Because I’m a ridiculously early riser most days, I often find myself in the kitchen listening to those pre-dawn overseas radio broadcasts from the BBC or Deutsche Welle or Radio Australia while making my morning coffee. The latter gripped my bean-grinding attention at about 4:45 one morning recently when host Natasha Mitchell was interviewing clinical psychologist Dr. Richard Bryant.
Their conversation aired on her award-winning program on mental health issues, All In The Mind. Their topic, psychological debriefing to help Australia’s traumatized flood victims, contained many unexpected gems for those of us who have gone through other forms of traumatic events – like surviving a heart attack.
Dr. Bryant, who is the director of Sydney’s Traumatic Stress Clinic and a professor at the University of New South Wales, gave an overview about Critical Incident Stress Debriefing (CISD), a counselling technique that’s been deployed in crisis and emergencies around the globe since the 1980s in situations where people’s lives were overturned in an instant by a traumatic event beyond their control.
That’s a pretty accurate description of a heart attack.
It’s been estimated that about 7-8% of the general population will develop the mental health condition called Post-Traumatic Stress Disorder (PTSD) during an average lifetime, but for survivors of military combat, rape, catastrophic natural disasters and, yes, heart attack, this number can go up to an astonishing 30%.
In fact, a U.K. study led by Dr. Susan Ayers at the University of Sussex published in the British Journal of Health Psychology confirmed that heart attack survivors may have a disturbing incidence of undiagnosed PTSD. Her research team found that 16% of survivors studied met clinical criteria for acute PTSD, and a further 18% reported moderate to severe symptoms. She explained:
” Feelings of fear, anxiety and depression are common after a cardiac event. The findings of this study suggest that a high proportion of survivors experience very severe distress. This has the potential to impair recovery, quality of life and threaten future health.”
Dr. Bryant told Natasha Mitchell, however, that the psychological help that victims of traumatic events may actually respond best to is what he calls a heightened sense of expectancy of recovery and normalcy.
“What we can tell victims is that these feelings might be there, but if they are, they’re transient. If it does persist, then there are things we can do about it. Research evidence tells us if we can heighten people’s expectancy of recovery and of normalcy, then that will facilitate a better outcome.”
Dr. Bryant’s explanation made eminent sense to me. It reminded me how helpful this expectancy of recovery and normalcy could have been for me personally before I was discharged from hospital after my own heart attack.
If only somebody could have reassured me then that many heart attack survivors experience distressing emotional symptoms – but that these symptoms are to be expected, are treatable, and will not last forever. This reassurance and expectation of recovery would have made such a difference to me.
Indeed, one of the most damaging elements of surviving such a traumatic medical crisis was the distressing conviction at the time:
“I I feel so awful now – and this will only get worse! How will I be able to stand it?
If only the cardiac nurses in the Coronary Care Unit could have explained that, although I may experience truly overwhelming feelings of fear, anxiety and depression because of what had just happened to me, such reactions are actually very normal in heart patients. In fact, some studies have suggested that up to 65% of cardiac event survivors experience some form of mental health issues, but there is help available at the earliest signs.
If only I’d trusted that being trapped in the depths of debilitating anxiety and anguish would not be permanent, and did not mean that I was losing my mind, or that I would be on mind-numbing drugs for the rest of my natural life.
The escalating grief I felt because I thought that the “normal” life I once knew and loved might now be over forever would surely have been relieved by such awareness.
The Australian radio interview also explained that people who experience trauma (like disaster victims or heart attack survivors) or witness the trauma of others (like caregivers or humanitarian aid workers) often report that they couldn’t talk to their peers about all they have experienced because they didn’t want to add to the trauma of others. They couldn’t talk to their spouse about their experience because that might traumatize them, too. Family and friends wouldn’t be able to identify with what they were feeling, and yet they felt that somehow they needed to express these to someone. That’s where CISD and/or professional talk therapy can come in.
NOTE FROM CAROLYN: In my book, “A Woman’s Guide to Living with Heart Disease“ (Johns Hopkins University Press, 2017), I included much more about how we learn to adapt after becoming a heart patient. You can ask for this book at your local library or favourite independent bookshop, or order it online (paperback, hardcover or e-book) at Amazon, or order it directly from Johns Hopkins University Press (use their code HTWN to save 30% off the list price).
Find out more about mental health concerns following a cardiac event: