Advice for crew suffering reactions from a crisis

People who have been involved in a traumatic event usually react to the experience and suffer some kind of crisis condition. A crisis is characterized by rapidly changing feelings, chaotic thoughts and other strong, overwhelming reactions.

Contents:

Causes of crisis reactions may differ widely but they all have the following in common:

  • The events are external
  • People will have felt intense fear for their own or somebody else’s life or experienced some other threat of losing something significant
  • Previous experience is insufficient and people have felt helpless in the situation

A crisis is typically characterized by being a short-term, time-limited condition and people get back to normal again within a couple of weeks or a few months. How people survive a crisis depends on the specific event, their personality, their co-workers, relatives and previous experience of dealing with difficult circumstances.

Many people and crews/teams get through a crisis together by helping themselves and with support from each other and immediate family. Others may need professional help during the process so as to avoid reactions to the crisis becoming chronic or developing in a negative direction. Both groups of people will often subsequently get the feeling of having benefited from adversity both as a person and as a crew/team.

The first hours

When someone suffers a traumatic event, they may often suffer from shock while the event is ongoing and for some hours afterwards. This state protects people from acting rashly and protects them against a nervous breakdown.
 

Feeling of unreality

The person affected often gets a feeling of unreality, as if what happened was part of a dream or nightmare. Many people describe it as like watching a film. Their sense of time may change, either passing very slowly or rushing by. Certain sensory impressions may be burnt into the consciousness. They may feel remote from what has happened and they may feel strangely empty and have a feeling of being in a bell jar.

In this phase, the person or people affected need to be protected and taken care of and it is important that there are people available to provide practical help and emotional support.

After the event the most normal reactions are

Violent emotional outbursts
In an acute situation, many people show no emotional reactions. Only later may they be overwhelmed by a feeling of helplessness and experience strong reactions such as crying, anger, screaming or other attacks of rage.

Flashbacks
Sometimes certain strong sensory impressions (for example something people have seen, heard, smelt, tasted or touched) will have burned themselves into their consciousness and people experience flashbacks of them again and again while awake or dreaming. It is characteristic that they cannot themselves control when these flashbacks occur.

Sleep problems
People may for example find it difficult to fall asleep, or they wake up many times during the night, or they may feel the need to sleep constantly. Thoughts of what has happened break through at night when trying to sleep which makes it difficult to fall asleep.

Anxiety and vulnerability
Feelings of increased anxiety and a sense of vulnerability are very common after having been exposed to or witnessing a traumatic event. Anxiety can make people restless and uneasy, or make them react to sudden sounds or lights. They may for example try to avoid the place where the accident happened or try to avoid thinking about it. People may also feel anxious from thinking about what could have happened.

Physical discomfort and tension
Anxiety often leads to physical discomfort. People may often also feel cold or may sweat more than they usually do. They may get stomach ulcers and feel dizzy, nauseous or more tired.

Irritation and anger
It is common for people to be more irritated and angry and this most often affects those closest to them but it may also be directed at those they hold responsible for the accident, at the media or some of the assistance they are dissatisfied with.

Sadness and grief
There are many reasons people may feel sadness and grief as the result of an accident. This might for example mean grief at having lost somebody or sadness from recognizing the transitoriness of life or of having lost their own feeling of invulnerability. Sadness is often accompanied by a sense of vulnerability and can often mean people being easily moved to tears.

Feelings of guilt/self-reproach
Especially in situations in which others have died while they have survived, people may subsequently blame themselves and feel guilty. And also even if they could not have done anything to save those who were wounded or died or could not generally have done anything different which could have affected the situation. People may also feel guilty at having been so occupied in ensuring their own survival that they did not think of saving others. After a traumatic event, some people spend a lot of time thinking whether they could have done anything different.

Lack of external support
Especially when those affected by a crisis go home and meet other people who have not been involved in the accident, they often find that others feel it is difficult to understand that they are still affected by the accident. This can easily make people feel very alone and that others do not understand them.

