Crisis Intervention and Promoting Resilience
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Crisis Intervention and Promoting Resilience

This episode was pre-recorded as part of
a live continuing education webinar. On demand CEUs are still available for this
presentation through ALLCEUs. Register at I’d like to welcome everybody to today’s
presentation: crisis intervention, promoting resilience, and resolution. This
is a textbook or a book. It’s not really a text it’s a little paperback but it is
an old book that I actually used when I was in graduate school but I’ve hung on
to it because I found it to be exceedingly helpful in helping me
remember some crisis intervention techniques and teach crisis intervention
not only to students but also to supervisees .So it’s a book that I really
really like if you can find it at the library or get it used on Amazon I would
strongly recommend it but you know it’s my personal preference so it’s obvious
obviously up to you over in the next little while we’re going to talk about
resilience and transcendence as it applies to crisis intervention we will
look at the change process in crisis resolution we will also look at how to
make contact with people when they’re in crisis and exactly how much power it has
just to connect with someone you don’t have to fix it you don’t have to make it
better you don’t have to take away their pain in fact we don’t want to take away
their pain it’s theirs if they want to give it to us that’s a
whole different story but just being there can be really really helpful then
we’ll move on to how to make meaning from a crisis transforming that
narrative into something from which a person can grow instead of something
that is going to make a person stuck or hold a person back we’ll talk about
managing emotional arousal envisioning the possibilities and using creative
coping strategies and finally we’ll kind of touch on crisis intervention with
families obviously we’ve got a lot to cover in the next hour so I will cover
it as quickly as possible so crisis is a point of threat and opportunity and a
lot of times we think of crisis as just a threat it’s something bad that
happened but it’s also an opportunity unity it’s a time to rewrite the
narrative about how we deal with crisis rewrite the narrative about our
strengths and our resilience and it’s a time to maybe rewrite or re-examine what
our priorities are so it can be a great opportunity yes there is you know the
threat there and we’re going to have to learn how to walk that middle path when
it comes to navigating crisis the six facets of a crisis experience are the
acronym basics behavioral when there’s a crisis we have a behavioral reaction we
have that fight-or-flight reaction that comes out we have a lot of different
urges that we feel when we want to either escape or fight whatever the
threat is we have emotional reactions it can range from depression anxiety anger
terror whatever is going on with that person and it may be a mixture of all of
those grief resentment as a whole bunch of things they are as they are our
somatic experience when we’re in crisis a lot of times we’re not at our best
we’re having difficulty kind of getting through day to day we have changes in
sleeping habits changes in eating physical complaints that happen during a
crisis experience interpersonally there may be some stress interpersonally but
there also may be a lot of good things interpersonally that happen cognitively
it’s more difficult to focus in crisis however it can also highlight some of
our strengths and resilience ease as individuals and spiritually how we
envision the world as being a just place or being a scary place there’s a lot of
impact when a crisis happens because it basically turns your world upside down
whatever the crisis is if it’s a natural disaster you’re sitting there going well
you know that was really scary that was really awful
and it was unpredictable if it was a hurricane you had like a week to predict
but it wasn’t something that you could be prepared for ahead of time and know
exactly what was going to happen so we want to think about crises in a very
very broad very very broad spectrum crime victims
that’s generally one of the things we naturally think of when we think of
crisis someone’s in crisis because they’ve been victimized
okay so behaviorally what may be going on with them they may want to withdraw
they may not want to be around other people they may start shutting down
effectively emotionally there may be some devastation fear a certain amount
of shock cymatics we have the internal things
that I already discussed upset tummies difficulty sleeping changes in eating
habits interpersonally they may become more clingy or they may become more
withdrawn from others cognitively it’s a lot more difficult to
focus the way you conceptualize the world the way you interpret the world as
being good and safe or however you interpret it it is changed now so every
time something happens you need to think about it in terms of this new pseudo
reality and I say pseudo reality because when a person is still recovering from
crisis when they are still working on transcending the crisis it’s not a
concrete reality for them yet everything is still sort of in flux and spiritually
a crisis being victimized is going to impact how people look at other people
how people look at the world in general now it doesn’t mean it has to change it
for the worse it doesn’t mean it has to always stay
negative but it may point out that not everybody is a safe person another kind
of crisis is the death of a loved one and when you’re thinking about people in
crisis I want you to really think broad just like we’ve talked broadly about
losses think broadly about what crises may look like for people natural
disasters already talked about that the other thing we don’t talk about a lot is
secondary trauma by the media in children and am i putting a lot of
emphasis on the media yes I am I remember well just about any major thing
