (information covered in book)

Sanitation and Disease

Sanitation is not a luxury, it is a survival necessity. More civilians die in wars from diseases resulting from the breakdown in sanitation than from flying bullets and bombs.

Modern sanitation, not immunization, is responsible for eliminating most major diseases. During a time of disaster, public sewer and water facilities will not function. As a result, diseases such as cholera, typhoid and scurvy will reoccur if good sanitation practices are not maintained. Close confinement and a lack of medical care will compound the effects of poor sanitation. Following is a description of several of the major diseases that are of potential concern to people during a disaster.

Typhoid Fever(information covered in book)

Cholera(information covered in book)

Hantavirus(information covered in book)

Hepatitis(information covered in book)

Chapter 9
Sanitation

Disposing of human wastes is something that most of us do not have to deal with too much. Modern plumbing and flush toilets have enabled us to distance ourselves from this sometimes-unpleasant task. If you live in a rural area and you have a well pump that supplies your water, any loss of power will disable your normal means of flushing the toilet. If you have surface water nearby, possibly a swimming pool, pond, stream or swamp, you can fill a bucket from one of these water sources and use it to flush the toilet by pouring it into the toilet bowel. If you live in the city you can so the same thing to the extent that the municipal sewer system is still operating its pumps.

If these options fail then you will have to resort to a more primitive approach. Camping supplies sell various stool-type toilets that either come with a bucket or a plastic bag arrangement. With either option there is usually a disposable bag liner and some sort of deodorizer. When the bag liner gets full you take it out, put a twist tie on the bag and get rid of it. The next question is where do I get rid of it. If you donÕt have power, water or sewer chances are you wonÕt have trash removal either. Dig a hole in your back yard and bury the bags. Do not bury waste products within 50 feet of a water source.

If you do not have one of these wonder buckets, then you had better have a shovel, or else you are in deep do-do. Go out in the back yard and dig a trench or hole 2 to 3 feet deep. Take the seat off your toilet and rig some sort of support frame over the hole to put the seat on. If you have wood ashes from a fireplace or wood stove, save these and put them in a bucket next to this privy with an empty tin can. Every time you do your business use the can to put some ashes over the stuff in the hole. It will keep the smell and flies down.

DonÕt forget to stockpile some toilet paper. Having to do without toilet paper would probably be one of the hardest tests of all. I wonÕt tell you how to deal with the problem at this point. I will leave it to your fertile imaginations. You may realize why great granddad ended up valuing that Sears-Roebuck catalog so much!

Wash your hands in a water bleach solution. Make sure you have a stockpile of bleach and soap. Bleach, soap and toilet paper become high value barter items in hard times.

In terms of other types of trash, a good burn barrel will work wonders.

Chapter 10
Security

Security concerns are a very sensitive issue. The social trend today is toward disarming the public. Anything relating to gun ownership, personal defense or property protection is looked upon as politically incorrect. If the local media picks up on any such activity, they will be sure to accuse you of intending on having some sort of confrontation with the government. The security of your person and property are legitimate concerns in this day and age. The Y2K problem or other future disasters could potentially compound the need for personal protection. Security is a legitimate concern that is not based on an intent to conflict with the government, but a concern that during a national crisis there won’t be enough government to ensure law and order.

If you live in a major urban area and you have to dial 911 during the first week of January 2000, chances are it might not be working. And even if it does work the police may be overwhelmed with other emergency calls. In the case of major regional disturbances, riots and disorders, the first priority of any individual, civilian or policemen will be to protect their own property and family. Law enforcement personnel may not be on the job helping to maintain order if their families and property are in jeopardy.

If a life-threatening incident occurs, try to contact the local authorities by radio and ask them how they would like you to deal with the situation. Document and record if possible any such urgent communications. A major disaster is not necessarily going to bring the end of the world and you might have to answer for rash actions after the dust settles.

Non-lethal Deterrents (information covered in book)

Firearms (information covered in book)

Body Armor (information covered in book)

Night Vision Equipment (information covered in book)

Shelter Security Concerns (information covered in book)

Second Amendment Rights

Certain elements in this country and the mainstream media have deliberately attempted to misinform the American public about the meaning of the Second Amendment. The authors of the Constitution and Bill of Rights were very explicit in their intentions. In spite of this, legislators and judges, sometimes through ignorance and other times through direct intent, continue to erode our natural, inalienable right to self-defense. The issue has nothing to do with the use of guns for hunting, sporting or recreational use. The founding fathers intended that the citizens should be armed so they could defend their person, their property and their freedom. The real agenda of gun control is not safety in the streets and reduction of crime, but disarming the American people.

The founding fathers of this nation specifically intended citizens to be armed to prevent abuse of power by government acting under the color of authority, the color of law.

