WHY? -- IT'S OUR DUTY!
The onus for training and preparing in this field must fall on the
First Responders. The reason for this lies in the fact that the Next of Kin
are secondary victims and our duty as First Responders is to offer AID TO ALL
VICTIMS.
OVERVIEW
Dealing with and rendering assistance to the Next of Kin (N.O.K.) at
the scene of a tragedy is a unique skill that anyone can develop. This skill,
when utilized carefully and with compassion will not only result in easing the
pain caused by the tragedy but, help gain public acceptance and support of the
Emergency Response Team by the public, the media and the supporting agencies.
NEXT OF KIN (N.O.K.)
Are any family, relation or close friends who have a moral interest in
the lost (or deceased) person. They are easily identified by their attitude
and personal concern at the site of the tragedy.
FIRST RESPONDERS
Are any Search, Rescue, Medical or Dive Team who have a moral and
professional interest in the lost (or deceased) person. They also are easily
identified by their attitude and personal concern at the site of the tragedy.
In the past, these two groups who should be communicating the most,
have usually spoken the least. The reason is simple: Neither was prepared or
trained.
To effectively help deal with and help the N.O.K., we should understand
two main principles of human behaviour.
These are ANCHORING and THE FOUR STAGES OF SUFFERING.
ANCHORING
As First Responders, perhaps the most important process for you to
understand and remember is the process/phenomenon of ANCHORING.
When you approach the N.O.K., you will likely be deeply involved with
their most tragic, sad and memorable life event. Everything you do, say and
act out will be remembered in fine detail. This can be demonstrated easily -
if you think back to your own "memorable" life events, for example: YOUR
FAVOURITE CHRISTMAS (happy or sad!), DEATH OF A PET, SCHOOL GRADUATION, BIRTH
OF YOUR CHILDREN, it is easy to bring back vivid memories of these events.
Even small insignificant memories will float back into consciousness. Most
people can remember their favourite Christmas present, favourite holidays,
etc., and with these memories come details that are often surprising.
An ANCHOR is anything that pulls these memories back into your
awareness. Music is a powerful anchor -- most people have favourite songs that
"remind them of the good old days" and often an old photograph (that you have
not seen for years) will act as an ANCHOR, dragging you back to the moment it
was taken. It is important to understand that this anchoring phenomenon not
only brings back all the memories in vivid detail, but also the feelings you
experienced when you "set" these anchors. You, as First Responders will be
ANCHORS to the N.O.K. This is your chance at "immortality".
For this reason, when you are with the N.O.K., you should remember that
these people may very well remember everything you did, said and acted out.
They will then (in their memories) tend to magnify their feelings towards you
-- hence you will either become (as time passes by) the most compassionate,
wise and kind person they have ever met, or a callous, uncaring, blundering
individual who should never have been there!
The N.O.K. will tend to anchor to you and your Emergency Response Team.
It is your duty to give them something good to anchor to. An excellent example
to illustrate this behaviour is the role of a nurse in a hospital. Patients
will often refer to them as the BEST NURSE IN THE HOSPITAL, or THE NURSE THAT
DID NOT CARE. I have put the last description in as mild terms as I could but
you should be able to understand that when people anchor to people, they tend
to behave in extremes. The greater the emotion attached to the event, the
greater the extreme.
The N.O.K. is your doorway to IMMORTALITY. If you care to open this
door, do so only with compassion. Speak with them in kind, quiet and caring
terms remembering the words of CICERO, "A word is like a stone, once launched -
cannot be recalled".
THE FOUR STAGES OF SUFFERING
There are four basic stages (or phases) that people will pass through
when tragedy strikes. While there are no "set rules", they are usually
experienced in a predictable order. They are:
DENIAL, REMORSE, ANGER and GRADUAL ACCEPTANCE.
THE ACRONYM, D.R.A.G., is useful in remembering their order of
occurrence.
While there are no strict rules governing human behaviour, it is
usually seen that each stage must be experienced before it is completely passed
through and the next stage is entered. Some stages may be experienced in very
mild forms and may not be noticed except by very close friends, but to some
degree at least, they will be experienced. These "stages of suffering" vary in
length from very short (seconds or minutes) to very long (often weeks, months,
or years).
