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Crisis Intervention

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I remember vividly the first time anyone asked me to become involved in a crisis situation.  I was an undergraduate at Ohio University, and one of my friends came charging into my room, saying, “Come on, you have to help Jerry!  You have to help, come on!”  Even then, I intuitively knew that you don’t just stick your nose into every dogfight you happen to come across.  The alarm and urgency of my friend, though, was nothing to ignore or take lightly.  When I got to Jerry’s room, he was doing nothing.  I mean absolutely nothing.  He was not talking, he was not looking at anyone, he was not responding when people touched him, he was simply doing nothing, and it was scary.  I would like to be able to tell you how clever and effective I was, but the fact is, I really screwed up.  I acted scared, then I acted concerned, then I ignored him; then I got angry and went back to my room, figuring, “The hell with it.”  For that matter, the guy who came barging in so upset about Jerry handled the situation in about the same way.  The next we heard, Jerry had been taken by the emergency squad to the University Health Center.  Fortunately for Jerry (and for me as far as that goes), he had one friend who had stayed with him, who had somehow got him to talk a little, and who realized that something had to be done by someone.  In Chapter 3 we will talk specifically about our right and responsibility to intervene in crisis situations, and about the criteria for deciding whether or not to intervene.  My memory of Jerry tells me, though, that people in crisis need help more that they need to be left alone; that it is better to do too much than not enough, and that just because things sometimes work out on their own does not mean that they always will.

A minister told me about one of his early crisis experiences.  A very upset and frightened lady in her middle forties came to his home one evening in real desperation.  Her husband was a successful physician in the community; his gambling had started innocently enough with a Tuesday night poker game and an occasional trip to the racetrack.  He had gradually started gambling in amounts that far exceeded what he and his family could afford to lose, and the squeeze had come.  He had borrowed against his house and everything else he had of value.  Over a period of a year or so, his surgical practice had deteriorated because of his preoccupation with gambling and the resulting debts.  That afternoon, he and his wife had had a terrible argument over the situation, and she was terrified about what might become of him and the family.  “Will you please go talk with him,” was her plea to the minister.  “I can’t help him unless he wants help,” was the stock reply.  I’ve said the same thing, haven’t you?  One of our employees or co-workers, one of our friends or neighbors, a member of our family, or even someone we don’t know very well, wants us to try to help.  They want us to become involved in their problem and they ask us to try to talk with someone for them.  It is my hope that this book will help you get to the place where you can tell the “dogfights” from the real crisis situations, and that you will be able to intervene effectively when intervention is justified.  You will still get a little too involved once in a while, but you will rarely refrain from getting involved when you really should.

I was recently talking with a deputy sheriff and a city policewoman after one of a series of crisis intervention training classes that were part of a more broadly oriented police training school.  It surprised me a little to learn how frequently police are called in to respond to emotional and social crises.  For many people, the police are their first resource when they are involved in or observe severe arguments or blowups within families, apparent drug reactions by teenagers and young adults, heightened social tension within schools and community groups, and when things are generally getting out of hand and people cannot think of anyone else to call.  It is very important for the police not to increase tension, to avoid making people more angry and agitated, to refrain from exceeding their authority, and, above all, to avoid overreacting.  Nonetheless, both the deputy and the policewoman expressed a sincere desire to help people who really need help.  With their improved understanding of the social interaction nature of conflict and crisis, they felt that “crisis communication” was a tool that would make them more effective in their efforts to get people to slow down, calm down, think things through, and plan ahead.  For the police, as with the rest of us, there is nothing they can do about what has already happened.  But being able to see the potential cumulative effects—that is, the snowballing effects of a situation—and being able to respond in a way that gets people to slow down and calm down will take the crisis potential out of the situation and effectively keep matters from getting worse.  Interestingly, the police officers indicated that in these kinds of situation a crime usually has not been committed.  With that in mind, the officers see crisis intervention and crisis communication as improving their skills in crime prevention.  Their real enthusiasm, though, stemmed from the fact that they have acquired a new and felt ability to help people in extreme social and emotional difficulties.

