Education Corner – Communication in Crisis Moments

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Communication in Crisis Moments (Download PDF Version)
Key to safety in crisis moments = Human Connection

What makes people feel unsafe?

  • Unpredictability
  • Unfamiliarity
  • Loss of control
  • Lack of support systems with no outlets for frustration

Physiological responses to emotions – Polyvagal Theory of Emotions (Stephen Porges)

  • Two branches of the vagus nerve:
    • The myelinated vagus branch is responsible for the parasympathetic action of lowering the heart rate, but also engages and regulates muscles in the face and head, resulting in a ‘coupling between social engagement behaviors and bodily states.’
    • The unmyelinated vagus branch engages a freeze response in reaction to life-threatening circumstances.
  • Described as the green, yellow, red states:
    • Red light state: Oldest defense system (evolutionary) – can lead to complete shut down, dissociation, freezing, or complete immobilization of the individual (unmyelinated vagus nerve is activated).
    • Yellow light state: Sympathetic nervous system is mobilized – preparing for fight or flight. In this stage, things appears adversarial, hormones surging through the body can cause feelings of aggression or withdrawal. This is a common state for grieving families.
    • Green light state: Most recently developed system – our social engagement system. Human beings have a need to connect. In this state, we feel safe, things can happen normally, we are productive, kind, we bond (myelinated vagus nerve is activated).
Autonomic nervous system is scanning the environment to determine if we feel safe.
  • The middle ear muscle acts differently in the different states. In the yellow state, the middle ear muscle cannot hear human voice as well as in the green state. In the yellow state, it is geared to hearing high pitched sounds signaling need for alert and low rumbling noises suggesting danger. Quiet places without noise will greatly assist families in a yellow state to have a chance for better communication.
Engage the vagus nerve by doing very human things – get them to the green light state.

What makes people feel safe?
Basic Human Connections:

  • Eye contact
  • Modulating soft voice and tone
  • Using our facial muscles
  • Reassuring looks
  • Quiet place without loud noises (due to middle ear muscle compromise)
  • Get the person to speak, the more they speak, the better the engagement

Do your PART (Daniel Siegel, MD)

  • Presence
    • be emotionally present in the conversation
  • Attunement
    • family needs to feel ‘felt’ by you (how are you listening to them, invite dialogue, ask questions)
  • Resonance
  • Feeling close – You are ‘getting’ them

TRUST (P+A+R)

Goal: Get people to a place of social engagement = Relationship before Task!

References:

Porges SW. The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, Self-Regulation. New York, NY: W.W. Norton & Company; 2011.

Glaser JE. Conversational Intelligence: How great leaders build trust and get extraordinary results. New York, NY: Bibliomotion, Inc; 2014.

 

Special thanks to Marcel E. Pincince, BA, STB, Director, Donor Family & Advocate Services, Donor Network of AZ, Phoenix, AZ for providing the content of this issue.

Written by Hedi Aguiar RN, MSN, CCRN-K, Senior Director of Programs, The Alliance

Editor: Corey Bryant, Communications Manager, The Alliance, cbryant@odt-alliance.org.
This Education Corner is available for download. The Alliance grants permission for the distribution and reproduction of this educational communication.

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