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by Mark D. Lerner, Ph.D.

Chairman, The National Center for Emotional Wellness

During a mass casualty incident (MCI), the primary goal must be the stabilization of injury and the preservation of life. Our physical and safety needs are always the priority.

As we have learned, physical trauma can destroy many lives. However, we have also learned that a “hidden trauma,” traumatic stress, will ultimately destroy many more. Traumatic stress refers to our feelings, thoughts, actions, and physical and spiritual reactions when we are exposed to or even witness, events that overwhelm our ability to cope.

Following is a list of twenty-three things we can do to foster Emotional Wellness during and in the aftermath of an MCI:

1. Take immediate action to ensure your physical safety and the safety of others. If possible, remove yourself from the event/scene to avoid traumatic exposure.

2. Address your acute medical needs. If you have difficulty breathing and are experiencing chest pains or palpitations, seek immediate medical attention.

3. Find a safe place with shelter, water, food, and sanitation.

4. Become aware of how the event is affecting you (i.e., your feelings, thoughts, actions, and physical and spiritual reactions).

5. Know that your reactions are normal responses to an abnormal event. You are not “losing it” or

“going crazy.” It’s okay not to be okay right now.

6. Speak with your physician or healthcare provider and make him/her aware of what has happened to you.

7. Be aware of how you’re holding up when children are around you. Children will take their cues from the adults around them.

8. Try to obtain information. Knowing the facts about what has happened may help give you back a sense of control when you're feeling a loss of control.

9. If possible, surround yourself with family and loved ones. Please realize that the event is likely affecting them, too.

10. Tell your story and allow yourself to feel. Your feelings are not right or wrong ... they just are. People who expose themselves to their thoughts and feelings fare better than those who don't.

11. You may experience a desire to withdraw and isolate, causing a strain on significant others. Resist the urge to shut down and retreat into your world; avoid avoidance.

12. Traumatic stress may compromise your ability to think clearly. If you need help to concentrate when someone is speaking to you, focus on the specific words they are saying and work to actively listen. Slow down the conversation and try repeating what you have just heard.

13. Don’t make important decisions when you’re feeling overwhelmed. Allow trusted family members or friends to assist you with necessary decision-making.

14. Speak with empathic and compassionate listeners rather than people who have all the answers. No one has the right to tell you how to feel!

15. If stress is causing you to react physically, use controlled breathing techniques to stabilize yourself. Take a slow, deep breath by inhaling through your nose, holding your breath for five seconds, and then exhaling through your mouth. Upon exhalation, think of the words “relax,” “let go,” or “I’m handling this.” Repeat this process several times.

16. Know that sleep difficulties and repetitive thinking are normal reactions. Don’t fight sleep difficulties. Try the following: eliminate caffeine for four hours before your bedtime, create the best sleep environment you can, and consider taking a few moments before turning out the lights to write down your thoughts, thus “emptying” your mind. Speak with your healthcare provider about addressing these common "target symptoms."

17. to rest, relax, and engage in non-threatening activity. Read, listen to music, or consider taking a warm bath.

18. If you can, physical exercise or any movement (e.g., walking) may help dissipate the stress energy that your experience has generated.

19. Create a journal. Writing about your experience may help expose yourself to painful thoughts and feelings and, ultimately, enable you to assimilate your experience.

20. If your experience is too powerful, allow yourself the advantage of professional and/or spiritual guidance, support, and education.

21. Limit watching and listening to the news on television and online. Many people experience very real traumatic stress reactions by repetitively watching the news.

22. Try to maintain your schedule. Traumatic events will disrupt the sense of normalcy. We are all creatures of habit. By maintaining our routines, we can maintain a sense of control at a time when circumstances may lead us to feel a loss of control.

23. Become "experts" on our physical conditions, learn how to harness our painful emotional energy, and use it in goal-directed problem-solving ways.


Dr. Mark Lerner

Chairman, The National Center for Emotional Wellness

© 2015 by Dr. Mark Lerner


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