"Firearms stand next in importance to the Constitution itself. They are the American people’s liberty teeth and keystone under independence. To ensure peace, security, and happiness, the rifle and pistol are equally indispensable. The very atmosphere of firearms everywhere restrains evil interference. They deserve a place of honor with all that’s good."
– George Washington

"The constitutions of most of our states assert that all power is inherent in the people; that they may exercise it by themselves; that it is their right and duty to be at all times armed; that they are entitled to freedom of person, freedom of religion, freedom of property and freedom of the press."
– Thomas Jefferson

"The strongest reason for the people to retain the right to keep and bear arms is, as a last resort, to protect themselves against tyranny in Government."
– Thomas Jefferson

"No free man shall ever be debarred the use of arms."
– Thomas Jefferson

"The great object is that every man be armed. Everyone who is able may have a gun."
– Patrick Henry

"Americans have the right and advantage of being armed unlike the citizens of other countries whose governments are afraid to trust people with arms."
– James Madison

"The Constitution shall never be construed ... to prevent the people of the United States who are peaceable citizens from keeping their own arms."
– Samuel Adams

"The best we can hope for concerning the people at large is that they be properly armed."–
Alexander Hamilton

"The right of the people to keep and bear firearms shall not be infringed. A well regulated militia, composed of the body of the people, trained in arms, is the best and most natural defense of a free country…"
– James Madison

"And that said Constitution be never construed to authorize Congress to infringe the just liberty of the press or the rights of conscience, or to prevent the people of the United States, who are peaceable citizens, from keeping their own arms."
– Samuel Adams, 1789

"I ask, sir, what is the militia? It is the whole people, except for a few public officials."–
George Mason

"I ask what is the purpose of the militia? To offset the need of large standing armies, the bane of liberty."–
Elbridge Gerry

"Our task of creating a socialist America can only succeed when those who would resist us have been totally disarmed."
– Sarah Brady, Chairman, Handgun Control, Inc.

"Gun registration is not enough."
– Janet Reno, December 10th, 1993

"Waiting periods are only a step. Registration is only a step. The prohibition of firearms is the goal."
– Janet Reno, December 10th, 1993

"The current state of federal law does not recognize that the Second Amendment protects the right of private citizens to possess firearms of any type."
– Ronnie Edelman of the U.S. Department of Justice, February 20, 1997. From a letter explaining the Clinton administration’s position on the Second Amendment.

"We strongly endorse community initiatives to … encourage the disarming of civilians."
– Boutros-Ghali, UN Secretary-General

---

Chapter 11

Psychological Considerations

Psychological Responses to Disaster

It is important to understand some of the ways people react during emergencies, disasters and unusually adverse conditions. It is very difficult to predetermine what different individual reactions will be. This is something that can only be determined through actual experience. There are, however, fairly common reactions that can be predicted. Understanding these reactions will help the individual and the group to maintain some sort of objectivity and implement remedies and prevention.

The natural psychological and emotional reactions which people have as a result of a disaster include fear, terror, panic, emotional containment and depression.

Fear

Fear is a normal reaction. Fear fulfills a function within certain limits. Fear serves as a warning and an aid. Fear mobilizes the body’s reserved strength and increases its physical abilities. Fear allows people to accomplish feats which otherwise would be unthinkable. Fear can be a useful driving force.

The symptoms which people show when under the effects of fear are an increased need for contact (conversation provides a sense of security) and increased inner tension, which can result in the involuntary shaking of the hands, sweating, flushing, palpitations of the heart and pressure on the bladder. Fear is usually short term in duration and does not have long-term adverse side effects.

Terror

Terror is fear that has intensified and is usually provoked by an unexpected danger. Suddenness and surprise are essential ingredients for producing a terror reaction. Terror is a storm of emotion that expresses itself violently and irrationally and can increase the danger in a situation. Terror is an emotional obliteration of the will, reason and common sense. The mind is completely flooded and it is unable to clearly evaluate the real level of danger. The power to deliberate is put to flight by the absolute emotion of terror. Terror overwhelms the ego and paralyzes certain mental facilities.

Terror manifests in two phases. The first reaction is apathy. This will be seen as an absolute inhibition and immobility, in other words, terror stricken. Typically, terrorized people in dangerous situations can become indifferent to their own safety and the destruction going on around them. The second phase of terror that follows apathy is the impulse to flee. This is usually indiscriminate, without common sense. Both phases can involve a dazed condition and a loss of memory.

Terror is an emotional reaction that generally does not benefit the individual, but increases his vulnerability to injury and disaster. Also, terror is an emotional reaction that has the very dangerous quality of being explosively contagious.

