How to Address the Human Side of Critical Incidents

by George S. Everly Jr.

Most chemical, biological, radiological, nuclear, and high-yield explosive (CBRNE) critical incidents differ from more common hazardous materials (hazmat) events by virtue of four factors: broader scope, enhanced physical toxicity, malicious intent, and the potential to do the unimaginable. The net effect is new levels of stress and psychological toxicity.

When CBRNE incidents are specifically utilized in terrorist acts, however, the net psychological effects are even more toxic. It is important to remember that terrorism is psychological warfare. The true goal of terrorism is not to kill or destroy. The goal of terrorist incidents is to influence societal or governmental change by creating psychological terror. CBRNE terrorist tactics are merely enhanced means to the ultimate goal of creating psychological terror. If these assertions are correct, then an inescapable corollary emerges: greater efforts must be directed to preparing and fostering resilience among emergency and disaster response personnel in the face and wake of CBRNE incidents.

Shifting the Preparedness Focus

Frankly, the preparedness focus must expand from “things” to people – the human side of the enterprise. Recent neurological evidence illustrates that the most distressing incidents are not those that engender fear. Rather, they are those incidents that are unexpected and unimaginable. They are those incidents that break the rules, overstep boundaries, and violate the most deeply held beliefs. For such incidents, better psychological preparation is required. Sadly, advances in the physical side of preparedness have outshone advances in psychological preparedness . . . until now.

The future is promising. Building on cutting-edge neurological and psychological research, researchers now believe that humans have the ability to build psychological immunity to the debilitating effects of adversity (often called “psychological body armor”) as well as foster resilience (the ability to rebound from adversity) like never before. From the organizational perspective, and consonant with recommendations from the Institute of Medicine, organizations must learn to create a culture of resilience that employs resilient leadership training as well as resilience-oriented communications.

The steps toward psycho-centric preparedness (psychologically centered preparedness) seem clear. First, from the individual perspective, people must first acknowledge the extraordinary stress that first responders face, especially in the wake of CBRNE incidents. Information is power! Second, based on analyses of the neurology and psychology of such situations, preparedness and disaster response professionals must develop new neuroscience-based training programs for building personal immunity (psychological body armor) and resilience. With new insights revealed through analyses of the brain’s dual cognitive processing mechanism, it is time to abandon reliance on concretized inflexible protocol-driven behavior. Rather, preparedness and disaster response educators must teach critical thinking skills that anticipate the unexpected and innovate and improvise to create new response options.

Psycho-Centric Preparedness Training

The final step is to educate preparedness professionals as to the existence of these new training technologies – for example, resilient leadership, psychological body armor, and resilience-based communication tactics, or psycho-centric preparedness training. Such training combines breakthroughs in neuroscience with critical thinking skills and resilience-based leadership and communication tactics. Only through including this new psycho-centric standard of care in public health preparedness and disaster response training will first responders and communities as a whole be best prepared to respond to a new era of critical incidents whether natural or human-made.

George S. Everly Jr., PhD, ABPP, FAPA, FAPM, CCISM, is an award-winning author and researcher. In 2016, he was ranked #1 published author in the world by PubMed in two fields: crisis intervention and psychological first aid. His paper on resilient organizational cultures was ranked #1 in its content domain by BioMed Library. He holds appointments as professor in the Department of International Health (adjunct) at the Johns Hopkins Bloomberg School of Public Health, associate professor (part time) in psychiatry at the Johns Hopkins School of Medicine, and professor of psychology at Loyola University in Maryland (core faculty). In addition, he is co-founder of the International Critical Incident Stress Foundation. He is considered one of the founding fathers of the modern era of the field of disaster mental health.