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Protección Civil
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Coordinación Nacional de Protección Civil
CENAPRED
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00:00:00
How are you all, allow me
00:00:03
to introduce myself. I am Dr. Alejandro
00:00:06
Molina López. I am a
00:00:08
master psychiatrist and doctor of science. I
00:00:10
am currently a national researcher
00:00:13
at the National Council of Science and
00:00:16
Technology. I am
00:00:17
very grateful to Al Cenaprece for
00:00:21
doing me the honor of doing this.
00:00:24
invitation to talk to you about a very
00:00:25
important topic. It is a basic topic so
00:00:29
that we understand that not all
00:00:31
interventions in emergencies are
00:00:33
the same. There are interventions that are
00:00:36
wanted in a matter of how
00:00:41
quickly they can be presented
00:00:44
after a disturbing event.
00:00:47
However, let's go. Let's see that the time
00:00:49
after a disturbing event
00:00:51
occurs there are also other types of
00:00:55
interventions that can be given and
00:00:58
after even more time,
00:01:01
other types of interventions must be given and as
00:01:05
more time passes these
00:01:07
interventions become increasingly more
00:01:10
complex, it is seen that they become increasingly
00:01:15
technically
00:01:17
important in terms of their
00:01:19
intervention and we will see in a
00:01:23
universal principle that sometimes when we
00:01:26
intervene in the simplest way
00:01:30
but at the most critical moment of a
00:01:32
situation, the benefits can be
00:01:36
incalculable. over time and
00:01:39
that if we focus on that first
00:01:43
intervention, it is the most
00:01:44
basic intervention that does not require
00:01:51
very advanced knowledge in psychology,
00:01:53
which is psychological first aid.
00:01:55
If we can give it at the
00:01:58
right time, there may be a
00:02:00
incalculable benefit over
00:02:03
time and on the contrary, when we
00:02:07
have these interventions in time, the
00:02:09
consequences on mental health in the medium
00:02:12
and long term can be very strong.
00:02:15
I am going to talk to you about these
00:02:17
first,
00:02:19
second and third psychological interventions,
00:02:22
for this we have to understand the
00:02:24
definition of crisis in mental health
00:02:26
we understand crises in many
00:02:29
ways but we must understand
00:02:32
something very important: the mind
00:02:34
or the mental system as well as other
00:02:36
types of
00:02:38
biological systems such as the
00:02:41
respiratory system or the
00:02:43
nervous system or the digestive system, let's go. to
00:02:48
think that there is a mental system
00:02:51
no we are not going to think there is a
00:02:54
mental system that in a way functions within
00:02:57
a parameter of
00:03:00
stability that is called homeostasis and
00:03:03
this homeostasis can be altered or
00:03:06
can be threatened by different
00:03:09
internal or external stressors
00:03:13
this when when homeostasis is
00:03:16
threatened because homeostasis is a
00:03:19
continuum that has a minimum value and a
00:03:21
maximum value if we see it, for
00:03:24
example with body temperature, the
00:03:27
body temperature is 36 degrees
00:03:30
Celsius if a person is in a
00:03:32
very cold place and that temperature drops to
00:03:35
35.5 the person will begin to have
00:03:39
different conditions where he or she will
00:03:43
try to fight to keep the
00:03:46
taxis but will reach a time
00:03:48
when he or she will not be able to endure being for a long
00:03:51
time with temperatures below 35
00:03:54
degrees Celsius. and you will fall into a
00:03:57
state where you lose some taxis, which
00:03:59
is called collapse, on the contrary, a
00:04:01
person in a desert because the
00:04:03
body temperature can rise to 37 or
00:04:06
38 degrees Celsius,
00:04:08
the body will use
00:04:10
mechanisms to try to conserve the
00:04:13
deep taxis but these mechanisms are going to
00:04:15
be limited and in the same way we
00:04:17
can also fall into a collapse in the
00:04:21
mental system. Something similar happens.
00:04:24
We function in a balance perhaps not
00:04:28
measured in degrees Celsius but in
00:04:30
a balance in which our
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emotions
00:04:33
and our thoughts They function at a
00:04:37
certain speed and at a certain fluidity
00:04:39
when there are certain stressors, since
00:04:43
this mechanism and this homeostasis
00:04:45
can be threatened and
00:04:48
a series of periods occur just before the collapse
00:04:52
in which homeostasis is preserved but
00:04:55
already begins to show signs of being
00:04:58
lost in this part. It is called a crisis,
00:05:01
therefore our first mistake is
00:05:05
to consider the crisis as something
00:05:07
pathological or something that has to do with
00:05:11
illness. The crisis is a
00:05:14
completely normal phenomenon in which
00:05:19
the loss of homeostasis is being threatened
00:05:21
and the body is doing the same.