One significant indication of when normal fear is on the verge of dissolving into terror is when the need to talk increases and people begin to scream. The raising of the level of the voice indicates an acceleration of emotions that are beginning to overwhelm the individual’s faculties of logic and control. When people are showing signs of trembling, walking back and forth and doing unnecessary things, this indicates a buildup of inner tension. The only thing you can do for a person suffering from terror is isolate them. If such an individual is violent, they need to be brought under control for their own good and to prevent infecting others. Methods of force should be limited to keeping them quiet with a gag and tying them up. If the means is available, sedate the individual.

Panic

Panic is a group emotion. Panic, like terror, is explosively contagious and spreads quickly. Panic is a reaction to a suggestion of danger that may or may not be real. When the individual loses his power to exercise common sense, he can easily be swept away by group emotions. Panic is a mass psychosis that can drive a whole group to irrational acts.

Panic is grounded in man’s herd instinct and his need for security. People fulfill their needs for security through group contact and interaction with other people. This security and herd instinct outpictures in day-to-day life as people find places in various social groups. People feel protected by the similar behavior of those around them. This is seen at sporting events. What happens is that the individual in the group lets the imitation instinct take over individual thinking and thus satisfies or fulfills a need for community feeling.

Panic usually starts with one weak-willed person and spreads lightning-fast throughout the group by way of suggestion. Those in the group who usually have the ability to control their inner anxiety can also be swept along with this herd reaction of abandoning one’s ego and dissolving into the group. Strength of character and a well-exercised willpower are the only deterrents to being swept away in such group reactions.

Emotional Containment

Emotional containment is a positive, involuntary reaction that some people experience in the face of a dire emergency. In this situation, the dominating emotional impact of the incident is totally suppressed. This allows for a better possibility of control and common sense. Under emotional containment one can think clearly and act purposefully. An extremely focused consciousness accompanies emotional containment, which shuts out anything going on outside the person’s immediate surroundings.

Depression

Many factors can cause depression, including disaster or personal loss. Couple this with the unknown, concerns for the fate of close friends and relatives, a perceived inability to improve one’s personal situation, or feeling out of control of one’s future, and such a situation could easily become overwhelming for many individuals. This could result in a breakdown of normal psychological defenses, and thus a downward spiral of mental and emotional despair, ultimately resulting in emotional depression.

Depression Symptoms(information covered in book)

Treating Depression(information covered in book)

Early recognition and treatment is vital(information covered in book)

Predictable Psychological Reactions to Disaster

Warning Phase(information covered in book)

Alarm Phase (information covered in book)

Impact Phase(information covered in book)

Inventory Phase

During the inventory phase those stunned by the impact of the disaster are confused and disoriented as they start to regain their senses. The first thing people do is take inventory of their situation by beginning to assess their losses and the current level of danger in an attempt to figure out how to cope with the situation. Once people feel assured that things are reasonably under control and that they are safe again, some of these people are able to start helping and assisting other victims of the disaster. Research indicates that about half the people in disasters will move quickly through the warning, alarm and impact phases into an adaptive mode and thus be able to help other victims. The other half will have difficulty adjusting to the situation. They will stay stunned and thus remain in a victim mode. Those remaining in the victim mode will require the most help.

If you are involved in a disaster, the first thing you should do once the inventory phase starts is to enlist and organize those who have made it through the warning, alarm and impact phases, and start assisting less fortunate victims.

The second step is to set up a triage program, sorting victims according to a hierarchy of need (who needs the most service right now, who needs the least) because you have limited resources and you need to pour your initial effort into those who have the most need. It’s not only the most need but it is also a practical matter of efficiency and effectiveness. Some people get triaged out of the first response assistance because they are too far-gone, and their condition can’t be improved.

This is a practicality and a reality that rescuers and medical-aid personnel have to face in a disaster. You can’t waste time and medical resources on people who have mortal injuries when there are numerous people suffering from serious but salvageable injuries waiting for treatment. This involves making hard decisions. In a typical major disaster there aren’t enough immediate medical services available to treat all the injured at once. You concentrate on the seriously injured which have a real potential for recovery.

Rescue Phase

During the rescue phase victims are elated, they are happy to be alive and they are euphoric, but this reaction is short-lived. Very quickly reality sets in and the victims begin to realize the seriousness of the situation. Thus, euphoria will often turn to anger, depression or desolation.

Recovery Phase(information covered in book)

Reconstruction Phase

During the reconstruction phase the victims have adapted to change and they have essentially returned to a functional level. The victims are not necessarily the same people they were before the disaster happened, but they are now at a level where they can mobilize their internal resources, assess external resources and begin to function in a helper/responder role. All the human faculties essentially return to a minimally productive level, but the one thing that needs to be watched for in this last phase is the potential for relapse.

Some victims will assume that they have put the disaster behind them and that they have dealt with it, but they don’t realize that resolution and recovery is going to be an ongoing process. This involves dealing with reemerging feelings, reverting back, and repeating some of the phases. Thus, some victims may relapse back into a deeper state of any one of these phases.