DENIAL
The denial stage usually lasts for only a few seconds or minutes. If
the individual should remain in this stage for a protracted period of time,
they should be encouraged to seek professional counseling. The denial stage
is a one dimensional stage. For the person in this stage, there is no
yesterday or tomorrow. They are trapped in the "now". They cannot be reasoned
with and communication is very difficult. A forceful approach in this stage
may result in very erratic behaviour. They can often be moved on to the
remorse stage by offering them an anchor. A piece of clothing or some property
(if available) like a toy (if the lost/deceased is a child) may be offered as
an anchor to move them on to the Remorse stage. The denial stage is caused by
the person's mind saying "THIS IS TOO PAINFUL TO ACCEPT -- THEREFORE IT HAS NOT
HAPPENED!".
REMORSE
The "remorse" stage is the most common state-of-mind which "first
responders" will deal with. It MAY last only a few hours but commonly lasts
several days or even weeks. When the remorse stage of development has not been
"passed through" after a protracted period of time professional counseling is
often indicated. The length of time spent in this stage will depend on the
severity of the loss and the personal make-up of the individual survivor. To
our advantage is the fact that this "remorse" stage is the stage where
"anchors" are dropped and lasting friendships begin. The first responder
should attempt to keep the next-of-kin in this remorse stage at least while the
search is in progress. This is the stage that we as "lay people" can best and
most easily work in. Genuine friendship and personal contact is necessary
between the N.O.K. and the first responders.
ANGER
This is the stage which is the most dangerous (for the first
responders) to encounter. It is brought on by the N.O.K. not being able to
accept the fact that they have just experienced a deep loss. It is often
enhanced or triggered by the inference that either the deceased was at fault
(i.e. drunk swimmer) or someone else was at fault (i.e. no lifeguard on duty).
It is a state-of-mind that cannot easily be reasoned with and should be avoided
at all costs. The "anger" phase is often triggered by casual conversation
overheard from first responders (relating to alcohol involvement), news media
personnel, comments on police radios, or even guilt felt by the surviving
N.O.K. who wonder what they could have done to avoid the tragedy.
The anger phase may be eased by assigning a team member to attend
directly to the needs and wishes of the N.O.K. This individual does not
necessarily need training in counseling skills, but should be a warm and
friendly individual who relates well to the needs of others. Some agencies use
"clergy" for this task, or depend on local "mental health care personnel"
for assistance. The use of clergy may be an excellent choice but care should
be taken to avoid inter-religious belief conflicts. Simply put, you would
not want a Christian minister to assist with the needs of a Buddhist family
who were erecting a prayer-shrine at the site of the tragedy. In short - be
sensitive to the needs of the N.O.K. Honor their needs. This includes their
need to be informed AND their need for privacy away from the eyes of the public
and the news cameras/reporters.
If anger is directed towards the first-responders, BE UNDERSTANDING,
REALIZE IT IS A NATURAL REACTION AND NOT PERSONAL, and REACT ONLY WITH KINDNESS
and UNDERSTANDING. It is a fact that you may be the recipient of ANGER merely
because you are the closest. As a last resort, if you cannot deal with the
anger - DO NOT ARGUE merely remove yourself from the source.
GRADUAL ACCEPTANCE
This is the FINAL STAGE OF GROWTH. It occurs when the N.O.K. has
developed to a stage where they are able to accept the loss and the
accompanying pain. Gradual Acceptance merely means that they have come to
terms with the loss and while there will still be periods of remorse (and even
anger) they will lessen with time. The N.O.K. has accepted the fact that their
life must continue - perhaps forever changed - but it MUST continue. This is
the stage of development where there is forgiveness and lasting friendships are
cemented.
CONCLUSION
The NEXT-OF-KIN: Whoever they are, and where ever you might meet them,
are your most valuable resource, simply because they can ensure the survival
of your Rescue Team, or more important, perhaps because by helping them - we
help ourselves.
In order to be human - you must first do a humanitarian act - Jose Silva
This article appeared in SARNEWS.