00:05:24
possible to preserve itself for the same reason,
00:05:27
then we must understand that the
00:05:29
crisis is part of a normal phenomenon and
00:05:33
we are going to present it when
00:05:36
we are faced with some condition or
00:05:39
situation that implies threat or
00:05:44
damage, that is, a disturbing phenomenon,
00:05:48
all the crisis is the presence of
00:05:50
an event or situation beyond the
00:05:53
coping mechanisms
00:05:56
with ping kong and latina no no and ccoo ping
00:06:00
kong ni latina is the
00:06:03
Anglo-Saxon term to understand
00:06:05
coping,
00:06:06
the efforts that a person must make
00:06:09
to adapt to some quote
00:06:11
or ping kong and is copying is something very
00:06:16
different and so there are three elements
00:06:19
in a crisis number one there is a
00:06:22
precipitating event number 2
00:06:25
the event leads to subjective distress
00:06:27
because number 3 the usual
00:06:30
coping mechanisms are failing
00:06:34
so that something very important and we have
00:06:36
seen it in this gigantic disturbing event
00:06:39
that has been the
00:06:41
kobe 19 pandemic,
00:06:43
a crisis not only affects here the
00:06:47
degree water high at level a I am going to use
00:06:51
this a pointer level a is the
00:06:54
individual but the level the individual
00:06:56
has another series of conditions or another
00:07:00
series d
00:07:03
social circle which could be your family it
00:07:06
could be the work environment in the
00:07:08
school environment that your condition affects
00:07:11
or has a certain
00:07:13
effect on it in the disturbance that
00:07:16
the individual is experiencing in the same
00:07:19
way there is a larger circle that could
00:07:22
be the bereaved of the extended family or
00:07:25
in unemployment or the entire
00:07:28
community then we will see that not only does it
00:07:31
affect us but it
00:07:34
also affects other social circles
00:07:36
and in the same way what is
00:07:38
happening in other social circles
00:07:40
affects the person in Individually,
00:07:46
we saw it many times in the pandemic,
00:07:49
there were people who had a
00:07:52
much higher level of stress, for example,
00:07:55
colleagues in the health profession who
00:07:58
had to continually face being
00:08:00
in the line of fire on the front lines
00:08:03
of the pandemic, we said,
00:08:07
we thought that They were the professionals
00:08:10
who were most affected and on the
00:08:12
contrary we said or thought no because the
00:08:15
people who are at home without
00:08:19
working receiving their salary are the
00:08:21
people who have the least stress, they have
00:08:23
very wrong loans even though
00:08:27
the people at a given time who
00:08:30
had the privilege of being able to remain
00:08:35
at
00:08:37
home without major stressors the
00:08:41
fact that there was confinement and the
00:08:44
fact that other people were
00:08:46
affected and the confinement itself
00:08:50
ended up being a disturbing event that
00:08:53
triggered multiple mental health problems
00:08:58
I can speak without fear of I am wrong
00:09:02
that absolutely no one was exempt from
00:09:07
stressors during the gang,
00:09:10
whether we received them directly
00:09:14
or whether we received them indirectly
00:09:17
from any of these circles and
00:09:19
that finally the confinement, which was
00:09:22
a measure to prevent us from
00:09:25
falling into three
00:09:28
contagion conditions the same confinement
00:09:32
ended up being a disturbing event that
00:09:36
manifested the presence of a whole series
00:09:38
of these signs so I can
00:09:41
talk about Dr. Hans Sail Dr.
00:09:44
Hans Eisler was a
00:09:48
Hungarian endocrinologist who was
00:09:50
the national endocrinologist who was later made
00:09:52
Canadian he established that any phase
00:09:56
of stress, defining stress
00:10:00
as this physiological process in which
00:10:04
the organism, any organism that
00:10:07
is in charge of a situation that is
00:10:09
disturbing, will first have an
00:10:12
alarm phase, that is,
00:10:14
alarms
00:10:17
related to what is happening will be triggered. It is the contact
00:10:21
with the disturbing phenomenon and then there will be
00:10:24
a phase of resistance which is
00:10:26
precisely this phase that we could
00:10:28
define as a crisis where
00:10:32
homeostasis is being threatened and the
00:10:35
organism uses a series of
00:10:38
reactions with the aim of trying to
00:10:40
preserve it. If these reactions are
00:10:45
satisfactory,
00:10:47
homeostasis returns, but that does not mean that the body
00:10:51
returns to the same taxis because
00:10:53
this part expends energy with the
00:10:57
objective of recovering the two taxis.
00:11:00
However, if this phase of resistance is
00:11:02
not successful, the person can We
00:11:11
will see then that
00:11:14
overcoming a crisis does not mean success in all
00:11:17
cases because the person can
00:11:22
but in the process of the crisis he could have
00:11:25
had a condition. of
00:11:29
energy loss, this loss of
00:11:32
energy is called load, static is
00:11:35
the energy that the organism has to
00:11:37
invest in order to maintain
00:11:40
homeostasis. We are
00:11:46
also going to see that not all
00:11:48
people react the same. We are going to have
00:11:50
an example where Let's imagine that there are
00:11:52
five people inside a bank and
00:11:55
at that moment some robbers arrive to
00:11:58
rob the bank
00:12:01
and we see that the five people are
00:12:02
obviously scared but not all of them are
00:12:05
scared.
00:12:07
Of those five people, there is one who is
00:12:10
having a very crying crisis. loudly,
00:12:13
three other people stand up and say
00:12:16
oh, what an outrage, what a horror, what a step
00:12:18
they begin to call their family and
00:12:21
react as much as possible with a
00:12:23
certain assertiveness and the last one does not say
00:12:27
or do anything at all, he is
00:12:30
completely impassive, undaunted, no, he doesn't
00:12:34
move, yes I I would tell you which of those three
00:12:37
he has the most serious reaction.
00:12:40
Surely everyone would tell me that
00:12:42
obviously the most serious is the one who has
00:12:44
the crisis, the one who is screaming and the one who
00:12:46
is crying.