that happens whether it’s an airplane crash a hurricane the 9/11 there are
many many many many examples where there has been some sort of major crisis and
the media has played it over and over and over and over again to a small child
who’s seeing this they are interpreting that it’s an ongoing situation not
something that happened that we’re just continuing to talk about three weeks
later likewise even if the child is not watching it on TV the child is hearing
the parents and you know the other adults still talking about it three
weeks later because the other adults are still seeing the media’s portrayal of it
three weeks later and a lot of times it’s focused on the negative not how to
be resilient how to transcend this but oh my gosh how did this hit us from out
of the clear blue and we’re still in shock we’re still trying to figure out
how to pick up the pieces so children naturally are going to become a lot more
stress and be traumatized not it directly but indirectly by all of that
ambiguity all of that fear all of that terror and like I said just seeing it
ongoing and not being able to understand in their little brains this happened
three weeks ago and we’re just still talking about it so validation of the experience is
crucial and I added an e on to the end of their acronym in the book it talks
about love lu v I added the e because I really think it’s important to explore
client strengths but love means listen listen to what they have to say and the
can be the victim this can be the survivor this can be the child
understand their perspective put yourself in therefore in their shoes for
a little while and see what it looks like what does it feel like to be them
and if you were in their shoes how might it affect how you look at things
remember with children they think very dichotomously especially young children
so they’re not able to walk that middle path and look at okay well there there
are some people that will do bad things but most people are good it’s like all
good or all bad or I can’t tell they don’t have the knowledge they don’t have
the experience to really interpret things so it’s up to us as their adult
caregivers to help them figure out and understand a little bit more eh about
what happened but B about what their feelings are why are they having
nightmares why are they feeling stressed out children don’t understand and they
don’t have that level of mindfulness and even if they did they know they felt
icky but they wouldn’t really understand why you know we a six-year-old doesn’t
understand the fight-or-flight concept it’s up to us to help them understand
what’s going on which means we’ve got to understand it from their perspective and
validate validation is so important we’ve talked
about this in dialectical behavior therapy and we will continue to talk
about this throughout a lot of different classes a person feels how a person
feels and it’s not our place to tell them they’re overreacting it’s not our
place to tell them that doesn’t make any sense they feel how they feel so we need
to help them name it and then figure out what to do with it which takes us down
to exploring their strengths when you felt this way before
when something has pulled the rug out from under you before what did you do
how did you survive because you’re here you survived it so tell me what helped
you know it may have not have done everything you may have really struggled
and it’s okay but you are here so that’s really what we want to focus on is what
the strengths were that got you through this and helped you transcend that
situation that sort of turned your world upside down while we’re trying to understand
transcendence we also need to understand a little bit about the change process
chaos theory says that chaotic symptoms systems are predictable for a while and
then appear to become random so something happens and there’s a
predictable outcome from it but then all of a sudden it kind of goes awry each
point in a chaotic system is closed to other points with significantly
different future paths an arbitrarily small change of the current path may
lead to significantly different future behavior okay so what does that mean
that means that you’re walking along and if you’re like me I’m very ATD sometimes
and I’m just like squirrel but yeah well I’ll give you a perfect example of chaos
of my mind I was leading a group in my adolescent treatment facility and I’m
sitting there talking to them and there were I gotten over the dining room
behind us and a door that went outside so they could take the trash out
and past that door there was an oak tree and I’m teaching the class and all of a
sudden in the middle of class I see this great big squirrel running up the oak
tree and I love squirrels and they knew that so they weren’t really all that
surprised and all of a sudden I just was like Oh squirrel yeah
the clients were like what I’m like big squirrel climbing up the tree and you
know this was something they knew to expect from me at this point but it was
a very small thing that totally changed the direction of that group I was just
like talking about whatever I was talking about and then we started
talking about squirrels whoops now you can choose once you diverge to go back
to the original path another example would be if you take somebody two people
from the same family who experienced roughly the same things but one develops
addictive behaviors and the other one does not what happened what was the
arbitrarily small change that pushed one person over toward addictive behaviors
and the other one not so we want to look at what’s going on but we also want to
look at what arbitrarily small changes we can put in there positive changes to
help somebody go on to a more positive path crisis is this big event so as
they’re trying to get back on their feet again they’ve got to figure out what to
do we can help them choose small changes that will help lead them toward a
survivor or transcendent perspective instead of getting stuck feeling angry
and afraid combining that with complexity theory complexity theory
