Today we will begin working with the psychological first aid. What you might probably know is the other first aid, the medical, the one applied on the road. And if I ask what are they, you will tell me something like: they are some processes or techniques that are applied to people that has been harmed in an accident while waiting for the ambulance. That's correct. But between these first aids, the non-psychological and the psychological, there is a very important difference that I would like to make clear from the very beginning. Psychological first aids are an intervention technique that isn't waiting for an ambulance, which means that they are an intervention technique by themselves. They are used with people who have just suffered the impact of a new, had an accident, have been victims of an attack, or have suffered a disease, that is, people who are in shock, feel vulnerable, and are trying to understand what happened to them and its consequences. Basically, psychological first aid have as an objective protecting these people from suffering more damage, a physical damage or a psychological damage, which could happen during the management of this difficult moment, where people have difficulties to manage themselves, to understand and it also involves calming down these people. And this is very important, because the more nervous they are, the more activated they are, the bigger the chance of getting negative effects from what just happened to them. So generating a calm environment in which we can offer information and control people, having their families in a safe place will be a way to avoid that the situation they are living has more effects than the necessary, what we call secondary damage, which is produced after the impact and the primary damage, the original one, which is the one that can't be avoided. But as in the medical first aid on the road, when we are getting our driving license we are told we must be trained and if we aren't trained we better ask for help without moving the victim, in psychological first aid we must be aware that we must be trained for the application of this technique, this process. You don't need to be a psychologist, or a psychiatrist, or a doctor, or a health worker, but you must have learned what they are, what they aren't and how to apply the psychological first aid. And this is what you and me are going to do from now on, during this week and four other weeks. When do we have to apply the psychological first aid? Well, psychological first aid are recommended from immediately after the impact of what happened, either a daily crisis or a massive emergency and until approximately 72 hours later. This doesn't mean that after 72 hours affected people that have lived a hard situation, even traumatic, don't need help, intervention or assessment. This only means that the psychological first aid are the appropriate technique during the first 72 hours after the impact. Then, if it's necessary, we will use other processes which are outside this course. Which are the objectives of the psychological first aid? Well, the first one, the basic, is reducing the stress level produced after the impact of the new or the traumatic event. But it is also very important connecting the affected one or ones with their support network. Individuals and people live in community and being able to count with these people, either family or neighbors, or community leaders and religious leaders if the person is a believer, helps us feeling protected, help us feeling better and it helps us a lot seeing the solidarity of the other people when we feel bad. So, connecting the victims with their support network is a way of reducing the consequences of what is happening. A third objective, very important, is potentiating the confrontation strategies in the victims. Everybody, you, me, all us have determined strategies to face difficult things. Most of us have suffered traumatic experiences, we have had losses, we have suffered hard situations. And we have some resources and capacities that have worked or have helped us and we know more or less what is good for us and what complicate us being able to manage what has happened. It is very important that the victims can be aware of the fact that they have an experience, they have resources and so stimulate them to think how have they faced other kinds of similar situations, will help them realizing that, probably, although it may seem hard they will be able to manage what has just happened. The fourth objective is also priority when preventing the negative effects after a traumatic event. What we are trying to do through the psychological first aid is potentiating the autonomy of the victims, so that they can make decisions by themselves, even if they are small, that they can try to get back control over their life, the control they've just lost due to the impact of what has happened. So, psychological first aid must never be a way of overprotecting, doing this we don't help the victims. So then how should psychological first aid be? First, and most of all, they must bring calm and model healthy answers. Psychological first aids must be a non-intrusive help, they must help if a person wants to talk without pressuring him. We mustn't put the victims under an interrogation, simply get close to them and ask them if they need something. Usually people know even better than us which is the first need they have in a determined moment and we don't have to censure these needs. And what shouldn't psychological first aid be? Well, they aren't a therapy, a way of diagnosing, not even a way of getting away, such as defusing and debriefing. Psychological first aids must never be a way of deeply talking on what has just happened, this is very useful and necessary and it will be done in the posterior stages to the first 72 hours after an impact. To finish, I would like to remark something I consider very important. People to which we are going to provide psychological first aid are in a high vulnerability situation, they have just lived a loss, an accident, maybe many losses, they are suffering. They are trying to adapt what has just happened to what they had previewed, to what they thought their lives would be. And this is usually a high difficulty situation with a great suffering. In this context we must be especially honest and trustful. That means we mustn't make promises we won't be able to accomplish. Sometimes taken by compassion, sometimes by empathy, we would like to do things that aren't in our hands for these people. If we promise them in a vulnerability moment and then we don't keep our promise, we will hurt them more than if we say, "look, I will try to find out if I can help you with this, and if I can't, I will tell you". It is also very important trying to keep the dignity and the confidentiality of everything that happens. When there's an emergency, and mostly if it's massive, usually media appear, with the will of accomplishing their job of informing, they make a good job and usually they help professionals to spread guidelines, to try to understand what the victims need, but on the other side sometimes they want to know details, information that infringe the right to confidentiality of the affected people. And as psychological first aid providers we must be very scrupulous with this. And finally something obvious, when we are applying psychological first aid to a community or even simply to a family, we can find a wide range of cultures, religions, ways to see the world, ways to think, ways to decide. The person who is applying psychological first aid must be extraordinarily sensitive when facing this diversity, they must adapt their clothes, their language, their way of acting, even their point of view to this diversity of the people to which we are giving the psychological first aid.