00:12:47
In second place are those who are
00:12:50
calling their family and in third place. place
00:12:53
is the one that is calmest of all
00:12:55
name that what great security here in the
00:12:59
third I wish we were all like him if
00:13:04
I told you that it is exactly the opposite
00:13:06
that the one who has the
00:13:09
most serious psychological reaction is the one who seems calm
00:13:13
and I am going to tell you explain why because you
00:13:17
are not calm at all you are experiencing
00:13:20
such intense terror that you are not even
00:13:23
experiencing it consciously and you are
00:13:26
probably experiencing a phenomenon
00:13:28
called dissociation and this
00:13:32
phenomenon of dissociation is accompanied
00:13:33
in the most serious cases of stress in
00:13:36
which is not presenting not even the one
00:13:39
who has the crying crisis nor the
00:13:42
seconds who are reacting in a
00:13:43
more assertive way
00:13:46
obviously when the emergency bodies arrive
00:13:49
who they are going to attend to first
00:13:51
because the one who has the crying crisis
00:13:53
thinking that he is the most serious and the
00:13:56
last one is going to go completely
00:13:58
unnoticed, they are going to think
00:14:01
that they are ageless, this is where they
00:14:04
operate, this is precisely the nebot in
00:14:07
which it is called casyc, it
00:14:10
seems to me that the author of the casyc mnemonic
00:14:13
is an author of intervention in
00:14:16
crisis that is called more like you'
00:14:18
it seems to me that I am not completely sure
00:14:21
if I am talking about another author of the
00:14:24
author if ours I am issuing the
00:14:25
original author I apologize for the
00:14:28
mnemonic almost that it is precisely this
00:14:30
technical demo that has to do with the
00:14:32
behavioral part That is, the part that
00:14:35
is observed, the
00:14:37
affective part, that is, what has to
00:14:40
do with emotions, the somatic part,
00:14:42
which is physical sensations, the
00:14:45
interpersonal part, which has to do with how the
00:14:48
person has changes between one person
00:14:50
and another, and the cognitive part, that is,
00:14:52
how the person processes these we are going to
00:14:55
see that in the term of almost the person
00:14:59
at a given moment, for example, the
00:15:01
person who cries a lot is
00:15:03
having a very
00:15:06
obvious symptom, which is the
00:15:09
crying behavior, is going to have a some
00:15:13
unbridled emotions of sadness in the emotional circle
00:15:17
probably have some
00:15:20
somatic discomfort and it will be interpersonal or
00:15:22
cognitive
00:15:24
thank you and then finally what
00:15:29
follows is what happens with the
00:15:32
people who are talking to your house and
00:15:33
who have a different feeling
00:15:38
They will be presenting
00:15:43
different somatic and affective behavioral manifestations and probably the
00:15:46
person who does not open so much
00:15:49
apparently behavioral has nothing
00:15:52
is perfectly calm but it is very
00:15:56
likely that he will be cognitively
00:15:58
this
00:16:00
frankly chaotic
00:16:02
probably also has an
00:16:04
affective situation that we are not seeing
00:16:06
directly so it is very It is important
00:16:09
that first of all we detect that not
00:16:12
all people react the same and
00:16:15
something very important is that we must get rid of
00:16:18
the idea that a stressor, if it is small,
00:16:22
must also cause
00:16:25
equally small emotions, many times
00:16:28
this is disproportionate, sometimes it depends
00:16:31
on the capacity of each person. A
00:16:34
certain stressor is going to generate
00:16:37
reactions that do not have to be
00:16:41
proportional to the stress or it is very
00:16:43
important that we understand this and
00:16:45
secondly never dismiss that
00:16:48
because from our
00:16:51
perspective we believe that a stressor
00:16:53
is not serious
00:16:54
let us dismiss the expression of another
00:16:56
person because here We have examples
00:16:58
precisely of the quasi-
00:17:01
behavioral phenomenon, it does not mean that all
00:17:03
people have the same behavior,
00:17:06
for example, social isolation,
00:17:07
loss of interest in activities,
00:17:10
use of affective substances, it would be the
00:17:13
feeling of being surpassed, for example,
00:17:15
interpersonal somatics and with that and all of
00:17:18
this Comrades will address it, I
00:17:21
also thank Dr.
00:17:24
Rodrigo Garibay for this writing,
00:17:27
Al Sena, Freddy and my friend, and this very well,
00:17:36
very well prepared colleague in the matter of
00:17:38
disasters who also helped me
00:17:40
understand the system much better, almost than
00:17:44
now. We are going to understand then what
00:17:47
are the first,
00:17:49
second and third instance interventions.
00:17:52
We are going to understand that the
00:17:54
first instance intervention is a more
00:17:57
recent and more acute intervention that occurs hours or
00:17:59
days after undergoing a stressor
00:18:01
in the place that occurs in the stress
00:18:03
now and that is what we call
00:18:06
psychological first aid and it is the
00:18:08
intervention that anyone
00:18:10
anyone regardless
00:18:14
of their educational level or their cognitive level
00:18:20
anyone can train to
00:18:23
give psychological first aid the
00:18:26
second instance intervention is the
00:18:28
subacute intervention that is already It does not
00:18:31
occur in the disaster zone but it occurs,
00:18:33
for example, in a more professional environment
00:18:35
such as an office, it can be weeks or
00:18:38
months later and it does not mean that it is one,
00:18:41
as psychological first aid
00:18:43
can be several and the person
00:18:46
is generally a health professional.
