 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, you know, little paperback, but it is an old book that I actually used when I was in graduate school, but I've hung onto 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 obviously up to you. Over in the next little while, we're gonna 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 wanna 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 kinda 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. 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 reexamine what our priorities are. So it can be a great opportunity. Yes, there is the threat there, and we're gonna 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's maybe a mixture of all of those, grief, resentment, 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 resiliencies 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, 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 wanna 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. Somatic, 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 interpreted 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 broadly, just like we've talked broadly about losses, think broadly about what crises may look like for people. Natural disasters, I 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 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 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 negatives, 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 stressed and be traumatized, not 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, L-U-V. I added the E because I really think it's important to explore client's strengths, but love means listen. Listen to what they have to say and this can be the victim, this can be the survivor, this can be the child. Understand their perspective. Put yourself 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 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, A, 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'd 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 that'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 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 close 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 ADD sometimes and I'm just like, squirrel. But 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 was a 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. The clients were like, what? I'm like, big squirrel, it's climbing up the tree. And 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 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 wanna look at what's going on but we also wanna look at what arbitrarily small changes we can put in there, positive changes to help somebody go onto a more positive path. Crisis is this big event. So as they're trying to get back on their feet again they've gotta 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 go in there and we start talking to them and we say, okay, what are you ready to address? What do you think is your most problematic symptom right now? And the person says, 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 30 other people or 300 other people. There's noise, there's no safety. There is no privacy. Think about how that affects somebody. It 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 gonna 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 big reward is people feeling safe. The big reward is 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 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 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 that's going to help you get through today? What is it that'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 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 strengths-based 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 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 that 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 could have a huge effect on your ability to sleep, your sense of agitation and we can go on from there. Other small changes, 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 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 save where I'm at. 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, 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 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 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, it comes back on and it's 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 change is 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 in people or your loss of, you know, 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. You know, he's 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 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 walk you 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 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 and recognizing 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, wow, okay, you know, things are 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 the 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, 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 the individual. So I'm not gonna 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 precipitates a 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 nurture those relationships? We're hardwired to help each other. Whether you want to admit it or not, most people are very, very hardwired to reach out and lend a helping hand. Part of this is because humans 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 does the baby do? Baby gets upset. If mom's happy, no, the baby's not always happy, but generally the baby is happier than 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. We're 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 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 and go, this feels like it's the end of the world. Now, I've told you before, I've got teenagers at home and with teenagers, crises seem to happen on a pretty much day-to-day basis. So 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 the situation. Make positive observations about what supports are 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 observations. Instead of going, you are coping so well that 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 to handle on this at least a little bit right now. You know, I can hedge with the best of them. 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 there narrative in their time because there's going to be a certain amount of shock and denial at first. We talked earlier, every crisis involves 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 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'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. No, sometimes bad things happen to good people and it doesn't make any sense and sometimes you can't predict when things are gonna 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 fair, it happens. And these are just a couple of the assumptions, but they're the, some of the main assumptions that most people hold as 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 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. It's 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. As they tell it, that way they can go back and revisit the recollections, because you know what? I bet each part or each time 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. So 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 the 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 dialogues in the book that demonstrate 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, whatever happened happened, that's in the past, you are trying to transcend it, that's the present. So what is it gonna 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 happened and where you are right now? What do you see as the purpose for this? Or even what keeps you going through this difficult time? If people are still not there, they haven't transcended it, but they're going, they're 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? Cause 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 victim's perspective or the survivor's perspective, but we also wanna 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. From the survivor's perspective of FEMA did not XYZ, well, let's put ourselves in FEMA's position and explore what it might've been like to be at the FEMA offices at that point in time. That doesn't take away your feelings of whatever's going on, but it helps expand the narrative. So people can get a resolution. Blaming doesn't ever end in resolution. 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 wanna highlight these. Anything they do or say that highlights 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 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. There may be some resolve, but we wanna bolster this. Performance quality is curviliner, creepy linear in proportion to emotional resolve. 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 gonna 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 cortisol. That's 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? 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 gonna look like? And then use scaling. So on a scale from one to 10, right now the crisis just happened, you're at a one, you got some work to do. So what is it to look like and what will get you there? If you're gonna feel safer, we'll just use that for this example. What is it gonna 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, a 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, I mean, 10 steps is 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 gonna 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, 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 plump, 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 wanna be forever, but it makes 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 overstimulated. 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, I'm more irritable right now. I know where this is coming from. Or, okay, my kid's 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 that they're looking for? Are they looking for structure? Are they looking, do they need a timeout? 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. Want somebody else help? Most places have a united way that can help people find resources, whether they need food, clothing, shelter, counseling, crisis counseling. There'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. 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. 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, 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 there. 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, 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 gonna do? If somebody says they feel overwhelmed, you might suggest 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 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 don't 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 situational context from global to specific. I will never feel safe again. The world, every, everywhere I turn is dangerous. Okay, so let's look for exceptions to that. Emphasize the specific. You know, maybe, you know, living in Florida, there are hurricanes. Living in 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, the crisis ends, the, 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 transcendence. 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 back, 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, we're 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 child was very, very happy and still diligently working. And the parents were very confused. They're like, you just shoveled manure for eight hours. He's like, yeah, but with all the poop in this 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's 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 path. 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. 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 gonna 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.