Wherever you have personal wounds in your psychology or your history, those may match up with any one of these phases. You don’t necessarily go back to the beginning and run through all the phases again. You may go back to a specific phase.

Disaster Myths

There are a number of commonly accepted myths in regards to people’s reactions to disasters. Examining these myths will help us better understand, prepare for and cope with disasters.

People will heed warnings.

The first myth is that people will heed warnings. People generally do not heed warnings. Historical research on the Pompeii disaster indicates that there were many warnings from nature as well as warnings from people in society which were not heeded. The truth is that even though people generally ignore warnings, they will listen if they are repeated and repeated by trusted leaders, close neighbors, friends and family.

People always panic in a crisis.

This is not true. Mass panic only happens in about 10 percent of the disasters, and then only when there is no clear evidence of an escape route or protection from the disaster. The existence of a prepared shelter or other preparedness becomes a key element in helping people psychologically deal with the crisis when it arrives. When people know that they have a potential escape, such as a shelter, and that the shelter will protect them to a reasonable extent, they will be less likely to panic. The only other question is, are they in a position to get to the shelter? The key element is that a person has a safe place to go and a way to get there under the worst
circumstances.

In a disaster, the entire social structure of the community will remain psychologically devastated.

People have a miraculous resiliency and the ability to respond to difficult situations. History has shown that people do have the ability to rise to the occasion and deal with what needs to be dealt with. This is not to say that it does not happen without pain, mistakes or difficulty. The truth is that communities restore themselves to normal functioning, and only about 50 percent of the people
who will need help coping with depression or anxiety.

Factors that Affect Human Reaction to Disaster Escalating Factors(information covered in book)

Mitigating Factors(information covered in book)

Variable Factors(information covered in book)

Age of the Victim (information covered in book)

Disaster Management Objectives(information covered in book)

Critical Incident Stress

Some of the conditions that cause critical incident stress are events, emergencies or disasters that result in sudden or unexpected death. These can burden rescue personnel, family and bystanders with great amounts of stress. This stress is often magnified if the victim was a child, if the emergency involved carnage or great human suffering, if a death occurred after a prolonged rescue attempt, or if a victim at the incident was expressing uncontrolled emotion. These stressing situations are experiences outside of the usual range of human experience and would be distressing to almost anyone.

This type of stress is called critical incident stress. The individual’s reaction to stress can be either acute or delayed. The acute stress response (immediate reaction) to the incident can include becoming physically ill, the inability to function, becoming immobilized, and mental or emotional breakdown.

The delayed stress reaction is referred to as post-traumatic stress disorder (PTSD). PTSD is a delayed psychological reaction to severe stress that results in behavioral problems. PTSD has been a serious problem with fire, E.M.S. (Emergency Medical Services), and law enforcement personnel nation-wide. It is the major cause for people leaving the E.M.S. field today.

In one particular incident in Billings, Montana, firemen responded to a mobile home fire. When they arrived, the mobile home was completely engulfed in flames. After suppressing the fire, the firemen found the bodies of five children and two parents in the rubble. This is the type of situation a person may deal with in a real disaster.

Many of these particular firemen later had nightmares, mainly due to the visual impressions they experienced at this incident. This is the same problem that Viet Nam war combat veterans have experienced. Some of the typical symptoms are nightmares, intrusive thoughts and disturbing memories. These disturbing memories can work their way into the person’s daily thoughts in an uncontrollable way. The burden of this becomes so overwhelming that the individual starts to fear and avoid any additional exposure to stressful events.

Thus, these types of inordinately stressful experiences may result in critical incident stress. If this stress is ignored or suppressed, it can lead to physical and emotional symptoms as well as behavioral problems that incapacitate valuable people.

Common Stress Reaction Symptoms

Some people, particularly those who avoid dealing with their emotional reactions, may find themselves increasingly reliving their trauma. The following are twenty signals that indicate "I’m stuck." An individual who has these reactions to a level that interferes with his or her ability to function for an extended period of time should seek professional help.

•Intrusive images—distressing memories, thoughts, nightmares, flashbacks

•Distress at exposure to events that resemble or symbolize the event

•Avoids thoughts and emotions connected with incident, or activities that arouse memories of the trauma

•Numbing or restricted range of emotional responsiveness

•Excessive stress reactions

•Hypervigilance

•Overreaction / underreaction / risk taking

•Increased irritability, anger, or rage

•Obsession with the incident

•Current incident can trigger feelings associated with past events; emotional impact of old and new situations becomes overwhelming

•Self-doubt, guilt, second guessing of oneself, feelings of inadequacy, obsession with perceived mistakes

•A growing sense of isolation: "No one understands what I’m feeling."

