Ask Dr. Ceren: Crisis Intervention
© 2003-2006, Sandra Levy Ceren. All Rights Reserved.

Your angry co-worker, a recent father of twins, tells you he is being laid off.

Your tearful friend tells you her husband is involved with another woman, again.

Your hysterical, newly widowed neighbor knocks on your door after her long time pet has been run over.

You may be type of person others reach out to when they need a shoulder to cry upon. You console them, you soothe them. Your friends and associates value your sensitivity, your good judgment and turn to you when they are troubled.

You are calm, confident, and provide a good role model and can persuade the person that you don't see the situation as hopeless. You do for the troubled person what she doesn't seem able to do for herself, but no more.

You offer emotional support, listen with interest, are non judgemental, non-challenging. You allow the person to verbally vent.

You show you care and identify in some way with the crisis. "I'd feel as you do, if that happened to me."

The troubled person knows she isn't alone, for you are her friend. You make physical contact, touch her shoulder, offer a cup of tea or food.

These things are easy for you to do, but there may come a time when you are called upon to help in a serious crisis situation and your soothing isn't sufficient. You may not be able to assess the full situation, but you are called upon to make quick decisions with limited data.

You may be dealing with a chronic problem for which there are no easy solutions. The person in crisis can drain your energies. You must be aware of your own feelings of frustration, annoyance, the possiblility of your wish to control another, knowing when to let go, where the resources are for you, the helper and for the person in need of more than you can handle.

You must be aware of the limits of your expertise in psychodynamics, psychopathology and suicidology. It is imperitive to consider the possibility of suicide occurring during a crisis.

Some serious symptoms leading to suicide may include any of the following: anxiety, fatigue, depression, worry, loss of appetite, insomnia, nightmares, hyperactivity, drug/alcohol abuse, guilt, irritability, disappointments, personal losses, hyperventilation, fearfulness, thoughts and expressions of death, accident prone, illness of self or loved ones..

A suicidal person may be motivated by a wish for attention through being missed, or as an atonement for guilt, or an urge to join a lost love object, to be born again without blame, a release from an intolerable situation. Obviously, suicide is the most extreme act of self-punishment. The triggering event may seem trivial to others, but may evoke a childhood conflict unknown to you, the helper.

Many people who commit suicide have made gestures before. Some sucides occur within three months of a crisis, AFTER they seemed improved.

You, the helper, must be vigiliant and alert but figuring out the seriousness of a person's intentions is a burden for which you are not equipped. Your responsibility is to urge the person to seek professional help and see that they follow through. You may assist the troubled person in finding a proper mental health resource such as psychiatrist or psychologist trained in suicidology. This may make the difference between life and death.

If you cannot access help immediately, check your phone book for a toll free Suicide Prevention Hot Line. Know the community resources. All police and sheriff departments maintain such a list. If you refer the person in crisis, keep in frequent contact and ask your friend to let you know the outcome of the referral.

You, as helper have a unique opportunity. When you help a person emerge from a conflict, if it is resolved well, he may be healthier because he has learned or strengthened coping mechanisms. You can help him feel a deeper sense of his assets, an appreciation of himself and others. He may design more realistic goals and develop an increased tolerance for stress.