00:18:49
Here the ideal is that you have a degree and a
00:18:52
professional license to practice
00:18:55
and thirdly there is the
00:18:57
third instance intervention which is a
00:19:00
chronic intervention that can take
00:19:02
a long time and is carried out by a psychologist or
00:19:05
psychiatrist but here it is not just any
00:19:08
psychiatrist psychologist, you must have a
00:19:10
very specialized training in the
00:19:13
treatment of conditions that are not
00:19:16
processed and are called trauma, we
00:19:19
would all leave that the ideal then
00:19:23
is this the third instance because
00:19:25
it is given by the most specialized people
00:19:30
and this is not the case either. The ideal intervention
00:19:34
is this one of first instance in the
00:19:37
city not exactly a psychologist with a
00:19:41
doctorate at Harvard but the dau
00:19:43
brigadista is given by a paramedic the age and
00:19:46
a this and even a volunteer
00:19:50
remember that the volunteers have
00:19:53
to adhere to the protocol of this management
00:19:58
that is taking place in the place and something very
00:20:01
important is that this one is that it is
00:20:05
simple it is that it gives to anyone who does
00:20:08
not have a profession it
00:20:10
is going to prevent this it is going to prevent you from
00:20:14
being
00:20:16
or the 3rd instance that is to say it is so
00:20:20
simple when it occurs at the moment
00:20:22
Appropriate treatment can have incalculable beneficial effects.
00:20:29
What happens is that many times they do not
00:20:31
have the sensitivity
00:20:33
or the disposition to understand what
00:20:37
the brigade members believe that they have already done
00:20:40
enough to save lives, they have already done
00:20:43
enough to care for and
00:20:45
perhaps they care for one or two who They were
00:20:47
visibly upset and they say the others
00:20:51
had nothing, the others were
00:20:52
calm and one did not even move,
00:20:56
this important achievement was so important that
00:21:00
nothing happened, they are very wrong,
00:21:03
only those who
00:21:05
were constructively more evident were attended to, but
00:21:09
not all the others. It was considered that
00:21:11
they were also having a
00:21:13
disturbing phenomenon and that this
00:21:15
disturbing phenomenon, if it did not occur within
00:21:18
five or ten minutes after the
00:21:21
disturbing event, was going to manifest itself for a
00:21:23
long time
00:21:25
and that later they would probably need
00:21:28
this intervention,
00:21:30
but if when the person began to
00:21:32
feel unwell they would she faces the
00:21:35
stigma and the ignorance and the
00:21:37
indifference of a society where
00:21:40
I said, instead of taking her to a
00:21:42
mental health professional, she is told to
00:21:44
forget it, give it a try, I know
00:21:48
people like this who have faced
00:21:52
worse situations than yours. "You are
00:21:56
alive," other people explained under the
00:21:59
rubble, "it occurs to us to give a series of
00:22:02
comments that could seem very well-
00:22:05
intentioned but that ultimately do
00:22:08
more damage. The only thing that is being done
00:22:11
is
00:22:13
that the person later needs this
00:22:16
type of intervention or does not even
00:22:18
want to take this type of intervention
00:22:22
and we got to know people who
00:22:25
lived through the earthquakes of '57, the earthquake of
00:22:29
'85 and the earthquake of 2017 and who had
00:22:34
re-experiencing that they had nightmares
00:22:38
that they had discomfort that they had avoidance
00:22:40
for more than 30 years and in their life they
00:22:44
visited a doctor's office. a psychologist
00:22:46
because everyone told them that a
00:22:48
psychologist is for crazy people,
00:22:50
it's terrible. That's an example of how
00:22:54
there is a chain where we
00:22:56
feed it with stigma. If we don't
00:22:59
fight it in an adequate way,
00:23:02
then the first psychological help is
00:23:06
that help. which refers to the
00:23:08
human response of support to another human being.
00:23:11
Look carefully here, we should not
00:23:14
get confused, although psychological help
00:23:17
says psychological, so nothing, a
00:23:19
psychologist does not exactly have to
00:23:23
be a psychologist, he is a human being who supports
00:23:26
another human being, that is, he is a
00:23:28
humanitarian intervention in which
00:23:32
the safety,
00:23:33
dignity and rights of people must be respected,
00:23:35
the action itself must be adapted to the
00:23:38
culture of the people, we must be
00:23:40
aware of other response measures
00:23:42
and we must take care of ourselves or to
00:23:45
oneself and here it is precisely the
00:23:48
three is that what are those three S's
00:23:52
this is
00:23:55
a
00:23:56
contribution from Dr. Valerio Villamil
00:23:58
with whom I began to give these
00:24:04
psychological first aid training at the National Institute of
00:24:06
Psychiatry more than 10 years ago
00:24:08
currently the Dr. Valerio Villamil
00:24:10
is in the United States of America
00:24:12
precisely supporting these migrants
00:24:16
and vulnerable people right in the
00:24:19
United States and this matter of Dr.
00:24:22
Valerio Villach and Dr. Pérez
00:24:24
Villamil established that the 13 are to
00:24:27
evaluate, listen and link, evaluate
00:24:31
means,
00:24:33
in some way, find out of what
00:24:36
is happening, listening
00:24:38
means that we understand or try to
00:24:41
understand what the person is saying and that the
00:24:44
person feels understood and linking
00:24:48
means referring to another place,
00:24:52
here it does not say giving advice, here it does not say
00:24:55
giving motivation, it
00:24:58
simply means that the person feels
00:25:01
accompanied Later
00:25:04
some of my colleagues will talk about the
00:25:07
1097 competency standard is a
00:25:10
competency standard approved by the
00:25:12
being and knowing what it does that supports
00:25:18
the certification of the first two
00:25:20
psychological threads of people but in
00:25:23
this first talk where I I am going to
00:25:26
talk about the three interventions. I am
00:25:29
interested in you
00:25:31
and stick with this definition of
00:25:34
evaluating, listening and linking, and the most
00:25:37
important thing is to take care of ourselves,
00:25:40
take care of our own health and well-being, make
00:25:42
sure that we are
00:25:44
physically and emotionally capable,
00:25:46
take care of them to take care of others. in
00:25:49
adequate conditions and if you are a member of
00:25:52
a team, also worry about the
00:25:54
well-being of your colleagues when
00:25:57
we see colleagues who feel
00:25:59
bad, who feel nervous, who are
00:26:02
crying,
00:26:05
it is very wrong for us to judge them, to
00:26:07
say no abud, this is not for him, look,
00:26:10
nothing more. In other words, he is there to help others
00:26:12
and starts crying,
00:26:14
brave interventionist, no no no no,
00:26:17
wait a little while
00:26:19
that is a completely normal human response
00:26:23
and even if you have a master's degree and doctorate at
00:26:26
Harvard
00:26:27
that is not exempt from the fact that you
00:26:30
are also being this
00:26:34
is a victim from stress and also that
00:26:37
your energy from taxis ends and your
00:26:41
charge to static ends up overflowing.
00:26:44
It is very important that we do not
00:26:47
judge our colleagues who may
00:26:49
also have a crisis and
00:26:52
support them in crises and
00:26:55
we too can fall into a crisis and
00:26:57
have the maturity and courage to ask for
00:27:01
help, not to say no, I can't, I'm going to
00:27:04
continue in the end because that
00:27:06
energy is really going to run out and this is going to
00:27:08
impact the users that we
00:27:10
apparently want to help, first
00:27:13
we have to be well.
00:27:17
Now I am going to talk about
00:27:19
second-order crisis intervention models,
00:27:21
which are those that already occur
00:27:25
in a situation that is more professional.
00:27:29
This image, for example, we see that it is a
00:27:32
paramedic, there are two people who are
00:27:34
here and in one place a A little
00:27:37
improvised, the red sign is
00:27:41
characteristic of psychological first aid,
00:27:44
but in an office, for example,
00:27:49
other types of interventions are already given
00:27:53
and here I am going to mention several authors
00:27:57
here, for example, Collins tells us that the
00:28:00
ABS model of crisis intervention
00:28:02
It should be focused on the responses a b
00:28:05
c d and English affective behavior and
00:28:09
means behavioral cognitive
00:28:12
development and ecological we could seem
00:28:15
a little similar to the almost model but
00:28:18
in Spanish and finally we are going to see that
00:28:21
the same phenomenon is being described,
00:28:23
each of them must be discarded.
00:28:27
these situations in particular
00:28:29
the author of crisis intervention that
00:28:32
in particular I am not saying that
00:28:34
others do not have that characteristic or rather
00:28:38
well the one that I have read the most in
00:28:43
particular is doctor albert roberts
00:28:45
he said that there is a model that It is called
00:28:48
act who, first during a crisis,
00:28:51
we must first have a link, what does it
00:28:55
mean to approach
00:28:57
immediate needs and move away from threats? That
00:29:00
could be understood as the
00:29:03
first-order intervention that we do
00:29:06
after a disaster. What we do is
00:29:09
first get people out of there.
00:29:11
A beam is going to fall on them or from a fire or
00:29:15
incorporate them into a shelter, give them
00:29:19
something to drink, but if they don't have
00:29:22
clothes, give them something to wear, a
00:29:26
bottle of water, we never start
00:29:29
saying this,
00:29:32
start valuing life, look at this, you
00:29:35
just lost your house. It was something material
00:29:37
that we do not do in any of the
00:29:40
interventions
00:29:42
that we usually do because when we see
00:29:46
a person crying that constitutes in
00:29:49
our brain a
00:29:51
disturbing event for us
00:29:54
interveners because obviously a
00:29:57
crying person is recorded in our
00:29:59
brain with an instinctive signal that
00:30:02
we have to help the other person
00:30:04
we have to be
00:30:07
instinctively empathetic that's why we cry and that's why
00:30:09
we have this
00:30:13
facial characteristic the tears the
00:30:16
characteristic gestures because we have that
00:30:18
engraved as an instinctive imprint
00:30:23
in which when we see someone
00:30:26
crying our eyes have to wake up.