•Intense or sustained feelings of depression, grief, loss of control

•Mental confusion: increased distractibility, difficulty concentrating or making decisions, poor judgement

•Development of suspiciousness in dealing with others

•Relationship problems: peer/supervisory/family; withdrawal from others

•Decline in work performance

•Having little or no noticeable initial reaction to the incident, but reactions are triggered months later

•Self destructive behavior: substance abuse, poor judgement

In rare cases, suicidal thinking may result from feelings of depression, guilt, despair, and anger at oneself.

Ways to Reduce Reactions to Stress(information covered in book)

Maintain a sense of hope

Remember that your survival effort is important. It is important in terms of the survival of your family and loved ones. Remind yourself and remind one another why you are doing this. It may seem so chaotic at first that you’ll wonder, "Why are we doing this?" Some may even wonder, "Wouldn’t it have been better for us to have just stood under the bomb and let it drop on us?" You may imagine that no one will think this, but your preparedness group will have the same problems as any other group in the world that has gone through traumatic experiences.

Critical Incident Stress Debriefing

It is important in a crisis to maintain emotional control in the interest of stability, but it is also very important for people to be encouraged and assisted in expressing pent-up emotion as soon as it is opportune after a traumatic incident. This process is referred to as critical incident stress debriefing. There is a whole science regarding how to deal with critical incident stress. Psychologists have developed a model that helps first responders get through the emotional stress that comes with their job.

Most people don’t like to show weakness, but it is very unhealthy from a psychological standpoint to suppress the expression of emotions. Denial or dismissal of one’s own emotional pain will eventually lead to depression or worse. Suppression can lead to depression and post-traumatic stress disorder. Typically, those affected by PTSD become subjective, irrational and unreliable. Because of this problem, national emergency organizations, including police, fire and E.M.S., have implemented CISD or critical incident stress debriefing programs. When ever people are involved in a traumatic incident it is important to get them to sit down and say what they saw and what they experienced. This process enables individuals to vent an experience that, if otherwise suppressed, would emotionally incapacitate them or become a mental scar.

The following is a summary of the model used by teams of professionals for critical incident stress debriefing (CISD). Normally, mental health professionals do these debriefings. However, if such individuals are not available, the leaders of a preparedness project, a shelter or any other group involved in an incident could conduct a debriefing as long as they are sensitive to the needs of the individuals involved.

The group of individuals most closely involved with the incident are brought together after the incident is over. This can be done from a few hours to several days after the incident. Conduct the debriefing in a room where you will not be disturbed. Don’t begin a debriefing and not complete it.

Introduction

Ground rules, such as confidentiality are set down. Opening comments such as "My experience is people who talk about an incident eat better, sleep better, stay on the job better, feel better." No notes, recorders, or sign-in sheets.

Fact Phase

The situation and the aspects of the situation that made it difficult to experience are briefly reviewed with an emphasis on how those facts produced emotion. "Can you help recreate what happened?" Encourage everyone to comment but do not force anyone.

Thought Phase

The participants are able to state their first thoughts upon exposure to the worst part of the incident. "What thought stands out? What struck you?" This phase can be skipped if the group said so much naturally in the Fact Phase.

Reaction Phase

The participants can state their overall feelings or emotional reaction to the situation. "If there was one part of this you’d like to erase, what would it be?" Feelings of guilt if there was human error involved and feelings of frustration because there wasn’t anything one could do are real and natural feelings at this stage.

Symptom Phase

The group can discuss the cognitive, physical, emotional, and behavioral symptoms that occurred at the scene, during the next few hours, and that are going on at the time of the debriefing.

Teaching Phase

The group leader provides reassurance that what the members of the group are experiencing is a set of normal reactions to a bad incident and that they are not "going crazy."

Re-entry Phase

The people involved get a chance to ask questions and to clarify what has occurred. Referrals for additional help, if available, and helpful summary remarks can be made at this time. A follow-up group may be needed.

Patrick M. Wolberd, M.S.W., was a major contributor to this chapter on Psychological Conditions. He has a private counseling practice in Billings, Montana, and is also a member of the Critical Incident Stress Debriefing team there. He can be contacted at (406) 657-0611 or by writing to P.O. Box 20601, Billings, MT, 59104. Source for the seven phases of CISD: "Critical Incident Stress Debriefing Seminar and Team Training for Emergency Service Personnel" Jeffrey T. Mitchell.

Psychologically Preparing Oneself for Disaster

People can condition and prepare themselves psychologically for dealing with difficult and stressful situations. The author has had to consciously develop a calm and composed nature in emergency medical response situations. The logic I personally used, in combination with a great desire to change, was that having an emotional reaction to an emergency, being flustered, in a hurry and excited caused me to fumble, make mistakes and not follow established procedures. Such a reaction in no way helps the situation or the patient. It is better to consciously be in control of your emotions, slow down and take your time doing things effectively the first time.