emphasizes the interactions in the accompanying feedback loops constantly
change systems so again let’s take the person in crisis they are struggling
they are not sleeping well they’re not eating well they don’t feel safe they’re
crying all the time so we and then we start talking to them and we
say okay what are you ready to address what do you think would is your most
problematic symptom right now and the person says I just I need to get some
sleep I’m exhausted so we help them figure out how to get some sleep if the
person starts feeling a little bit more rested then they’re going to have more
feedback they’re going to feel a little less overwhelmed and life on life’s
terms isn’t going to feel quite as daunting which will mean that they can
probably relax a little bit more on their own and rest a little bit better
on their own so it’s this progressive positive feedback loop likewise if you
take someone who’s in crisis and I’m thinking back to hurricanes and you put
them in a situation where they’re constantly stressed put them into a
shelter where there’s you know 30 other people or 300 other people there’s noise
there’s no safety there is no privacy think about how that affects somebody
makes them irritable when somebody’s irritable and then they’re probably
going to be a little less patient with other people if they’re less patient
with other people tempers flare things intensify
negatively so complexity theory really encourages you to look at those feedback
loops but it also says that systems are unpredictable but constrained by order
generating rules so you’ve got people in this facility in this shelter and they
don’t have a home anymore they’re all dealing with devastating loss they’re
all in some amount of crisis so there’s a lot of unpredictability about how
they’re going to behave but guess what everybody is going to choose or nearly
everybody is going to choose the behavior that is most rewarding to them
at that point in time so they may some people may look for the longer-term
reward of just getting through this some people may look for the reward of right
now what’s going to make me feel better or numb right
now but ultimately behavior is driven by rewards individual behaviors and choices
are more important than executive plans in an organization or in a system so we
need to look at not what the big reward is the big reward is everybody getting a
home getting out of the shelter the bit reward is people feeling safe the big
reward is you know catching the criminal that committed the acts so he or she
can’t do that again sure however that does not change what’s going on with the
individual we need to focus on each person when someone is victimized you
have the primary victim and they’re going to behave in a certain way
whatever is working for them but then you also have other people in
that system their spouse their children their family anybody who’s providing
support or not providing support that is going to have an impact so we would like
the family to come together we would like the family to form a cohesive unit
but that may not happen we need to look at the individual behaviors to make sure
that each individual’s behavior is supporting cohesion if you know Mom over
here is just not able to cope then and child is the one that got victimized and
we need to figure out how to help child and mom navigate that in order to get to
the best goal in order to get to the resolution we want we do need to focus
on the impact of individual behaviors because if mom is continues to fail to
thrive if you will it’s going to have a negative impact on the primary victim or
Junior the focus needs to be on self organization instead of management
control I want to empower people to start taking control of identifying what
their strengths are what they need how they’re feeling and becoming aware you
know mindfully of what’s going on within them what are
their feelings what are their reactions and what do they need and I encourage
them to use small changes in interventions this is not the time to
kind of try to turn the world upside down again what is it it’s going to help
you get through today what is it it’s going to help you sleep tonight small
changes and if you sleep tonight how are you going to feel better in the morning
what’s going to be the benefit to getting a good sleep tonight we don’t
have to focus and actually initially it’s probably not helpful unless the
client wants to to focus on the crisis itself what I want to focus is focus on
is the resilience I want to focus on how can you make this into something that
from which you can grow we want to encourage conflict and change now that
sounds weird you’re going well we’re trying to help them get better why are
we encouraging conflict part of the conflict is their internal conflict
saying I can’t handle this and then encouraging them to get that strength
spaced voice going yes you can so they have an internal conflict going in their
head and we say okay if we want to make this positive voice stronger what can
they do to change what is it that you need to do to prove to yourself that you
can this encouraging conflict may seem to push a person into an unstable
situation but they can gain improvements from the healthy edge of chaos they can
push themselves past their comfort zone maybe they want to go and just lay down
and sleep and they don’t want to see people and they want to withdraw I hear
that and I really get where that’s coming from
however the OP the other option is getting up and going to group and
putting one foot in front of the other let’s weigh our options
do a little decisional balance exercise you know I love those and help people
try to find the motivation to get outside their comfort zone to move past
that safety of staying in bed to help them transcend where they’re at right
now because nothing is going to be the same now that whatever this crisis is
has happened they have changed as human beings forever and the situation has
changed forever so three principles to remember large
changes result from small changes that butterfly effect you can google that
online if you want to look at it but remembering a small thing a small thing
like getting your circadian rhythms right so making sure you get out of bed
in the morning and open the blinds get dressed
those are three different things but that can have a huge effect on your
ability to sleep your own sense of agitation and you know when you go on
from there other small changes you know sleep is obviously a big one nutrition
reaching out to people going about your daily life again starting to get back
into a routine change can begin suddenly and resolve rapidly so you know think
about Microsoft updates if you’ve ever been working on your computer and all of
a sudden the sucker just shuts down I hate it when it does that because it
doesn’t say where I met but anyway I digress it just shuts down and you’re
like oh my gosh what just happened and then it comes up with that little spinny
thing that says Microsoft is updating but this resolves rapidly you don’t have
to do it’s not an ongoing thing where you’ve got to call that a technician it
resolves itself when it’s given enough time to install the updates and reboot
my daughter made a similar analogy we recently had to put down one of our one
of our animals and she’s like you know for me when something like this happens
it’s kind of like when the computer installs updates
it just shuts down and you know I just don’t feel anything
for the longest time and then it does that thing where it reboots and it seems
like it’s never going to start again and I can’t seem to feel feelings but then
when it does reboot you know it comes back on and as wonderful but I’ve got to
figure out what to do with all this new stuff all these updates because
everything’s changed I’m like what a great analogy so you know we’re really
wanting to help people understand what’s going on but not think that this
happened this was some big tragedy and it’s going to just hold them down and
hold them back and be an albatross for six months or a year or five years I’m
not saying it won’t impact them you know obviously things are going to change
however we need to respect the fact that they may not be stuck for a long period
of time and changes a complete reordering something new emerges and
nothing is ever the same so it’s important to look at that and there’s
going to be a grieving process part of transcendence is grieving the loss of
what was how you viewed the world before whether it’s your loss of innocence or
your loss of faith and people or your losses I could go on but I won’t
helping people grieve that loss but also embrace what’s new and how cool it is I
mean think about the caterpillar and you have a cute little guy he’s a cute
little fuzzy guy and I like caterpillars but when they emerge as butterflies
they’re never going to be a caterpillar again but isn’t the butterfly amazing
and beautiful in its own right so what about solution versus resolution
solutions are largely outside yourself you can add stronger security you can
get a dog you can alter your behavior so maybe if if something happened where you
were victimized going to your car in a parking garage at night
you might alter your behavior so you carry mace so you have somebody walking
to your car at night so you don’t have to go to your car after dark there are a
lot of different behavioral alterations that you can go through but these are
outside of yourself these are making your surroundings more
controllable resolutions on the other hand are internal events alterations in
mood choosing to look at some of the happy things and choosing to be happy
and depending on the crisis there may be some guilt associated with surviving
there may be some guilt associated with being happy and as clinicians we can
help them help people identify that and work through it but resolution is when
the mood alters and people can feel happy again the happy chemicals are
going there’s a shift in thinking from being a victim to a survivor from being
devastated to being able to transcend or to cope with looking at a recognized how
much stronger a person is than they thought they were and it can involve a
change of heart where instead of looking at things from
a negative perspective from a victim’s perspective there’s an optimism of well
okay you know think you’re changed and I really don’t like the way it happened
however what can I do to make this new reality even better than the past one I referred in the beginning to the power
of connecting social supports are an extremely powerful buffer when I’ve
worked with people with PTSD when I’ve taught classes on PTSD and research has
shown that the most important time to get social support is within the first
24 hours ideally within the first two to four hours and you may be thinking well
that’s awful fast well think about it if you’re a victim of a rape do you really
want to wait till the next day before somebody calls you and says hey how you
doing no do you want somebody to meet you at the hospital if you are if your
house burns down same thing you don’t want to be waiting around at
some shelter for a while and for 24 hours before somebody calls you and says
wow I heard what happened how can I help the best time for people to help is in
the first two to four hours because at that point everything is still fluid and
people can come in they can help and they can help buffer the stress so when
the memories start to be formed it’s not formed in a state of being in isolation
and devastation connecting to others is a fundamental human need whether we like
it or not not everybody has 150 friends some
people have one or two but that’s okay that’s the one or two they need and it’s
personal depending on on the individual so I’m not going to encourage people to
reach out and find 30 friends but who is it that you want beside you if you’re
having a crisis this is one of those things that I talk
about with people early in treatment for anything because most likely during
