How to support others in a crisis?

What are the types of crises?

Psychologists define a crisis as experiencing a change so significant that it causes significant cognitive or emotional stress in those involved. There are many varieties of crises. They can have a developmental basis when we experience changes typical of particular stages of life, such as moving out of the family home at the threshold of adulthood, when we try to adapt to a new situation. Another type of crisis is the so-called situational crisis, which occurs as a result of sudden, unpredictable events, such as a natural disaster (e.g. a flood). A special type of crisis is mental health crises that occur, for example, with depression.

What to look for when we suspect a crisis in a loved one?

Recognizing the signs of a worsening condition is crucial when supporting a person going through a crisis. Here are the symptoms that we should pay special attention to:

1. Neglect of personal care or duties

Neglecting hygiene, skipping days at work or school, and not fulfilling basic duties may indicate that a person feels overwhelmed or unable to cope with daily tasks. Such negligence can be associated with experiencing severe stress or depression.

2. Changes in behavior

Significant changes in behavior may indicate a deterioration in mental health. These include withdrawing from social interactions, losing interest in previously enjoyed activities, or sudden changes in eating or sleeping patterns.

3. Greater agitation, nervousness, or irritability

Increased irritability, anxiety, or unexpected anger can be a sign of an escalation of inner anxiety. These behaviors are often associated with acute stress responses
and may be associated with coping difficulties or emotional overwhelm.

4. Expressing feelings of hopelessness or helplessness

If a person often verbalizes feelings of hopelessness (eg, “It will never be better”) or helplessness (eg, “There is nothing I can do”), this may suggest that the crisis is deepening. These types of expressions are often preceded by more serious effects (e.g. suicidal thoughts).

5. Drastic mood swings

Sudden and extreme mood changes — such as a rapid transition from sadness to euphoria or vice versa — can signal a crisis, so in such a situation it is worth persuading a loved one to reach out for professional help.

6. Unusual, risky behaviors

Engaging in risky or reckless behaviors, such as substance abuse or careless driving, may reflect difficulty with overwhelming emotions or indifference to one's own safety and well-being.

7. Expressing the conviction of being a burden to others

The repeated statement that a person in crisis feels like a burden to others or is unimportant is a serious warning signal. It may indicate a deepening emotional pain and the onset of suicidal thoughts.

8. Isolation despite attempts to support

Withdrawing from relationships with others during a crisis is a common phenomenon. However, a noticeable change, as a result of which the person isolates himself even after repeated offers of support, may indicate the need for immediate professional intervention. Isolation of this type can be a factor resulting, for example, in suicidal thoughts.

9. Preoccupation with death or self-harm

Talking about death, expressing a desire to harm oneself, or making statements such as “The world would be better without me” should be especially alarming. Such statements are often warning signals that indicate suicidal thoughts, so it is important to consult a psychologist or psychiatrist immediately.

What to do and what not to do?

Supporting a loved one during a crisis while respecting their boundaries is a huge challenge. Psychology, however, provides us with valuable knowledge on how to provide support while taking care of our own well-being. Here are tips on how to act in contact with a person affected by a crisis:

1. Active listening without judgment

Active listening is the basis of emotional support. Research indicates that giving the other person a safe, evaluation-free space to express their feelings and thoughts can reduce their anxiety and promote mutual trust. Active listening involves maintaining eye contact, using “I'm here for you” statements, asking open-ended questions, and refraining from interrupting, proposing solutions, or unsolicited advice. Research also shows that reflective listening and paraphrasing the other person's statements helps them feel better understood.

2. Empathy and Affirming Emotions

Acknowledging and validating emotions is crucial when we undertake to support a person in a mental crisis. Research related to emotion-focused therapy emphasizes that acknowledging someone's feelings (statements such as, “It's understandable that you feel this way”) reduces feelings of isolation. However, it should be borne in mind that this way of communication does not have to mean agreeing to everything that the other person says. Rather, it goes
about showing that we understand her emotions and accept them with respect.

3. Asking about needs instead of assumptions

One of the simplest and at the same time the most effective ways to support
while respecting the other person's boundaries, there is the question “How can I support you now?”. Offering choices or asking open-ended questions prevents unwanted advice from being imposed and helps the other person maintain a sense of control in difficult times.

4. Being Present

Sometimes our mere presence is enough to make the other person feel less overwhelmed by the problem. Research on the supportive presence of loved ones shows that physical or emotional closeness can significantly reduce stress levels. Being with the other person
in silence, offering a comforting touch (if welcome) or being available
strengthens our role as a safe support if necessary.

5. Avoiding offering unsolicited advice

Unsolicited advice and solutions can give the impression of disregard, moralizing, or trying to take control, even if the intentions are good. Research on communication patterns during crises shows that advice is more helpful when the other person asks for it. Instead of giving advice, it's a good idea to use phrases like “Would it help if I shared what I think?” This allows the other person to maintain autonomy, while communicating the possibility of more concrete support if needed.