In the same manner, one can condition oneself to be in emotional control under other contemplated emergency situations. This potentially includes not being overwhelmed by carnage, dead bodies and people who are seriously maimed. If you allow yourself to be swept away by flood tides of emotion, you will not be able to help those around you who are in distress and seriously need assistance.

Anthony Robins, in his book Awaken The Giant Within, affirmed this concept in what he refers to as "The Law of Reinforcement." Any pattern of behavior that is continually reinforced will become an automatic and conditioned response. Anything we fail to reinforce will eventually dissipate.

Cataclysmic vs. Localized Disaster (information covered in book)

Children’s Reactions to Disasters (information covered in book)

Understanding Children

The average child’s environment consists of certain regularities. For most school age children, regularity involves the presence of parents, awakening in the morning, preparing for school, meeting with the same teacher, the same children, playing with friends and sleeping in their own bed. Essentially, the child is able to depend on a series of predictable events. The child expects dependability from adults and certainly from the forces of nature. For the preschooler, life is much the same. He spends his day within the familiarity of his world—be it at home, with baby-sitters, a nursery school, etc. His family life remains more or less constant. When there is an interruption in this natural flow of life, the child experiences anxiety and fear. How the adults help the child to resolve these "problem times" may have a lasting effect on the child.

Children’s Fear and Anxiety (information covered in book)

Death and Dying

This is not a popular subject but it is one that needs to be covered. All of us could be faced with an inordinate exposure to death in the coming years. I personally experienced a near-death situation when I was 19 years old. The one thing I recall distinctly from the experience was the thought that no one had, in any way, prepared me for this.

Death is the ultimate threat. Many people today view death as the opposite of life and the complete end of everything. The idea of the extinction of self is a terrifying concept.

Members of present day society are generally uncomfortable in the face of death. It is a taboo and people don’t usually have open and frank discussions about it. In many people’s minds, death is an overwhelming disaster that is too terrible to think about.

The way most people deal with death is to avoid it or deny its existence. Consequently, many people have not developed a realistic concept of death or a means of dealing with it. Very few people face death and admit that it is an inevitable part of life. This is especially true in the case of those who are young and full of life. They view death as something very distant, something that happens to other people. The general social practice for dealing with death is to try to limit its appearance, to avoid talking about it and to spend as little time as possible with dying people.

In less developed third-world countries and agrarian cultures, people are better equipped to deal with death. In rural environments, children grow up with a closer relationship to nature. As a result, they are exposed to the cycles of life and death in the changing of the seasons and in the shorter life spans of pets and livestock. Modern urban living tends to separate people from exposure to the basic cycles of nature and fosters false attitudes of immunity from the effects of nature and the inevitability of death. The advance of modern medicine and the subsequent increase in the average life span has also contributed to an illusion that man has mastered death.

Fifty years ago, a major portion of American culture was centered around a more rural, agrarian structure which included a close-knit family life. This family structure usually included a large circle of aunts, uncles, cousins and grandparents living in the same house or in close proximity. If a parent died, other family members were readily available to assume the position of the deceased parent.

Today’s modern family unit does not usually include family members other than father, mother and children. As a result, family members tend to have stronger emotional investments in each other. In the event of the death of a family member, the sense of loss seems to be far greater and there is not necessarily someone readily available to fill the void.

Grief and Loss(information covered in book)

The Grieving / Healing Process(information covered in book)

Shock and Denial(information covered in book)

Crying

Crying is a typical response in this stage and should be encouraged, as it plays an important role in the grieving process. Crying is a legitimate release in the presence of death for both males and females. One should not only accept crying but expect it. No one should be shocked at the sight of a man’s tears under these circumstances. When men lose their customary control of emotions, they need reassurance and support because they feel ashamed of their inability to regain their composure. It is important to accept the crying without any hint of disapproval.

Anger

Another very important emotion that may be openly displayed in the second stage of the grieving process is anger. This anger may be irrationally directed at anyone who the grieving person imagines must have allowed or contributed to his loved one’s death. This anger is more a manifestation of a person’s feelings of frustration and helplessness and their inability to do anything about it. Anger may also be felt toward another family member who somehow failed in an obligation toward the deceased. Anger may also end up being directed against the self if the person feels himself to be somehow at fault.

It tends to be easier for people around a grieving person to tolerate crying than it is for them to tolerate anger. It helps to understand where the anger is coming from. Do not react to this anger or any rash statements that the individual might make when he is grieving. Remain calm and compassionate until the anger subsides. Do not take it personally or be offended.

Occasionally, a grieving person will have the fear that they are going insane. Those who express this fear need to be quickly reassured that the feelings they are having are a natural part of the grieving process. It is normal to have such feelings under these circumstances and they will eventually go away.

