Today’s post is a brief overview of the 6 Cs Model for Psychological First Aid.
I know I promised you a story about treating colds with Chinese Medicine, but given the events in the south of Israel over the last few days I decided this was a more urgent subject.
Why You Should Read This
Learning how to help people suffering from emotional shock has two main benefits for you.
- Just like with CPR, the more people who know psychological first aid, the safer and healthier our society is as a whole. Which makes life better for you too.
- You will learn how to protect yourself. Taking constructive action in the case of a traumatic event is the best way to help yourself emotionally.
What Does Psychological First Aid Even Mean?
Psychological first aid is a very simple method of helping people who are suffering from psychological/emotional shock. It takes around one to two minutes, and can greatly increase a person’s immediate well-being, as well as help prevent long term effects of shock like PTSD.
How Woo-woo Is This?
The 6 Cs Model was developed in Israel by Dr. Moshe Farchi. It was adopted by the IDF in 2013 and as of last year the Israeli Health Ministry announced that civilian first responders must be trained in this model, and recommends the general public be familiar with the guidelines for treating acute trauma using with method.
A Very Simple Description Of How Brains Work
Our brains are made up of a variety of structures. The area of the brain that is dedicated to survival (the inner lizard from a few weeks ago), the parts of the brain that manages our complex emotional life (our inner monkey) and the thinking brain live in a constant state of dynamic tension.
If we are mentally and emotionally healthy we can go back and forth between them as needed. This is actually a pretty good definition of mental health.
When you have an algebra test you need your cognition to take the lead and not let you get caught up in how you feel about your crush sitting right next to you.
When you are looking at your first grandchild your want to be able to fully embrace of love you feel without thoughts or fear distracting you.
And when you hear a red alert or a car runs a stop sign right in front of you, your lizard takes the wheel. The other two parts of the brain are temporarily bypassed as survival becomes the priority.
How The Lizard Works
When the lizard takes over, it ‘turns off’ the thinking brain, quits dealing with emotions, and leaves you running on instinct. It does this for two reasons.
- Energy conservation. Your brain is about 2% of the total weight of your body. But it usually takes about 20% of the blood and oxygen of every heartbeat. When your survival might depends on outrunning danger, redirecting blood away from the energy-guzzling thinking brain gives your body more resources to work with.
- Thinking takes time. You save valuable seconds by switching from thinking to reacting instinctively. Sometimes seconds count.
Hugely Important Side Note
By the way, it is very important to remember that when a person is dealing with a traumatic situation they cannot think logically. Blaming a person for how they reacted to trauma is unfair. Designing things on the assumption that humans can think clearly while scared is a terrible idea. There is a reason the law makes emergency exit signs big and colorful.
Well Done, Lizard! We Survived! Now What?
After the danger has passed, it is important that the brain return to its usual balance. Ideally the thinking brain with turn back on first, letting you deal with the current situation: calling your family, talking to the police, finding someone to take you home. Only after you are completely safe do you want to begin processing the emotional aspects of the event.
In A Less Than Ideal Situation
Sometimes after being severely scared, the monkey brain will kick in to overdrive. When that happens, the emotional brain will get caught up in feelings of isolation, helplessness and confusion, and will take so much energy that it stops the thinking brain booting up.
This is a big problem, because with the thinking brain not working, the person is unable to do the things that would help counteract the emotions they are feeling. They can’t call for help, and so feel more alone. They can’t do anything to help themselves and so feel more helpless, and they can’t think through what happened (because the thinking brain is turned off), and so feel more confused. This can become a very harmful self-perpetuating cycle.
What Do We Do Then?
If this should happen, the last thing the person in shock needs is to be hugged and asked how they are feeling. Thinking or talking about their emotions keeps the monkey brain running and suppressing the thinking brain. Feeling that other people need to take care of them increases the feeling of helplessness. What we need to do is break the cycle and get the brain working normally again.
Sounds Great. How Do We Do That Exactly?
This is where the 6 Cs come in (remember them? from way back in the beginning?).
For each component of the cycle of shock we have a corresponding response.
1. Isolation – Make a Connection to the person and and a Commitment to their safety
Counter isolation with engagement.
For example, say, “You are not alone, I am here with you!”
If you know the person’s name, use it.
2. Helplessness – Challenge the person and give them Control
Counter helplessness with effective action. Encourage them to perform simple, effective actions.
For example, have them count the people present, collect phone numbers or call family.
3. Emotional Overwhelm – Cognitive Communication
Ask simple questions requiring logical thought. Just like overactivity of the emotional brain shuts down thinking, activating the thinking brain turns down the strength of emotions.
Counter emotional overwhelm with factual questions about the event.
For example, “How long have you been here?”, “Where were you going?”, “Would you rather to straight to the hospital or call your family first?”
4. Confusion – Continuity
Create a timeline of the event. When the thinking brain is turned off, memory are not processed normally. Helping the person create a coherent timeline helps get the brain back on the right track, and lets them realize they are out of danger.
Emphasize that the danger is over.
This Is A Really Long Post. Couldn’t I Just Watch A Video?
Sadly, while the 6 Cs model is starting to be taught outside of Israel, I couldn’t find any videos in English. Below you can watch the Health Ministry’s official video demonstrating the method in Hebrew, and the IDF’s video in Hebrew with English subtitles.
Please note that the videos contain content that certain people may find disturbing or triggering such as a recording of an air raid siren.
Click here if you would like to read an in-depth article about the 6 Cs model published in the International Journal of Emergency Mental Health and Human Resilience.
Check back next week for (God Willing) anecdotes about sick students. Or sign up here if you would like to get your amusing stories in email form.
Really well written, very informative! (I especially liked the “woo-woo” reference.)
Thank you! I know your knowledge of good writing is not to be sneezed at 😉
[…] For more about the affects of extreme stress on the body and brain, you can also check out this post from the archives: Psychological First Aid […]