treatment at some point in time there is going to be a crisis we’re going to
precipitate something we’re going to start talking about something that
precipitate to crisis so encouraging them to think ahead of time of who are
my social supports that I really want to connect with and how can I know those
relationships we’re hardwired to help each other whether you’ll want to admit
it or not most people are very very hard wired to reach out and lend a helping
hand part of this is because you must develop empathy even before verbal
skills think about a baby a baby can’t talk yet a baby doesn’t really
understand what people are saying but if mom gets upset what is the baby do baby
gets upset if mom’s happy now the baby’s not always happy but generally the baby
is happier then he or she would have been if mom were in some sort of
emotional turmoil so humans learn to be very receptive or what’s the word I’m
looking for perceptive of other humans emotional
states were designed to help each other out so the power of connecting is huge
and is there from birth we need other people if you’re trying to help someone
who is in crisis use reaching out questions what is it that I can do to
help you instead of saying this is what you need now engage them ask for their
input about what they need how is it that I can help you through this provide
encouragement acknowledge that this is a really awful situation this is a crisis
even if you know if it happened to you you wouldn’t think it was a crisis if
it’s a crisis for them it’s a crisis so we want to acknowledge this thing go
this feels like it the end of the world now I told you
before I’ve got teenagers at home and with teenagers crisis crises seem to
happen on a pretty much day-to-day basis so you know we want to acknowledge the
crisis experience and help them figure out how to work through it make positive
observations about how well they’re doing in a situation make positive
observations about what supports you’re around we don’t want to focus on how
poorly they’re coping obviously we want to highlight their strengths I don’t
want to minimize how they’re feeling but I also want to observe how strong
they’re being be tentative rather than authoritative owning your impressions so
this kind of goes with the positive active observations instead of going you
are coping so well you could say something more tentative like you know
based on what I’m seeing you know a lot of people would really be struggling it
seems like you feel like you’ve got a handle on this at least a little bit
right now yeah I can I can hedge with the best to highlight the survivor in
the crisis what did this person do that helped them survive it took a lot of
strength for you to get through that and to call 911 it took a lot of strength
for you to pack up your family and get to the shelter and not know what was
happening to your house invite the person to talk or not about the
experience and like I said earlier not everybody is ready to talk about the
crisis right then we want to let them move through this process right their
narrative in their time because there’s going to be a certain amount of shock
and denial at first and like it we talked earlier every crisis involve a
loss a loss of the way the world was before the crisis so there’s going to be
a grieving process and if you just kind of think about that denial anger
bargaining depression and acceptance shock and denial happens and it can
happen for quite a while for some people especially if they don’t have a lot of
support early on why is this in many cases the person will not be able to go
there they’re being dealing with the trauma until they have adequate social
support that’s one of the cool things about our brain it just keeps stays in
that denial stage until the person can start trying to deal with it because
they have the resources crisis can shatter people’s assumptions about the
world some things that obviously change sometimes in a crisis the world is
benevolent maybe maybe not so if this happens looking at what parts of the
world are benevolent what parts of the world are good and positive I had a I
was getting in my car this morning and I had a bunny run out it was a big old
bunny I love bunnies animals tend to be something that makes me happy something
that’s nice I know they don’t they’re not always nice to each other but not
everything in the world is going to harm me another assumption the world is
meaningful and predictable now sometimes bad things happen to good people and it
doesn’t make any sense and sometimes you can’t predict when things are going to
happen however what can you do to make meaning and what things are meaningful
now I mean once something happens let’s figure out how to make meaning out of it
you can’t always predict what’s going to happen so what parts of this are in your
control and what parts aren’t and what can you do about that the self is worthy
and life is fair you may be very worthy but you may not get everything that you
feel you deserve so how do you deal with that
because life is not err it happens and and these are just a
couple of the assumptions but they’re the some of the main assumptions that
most people hold a certain point in their life now these assumptions may be
dashed when they’re 10 or they may not be dashed until they’re 24 or older but
at a certain point people start stop thinking in the dichotomy of the whole
world is always benevolent that’s not the way it happens so let’s reframe this
and figure out what parts are as humans we need to create meaning for ourselves
so if you’re a victim of crime or if someone dies how do you make meaning out
of that how does that fit into your schema of the world we want to encourage
at some point people to tell their story survivors often have slightly different
accounts of the crisis each time they tell it sometimes and and you know
probably well-meaning but ill trained people may look at that and say you must
be lying or how can you why are you changing your story now changing