Guilt(information covered in book)

Mourning

The third stage is the process of grieving is referred to as mourning. This may begin during the funeral rites or shortly after. During this final stage, which may go on for a year
or more, the bereaved person works through his feelings toward his loss and is able to resume a normal life that revolves around new interests.

Supporting Family in the Event of a Death(information covered in book)

Supporting Children in the Event of a Death(information covered in book)

Giving Support to A Dying Person(information covered in book)

Communication(information covered in book)

Preparing Yourself for Death

When you are on the threshold of death your values seem to instantly change. Much of what was very important during life fades away and becomes very unimportant. A more profound set of values takes over.

To a certain extent, all of us relate to ourselves as our body. Most of the fear related to dying is due to this close identification with the physical body. In reality, the body is a vehicle which the real person, the spirit of the person, inhabits or wears. The body is what is discarded at death.

There is not much informational instruction available on the subject of going through the process of death because very few people go through the process and come back to tell about it. Some people view death as a veil that separates physical existence from spiritual existence. The problem we are faced with is that passing through this veil is usually a one-way trip. Most how-to books are based on someone’s personal experience in a subject, but in this case most don’t survive the experience. Thus, there isn’t much constructive advice left behind for those who will follow. If everyone who tried to climb a particular mountain never came back, then that mountain would develop a particularly ominous and mysterious reputation.

However, in recent years there have been a number of books on near-death experiences that have come onto the market. These books contain testimonies of individuals who survived near-death experiences. Typically, these were people who were revived after drowning, cardiac arrest or death during surgery. Most of these recorded experiences contain common similarities that lend credence to their validity.

Some of the near-death survivors recalled a detachment from the body and a release from pain and confinement. This was described by one person to be "the most beautiful instant in the whole world." Many people recalled floating above their body with a conscious awareness of their own death. Some recalled viewing the body from a distance or even seeing it from many different directions at once. Most all experienced tranquillity and delight, a timelessness, a limitless sense of freedom and the feeling of being an unencumbered spirit. There seemed to be a strong sense of having reached reality. There was a general experience of detachment from earthly concerns and a release from the burdens of mortal existence. Many people also relate experiences of being met by beings of light that conveyed to them, without words, great comfort and love. There are also references to traveling down a dark tunnel to a spiritual realm. In the final analysis, it appears that the moment of death is more distressing for family, friends and relatives than for the dying person.

By understanding death, we are better equipped to face and conquer fear. Another benefit to contemplating the death process is that it helps people reevaluate their present day priorities. What would you do different today if you knew you were going to die tomorrow? On the threshold of death, many of the things that once were so important become trite and people lament things that they neglected during life.

Dannion Brinkley, the author of Saved by the Light, made a profound statement regarding death and the fear of dying, "…once we’re not afraid they cannot take our freedoms…all of the conspiracies in the world don’t intimidate you."

Three books on the market today that cover this subject are: Life After Life by Raymond Moody, Saved By The Light by Dannion Brinkley, published by Villard Books, and Embraced By The Light by Betty J. Eadie, published by Gold Leaf Press.

Chapter 12
Groups and Project Management

Groups

Many people decide to go it alone when it comes to preparedness projects. The main reason is the inherent difficulties involved in working with a group. This is unfortunate because ultimately, the group can accomplish infinitely more through its collective effort than the individual himself can ever hope to accomplish alone. Also, the real key to survival in the future will most likely be community. An invaluable book for anyone attempting to organize a group effort is, The Different Drum, Community Making and Peace by M. Scott Peck. Scott Peck has some excellent instruction on group dynamics as well as understanding and appreciating differences.

One of the major problems with most of the failed or flawed group efforts always seems to go back to authoritarian management styles. The old saying that power corrupts and absolute power corrupts absolutely is a real part of human nature. Checks and balances are a necessity whenever people vest and concentrate their power in any form of organization or leadership.

Thus, the first step in bringing a group preparedness project into the physical, is creating a management team. Every project should have a good management team or a Board of Directors, which operates as a "Master Mind Alliance."

Napoleon Hill is the author of the "Master Mind Alliance" concept. Read Napoleon Hills’ books, Think and Grow Rich and Success Through A Positive Mental Attitude. Don’t be fooled by the title, Think and Grow Rich—just scratch out the words on the cover which say "Grow Rich," and replace them with the words, "Successfully Achieve Your Preparedness Goal." The new title will be: "Think and Successfully Achieve Your Preparedness Goal." The science involved in making money is the same science that applies to bringing a project successfully into physical reality.

The master mind alliance should be comprised of people with a complement of the skills necessary to fulfill the project, but the most important qualification for a member is his ability to be harmonious and work as a team member. One characteristic of a team player is having the capacity to be objective and open to suggestion and feedback. This is characterized by not being attached to one’s personal ideas and by being willing to submit one’s ideas to the group’s constructive evaluation. Maturity is an essential ingredient of the team player. The person must be at a level of maturity where he has come to realize that each individual has his blind spots and each individual has his points of genius.

A single individual cannot run a project as effectively as a management team. He can only spread his attention so far and due to his subjectivity, the project will become a victim of his blind spots.

The management group’s broader perspective mitigates the blind spots of the
individual team player. This, coupled with the combination of diverse talents and skills, produces a superior management team that is capable of achieving a higher level of success and productivity. This level of group dynamics causes the effectiveness of management decisions to make a quantum leap forward. When this level of community is achieved, a governing spirit is created that is much greater then the sum of the individual participants.

This community experience leads to personal transformation. This is not just pie in the sky idealism. This can and has been achieved through hard work. Half the battle is committing one’s faith to the process. Community, in the real sense, is an experience in spiritual growth.

Two other outstanding contributors to the field of management and interpersonal relationships are Anthony Robbins, author of Awaken the Giant Within, and Stephen R. Covey, author of The Seven Habits of Highly Effective People. Robins and Covey pick up where Napoleon Hill left off. Covey’s book has some very valuable instruction on over coming the interpersonal conflicts that we all inevitably face when undertaking any job or project. Personal conflict is one of the major causes of project failure.

A Common Vision (information covered in book)

Community (information covered in book)

Conflict in Community (information covered in book)

Dealing with Difficult Individuals (information covered in book)

Leadership (information covered in book)

Leadership in a Crisis

Self-control is an important leadership trait, especially during a crisis. If an individual loses control of his inner anxiety, he will be swept along with the group’s emotional herd reaction. Such group reactions are usually without logic and more often than not, worsen an al ready bad situation. If the leader loses control and is swept away by an emotional wave, all the others will follow. For this reason, self-control is of critical importance for the group leader.

It is important that a leader prepares himself mentally and emotionally in order to perform effectively under the pressure of a disaster or crisis. No matter how emotional an incident becomes, the leader must maintain control of his own emotions until the crisis is over. Visualize and rehearse your reactions to crisis. Imagine yourself in control of your emotions for the betterment and welfare of the group. Mentally rehearse and prepare yourself for the emotional challenges you will most likely face in a crisis. Mental exercise strengthens the muscles of the mind, which keep contained pressurized emotions.

A boat without a rudder will either move with the current or blow with the wind. If you let your mind wander, your tail will follow it. One way of maintaining control is to always be moving toward and concentrating on an objective. If you let your attention rest or dwell on an emotional situation, it will certainly absorb and overwhelm you. Try to dwell on the big picture during a crisis, always keeping one eye on the final goal.

Murphy’s Law

Murphy’s Law is a given truth, and based on my experience in the arena of human behavioral science, I have authored a few more statements of law after the Murphy tradition. They are as follows:

Murphy’s 1st New Law (information covered in book)

Murphy’s 2nd New Law (information covered in book)

Murphy’s 3rd New Law (information covered in book)

Murphy’s 4th New Law (information covered in book)

Murphy’s 5th New Law

If a person does not believe they can do something, then they can’t!

If a person believes they can do something, nothing can get in their way!

Belief is the most powerful force in the universe. The only thing that limits a person in life is their subconscious beliefs about what they can or can not do. We are governed by our personal beliefs about ourselves. All limitations are self-imposed. People create and maintain the limitations that surround them. Few people ever take responsibility for their condition in life and thus, few people ever become real achievers. Achievers realize this truth. Achievers consciously examine and eliminate the negative beliefs they hold toward themselves.

Murphy’s 6th New Law

It takes a blind man to achieve success.

A person moving toward their goal in life can’t always see where they are going to get the resources they need to accomplish their task. But if they move forward in faith, life will respond, resources will materialize from unforeseen sources and the hidden plan will be revealed. Life gives us everything necessary to accomplish what we need to do. Life gives us no surplus, because if we had surplus we would have no motivation to learn, grow or improve.

Murphy’s 7th New Law

Achievers get bruised fists from banging on life’s door.

Life guards success and only gives it out to those who are determined and persistent. Effort combined with grace can accomplish anything.

Murphy’s 8th New Law

He who is preoccupied with his problems perpetually finds more.

Don’t focus your attention on problems; focus on where you want to be. A person becomes what they put their attention on. If a person puts too much undo attention and emotional investment into the daily allotment of overwhelming problems, the person will get stuck there. Acknowledge problems, do what can be done and then move on. Worrying does not help improve an outcome; it only detracts from the desired goal.

Murphy’s 9th New Law (information covered in book)

Murphy’s 10th New Law

For the most part, nothing in life happens by chance.

Events that we face in life are part of a precise equation designed to mold and refine our natures.