PRINCIPLES OF PSYCHOSOCIAL AND SPIRITUAL SUPPORT
The RNAPU formulates the following principles :
- respect for human dignity, individual freedom and individual as well as collective values ;
- following a trying event, each and every one must be able to receive psychological support adapted to his/her needs, without regard for differences in gender, age, nationality or creed ;
- the people involved/affected must find their autonomy in life as quickly as possible ;
- targeted emergency psychological assistance aims to help affected people to reclaim the feeling that they are responsible for themselves ;
- psychological support is dispensed in an interprofessional, interconfessional manner that takes into account the rules in force in collaborating organisations such as the police department and the fire department ;
- emergency psychological support must not serve as a recruitement platform for patients or members (for associations or religious groups) ;
- proximity (assistance brought on site) ;
- rapidity (assistance brought as quickly as possible) ;
- simplicity (simple support and care methods);
- proportionality (do not provide more support than necessary in order to avoid overassistance).
According to the pioneering experience of the canton of Geneva, the Swiss Federation of Psychologists has developed a reflection on emergency psychology and enacted a number of rules and recommendations, notably :
► emergency psychology interventions aim for a spiritual and psychosocial approach, they do not consist of psychotherapeutic actions ;
Here, the reactions are considered as natural. No intervention having been demonstrated as capable of diminishing or preventing suffering, the task then consists in surround the people involved in dramatic events.
► the professionals that practice it know the basic principle of intervention in the field ;
Since it involves a professional group to officially intervene during such events, it seems important that its members know the phenomenon associated to them and develop skills such as the ability to avoid creating an area of therapy, proselytism or clientèle-building.
► they are capable of using the accumulated knowledge in a critical and flexible manner ;
The follow-up training should develop, in the intervention professional, the necessary skills to find an individual, and adapted, response to any given situation. Therefore, this means that standardized approaches are considered insufficient and are not recognized in their universal aspect. A critical reflection regarding one's own interventions is always necessary. Should we intervene ? Did we keep to our roles well ?
► they know their own limits and are able to judge the consequences of a trauma on themselves ;
The intervening professional must be watchful of his/her own reactions : over-investment, conflicts with other intervening professionals, exhaustion and vacarian trauma. The supervising organisms should ensure their well-being.
► emergency psychology is exercised only by professionals who do not depend on it financially ;
In order to maintain an adequate distance with the accompanied people, in order to focus our attention on the skills and resources of the victims and their close circle, it seems vital that the intervening professional have other fields of occupation.
If his/her occupation and part of his/her identity should be exclusively focused on psychological support during critical incidents, there would be a great risk that he/she tries to make themselves more useful, even necessary. If his/her income is greatly dependent on catastrophes, there is a great risk that he/she tries to validate his/her salary in considering some situations as critical when they needn't be.
► the approach aims for the acceptance of reactions ;
The reactions presented are not only considered natural, but also as means to protect, face and adapt. Under this angle, it would not be coherent to try and fight or diminish these reactions. However, a victim often suffers and complains from them.
In order to allow acceptance, the person in question needs to be able to give the reactions a meaning, to explain them. In most cases, it requires the intervening professional to show himself/herself capable of supporting these, sometimes surprising, reactions.
► the professional is only present for a time. Therefore, instead of suggesting himself/herself as a resource, he/she tries to mobilize the resources of the person, of his/her family and close circle in priority ;
The concept suggested here relies on the idea that, even though the victim might have momentarily lost contact with his/her skills due to shock, the person is nonetheless capable to face what's happening. Indeed, during the period of shock, every individual, every group or State, tends to feel powerless, helpless and incompetent. Offering oneself as a resource, or taking action in place of the victim, contains an implicit message : « we feel you are incapable of... ». This message, other than its disqualifying quality, tends to create a dependency for the victim and can ultimately be stigmatizing. Moreover, when exhausted or momentarily neutralised, his/her relatives and close circle are better-placed to provide support. If the here-mentioned happen not to suffice, the community could then relay them.
This approach considers the preoccupation between each other as a source of reinforcement of the link. Yet, several studies show the importance of that link's quality and that of the feeling of social support in the factors of protection.
We have understood that the feeling of powerlessness experienced by the victim, when the suffering appears to be lasting for too long, progressively extends to their close circle. Substituting oneself to the support a family can give would tend to heighten the feeling of powerlessness for the close circle in question. Moreover, giving support often results in a boost in self-esteem that would be better aimed at the close circle than to strangers that are not part of the natural milieu of the person, and whose responses might not be in line with the victim's (they might even, on the long term, end up more of a problem than a solution).
In this sense, our intervention should rely on the simple mobilisation of individual resources (in order to allow the victim to diminish his/her feeling of powerlessness and to reclaim a certain level of control) and those of the collectivity in which we burst in, in order for the victim to feel socially supported by the people with whom he/she lives.