Concentration/memory problems
Because people are so occupied in processing what has happened, they will find it difficult to concentrate on something else. They may find it difficult to remember things and it may take some time before they can work at the same level as before.

Previous crisis events come to mind
If people have previously been in crisis situations (such as death, accidents, etc.), memories of these may come back and get mixed up in whatever they are experiencing now.

The reactions noted above are generally most intense immediately after the event but should preferably diminish over the course of a month. If you find that they have not diminished, you should contact your doctor or a psychologist. This may be appropriate when for example you have not slept for several days or if your speech becomes disjointed or difficult to understand or if you yourself or others have seen that your behaviour has changed or that you have changed as a person following the accident. If required, Seahealth Denmark can help put you in touch with a psychologist.

How to handle the post-crisis time

The person hit by a crisis - Help to help yourself
It is possible for people who have been affected by a crisis to help manage it themselves. Here are some important things you can do.

Accept that your reactions are normal reactions
Make room for the feelings, faults and reactions that you have even if you feel that they are strange or inappropriate. Accept the fact that these are normal reactions to an abnormal event.

Talk to others about how you feel
Sharing your thoughts and feelings with other people (preferably those who were also present at the event), is a good way of creating a common understanding of what happened. Allow yourself and others to repeat the same things again and again if that is what is required. It is often the best way to process difficult experiences and to allow yourself to move on.

Do not isolate yourself
We humans depend on feedback from each other to understand what is happening around us. If you isolate yourself, you risk finding that your thoughts go round in circles or that you are just ticking over.      

Resume your daily routines
If you are at sea, you will naturally have to do your job as well as you can. If you have been given sick leave, it is important to establish some routines at home.  It is a matter of getting up in the morning and ensuring you have some jobs to do during the day.

Be realistic about what you expect from yourself and each other
It is important to accept that you cannot do as much as you normally do so as not to overload yourself. Processing what you have experienced takes a lot of energy and after such an event, you may feel more tired than usual.

Share reactions with those closest to you
It is important to share your reactions with your family and tell them why you react as you do (consider sharing this folder with them). This will help them understand how you feel and that it may be some time before you can put what happened behind you. It can be a good idea to write things down. This can help give more structure to the events and help you have a better understanding of what happened.

Take exercise or go for a walk – it minimises physical restlessness
Exercise and training can help get rid of some of the tension and stress in your body. It can also help provide better quality sleep and thus also help you get better faster and ready for a “normal” working day again.

Avoid alcohol or other stimulants
Coffee, tea and cola tend to boost physical restlessness. Alcohol may immediately seem to help you relax but this is only for a short while. Alcohol affects the body and restlessness comes back again among other things by way of poorer quality sleep. Alcohol may also prolong the time you need to get over an event because intoxication prevents experiences from being processed.

Take care of yourself
Be careful in the traffic and when near machinery, etc., since there is a greater risk of accidents and injury after suffering from serious stress.

Give it time
It is important to accept and understand that it will take some time for the body and mind to work normally again. There is no point in forcing the process. It will only stress you out unnecessarily.

Seahealth Denmark

Seahealth Denmark is a private, autonomous institution.
We advise shipowners and crew on occupational health and safety issues, including crisis situations associated with piracy, deaths or serious industrial accidents, stress, depression, etc.

We have set up a hotline that you can call if you need further assistance after an event.

You can call on (+45) 3311 1833

 

International Regulation

Information can be obtained in MOSH Guidelines 6.6 Emergency and accident response. 

 

Useful links: 

IMO-publications:

  • IMO International Life-Saving Appliance Code (LSA Code) (2010 edition), as amended
  • International Code for Fire Safety Systems (FSS Code) (2007 edition), as amended.

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Vivek Menon

Email: vm@seahealth.dk

+45 3311 1833

+45 2960 7427

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