recollections are the result of trying to find meaning and resolve the crisis
you remember it a little bit differently you’re like well maybe this happened
because it’s not because somebody’s trying to make it up it’s because their
brain is trying to assimilate or accommodate what’s happening go back to
Piaget it’s important for survivors to understand they’re not crazy it’s
important for survivors to understand that their story may change a little bit
or their recollection may change a little bit I try to avoid the word story
as much as possible because a lot of times people feel like that says that
they’re making something up and I know that they’re not if they is their
narrative of what happened so recollection and narrative are two words
that I try to use a little bit more encourage them to write things down you
know as they tell it that way I can go back and revisit the
recollections because you know what I bet each part or each time they they
tell it new parts will come up and eventually you can merge those all
together and come up with something that’s cohesive and tells a more
thorough picture of what happened help clients rectify discrepancies by
pointing out positive change or evidence of strengths sometimes sometimes it
might change and there’s no factual basis for it however the way they’re
remembering it now is a way that makes them come out stronger makes them feel
less victimized that’s not always bad and listen for the hero in a tragedy how
is it that you came out of this what is it in you that helped you survive this
and there are a lot of excellent excellent
dialogues in the book that demonstrates how to help listen for the hero and
rectify discrepancies so I would encourage you to look at that the
narrative can be used to help people explore the bigger picture so when
people write what happened they write it from a pretty narrow tunnel vision
perspective so we can help them broaden and say okay this is what you saw now
what else was going on where was so-and-so during this
who else was there to help what else may have contributed to this situation the
narrative can be continued into a positive resolution so once you get past
now you know whatever happened happened that’s in the past you are trying to
transcend it that’s the present so what is it going to look like when you have
transcended the situation so some of the questions you might ask might be what
have you discovered about yourself now that you’ve gone through all this and
you’ve survived it what sense can you make of what half
and where you are right now what do you see is the purpose for this or even what
keeps you going through this difficult time if people aren’t still not there
they haven’t transcended it but they’re going there putting one foot in front of
the other they’re coming to their appointments they’re maybe even going to
work that’s awesome so how are you doing that because some people wouldn’t be
able to what is it that is motivating you right now the narrative can be
explored in terms of focus and character development so we want to look at not
only the victims perspective or the survivors perspective but we also want
to look at the perspective from other people when something happens there are
often a lot of other people that are blamed and we can look at it from their
perspective you know from the survivors perspective of you know FEMA did not XYZ
well let’s put ourselves in FEMA’s position and explore what it might have
been like to be at the FEMA offices at that point in time that doesn’t take
away your feelings of whatever is going on but it helps expand the narrative so
people can get a a resolution blaming doesn’t ever end in
resolution but blaming helps people or encourages people to stay angry and
point fingers so we need to look at what could be done differently next time or
was there anything else that this person or organization could have done to avert
the crisis managing emotional arousal people in crisis experience fear anger
and grief you’re like well yeah but they also experience positive emotions
resolve courage compassion hope we want to highlight these anything they do or
say that highlight their resolve to keep going their courage in the face of
adversity their compassion for others and themselves and hope that they can
get better hope that this will resolve itself and they will be able to move on
I don’t want to minimize the distressful emotions but I want to balance I want
them to see that these two things can exist concurrently handling distress
catharsis is not necessary some people need a cathartic release they need to
you know go out and run they need to punch a punching bag they need to primal
scream whatever works for them but not everybody does some people manage it
more cognitively so if someone’s not crying if someone’s not screaming if
someone doesn’t seem out early just completely overwhelmed that doesn’t mean
that they are not handling their distress we want to encourage them to
express how they’re feeling and what they’re thinking in a way that’s
meaningful for them and then we want to arouse resolve you know there may be
some resolve but we want to bolster this performance quality is Kirpal inner Curt
be linear in proportion to emotional results what does that mean
that means as performance quality goes up the emotional arousal goes up as well
but at a certain point if you get too emotionally aroused your performance
quality goes way down we all know this we know that a little stress will help
us meet that deadline but a lot of stress we’re just going to sit there and
kind of twiddle our thumbs and have writer’s block or not be able to get it
done a little bit of stress is necessary that’s the cord as well as the
norepinephrine that says hey there’s a little bit of a threat there’s something
we need to do we need to get out of bed and do something so once they figure out
what that resolve is then we need to help them envision those possibilities
what are your goals now you know this has changed everything
so what are your goals for a week from now a month from now six months from now