6. Encouraging to seek professional help if necessary

If the crisis is severe, gently suggesting that you seek the help of a professional
The field of psychology can be groundbreaking. Research shows that many
in a difficult situation, they feel relief when the person they trust supports the search for therapy or advice. It is then worth using encouraging, non-derogable statements such as “I care about you and I think a specialist could provide you with more professional support”.

7. Self-care

Supporting a person in a crisis can be emotionally taxing. Research on caregiver burnout highlights that setting boundaries for yourself in helping protects against emotional burnout. Taking care of our own well-being is very important, because our psychological well-being guarantees that we will remain a stable source of support.

What to do when we notice alarming signals?

If a person in crisis shows symptoms of mental deterioration, support should be offered — here's what we can do:

• To monitor a person's condition, maintaining tact and empathy and respecting their boundaries — it is worth asking about well-being in a subtle way and expressing your concerns without judgment.
• Suggest reaching out to a mental health professional for help, emphasizing that seeking help is a manifestation of strength, not weakness.
• Be present, giving support to the person in crisis and reassuring them that they are not alone with their problems.
• If necessary, seek help immediately. If the person affected by the crisis is struggling with suicidal thoughts, we should immediately contact the emergency services or the emergency hotline.

It should be borne in mind that the stress caused by the crisis can reduce the ability of the person affected to process information effectively. As a result, such a person may disregard symptoms or make decisions that are not conducive to improving the situation,
They can even make it worse. This is an important tip for loved ones, who should show special vigilance and careful observation of behavior at this time.

Bibliography:

1. American Psychological Association, APA Dictionary of Psychology (2nd ed.), 2015.
2. Van Orden K.A., Witte T.K., Cukrowicz K.C., Braithwaite S.R., Selby E.A. & Joiner T.E. Jr., The interpersonal theory of suicide, Psychological review, 117 (2), 575—600, 2010, https://doi.org/10.1037/a0018697
3. Joiner T., Why People Die by Suicide, Harvard University Press, 2005.
4. Nock M.K. & Prinstein M.J., Contextual features and behavioral functions of self-mutilation among adolescents, Journal of abnormal psychology, 114 (1), 140—146, 2005, https://doi.org/10.1037/0021-843X.114.1.140
5. Rudd M.D., Berman A.L., Joiner T.E. Jr., Nock M.K., Silverman M.M., Mandrusiak M., Van Orden K. & Witte T., Warning signs for suicide: theory, research, and clinical applications. Suicide & life-threatening behavior, 36 (3), 255—262, 2006, https://doi.org/10.1521/suli.2006.36.3.255
6. Beck A.T., Weissman A., Lester D. & Trexler L., The measurement of pessimism: The Hopelessness Scale. Journal of Consulting and Clinical Psychology, 42 (6), 861—865, 1974, https://doi.org/10.1037/h0037562
7. American Psychiatric Association, Diagnostic and statistical manual of mental disorders (5th ed.), 2013, https://doi.org/10.1176/appi.books.9780890425596
8. Bodie G.D., Vickery A.J., Cannava K. & Jones S.M., The Role of “Active Listening” in Informal Helping Conversations: Impact on Perceptions of Listener Helpfulness, Sensitivity, and Supportiveness and Discloser Emotional Improvement. Western Journal of Communication, 79 (2), 151—173, 2015, https://doi.org/10.1080/10570314.2014.943429
9. Deci E.L. & Ryan R.M., Intrinsic Motivation and Self-Determination in Human Behavior, Berlin: Springer Science & Business Media, 1985.

https://doi.org/10.1007/978-1-4899-2271-7

10. Woldarsky Meneses C., Emotion-focused couples therapy. Person-Centered & Experiential Psychotherapies. 16. 1-20, 2017, https://doi.org/10.1080/14779757.2017.1330706.
11. Coan J.A., Schaefer H.S. & Davidson, R.J., Lending a hand: social regulation of the neural response to threat, Psychological science, 17 (12), 1032—1039, 2006, https://doi.org/10.1111/j.1467-9280.2006.01832.x
12. Goldsmith D.J., Communicating social support, Cambridge University Press, 2004, https://doi.org/10.1017/CBO9780511606984
13. Corrigan P.W., Druss B.G. & Perlick D.A., The Impact of Mental Illness Stigma on Seeking and Participating in Mental Health Care, Psychological science in the public interest: a journal of the American Psychological Society, 15 (2), 37—70, 2014, https://doi.org/10.1177/1529100614531398
14. Zarit S.H., Reever K.E. & Bach-Peterson J., Relatives of the impaired elderly: correlates of feelings of burden. The Gerontologist, 20 (6), 649—655, 1980. https://doi.org/10.1093/geront/20.6.649