00:30:27
events or our
00:30:30
cognitive processes of empathy to understand that
00:30:33
that person is suffering and we have to
00:30:35
modify our behavior but
00:30:38
it seems that the opposite happens, we try
00:30:40
to avoid that disturbing stimulus and
00:30:45
we try to prevent the person from having
00:30:47
that catharsis, which in the end is a
00:30:50
totally process. physiologically
00:30:51
totally normal, crying and the
00:30:56
condition that these people have is a
00:30:58
normal phenomenon, so this fact that we
00:31:02
focus on calming the person in a
00:31:05
certain way
00:31:07
in people who have a situation
00:31:09
where the virus is not 3 can be
00:31:13
traumatizing because if there is We have to look for more
00:31:16
than calm her, take her to places where there is not
00:31:20
an excessive condition of stimuli
00:31:25
but not so much because we have to more
00:31:28
laughable then connect to
00:31:31
support groups would be the second level or
00:31:34
crisis intervention and
00:31:36
trauma management after the crisis which would be the
00:31:38
intervention from third parties,
00:31:42
according to a Spanish author, the
00:31:46
first-order intervention involves establishing
00:31:47
contact, examining the dimensions of the
00:31:50
problem, exploring the possibilities,
00:31:52
helping to initiate some type
00:31:55
of concrete action and recording the
00:31:58
follow-up
00:32:00
and Roberts's seven-step model,
00:32:03
we realize it is the same
00:32:05
phenomenon. but with a different approach,
00:32:09
first, estimate the stability of the
00:32:13
second, establish rapport, laporta, this
00:32:15
is a
00:32:17
psychotherapeutic term that implies gaining the
00:32:21
patient's trust and there is
00:32:23
something called the therapist alliance,
00:32:26
identifying the main problem,
00:32:28
allowing people to show emotions, exploring
00:32:31
alternatives, developing a plan.
00:32:32
specific and establish a follow-up and
00:32:36
in the third order intervention the
00:32:38
intervention in trauma
00:32:40
we are going to say divide first that
00:32:42
strauss which is the extreme human experience
00:32:44
that constitutes a serious threat
00:32:46
to the physical or psychological integrity of
00:32:48
a person who has responded with fear
00:32:50
hopelessness winter's these They are
00:32:53
disturbing phenomena, a
00:32:55
jump from sexual harassment, a threat
00:33:02
and the first-order mental health response
00:33:05
must be immediately after
00:33:08
this
00:33:09
and we must understand the difference between
00:33:12
stress and trauma. Stress is part of
00:33:14
life according to Sheila and it is any
00:33:17
stimulus or situation of change that
00:33:19
caused an observable reaction,
00:33:22
however, except for trauma, it is no longer
00:33:25
normal. Trauma is a reaction of the
00:33:27
brain
00:33:28
associated with a poor adaptation to
00:33:32
a stimulus that is generating
00:33:34
persistent excitement
00:33:38
when a person is exposed to a
00:33:40
disturbing phenomenon. The first
00:33:44
one is The first diagnosis,
00:33:47
second,
00:33:49
the DSM 5 series is this one called
00:33:56
acute stress disorder. Acute stress disorder is for a person who
00:33:58
presents some type of
00:34:00
disturbing phenomenon or witnesses some type of
00:34:02
disturbing phenomenon in which, well, his or her
00:34:05
life was even in danger. and it can
00:34:07
present, among others, daze,
00:34:10
numbness, lack of
00:34:12
emotional response of realization,
00:34:14
depersonalization or dissociative amnesia.
00:34:18
If we remember the example
00:34:22
of the people in the bank, the
00:34:24
person who was accused
00:34:26
seems to be exactly like how
00:34:28
this person would be and we already know that
00:34:31
that person He is neither calm nor well,
00:34:34
anything but calm, that person
00:34:37
is having a very strong cognitive load
00:34:40
of dissociative events due to the
00:34:42
event and is the person who at a
00:34:44
given moment could be mostly
00:34:47
altered by the situation, so there is
00:34:51
an experimentation,
00:34:52
hyperexcitability,
00:34:54
significant discomfort. which is more than two days and
00:34:57
less than a month, let's say that
00:34:59
acute stress is exactly immediately
00:35:02
after the disturbing phenomenon occurs
00:35:04
and that is exactly when we
00:35:07
must come with the
00:35:10
first-order intervention and not only be guided by
00:35:13
those who are most unwell. But for
00:35:15
practically everyone, everyone has
00:35:17
a monitoring process
00:35:23
in countries like ours, because we have both
00:35:29
natural disturbing phenomena, we have two coasts, we have
00:35:34
five tectonic plates, we have volcanoes, we
00:35:37
have this, there could be this landslide at any
00:35:41
time, there could be this
00:35:45
slope. or there may be different
00:35:47
conditions that may have
00:35:50
hydrometeorological and geological phenomena and on the
00:35:53
other hand we also have
00:35:56
social situations that expose us to war
00:35:58
torture physical violence
00:36:00
sexual violence accidents and terrorism when I
00:36:03
ask what do you think the
00:36:06
prevalence of post-traumatic stress would be in
00:36:08
Mexico people say very
00:36:11
high level of stress, I believe that above 40 or
00:36:13
50 percent, I believe that one in every
00:36:15
two people has
00:36:17
post-traumatic stress.
