Crisis Intervention: A Social Interaction Approach (6)

MESSAGES AND RESPONSES

Figure 5 finds the individual in another crisis, but this time he has the good fortune to be in the communication loop with you. You are skilled at crisis communication and are focusing your intervention hypothesis on the need to help the individual slow down, and plan ahead.

In crisis communication, there is a communication loop in which messages, ideas, feelings, and so on, are sent out by the individual in crisis, picked up by you, and returned to the individual in a slightly modified and clarified form. Understanding this communication loop and the techniques involved in modifying and clarifying these messages, ideas, and feelings represents an important and valuable skill when working with people in crisis.

First, we need to consider the interactive nature of communication and of helping relationships. At an abstract level, a person in crisis is internally experiencing various and sometimes conflicting feelings, emotions, impulses, urges, and so on. Within the individual, then, is a confusing and possibly disturbing mix of things that contributes to his feelings of uneasiness and crisis.

Second, we want to help him feel better and become better able to deal with his situation. Within us are a variety of skills and ideas, including a knowledge of the crisis intervention process. Somehow, the individual needs to communicate what is going on within him. At the same time, and this must be emphasized, we need to make our knowledge and skills available to him.

Somehow, the individual in crisis needs to translate his feelings, emotions, ideas, and so on into messages and convey those messages to us. We will, in turn, need to decode the messages, interpret them in light of our knowledge and skills, and respond to the individual. He will then take in our response and send us another message. This interaction process of messages and responses may be verbal or nonverbal. Nonverbal communication is probably familiar to all of us. We get and give messages by touching, by the way we look or act, through gestures and posture, and so on. Whether the messages and responses are verbal or nonverbal, however, the purpose of the communication loop in crisis intervention is crisis reduction.

Betty is your neighbor and has stopped over for a cup of coffee. As you listen to her, think how difficult it is for her to translate her feelings, ideas, and emotions into meaningful messages. You want to help her focus on her immediate crisis situation, develop a picture of her crisis, and begin to think about possible solutions to her problems. This process starts by helping her to talk with you in a meaningful way. As we see, this is not so easy as one might think at first.

Betty sits on the edge of her chair, seems uncomfortable, and keeps fidgeting, putting her arms first on the arms of the chair and then in her lap, looking at you and then looking around the room, and then tentatively reaches toward her cigarettes lying on the kitchen table. Your best intention to talk to her without any interruptions gets off to a bad start. Your phone rings just as you start to talk, and she waits nervously as you talk with the store manager about your new television set that has never worked right. As you hang up the telephone, you say to her, “That’s just been one big headache. For that much money you should at least get something that works.” “At least I haven’t been having any problems like that lately,” Betty replies with apparent disinterest. “What kind of problems have you been having?” you ask.

“I don’t know how to explain it to you. You’ll probably think it’s silly. [You say: Our family and our problems are really serious to us and are never silly.] That’s for sure. It’s really serious to me. Maybe most people wouldn’t think it’s such a big thing, but it’s a big thing to me. [Betty seems to be deep in thought and rolls her cigarette in her fingers. She looks at you, then back at the cigarette, then back at you.] It’s my husband. I don’t think I love him anymore. At least I guess I don’t love him. I must not. [You ask: Have you and he been having trouble?] I didn’t think so, but I guess we must be. He says I’m boring to him and stays away all the time. If I loved him enough, he’d want to stay home more. Home must not be a very nice place for him. He’d rather be out with his friends than with me and the kids. [Her eyes began to tear a little, and she sniffles.] I don’t know what’s wrong. We have a nice house, and I try to take care of it. You can’t spend all of your time being pretty and paying all of your attention to him with kids and dirty dishes and scrubbing floors. My little girl’s teacher said I had to come in for a conference. [You can see that there is real difficulty in the relationship between Betty and her husband. She feels that he wants her to be something she cannot be. She is beginning to feel more relaxed, and her thoughts are apparently moving from here to there. She lets you know that she is also concerned about her daughter and the conference with the teacher. You ask: Did the teacher give you any idea about why she wanted to talk with you?} “No. But the way things have been going, I’m sure it’s not good.”

When people come to us, they always have a purpose or reason for talking with us about their situation. It is worth a moment’s thought to consider how you would feel taking your personal problems to someone else. It is likely that you would feel somewhat uncomfortable, perhaps a little embarrassed, and certainly unsure about how your personal feelings and ideas would be dealt with. Betty was initially uncomfortable and wanted to be sure that she was going to be taken seriously and that there would be enough time to really think about her situation. She was nervous and a little confused at first about how she should go about explaining her predicament. Your knowledge of people and their situations led you to the hunch that she may be having difficulty with her family. Had she said No in response to your question about her family, you would have moved on to inquire about other possible problem areas. For Betty, it was enough to focus her attention on her family. She was able to pick up on that and begin to talk about some of her difficulties.

Notice that she shifted rather abruptly from the discussion about her husband to the teacher’s request for a conference. In the initial phase of most crisis contacts, people will tend to jump from topic to topic in this abrupt fashion. At the beginning of the process, it is important to “go with the shift.” Your questions and comments should relate to the different problems brought up by the individual. For now, it is important to help him begin to talk about his problems and to help him feel comfortable expressing his very personal feelings and ideas. You are someone who will help him talk, and someone with whom he feels comfortable talking. Later, there will be time to keep the focus on one topic or problem at a time.