create goals that are positive not getting rid of depression but what are
you going to do positively that will increase your happiness use a goal
statement such as when you achieve this when you achieve a greater state of
happiness when you feel safer what is that going to look like and then use
scaling so on a scale from one to ten right now the crisis just happened
you’re at a1 you got some work to do so what will get what is it to look like
and what will get you there if you’re going to feel safer you know we’ll just
use that for this example what is it what is it going to take to get you to
feel a little bit safer in your own home tonight or maybe it’s not your own home
maybe part of feeling safer is sleeping somewhere else what gets you to a three
a four of five have them define what each step looks like and identify what
it’s going to take to get there once they do that generally they’ll see that
it’s not me ten steps a lot of steps but most of the time they’re small steps
so they can be accomplished pretty quickly we also want to examine current
behaviors in terms of creative coping if somebody’s drinking more if
somebody’s sleeping more if somebody tends to be more irritable and lashing
out we might automatically think of those as negative but from a creative
coping standpoint I’m going to say okay let’s look at what function that’s
serving if you’re drinking more it’s numbing the pain it’s helping you
survive till right and until you can get through this now it’s not fixing
anything but it is a creative way of trying to survive so let’s look at other
ways you can do this if you’re sleeping all the time
your body is plumb exhausted you have been on high alert for either a really
long time or really really high alert for a short period of time and you’re
exhausted you can’t deal with anything else you can’t deal with other people
you can’t deal with work you just can’t deal because you are out of gas so
sleeping a lot makes sense to me now that’s not where you want to be forever
but it make sense and if you’re lashing out people who are in crisis make it
irritable and angry and just push everybody away again it makes perfect
sense if you are barely keeping it together dealing with just life on
life’s terms and getting up day to day and brushing
your teeth then other people’s drama and other people’s input even if it’s
positive maybe too much stimulation you’re already over stimulated so it
makes sense that your natural reaction is to push away the extra stimulus so
you don’t get overwhelmed how can we deal with that I really want people to
see how their behaviors are very rational given the unusual circumstances
educate people about common behavioral changes in response to stress or crisis
so it doesn’t catch them off guard and they can go okay you know I’m more
irritable right now I know where this is coming from
or okay my kids wet in the bed now I know where this is coming from or he or
she the child wants to sleep in my bed every night I understand the meaning
behind this I can address it once people understand the function it becomes a lot
clearer if a child is completely acting out and losing it you want to say what
is it they’re looking for are they looking for structure are they looking
do they need a time out are they overstimulated we want to look
at the function of the behavior as a rational response to help them survive
and then we want to encourage people to use resources what else is out there you
don’t have to carry the weight of the world on your shoulders by yourself what
somebody else help most places have a United Way that can help people find
resources whether they need food clothing shelter counseling crisis
counseling you know it’s a variety of resources out there that are available
encourage people to reach out that’s what they’re there for other things that
we as clinicians can do and supportive people can do is refer to the acute
crisis in the past tense when the person broke into your house when the hurricane
came when your father died back then but then describe resolution and coping in
the present tense you know that was devastating currently you are having
difficulty sleeping or you’re wanting to sleep a lot more let’s look at how that
makes sense you know why is that happening and what else can
we do how can we help you resolve it in a way that you want to resolve it
special cases flashbacks and nightmares again there’s a lot of this is semantics
have been were versus you are if somebody’s having flashbacks that’s
putting them back in that situation so let’s leave that situation back day
you have been having flashbacks you have been having nightmares when you go to
sleep you’re right now number one you’re awake but if I say you are having
flashbacks or you are having nightmares that indicates that I’m expecting the
person will have another one tonight now maybe I am but we want to plant the seed
that they can move past that so use the flashbacks and nightmares use the past
tense when we’re talking about the crisis stuff before you you know
whatever the crisis was what were you doing we want to look at how their life
was different before or the same before and what they want to do in the future
transform crisis metaphors if somebody says I feel trapped okay I get that when
you begin to escape from the trap what’s the first thing you’re going to do you
know if you’ve been a victim before you can understand feeling paralyzed in your
own fear so when you start feeling less paralyzed what’s the first thing you’re
going to do if somebody says they feel overwhelmed you might suggest you it’s a
lot to handle on your own you know this is a really unusual circumstance that
nobody should have to go through on their on their own when you decide to
start sharing not if but when you decide to start sharing some of the load with
someone else to whom will you turn and what will you want them to do if they
say I’ll know okay well let’s turn the tables if this
happened to your best friend when she was ready for help what do you think she
