There is considerable evidence of psychological and cognitive performance changes when we are under crisis stress. When one is confronting a dangerous, threatening or critical situation we have a rapid physical response reaction which begins even before we even fully comprehend or understand what exactly is happening. However, we also quickly begin the emotional and cognitive reaction processes of appraisal and assessment of the situation and various mental “adjustments.” It is important to remind that not everyone reacts to the same situations, nor to any given situation in the same way, nor to the same degree, and not in the precise same sequence of reactions.
Cognitive and Emotional Reactions
When danger or threat is perceived, we measure the human mind’s initial reactions in terms of what one doesn’t know as much as what we do know about the event. Humans don’t usually like high levels of uncertainty – particularly when it comes to things that could potentially harm, injure or kill us. For most of us, when we are confronted by a potentially threatening high or hyper stress context, we typically start with high levels of uncertainty and ambiguity and even then, our first reactions are to make assumptions that might be erroneous (e.g. some untrained individuals may initially hear “firecrackers” rather than “gunshots”). As we reduce our uncertainty (“wait a second – people are running and bleeding from where I heard the ‘firecrackers’”) we next begin struggle to make sense of the situation or seek to grasp to understand (make meaningful) what is happening and define it even before we initiate reaction to the situations. This cognitive pause – or processing delay – various in process and temporal length but to some degree is a near universal human reaction (We can come back to Gladwell’s “Blink” notions at a later point).
So, as the anomalous event is perceived, we attempt to process what it is and what it means. We tend to think though the sound of the “firecrackers” and the injured people running past us: Is this a danger? Is the danger real? Have I been in this situation before? If so, how did I cope? If not, what should I do? Is help available? What are others doing? Is there a vulnerable person who needs my help? Should I act? The first major psychological aspect of experiencing crises is coping with uncertainty, ambiguity and initiating responsive behavioral actions. Yet, in addition to the more or less (quasi) logical cognitive process to reduce our uncertainty – we are also engaging in the initial non-rational (emotional) processes such as fear, anxiety, and anger. These are all fueled by and intertwined with the brain and body’s physiological Acute Stress Response (ASR) which is a central controlling command center to both our perception, processing, decision-making and emotional response.
Furthermore, much like the ASR process changes you physically and mentally, the mind’s psychological response results in additional (separate sequence) of cognitive process changes as well. (Human brains, bodies, and minds can really be an acute “hot mess” in a hyper stress situation.)
Partly because of the rapid physiological changes in response to a crisis event, and partly as an emotional and cognitive process variable, we must recognize that people change in the way that they perceive, process stimuli, listen, think, recall, decide, remember, speak and behave during and after crises – compared with pre-crisis baselines and routine or normal (non-crisis) baselines. (The effects of long-term chronic low, high or hyper stress are themselves dysfunctional but we’ll save the consideration of these factors for another essay.)
Researcher has found that there are also shifts in measurable non-emotional psychological characteristics such as “cognitive load capacity” (underloading and overloading within working memory thresholds), baseline vs. peak use of these cognitive load capacities, linguistic and vocabulary process change, temporal perception processing, and the needed information sufficiency threshold for decision making during and after crises. Some studies have found that those in crisis distress may experiencing debilitating fear, paralyzing confusion, and inability to function at tasks for which they held the necessary skills and abilities. Psychological and cognitive symptoms of crisis stress also include diminished intellectual functioning, mental distortions and misinterpretations of situational variables, events, messages and non-verbal interpersonal communication. Other noteworthy aspects include diminished concentration or mental focus (sustained attention to a task or decision). In addition, research shows that during high and hyper stress contexts that individuals demonstrate increased frequency of unproductive patterns of thinking, poor judgement, bad decision making and increased indecisiveness. Research has also found that some people easily distracted from critical tasks, inattentive, belligerent, impatient, and easily irritated. Further, short and long-term memory recall can be impaired and a decrease in the ability to form new memories during the high stress contexts.
Researchers have also found that people in high and hyper stress tend to exhibit unexpected or increased levels of negative emotions. Some of these emotions and manifest dysfunctional behaviors could include: abusiveness, controlling, aggressiveness, annoyance, irritability, antagonism, impatience, belligerence, desperation, insecurity, confliction, frustration, manipulated, manipulative, rage, resentful, obsession or apathy. For example, the research investigating “road rage” trigger incidents and driver emotional/behavioral responses are helpfully illuminating of emotional reactions to perceived threatening high and hyper stress events. (Road rage is emotionally aggressive or angry behavior exhibited by a driver of a vehicle, typically in response to perceived aggression or threatening behavior of a driver of another vehicle. Road rage has been linked to violent altercations, assaults and collisions that result in serious physical injuries or even deaths.)
Some studies have found that some instances of road rage are triggered by perceived challenging or threatening events (it may also connect to issues of territoriality, personal safety, and lack of emotional control resilience). What is interesting is that at least in some instances – there is a significant transition point – where both ASR and emotional and cognitive transformation makes it observable to compare road rage to a crisis threat trigger event. Emotional/cognitive frustration trigger event induced road rage responses may include behaviors such as rude and offensive gestures, verbal insults, physical threats or dangerous driving methods including those targeting another driver or even a pedestrian to intimidate them
Emotional and psychological trauma may also be the result of extraordinarily stressful crisis events. These experiences may involve a threat to life or safety, but any situation that leaves one feeling overwhelmed and isolated can potentially be traumatic, even if it doesn’t involve physical danger. These issues may arise during both long term (even low level but chronic) or a pattern of stress experiences or a single acute high or hyper stress events. For example, some research has found measurable psychological trauma among those studied who has experienced harassment in the workplace, workplace bullying, hostile and toxic work environments.