School principals and family physicians tell me about a problem they have in common.  An unexpectedly high proportion of their time with parents, students, and patients relates to social and emotional conflict and crisis.  The school principals talk about irate parents who feel that school has mistreated or mishandled their children, students who feel that they have been treated unfairly or who are reacting in a depressed or angry way to something that has happened with their friends or family, and teachers who are sure that they can run the school better than the principal or who are at their wit’s end with a particular student or group of students.  While we are talking about school people, superintendents of school districts have all of this plus the added burden of citizens and citizen groups who know that education isn’t like it used to be and want to know why.  Teachers, principals, superintendents, school counselors, and anyone else who deals with kids a lot in an education setting—as a Scout master, 4H leader, or anything else—it seems are seen as experts on all aspects of children and their adjustment.  They talk about parents and kids who have come to them to complain about or express concern about one another.  Kids think parents are unfair, unreasonable, and that the best solution is to run away from home, quit trying, get into trouble, or do something else equally drastic.  Physicians tell me that much of their practice consists of people who are expressing physical symptoms that are caused by or related to emotional and social upheavals.  Some of those people are spontaneously able to relate their difficulty to marital problems, depression, social situations, or other things in their life that are causing stress and tension.  Quite often, though, the family doctor is called no matter what goes wrong.  People are not experiencing any real medical emergency but are experiencing social and emotional crisis.

School people and physicians alike, then, are asked to deal with and help people in all kinds of social and emotional crises.  They do not have time for either short- or long-term counseling or therapy, and even if they did, they usually do not have time to develop the skills of a psychiatrist, psychologist, or psychiatric social worker.  Had they wanted to do that, they would not have gotten their degrees in education or medicine.  What they want and what this book has to offer is a well-grounded, common-sense, person-to-person approach to conflict, crisis, intense emotional and social difficulties, and deteriorating interpersonal relationships.  Students in mental health disciplines and volunteers training for service with hot lines and drop-in centers, a wide range of professionals and others daily involved with people in stress and in tension-laden situations should find it helpful in their efforts to understand real people with real problems.

In its historical development, crisis intervention has been a somewhat bastardized version of long-term therapy and counseling.  In both New York and California, crisis intervention was initially conceptualized as “short-term therapy.”  This book is about neither counseling nor therapy.  It is about people like you and me helping people like you and me to cope with situations that arise if and when things get out of hand.  We can use this approach to crisis intervention, crisis communication, and relationship building to help our students, patients, clients, friends, co-workers, family members, employees, and even to help ourselves when we are in crisis.

A cure for everything?  Definitely not.  Crisis with its concomitant intense social and emotional conflict is not an all-the-time or forever thing.  It is something that comes up once in a while for most of us and frequently for some of us.  When the boiler is about to blow, we can get it to cool down and can thus prevent the explosion.  We, or the other people involved, may need help—a lot of help—to get things straightened out and working smoothly again.  Ours is a first aid or emergency intervention.  At times, that’s all that is needed.  At other times, much more may be needed after things are cooled off.  Even though what we do is limited and fairly specific, if we just let things blow or do not know how to keep them from blowing, there may be nothing left to work on later.  We are talking about a limited kind of problem, a limited area of knowledge, and a limited set of skills.  We are, nonetheless, dealing with an area of life that our very human interest in each other presses us to deal with.  Whether it is part of our job, part of our volunteer work, or part of our trying to live with and deal with one another, knowing when to help and how to help is “where the action is” for most of us.

