Crisis Intervention: Theory and Methodology

By Donna C. Aguilera | Go to book overview

FOREWORD

Biological evolution has prepared humans to survive even in the most challenging of life's threats and traumas, both physical and psychological. We have learned, however, that the alarm reaction, first described in full detail by Hans Selye during the 1940s, is associated with trauma and threats of trauma by the flow of stress hormones and neurotransmitters and also with other rapidly changing bodily physiology that, if unmodulated, can produce illness (physical or emotional) from overreaction to trauma. We also now know that trauma and threat of trauma can lead to changes in the immune system, which may operate against survival if such changes are unmodulated. Oftentimes, the threat of trauma can be more devastating than the actual trauma itself, especially in the cases of children (for example, in the witnessing of home violence) and anyone else who is helpless and is without well-timed social and psychological support when the trauma threat occurs.

Humankind's physical and psychic survival require both physical and emotional supports from others in the environment. This modulating influence from the environment is a part of our biological and social heritage. Humans are social mammals and are predisposed toward social responses to others and integrated joint activity, ensuring survival of the species. This social predisposition toward shared experience in humans makes it possible for an individual suffering pain, trauma or distress, or threats of these traumas to be understood and acknowledged directly or intuitively by another person. Thus one person's pain and trauma or threat becomes a shared threat or a shared trauma for others in the community.

Even before the days of technically equipped emergency services, "911," the paramedics, mountain rescue teams, as well as the crisis intervention hot lines and professional societies mobilized to respond to massive trauma in the community (referred to in this volume), the lives of many men, women, and children were saved because someone noticed and responded to them and provided a safe haven and a protective environment for the person in trouble or threat. What was provided before our more sophisticated methods of life-saving technology was primarily psychological, together with warmth and protection. Such support provided by our unsophisticated ancestors worked then and still works now. We now know why it works, which is because a supportive psychological and physical environment actually does modulate the overreactive responses of the body and the mind to a trauma or threat; thus the feeling of helplessness is diminished and does not escalate into an exaggerated, nonadaptive illness-producing response. For example, during a recent backpacking trip to the high Sierras, one of our party was stung on the finger by a wasp. Her whole hand began to swell, and she was frightened of dying and not easily reassured, even after she received some Benadryl and cold packs were applied to the hand. Luckily, we met a pleasant, uniformed forest ranger who had also been

-vii-

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