January 2002
Something to think about from Dr. Wil Horton
Helping Those in Crisis, Trauma and Grieving, Critical Incident Stress Resolution.
This time I thought we would give you a review of Crisis Intervention and announce the release of a new product that you will want to add to your list of resources.
Recently I did a series of Critical Incident Stress Resolution Seminars that was so well received, we had people demanding that we get it on tape for the people who could not attend the live courses. We did this and they are now available to you.
This topic is one that we could use in these times of change and cultural changes.
A Crisis involves a disruption of a person's normal state. According to conventional thought (Caplan, 1961) it occurs "when a person faces an obstacle to important life goals that is for a time insurmountable through the utilization of his customary methods of problem solving." There are four usual manifestations of a person in Crisis: 1. Emotional upset (fear, guilt, anger, shame, anxiety, etc.), 2. Biophysical problems, 3. Cognitive upsets (can't solve simple problems, make decisions), 4. Behavioral changes (distributed sleep, eating problems, sexual dysfunction, substance abuse)
A crisis is something that is so overwhelming that it overrides a person's normal psychological and physical coping mechanisms. The overwhelming nature of a crisis can cause a person to shut down, as we do not have a reference point to draw from. As we develop, we learn to problem solve and form coping mechanisms in meeting life's demands. We use the experiences to form cognitive maps to deal with the world in general. This is how we solve problems; we rapidly categorize a demand, and pull from our resources to deal with it.
When a crisis happens that we have no reference point, we have no way to deal with the
Thoughts, feelings, and reactions because we have no experience in dealing with them. When faced with such a situation, our emotions are altered and that impairs our ability to act rationally. This can cause our perception of ourselves as helpless and this leads to high levels of psychological arousal in the form of anxiety. When we are in a crisis of any type, we are not good at solving problems, and this increases our anxiety. This further interferes with any attempt to deal with an already incomprehensible situation.
At times of great stress (Crisis) people seem to spontaneously seek out others for support, protection, comfort, and to some extent understanding. There has been considerable research that shows humans may have a biological based drive for this attachment. (Eagle 1987). When people reach out for support and it is not received, the individual in crisis feels abandoned. This absence of understanding during this crisis magnifies the loss of our coping resources. When all ways back to normalcy is blocked, the person's ability to cope is totally overwhelmed. When society as a whole is overwhelmed, or the people who normally help are also overly stressed or incapable of helping, it only adds to the problem.
Rates of Stressors
The classic study of Holmes and Rahe (1968) gives us an indication of the depth and severity of the trauma we can expect from a crisis.
EVENT:
Death of a spouse: 100 +
Death of another family member: 63 +
Personal wounds or illness: 53 -
Loss of a job or income: 47 -
Family member wounded or ill: 44 +
Personal possessions or financial losses: 38 -
Death of a close and personal friend: 37 +
Changing jobs or a new position: 36 -
Overwhelming debt: 31 -
A change in lifestyle or relocating: 25 +
A change in personal habits or routines: 24 +
A new school or a change in recreational activities: 20
A change in social activities: 18
Small debt: 17 -
Christmas, Anniversaries, and Birthdays: 12
* Not listed is Impact of Massive Society Changes, such as War, Economic Depression, and ongoing threats of Terrorism will affect us.
It is estimated that anything over 250 points will throw a lot of people into a reactive depression. You can see how in these rapidly changing times, it is easy to accumulate a large of amount of stressors.
Stages of Trauma
1. Impact stage
2. Recoil Stage
3. Adaptation Stage
The most common complaints at the beginning is the feeling of being stunned and bewildered, then a sense that things are not real. We hope to wake up from this nightmare, only to remember, in vivid detail, that it is all too real.
The other most common complaint is the feeling of vague fear, the underlying sense of being fearful of things you used to do easily. You begin to feel afraid of almost everything.
How can we help? We can use our skills to help people along the Behavioral Change Stairway, to get back into normal living, and maybe even improve their lives in ways they cannot imagine. To affect change at the level of belief. To work from our Rapport skills upward.
BEHAVIORAL CHANGE STAIRWAY
____________BEHAVIORAL CHANGE
_______INFLUENCE
____ACTIVE LISTENING SKILLS
__RAPPORT
Physicalizing* an Emotion
Sometime when a person is stuck in a state (emotion) one way to help them is to have them turn the emotion into a physical thing, something they can see, hear, feel, touch, smell and taste. Have them really get into the process of describing it. The more that they do this, the more they will disassociate from the emotion at the moment. It is hard for most people to have and emotion and describes it with their cognitive skills at the same time. This sets up a sort of cognitive dissonance, the holding of two thoughts at the same time. This is a simple technique that works wonders.
Have the person think about the emotion they are stuck in. Then have them describe: (submodalities)
Where is Located in the body?
How it looks, does it have a shape and color?
Is it big or small?
Is it moving or still?
Does it have a sound?
Is the sound inside or outside the body?
What does it feel like?
Warm, or cold?
Light or heavy?
Does it have a texture?
Once they have described it, ask if it has changed how they fell NOW.
Then you can teach them alter these submodalities.
Move it around, make it bigger/smaller.
Change the color.
Alter the sound.
Do whatever it takes to alter the feelings.
This simple technique works like magic!
Remember NEVER CONFUSE COMPLEXITY WITH COMPETENCE! True genius is taking complex ideas and making them simple.
Thanks for using your skills to help the world!