would want you to do what would you want to do for her and then start exploring
how to answer the original question of what do you want or need other people to
do for you reframing the situation contacts from global to specific I will
never feel safe again the world every every – everywhere I turn is dangerous
ok so let’s look for exceptions to that emphasize the specific you know maybe
living in Florida there are hurricanes living in California California there
are earthquakes but hurricanes and earthquakes aren’t everywhere
so let’s look at situationally you know is everywhere dangerous or can we find
some safety temporal context stable versus ongoing versus changeable or time
limited the hurricane ends of the crisis ends B you know things will end so we
want to encourage people to look at whatever happened in terms of a event a
time-limited event and normalize negative cognitions I should have done
this I can hear where you feel like you should have whatever so we want to talk
about that and we want to talk about how people may feel guilty for feeling happy
we may want to talk about any of their negative self-talk I don’t want to take
it away from them because it’s up to them to choose when they’re ready to
move on to the transcendent however we do want to point out that a lot of
people in crisis recovery have some negative thoughts we want to enhance the
emotion of resolve look for exceptions to the distress so encourage them to
keep daily inventories of how the day went
and maybe noticing when it’s a little half step better than it was yesterday
and tomorrow may not be you know there may be a backward step but encourage
them to look for the positive glimmers of hope ask presumptive questions like
when things improve what’s going to be different this encourages them to look
for those things in their daily inventories and reflect
those emotions that you’re hearing those emotions of resolve going I hear that
you are doing your best to get through this and come out the other end stronger
and finally moving on questions would be as you begin to resolve this time in
your life how are things going to be different if
we’re not into that global of a statement we can say you know let’s
focus on today when you leave here today what do you see the first thing you’re
going to do or what do you see as your next step what are you going to do
between now and our next meeting depending on what level of crisis the
person is in your questions are going to be longer or more immediate focused but
we want to encourage small forward steps finding the pony I love this one or
almost to the end of the class parents tried to teach their son that life
wasn’t fair by making him shovel a room full of manure when the parents returned
after eight hours the truck the child was very very happy and still diligently
working and the parents were very confused like you just shoveled manure
for eight hours he’s like yeah but with all the poop in his room there must be a
horse in here somewhere helping people find the pony look for
what they can create or what they’re hoping to find once they clear out all
of the stuff when families or couples are in crisis the system is in crisis
and they may face some developmental crises so we want to encourage them to
learn how to listen understand and validate each other and enhance each
other’s resolve for moving through the crisis and there are three chapters on
families couples and groups in crisis in the book I’m just kind of touching on it
right now obviously resilience and transcendence we want to
encourage people to look at their strengths and believe that they can move
past this and develop or create something completely new and even better
the change process is very variable it’s based on what individuals do and people
do things that are reward bearing but any little change in the system can
redirect a person’s past so they need to be aware of are they putting positive
changes in their system or negative ones just the power of having someone there
to help shoulder the burden is huge they don’t need to fix it but the power of
connecting is vital in recovery from crisis as people start to recover we
want to encourage them to transform the crisis narrative into one of survival
you know the crisis happened right now you’re trying to figure out what to do
with it so what’s the next chapter what does the end of the book look like help
them learn how to manage emotional arousal and what to expect in early
crisis resolution encourage them to envision the possibilities of what this
transcendence is going to be like what is their butterfly going to be once it
emerges from the cocoon and highlight any strategies they’re using as creative
coping strategies to help them survive but also encourage them to identify
alternate healthier ways if the ways they’re using are unhealthy if you enjoy
this podcast please like and subscribe either in your podcast player or on
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this podcast please like and subscribe either in your podcast player or on
youtube if you want to attend and participate in our live webinars with
dr. Snipes you can subscribe at HTTP colon slash
slash all CEUs comm slash counselor toolbox this episode has been brought to
you in part by all CEUs com providing 24/7 multimedia continuing education and
pre certification training to counselors therapists and nurses since 2006 you can
use coupon code consular toolbox to get 20% off of your current order if you are
a podcast listener especially on an Apple device it would be extremely
helpful if you would review counselor toolbox to do this on your Apple device
go to the podcast app search for counselor toolbox select the icon for
the podcast tap the reviews tab in the middle you should then see an option to
click write or review we’d love to see five-star reviews so if there’s anything
we can do to make this podcast even better for you please email us at
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