Coping with the high stress of a crisis, emergency, natural disaster can present unique challenges—even if you were not directly involved in the event. In fact, research suggests that reports and/or images on social media and news sources of disasters, terrorism or horrific crimes may be sufficient to cause psychological trauma in viewers, particularly if the viewers identify in some way with those who have suffered from such events.
Psychological trauma is a type of damage to the mind that occurs because of a severely stressful event. It may be a result of an overwhelming amount of stress that exceeds one's resilience to manage or tolerate. However, psychological trauma differs between individuals, according to their subjective experiences. People can react to similar events quite differently and not everyone reacts in the same patterns or sequences.
Crisis managers and emergency responders themselves face a potential for stress induced ill effects, including two distinct factors: 1. persistent occupational chronic stress and 2. high or hyper stress traumatic events. Further there may be special occupational contextual triggers of psychological trauma for crisis managers and emergency response. These trigger risks may include: interactions with disaster survivors and bereaved family members, adverse work environments such as uncomfortable or toxic environments or exposure to adverse conditions, intense public scrutiny pressure and high expectations to resolve the crisis, heightened media attention and scrutiny, being unprepared for multiagency, multi-jurisdictional operations, worry associated with knowledge of the dangers, worry or fear for the safety of one's family, witness to intentional injury or harm specially to children, prolonged intense recovery work such as searching for human remains, or intense emotional interactions with bereaved coworker family members. Such psychological trauma may persist long after a crisis has ended.
Posttraumatic stress disorder (PTSD) can develop after a person is exposed to a traumatic stress event. Although most people who have experienced a hyper stress or traumatic event will not develop PTSD, it is a substantial challenge which needs to be better addressed. According to some estimates, about 3.5% of adults in the US are experiencing some level of PTSD each year and about 9% of the population will develop it at some point in their life.
Symptoms of PTSD generally begin soon (most begin within the first 3 months after the inciting traumatic stress event), but sometimes does not begin until years after a traumatic stress event.
Those coping with PTSD may suppress or av avoid thoughts and discussion of the traumatic stress event. A typical pattern is for those coping with PTSD to vividly recall or “relive” a traumatic stress event. Those with PTSD may have trouble with their close family relationships or friendships, experience irregular sleep or appetite patterns, have emotional disfunction or problems with concentration or work performance. The symptoms of PTSD can cause communication and relationship problems including issues with trust, closeness, communication, and collaborative problem solving.
PTSD researchers have defined a clear scope of the problem and a range of concentrated occurrences (e.g. among military combat veterans, survivors of assault, victims of crime, and those who have endured natural disasters). In 2013, the U.S. Veterans Administration released a study that showed that roughly 22 U.S. military veterans die by suicide every day, or one every 65 minutes. Some suggest that this rate may be undercounting veteran suicides. Another study done by the Department of Veterans Affairs discovered that military veterans are more likely to develop symptoms of PTSD given variables such as:
- Longer time in combat stress
- Lower level of education
- More severe or extreme combat conditions
- Other soldiers around them killed or wounded
- Brain/head trauma
- Female gender
The Department of Veterans Affairs also discovered that where veterans were deployed and which branch of military in which they served can also have drastic effects on their predicted mental status after returning from service.
Issues of PTSD among first responders and active crisis mangers have been identified and increasingly are studied. For example, in the aftermath of 9/11, numerous widely reported studies of PTSD occurrence among impacted first responders (police and firefighters), emergency medical services, sanitation workers, and non-professionally trained volunteers who were involved in the recovery efforts, found rates of probable PTSD was lowest immediately after the attacks but increased from ranges of 4.8% to 7.8% to 7.4% up to 16.5% of those studied in the 6-year follow up samples. Probable PTSD was found in both the professional trained first responders and the non-professionally trained volunteers. However, the researchers found significantly higher probable PTSD prevalence, notably beginning at the 2.5 years after the event, among the non-professional volunteers. (This finding may be due to various factors including trained resilience differences, managed expectations, different post-event support networks, or volunteers performing (what for them were) atypical to the defined occupational role compared with the professional first responders.) Other variables correlated with probable PTSD included exposure intensity, earlier start date, duration of time spent on site, and constant, negative reminders of the trauma. Still other research has found that World Trade Center employees who survived the attacks have reported post-event alcohol abuse at levels about 50% higher than comparable populations
Where to Get Help for PTSD
If you are experiencing probable PTSD or other traumatic stress you have options to get help:
If you are currently in crisis, distress or experiencing suicidal thoughts:
- Call 911 now.
- Go to the nearest Emergency Room
- Call the National Suicide Prevention Lifeline 1-800-273-8255
- Contact the Veterans Crisis Line: 1-800-273-8255, press 1 (text 838255) or Confidential Veterans Chat with a counselor
If you are a veteran, there are special dedicated resources available at the following site:
People, including crisis mangers and professional responders can experience psychological and cognitive performance and emotional changes when under chronic or acute stress. We can’t fully address these issues until we acknowledge and seek to understand them. It is time for us to empower others and ourselves to better anticipate, mitigate and manage these impacts. It is also time to provide better resilience preparation, support and empathy.
In the next and final part of this 4-part series, I will briefly review some of the recent research on diminished memory and recall abilities which are associated with high stress and hyper stress experienced during crises.