For the Invisible Injuries: Psychological First Aid

Psychological First Aid is an essential form of intervention for the redressal of emotional distress, a phenomenon that is not as explicitly visible as physical injury.

Credits: Photo by eduard on Unsplash

September 05, 2022

What do we do when a friend bursts into tears while sharing a personal struggle with us? How are we supposed to behave if we witness a stranger undergo an accident? What is the first thing we could do when we encounter a victim of armed conflict or natural disaster?

These are some vital and valid questions that may have crossed our mind, if we have ever found ourselves in a situation where we could offer help. Little is taught in syllabi and discussed in conversations in living rooms, about the appropriate behaviour upon being approached by an emotionally distressed individual or finding oneself in a state to address an emotionally distressing situation. In other words, little knowledge is cultivated on the subject of ‘Psychological First Aid.’

“Psychological First Aid (PFA) is an evidence-informed approach that is built on the concept of human resilience. PFA aims to reduce stress symptoms and assist in a healthy recovery following a traumatic event, natural disaster, public health emergency, or even a personal crisis,” states the Minnesota Department of Health.

PFA has been an essential form of intervention for the redressal of emotional distress, a phenomenon that is not as explicitly visible as physical injury. The key feature of PFA is that it can be delivered by anyone, one does not have to be a trained mental health professional to carry out this intervention, just as one does not need to be a trained surgeon to perform first-aid on a physical wound.

For this very reason, the goal of PFA is not to offer long-term remedial treatment, but to contain the problem and prevent it from causing further harm to the individual. It is thus essential to remember that PFA is not the same as therapy.

Credits: Patty Brito

The process of Psychological First Aid can be better understood through its goals, which are as follows:

  1. Ensuring Safety: This entails ensuring that the individual seeking PFA is physically safe, and their immediate bodily needs are met. This can be done by nursing any physical injuries, providing drinking water and/or food, and taking the individual away from the site of disaster.
  2. Calming and Orienting: This means to listen to the person in need as they share their story, vent, cry, or even complain. Remember that an individual is not at their social and/or cognitive best, when triggered emotionally. Another notable recommendation is that the PFA interventionist must never probe the individual for details of the triggering event. Allow the individual to share it on their own, and if they choose not to, you may move to the next step.

3. Empowering: This goal aims to remind people of their efficacy. Self-efficacy is an individual’s belief in themself that they are capable of carrying out a particular task. In this context, it means that the interventionist must recognise that after an emotionally disturbing situation, people struggle to have faith in their abilities. Thus, encouraging them to solve smaller and immediate problems and empowering them with confidence as an essential part of delivering PFA.

4. Connecting: This entails connecting the individual to social resources such as their friends and /or family, a mental health professional, and an aid organisation if needed. For instance, if approached by a domestic violence survivor, the PFA interventionist may have to connect them to a legal practitioner, in addition to informing any friend or relative that the individual may trust.

Credits: Matheus Ferrero

5. Giving Hope: Distressing and traumatic events hold the power to leave an individual in a state of deep despair. However, the antidote to despair is injecting a narrative hope. This can be done by offering a follow-up meeting with the affected individual, allowing them to see and take pride in their resilience, lauding them for seeking help, helping them connect with the people they trust, and preparing them to expect certain temporary changes in their physical and mental wellbeing, while acknowledging that whatever they may be experiencing can be overcome with the right kind of help.

Do remember, that many a times people may be experiencing situations that could be beyond your capability as a PFA interventionist. This is the time to refer this person to the relevant expert. However, do not undermine your role, which is to prevent further harm. You never know, you might just save a life! 

(Author: Samreen Chhabra works as Assistant Lecturer at Jindal Institute of Behavioural Sciences)