Psychological First Aid Following The Manchester Arena Bomb SANDI MANN PHD C.PSYCHOL DOV BENYAACOV- KURTSMANN
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1 Psychological First Aid Following The Manchester Arena Bomb SANDI MANN PHD C.PSYCHOL DOV BENYAACOV- KURTSMANN
2 With thanks to Dr Moshe Farchi, Tel-Hai College Upper Galilee, ISRAEL, for his input with this presentation
3 About the presenters Sandi Mann Senior Psychology Lecturer UCLan Director The MindTraining Clinic Columnist Counselling at Work (BACP) Volunteer for HeadsUp CIO Author of over 20 psychology books EMDR and CBT trained Dov Benyaacov-Kurtzman Clinical Social Worker (ISR) Founder Heads Up CIO TotalMindFitness Mental Fitness and Resilience Trainer and Clinical Counsellor Author of Mind Over Terror (to be published summer 2018) CBT and ACT trained
4 May 22 nd 2017
5
6 Local reaction in Manchester Shock Terror Disbelief Anger
7 Circles of Trauma (Mann 2018) Other Mancunians Those injured/families/friends witnesses Those at the arena Those who knew someone at the arena injured Those with connection to the arena
8 Psychological First Aid: the process Pop up centre set up in city centre Training of over 100 volunteers in Zone 1 Cognitive First Aid Trauma Experts from Israel flown in (courtesy of Easyjet). Professor Yoni Gidron
9 Psychological first aid: The protocols Zone 1 Zone 2
10 Based on knowledge of the stress response Let s look at those in the closest circles of trauma
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12 Acute stress reaction (ASR) Helplessness Threatened Fear
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15 Trauma Stages ASR (90%) ASD (20%) PTSD (5%)
16 Who develops ASD/PTSD? Resilience Sense of coherence Hardiness Self-efficacy Neuropsychology Psychiatric history Perception of event
17 Zone 1 intervention: 6 Cs Model Goal of Zone 1 intervention (asap): To shift the victim from a sense of helplessness to a sense of active coping survival
18 What happens during traumatic incident? Hyperactivity of the amygdala and limbic system Underactivity of the cortex
19
20 Who can be trained in Zone 1 protocol? First responders Mental health professionals Employees Teachers Students Anyone?
21 Traditional post-trauma interventions Debrief Normalising reactions Support Tea and sympathy Allowing expression of thoughts and feelings
22 Zone 2: Memory Structure Intervention (MSI) (Gidron, 2006) Patient describes the event. Each time he/she says a feeling or a somatic sensation, therapist asks to elaborate verbally and give a reason. Therapist repeats the story, chronologically organized, with causal links between the event s segments, using verbal labels of emotions/sensations Patient repeats the story the way the therapist did
23 Vagal Breathing Vagal nerve = measure of adaptability People with High VN recover faster in BP, cortisol and inflammation Activating vagal response is thus vital
24 In 1921, a German physiologist named Otto Loewi discovered that stimulating the vagus nerve caused a reduction in heart rate by triggering the release of a substance he coined Vagusstoff (German: Vagus Substance ). The vagus substance was later identified as acetylcholine and became the first neurotransmitter identified by scientists.
25 what is that vagus nerve? The vagus nerve is the most important element of the parasympathetic nervous system (the one that calms you down by controlling your relaxation response). It originates from the brainstem and it is wandering all the way down, into the belly, spreading fibres to the tongue, pharynx, vocal chords, lungs, heart, stomach, intestines and glands that produce anti-stress enzymes and hormones (like Acetylcholine, Prolactin, Vasopressin, Oxytocin), influencing digestion, metabolism and of course the relaxation response. Vagus nerve acts as the mind-body connection, and it is the cabling behind your heart s emotions and gut instincts. The key to manage your mind state and your anxiety levels lies on being able to activate the calming nervous pathways of your parasympathetic system
26 The evidence
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30 Putting it into Practice in manchester
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32 Photos courtesy of HeadsUp CIO
33 With thanks to Dr Moshe Farchi, Tel-Hai College Upper Galilee, ISRAEL, for his input with this presentation References Effects of a neuroscientifically-based intervention on acute stress and PTSD: report of four studies: Yori Gidron, The European Journal of Public Health26(suppl_1) November 2016 Moshe Farchi, Ayala Cohen & Atalia Mosek (2014) Developing Specific Self- Efficacy and Resilience as First Responders among Students of Social Work and Stress and Trauma Studies, Journal of Teaching in Social Work, 34:2, Farchi, Moshe. (2011 From a Helpless Victim to a Coping Survivor: Innovative Mental Health Intervention Methods during Emergencies and Disasters. Prehospital and Disaster Medicine. 26.
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