00:36:18
Right now I am going to tell you the figure and this
00:36:21
very low figure does not reach what
00:36:23
people believe and that is that we are
00:36:26
confusing a very
00:36:28
important situation, a traumatic event is not the same as
00:36:30
developing
00:36:33
post-traumatic stress. I
00:36:35
believe that
00:36:37
99% of people have had it,
00:36:40
100% do, but that does not mean that we are not
00:36:43
all going to process them in a
00:36:46
different way and that It is going to lead us to a
00:36:49
processing problem such as
00:36:51
post-traumatic stress and it is also very
00:36:53
important that post-traumatic stress is not
00:36:57
going to occur
00:36:59
in this according to the severity of the
00:37:02
problem, it is going to occur especially
00:37:06
when the person does not have resources or
00:37:09
has means to share it or to
00:37:12
verbalize it,
00:37:14
then what truly influences
00:37:17
post-traumatic stress is more than
00:37:19
anything the difficulty in verbalizing it and
00:37:24
in providing support. From here we
00:37:26
realize again the importance of
00:37:29
first-order intervention,
00:37:32
psychological first aid,
00:37:33
arriving in The right moment at the
00:37:36
right time
00:37:38
and making a person feel
00:37:41
cared for
00:37:46
and giving them a sense of security and
00:37:51
dignity
00:37:52
can have an
00:37:56
incalculable effect on that person's life.
00:37:59
That is the value of psychological first aid
00:38:02
and good development.
00:38:05
This is post-traumatic depends on two
00:38:06
factors, one is vulnerability and
00:38:09
resilience and not all reactions to
00:38:13
traumatic events are universal and
00:38:16
fixed and the national
00:38:18
psychiatric epidemiology survey here
00:38:21
shows us an apparently
00:38:24
low prevalence of 2.6 percent at some point. In
00:38:27
life it is
00:38:29
practically twice as common in
00:38:32
women as in men since there is something
00:38:35
very important. The most frequent types of trauma
00:38:38
are victims of
00:38:42
sexual violence and here I would say
00:38:45
that the rate of rape is three
00:38:50
times higher than that of torture or kidnapping
00:38:54
or accidents because there are more
00:38:57
victims of sexual violence than
00:39:01
victims of assaults or victims of
00:39:03
rape, it has nothing to do with the
00:39:06
frequency of one or the other, what it
00:39:09
has to do with is that for this
00:39:12
sexual violence we have many fewer
00:39:16
mechanisms of protection. social coping and
00:39:19
social support to support a person
00:39:21
who suffers sexual abuse and
00:39:24
therefore the possibility of
00:39:28
having post-traumatic stress is tripled
00:39:30
compared to a person who suffers an
00:39:32
assault, a kidnapping, a victim of
00:39:36
war, torture, look how serious this is here. I know
00:39:40
what is being expressed
00:39:42
is not so much the mental impact of
00:39:46
sexual abuse, what is being expressed is that
00:39:48
victims of sexual abuse are the
00:39:51
least likely to receive care
00:39:55
in 1st, 2nd or 3rd org
00:39:59
and well, in intervention 3
00:40:04
Let's remember that a
00:40:07
psychiatrist psychologist with postgraduate studies
00:40:10
with a lot of experience applies it. There are exposure therapies,
00:40:15
cognitive reprocessing therapies, here in the
00:40:18
reprocessing traps comes a
00:40:20
therapy called this mdr, which in
00:40:24
English means ibook mentz and this one,
00:40:30
what is needed in the setback is the
00:40:33
term in English mdr or
00:40:37
eye movement for sensitization and
00:40:39
reprocessing acceptance and
00:40:42
commitment therapy is another that has had a
00:40:45
great boom in
00:40:49
acceptance and commitment therapy, what is sought
00:40:51
is for the person to somehow
00:40:54
involve a little more in the
00:40:57
treatment process and have a commitment
00:41:01
and precisely
00:41:03
in having a different vision and in
00:41:08
another term called desnos,
00:41:12
which is extreme stress disorder,
00:41:14
also known as this stress,
00:41:18
complex post-traumatic stress has a whole
00:41:20
series of
00:41:22
conditions here, for example, I am going to
00:41:24
mention experts, the
00:41:27
exposure therapy of maestro Edgar Miranda
00:41:30
in cognitive percent therapy,
00:41:32
my friend is also here, also the doctor
00:41:35
Miranda is my friend,
00:41:36
doctor Rodrigo Garibay, who is right now
00:41:39
doing a postdoctorate in Kyoto Japan,
00:41:41
he is an expert in Cognitive reprocessing therapy
00:41:44
and in these entities there is Dr.
00:41:48
Miguel Marín Tejer, there are many experts
00:41:51
who are dedicated to this part and there are
00:41:54
options behind training and
00:41:57
certification but these are already
00:42:01
very advanced professionals with
00:42:06
a very complex technique if we give ourselves
00:42:09
account first second and third level it
00:42:11
increases in complexity
00:42:16
then summarizing
00:42:19
according to the chronicity the
00:42:22
first order intervention that acute sub acute or
00:42:24
chronic
00:42:25
the time later in the first order
00:42:28
of your arm day week your months are
00:42:30
months or years
00:42:32
in this simplicity in the first is
00:42:35
any intervener in the second it is
00:42:37
personal it is health with an office with a
00:42:40
title and ID and here it is psychologists or
00:42:42
psychiatrists with a postgraduate degree in the first it
00:42:45
is to protect in the second it is to stabilize
00:42:47
and in the third it is to process what was not
00:42:50
done here and here you really the
00:42:53
third order is when a person
00:42:56
presents years later after he
00:42:58
had neither the first nor the second intervention
00:43:02
instead of the intervention is the site
00:43:04
of the disaster in the second in the second
00:43:07
order is the general office and in The
00:43:09
third is in a tertiary hospital
00:43:12
or a specialized clinic, the
00:43:14
act model by Albert Roberts, the first
00:43:17
is removing the threat, the cee is
00:43:20
connecting the support group and the
00:43:22
third is trauma management,
00:43:24
the abc model, which is like the cacique.
