Key Takeaways

    • During the first four weeks following the event, the mind is trying to put all the pieces together and process what happened and your role in it.
    • Traumatic memories are often disorganized and stored as fragments based on how our senses experienced the event—sights, sounds, tastes, smells, and touch.
    • The majority of us are able to piece together these sense memories to form an interconnected story or memory of the event, as opposed to continuously living in the event.
    • It’s normal to experience symptoms and emotional distress as you process the event. But processing is important to return to a state of balance and well-being. 
    • Remember, you are resilient. The mind is a powerful tool in self-recovery.
How do I begin to understand my thoughts, feelings, and memories?

Witnessing cardiac arrest and acting to save a life releases a rush of adrenaline in the body, increasing strength and focus. When the immediate danger is over and the adrenaline has cleared the body, the mind can start to process the event. This typically begins within the first four days after the incident. During this phase and over the course of about four weeks, the mind tries to put all the pieces together and return to a state of balance.

How our brain processes the event

A number of reasons decide how the brain makes sense of what happened and why it happened. 

When adrenaline surges at the time of the event, it alters how the mind processes and stores memories. For example, everyday memories typically get stored like a storyboard or timeline. But traumatic memories are often disorganized and stored as fragments—not as a cohesive story with a beginning, middle, and end. Rather, the mind records memories of the incident based on how the five senses experienced it. That’s why it’s common to have memories of a particular smell, physical feeling, taste, or visual or audible noise. These are “sense memories.”

Building the story from memory fragments

As we start piecing together the memory fragments recorded by our senses, we may find ourselves asking questions about our own actions and involvement. We may relive, have vivid images of, or remember a particular aspect of the incident that one or more of our senses has recorded. 

Sometimes we may feel out of balance as we piece our story together. We may go from a heightened state of arousal or alertness to feeling low energy or emotionally numb. During this phase, the mind is trying to make sense of it all to reestablish a feeling of safety, so it can return to its optimal state before the incident.

This may be a good time to speak with someone – a friend or a family member. Sometimes finding our voice to put words to what we are feeling can be difficult. Other co-survivors have expressed feeling isolated, misunderstood, and even invisible, as they struggle to articulate their own pain. 

Co-survivor insight: “I didn’t know how to explain to my family and friends what I was experiencing, so I used a name for the place I had gone. I called it the Quiet Place. It was a dark and empty chamber where no words were spoken or understood. If they were there, they flowed in and back out like a silent River Styx running through my brain. It was a place of grief and distress.”

After witnessing a cardiac arrest, it is normal for the mind to be disorganized and overwhelmed. In turn, how we feel, how we think, and how we reason can be impacted. While working through the “what ifs” and the “would’ve, could’ve, should’ve” thoughts, we can get stuck in a distorted state of negativity. These distortions in our thinking and resulting beliefs may cause us to become hypersensitive or have feelings of self-doubt. We may overthink, overreact, or become triggered by what was previously insignificant, causing emotional distress.

Why processing is important

The great news is that during this processing phase, the majority of us are able to mentally write the story, forming an organized memory of the event, as opposed to living in the event. This helps us to recover back to our optimal and balanced state. The mind is a powerful tool in self-recovery, and there are many techniques that can help.

It is normal and expected for people to experience some symptoms of emotional distress after witnessing cardiac arrest. The symptoms listed below vary in relation to where we are in our window of tolerance and our state of arousal. If symptoms occur for at least three days but not longer than one month, you may be experiencing “acute stress,” which is normal after a critical incident.

Normal symptoms in the days and weeks after the event:
    • Feeling numb or emotionally detached from the incident
    • Recurring, uncontrollable, and intrusive images of the incident
    • Recurring flashbacks of the incident 
    • Inability to feel positive (happy, satisfied, or loved)
    • Loss of memory and inability to recall certain aspects of the event
    • Consciously avoiding thoughts or feelings associated with the incident
    • Avoiding people, places, conversations, activities, objects, and situations that might remind them of the incident
    • Inability to go to sleep and stay asleep 
    • Recurring dreams of the incident
    • Easily irritated or having outbursts
    • Substantial changes in diet
    • Loss of sex drive
    • Being excessively attentive
    • Difficulty concentrating
Recovery is common

Many people recover from acute stress once they are removed from the situation and given appropriate support. This can take the form of understanding, empathy for their distress, and an opportunity to describe what happened and their reaction to it. Some people benefit from describing their experience several times or participating in a technical debriefing of the event. Emergency service personnel, friends, loved ones, or faith leaders can often provide this support. Otherwise, physicians or other mental healthcare professionals are helpful. 

It is important to remember that a critical incident is an event. It does not define a person. For some, being involved in acting to save a life can lead to positive activities and advocacy to inspire others to become CPR-ready.

Try to be patient with yourself during this early phase following the event. Processing the event is very important for you to return to a state of balance and well-being. Remember, you are resilient, and you are not alone.

Flanary K. The Quiet Place. J Card Fail. 2021 Nov; 27 (11): 1300-1301. DOI: PMID: 34749929.

Community AED & PAD Guide:

Thank you to our contributors

Paul Snobelen, Kristin Flannery, & Jennifer Chap

We Appreciate Your Feedback

Please leave any feedback you have regarding the content of this article. Have you found it helpful? What would you change or like to see differently?