As you come to know the many people you will find in the pages of this book, you may get the impression that crisis just reaches out and grabs a person.  You might also get the feeling that people in crisis always call the hot line, their minister, their family doctor, the police, or go to a drop-in center or emergency service.  Both of these impressions would be wrong.  Probably most people in crisis don’t seem unusually distraught and don’t turn to volunteers or professionals for help.  They talk with their family or friends.  I have tried to construct situation and develop realistic people you can relate to and remember.  Crisis intervention is a conceptual thinking process but it is also a feeling, doing process.  As you become involved (inevitably) in crisis and intense conflict situations.  I hope you will remember the people you have met and will relate their problems and intense emotions to the situation with which you are dealing.  That is, in part, why emphasis has been given to clearly picturing emotions and typical situations in a way that may make them seem a little unusual.  To get you to relate the material to your own experience, your own life, and to situation with which you may come in contact, let me tell you about Bill and Linda Green’s quiet crisis.

I was at home one evening, when the dogs started announcing the arrival of a car in the driveway.  It was Ed, my chess-playing buddy.  He didn’t want to play chess that evening.  Ed and his wife Judy had come to talk about their friends, Bill and Linda Green.  Bill had been talking to Ed that afternoon on their way home from work—they sometimes ride together.  Ed had asked “How’s the family?” and was shocked to hear Bill reply, “Linda and I are getting a divorce.”  Ed thought Bill was kidding and made a few of those wisecracks guys make to each other when marriage problems are mentioned.  “No, it’s true.  Linda was going to call our attorney this afternoon to see about a dissolution,” was Bill’s rather matter-of-fact reply.  “We still love each other and all that, but we just don’t have anything to talk about.  I talk to everyone else but not to Linda, and she talks to everyone else but not to me.  Last night we got to talking about our not talking.  Somehow a divorce came up, and we decided we might as well, since there seems to be nothing left of our relationship.”  Ed fumbled and stammered the rest of the way home and hit Judy with the news as soon as he got in the door.  She immediately called Linda to see if it were true.  Linda told her that it was and that she had an appointment with the attorney the next day.

Ed and Judy went over to Bill and Linda’s house later on but hadn’t gotten very far.  Bill and Linda seemed quite willing to talk with Ed and Judy about the situation but no better solution than a divorce had developed.  Ed and Judy had now come to me to see if I had any ideas about how they could help with what they perceived to be a real crisis.  Of course their perception was accurate.  Bill and Linda were in the process of making a life-altering decision in a most quiet and highly civilized way.  Ed and Judy really wanted to persuade me to talk with Bill and Linda.  I didn’t know them at all but agreed with Ed and Judy’s conclusion that my going to talk with them wouldn’t make things any worse and had at least some potential for helping.

After some awkward introductions and letting Bill and Linda know that I knew they were having problems, I asked Bill, “Do you really want a divorce or is it that you really want for Linda to talk with you more?”  The dam broke, and a flood of emotions came out.  There was a real mix of fear, anger, frustration, desperation, love, affection, hate, and about every other emotion you can imagine.  Bill didn’t want a divorce; he wanted Linda.  Above all, he wanted to be “civilized” about it.  If a divorce was what she really wanted, then that was what he really wanted for her.  “Me want a divorce?  You’re the one who brought it up.  I just want us to be happy and for us to live together and talk with each other like normal people.”  Linda’s emotions were as intense and as varied as Bill’s.  So did they kiss and live happily ever after?  No.  They are fighting, arguing, and really trying to negotiate a relationship with which they both can live and be comfortable.  Will they successfully build this new relationship?  I don’t know, but at least they canceled the appointment with the attorney and haven’t scheduled another one yet.  Are they seeing me or someone else for marriage counseling?  No.  They are both fairly strong-willed and self-reliant people who figure that if they can’t work it out between themselves, no one else can help them work it out.  They are even closer friends with Ed and Judy, though, and I haven’t heard from them since that evening.

However, things turn out with Bill and Linda, Ed and Judy did not make the mistake I had made with Jerry back in my undergraduate days.  Their friendship with and concern for Bill and Linda was strong enough and mature enough for them to run the risk of losing the friendship, get themselves too involved, and expose themselves to a possibly uncomfortable and embarrassing situation.  Caring is a commitment to try to understand, to feel, and to do all we can to help….

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