00:43:26
In English, it has to do with affective and
00:43:29
behavioral, that is, this affective or
00:43:31
behavioral, cognitive, developmental and
00:43:34
ecological, and then the
00:43:36
intervention program is psychological first aid
00:43:38
for first order,
00:43:41
anyone can give it, secondly, there is
00:43:43
crisis intervention, and
00:43:45
thirdly, what it is.
00:43:48
post-traumatic stress and in any of the
00:43:50
three I am almost going to finish
00:43:52
any of the three we have to take into
00:43:55
account these
00:43:58
there is a difference between what is
00:44:00
sympathy empathy and compassion
00:44:04
the three have the best intention of
00:44:07
trying to
00:44:10
merge with the idea or with the
00:44:12
emotions of another person only that
00:44:15
in sympathy we fuse we get
00:44:18
irrationally involved we almost almost
00:44:20
start crying with the other person
00:44:22
and we absorb we say colloquially like
00:44:26
little sponges we absorb everything like a sponge
00:44:29
and that is very wrong that is not an
00:44:33
intervention and it is going to end us also
00:44:35
affecting us that is sympathy on
00:44:39
the other side is on the other other other
00:44:43
side is compassion
00:44:45
in which there is a connection and a
00:44:48
personal involvement
00:44:50
compassion is characteristic of
00:44:53
people with high levels of kindness and
00:44:57
high levels of
00:45:00
involvement who are interested in
00:45:04
supporting other people, I am not saying that
00:45:07
compassion is bad, the problem with
00:45:09
compassion is that it will take a lot of
00:45:11
wear and tear,
00:45:13
so
00:45:15
what is always recommended is
00:45:18
empathy in the middle in which we
00:45:20
connect emotionally rationally
00:45:23
but always in a professionally in
00:45:28
a professional field which is what we
00:45:31
must continually train ourselves because
00:45:35
in the first one we get too involved in
00:45:37
the second we also get too
00:45:39
involved no but we do not leave a
00:45:42
professional context
00:45:43
so what we should seek is
00:45:46
empathy which allows us understand
00:45:48
the other but always within a margin
00:45:52
of
00:45:53
professionalism and above all
00:45:56
self-care that we do not allow this
00:45:59
involvement to alter our
00:46:02
professional ability to help others,
00:46:07
whatever we do first, second or
00:46:10
third order, we must consider and
00:46:14
take into account in everything moment with this
00:46:17
I conclude this is my
00:46:19
personal email for any
00:46:22
comments, doubts you may have I am
00:46:24
very grateful to the sena press this and there is the
00:46:27
lawyer Verónica Roja for her kind
00:46:30
invitation and well it is yours for
00:46:33
any questions or comments
00:46:35
that you
00:46:37
can make thank you very much

Description:

Curso: Atención psicológica en emergencias 2022 Tema 1: Primeros Auxilios Psicológicos: Intervención de primer orden Expositor: Dr. Alejandro Molina López Objetivo: Aplicar las técnicas de intervención en crisis en una situación de emergencia por la ocurrencia de algún fenómeno perturbador, con la finalidad de brindar la primera atención psicológica a los afectados mientras son canalizados al personal especializado en la comunidad. Sigue nuestras redes sociales: www.twitter.com/CNPC_MX y www.facebook.com/CNPCmx/

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  • The best quality formats are FullHD (1080p), 2K (1440p), 4K (2160p) and 8K (4320p). The higher the resolution of your screen, the higher the video quality should be. However, there are other factors to consider: download speed, amount of free space, and device performance during playback.

mobile menu iconWhy does my computer freeze when loading a "Curso: Atención psicológica en emergencias, Tema 1" video?mobile menu icon

  • The browser/computer should not freeze completely! If this happens, please report it with a link to the video. Sometimes videos cannot be downloaded directly in a suitable format, so we have added the ability to convert the file to the desired format. In some cases, this process may actively use computer resources.

mobile menu iconHow can I download "Curso: Atención psicológica en emergencias, Tema 1" video to my phone?mobile menu icon

  • You can download a video to your smartphone using the website or the PWA application UDL Lite. It is also possible to send a download link via QR code using the UDL Helper extension.

mobile menu iconHow can I download an audio track (music) to MP3 "Curso: Atención psicológica en emergencias, Tema 1"?mobile menu icon

  • The most convenient way is to use the UDL Client program, which supports converting video to MP3 format. In some cases, MP3 can also be downloaded through the UDL Helper extension.

mobile menu iconHow can I save a frame from a video "Curso: Atención psicológica en emergencias, Tema 1"?mobile menu icon

  • This feature is available in the UDL Helper extension. Make sure that "Show the video snapshot button" is checked in the settings. A camera icon should appear in the lower right corner of the player to the left of the "Settings" icon. When you click on it, the current frame from the video will be saved to your computer in JPEG format.

mobile menu iconWhat's the price of all this stuff?mobile menu icon

  • It costs nothing. Our services are absolutely free for all users. There are no PRO subscriptions, no restrictions on the number or maximum length of downloaded videos.