It goes without saying that health and safety is of paramount importance in any industry, not least the oil&gas industry.
But while legislation and organisational efforts greatly help minimise the risk of incidents, unfortunately, wherever there are people, there will be occasional incidents that result in varying levels of harm – physical, psychological and, sadly, death.
The Health and Safety Executive’s offshore statistics for the year 2007-08 reported 509 dangerous occurrences, 44 major injuries and no fatalities (not including the marine sector, where there were fatalities).
Being struck by moving or falling objects was the most common type of accident to cause injury, accounting for 30.2% of all offshore accidents.
Considering the numbers currently working offshore – about 28,130 – objectively speaking, it would seem that the chances of being involved in such an incident are minimal.
However, recent events have highlighted that when certain factors come together, quite catastrophic events can occur – sending an emotional ripple effect throughout the industry and all those connected to it.
So what formally defines an incident as “traumatic”? The American Psychiatric Association (2000) classifies a traumatic stressor by taking into account both the objective nature of the event itself (life-threatening, injurious) and the individual’s response to the incident (extreme helplessness, fear, horror).
The individual may be directly involved in the incident, be a witness to it or experience trauma via learning about an event. Formal definitions aside, it is the individual’s perception of what is traumatic to them that really matters and needs to be respected.
Those involved in helping support individuals can also be exposed to stressful material, but good self-care, support and supervision can help mitigate the risk of problems.
When experiencing a traumatic event, certain physiological “survival” mechanisms activate, such as raised heartbeat to get oxygen to muscles, hyper-vigilance (looking out for danger/threat), and hormonal release (adrenaline) to “fuel” such responses.
These reactions are often referred to as our “fight or flight” response, evolved to assist us tackle a perceived threat or, indeed, escape from it. However, when a response is extreme and goes beyond our natural coping threshold, we may experience more of a “freeze-like” state in that we feel paralysed, surreal and numb or detached in some way.
Such extreme neurobiological responses can impair the manner in which the mind processes events at the time of the trauma, affecting the brain’s normal integration of incoming sensory information into memory.
This impaired information processing may give rise to distressing after-effects for the individual, such as intrusive images, sounds, smells and emotional responses: avoiding places, objects or people which act as reminders; feeling emotionally “numb” and more withdrawn; being irritable with others; concentration problems, and drifting off into dream-like states.
Such reactions can be quite frequent in the early days after the event, but tend to reduce in frequency and intensity over the course of a month or so as the body and mind go through their natural recovery processes – unless there are subsequent stressors.
It is this unique collection of biological processes that makes traumatic stress different from “normal” stress.
What may help following such an event is if the person affected has a good social support network of family and friends to provide practical and emotional support and help re-establish a sense of safeness. Trying to re-engage in normal day-to-day routines may also be helpful to establish some sense of normality and connection with the world again, and we should not underestimate the importance of eating and drinking well.
When there is a traumatic bereavement, the process of recovery may be different in that there is a traumatic stress aspect as well as the loss and grieving processes.
It may be helpful for those involved to receive some practical trauma education and information on what reactions might be experienced.
Such “psychological first aid” may not prevent the development of more extreme conditions such as post traumatic stress disorder (PTSD), but it can help people feel able to seek help at an earlier point in time if their reactions get worse.
Formal therapy is not needed at this early stage and the National Institute for Clinical Excellence (NICE) guidelines on the management of PTSD (2005) recommend a four-week “watchful waiting” period post incident before assessing for concerns that may require formalised therapy, although medical intervention may be required before this, depending on the individual case.
NICE does state that practical social-emotional support should be offered in the acute phase of a trauma. If someone’s symptoms are not improving or deteriorating, they should visit their GP.
One must also remember that what people “bring” to an incident, such as prior trauma history or personal beliefs, may influence their interpretation of the event and emotional response to it. Other factors, such as the nature of the incident in terms of its predictability, suddenness and duration, are also put into the “trauma pot” – it is not as simple as “X” causes “Y”.
Therefore, it is important to note that not everyone will experience an event in the same way – we are all different and this is reflected in the different recovery timescales and in the different types of support that people find helpful to them.
What appears evident is the overall tendency toward human resilience in the face of adversity, such as Piper Alpha, Hillsborough and the London bombings, and the manner in which people and communities pull together to support those in such times of need.
Useful numbers include the Samaritans on 08457 909090 or the Sudden Trauma Information Service Helpline (STISH) on 0845 367 0998.
Jamie Patterson is a cognitive-behavioural psychotherapist at Abermed, which specialises in providing medical and occupational-health services to the international oil&gas industry. For more information, see the website at www.abermed.com