It is vitally important that we change the way we think about CIR, and to do that we must change our language. When it comes to interventions after a workplace event, I use the term potentially disruptive event (PDE) in place of critical incident. Instead of critical incident response (CIR), I think resilience support.
Most definitions of “critical incident” include the idea that the precipitating event is stressful enough to overwhelm normal coping responses. Critical incidents are seen as sudden, powerful, and outside the range of normal human experience. One has only to recall the recent events in San Bernardino and Paris to see that critical incidents do occur, and that they are potentially traumatic. In the context of such events, the usual language of CIR makes sense.
The problem is that we use the same terminology to describe all incidents to which CIR is applied, regardless of the nature of the event. But as Dennis Potter recently pointed out in What Is a Critical Incident?, nearly two-thirds of requests for on-site CIR involve events that don’t fit the definition of a critical incident. Instead, the most common events are the death of a colleague, robbery without violence, and workforce downsizing. These events are unsettling and stressful, but the majority of them are neither overwhelming nor outside ordinary experience. They have the potential to distract focus and hamper productivity, but it is extremely rare that they are truly traumatic. In short, these are potentially disruptive events, but they are not critical incidents.
The disconnect between CIR terminology and its application is not mere semantics, and it isn’t trivial. Language leads to assumptions, and our underlying definitions presume that those receiving a CIR will cope poorly and are likely to have been traumatized. As a result, our affect will convey deep concern for the vulnerability of the “victim“, and our interventions will focus on “fixing” what has been broken.
The reality is in fact quite the opposite. The most common human response to stressful events, regardless of severity, is resilience, not long-term trauma. We can be knocked off our game, we may grieve, and we may temporarily lose focus and productivity, but we usually recover quickly. In fact, even events that are extreme, such as witnessing a violent death or being the victim of a serious accident, rarely overwhelm normal coping mechanisms more than briefly, and there is accumulating evidence that those who survive extreme trauma often become more resilient, rather than less.
Focusing on trauma also has implications from an organizational perspective. Employers care about their workers and want what is best for them, but from their perspective the primary impact of a stressful event is lost productivity. By assuming that a workplace event is a “critical incident” that might traumatize employees, we inadvertently convey vulnerability where there may be none. Even to “normalize” reactions conveys the presumption that employee’s responses are somehow not normal. Instead, the most common response will be for most employees to gather, bond with their coworkers, talk about the event, and then go back to work. Our job is to facilitate the normal process, and this is where services that support resilience have an important role.
The language of CIR presumes that people react to stressful events in a way that is quite the opposite of what usually happens, and that makes us less effective. If the usual response to stress is resilience, and the usual response to disruption is a return to productivity, that is where our language should focus. By replacing “critical incident” with “potentially disruptive event,” we focus more on coping, and facilitate the natural drive toward resilience.
About the Author: Les Kertay, a licensed and board certified clinical psychologist, provides clinical direction and perspective to all areas of R3 Continuum as chief medical officer. He brings extensive experience and expertise in the arena of mind-body health including disability medicine, chronic pain, health behaviors, and managing workplace absence. With over 15 years in executive leadership positions in the medical and vocational areas of the disability insurance industry, Dr. Kertay has presented at national and international conferences on topics related to the psychological aspects of work and disability, practical approaches to managing psychosocial issues in medical practice, pain management, somatoform and personality disorders, and professional ethics. Also, in addition to other publications, he is a contributor to three books on psychosocial aspects of complex disability claims and is lead editor for the AMA Guides to Navigating Disability Benefit Systems. Dr. Kertay is also a practicing clinician and industry consultant.
