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Characteristics of a Person in Crisis
PHYSICAL REACTIONS TO A CRISIS
Shock, numbness, frozen fright, fight or flight, adrenaline, heart rate, hyperventilation, body relieves self, and slow motion.
EMOTIONAL REACTIONS TO A CRISIS
Shock, disbelief, denial, fear, terror, confusion, frustration, out of control, guilt, grief, loss of trust, faith, identity, future; selfish, unpredictable.
SHORT ATTENTION SPAN:
-- person shows a narrowed, fixed span of attention. Will often have a "topic of choice", and return to that topic despite helper's attempt to change the conversation.
CHANGE IN ATTACHMENTS:
-- person is willing to talk to anyone who will listen. Much more trusting of others during this time period, much less paranoid of others...in other words, very vulnerable and open to receiving help.
CHANGE IN PERFORMANCE:
-- person's normal level of functioning decreases...job performance, social, personal, etc. A strong indicator that the person is in crisis.
ALTERED STATE OF CONSCIOUSNESS:
-- tunnel vision. Person often does not see what is obvious.
REDUCED DECISION MAKING ABILITY:
DISTRESS:
The Five Basic Steps in Crisis Intervention Counseling
1. ESTABLISH A RELATIONSHIP
2. DEFINE THE PROBLEM (assess the situation)
3. EXPLORE FEELINGS
4. EXPLORE PAST COPING ATTEMPTS
5. EXPLORE ALTERNATIVES AND DEVELOP A PLAN OF ACTION
Adapted from Kalafat, J., "Training Human Service Workers; Skills, Strategy and Self" in CRISIS INTERVENTION. 2nd Edition. Cohen et al (eds).
Helpful and Harmful Things to Say to a Victim
The following list of helpful phrases may be used if you have ever found yourself "stuck" for what to say to a client. You may use the list of harmful phrases below as a check to be sure you are not inadvertently saying things that may not support a victim. These lists may be especially useful to new legal advocates until they decide what phrases feel most comfortable for them, however, they are in no way intended to be inclusive.
Helpful Phrases:
Harmful Phrases:
10 Questions to Ask Yourself before Becoming an Advocate:
Do your best to help an individual and be supportive. Many times individuals need someone to help them through their crisis, however know your limits. If the issue seems to be getting too difficult or more complex than you are able to handle, know when to refer to a long-term counselor or another professional who is more equiped to help the person in crisis.
What It Is
Post = after Trauma = crisis Stress = impact
A working definition of Post Traumatic Stress Disorder (PTSD) is the impact after the crisis.
First applied to veterans of the Vietnam War, it has been expanded to crime victims, as well as victims of natural disaster. The essential diagnostic feature of PTSD is the development of characteristic symptoms following exposure to an extreme traumatic stressor involving direct personal experience of the event, witnessing the event or learning about such an event of a close family member or associate. The event is characterized by actual or threatened death, serious injury or threat to physical integrity. Symptom clusters may include:
Anyone can be affected by PTSD, regardless of age, race or gender. In "at risk" groups (such as war veterans and crime victims) the occurrence ranges in prevalence from 3-58%.
(Reprinted for training purposes from author: TS Nelson)
The Symptom Clusters
The symptom clusters are:
(Reprinted for training purposes from author: TS Nelson)
"What Victims Want to Say to Clergy"
A collection of feelings expressed by victims
Rev. Dr. Richard Lord
Re-printed from The Spiritual Dimension in Victim Services, A Manual for Clergy and Congregations
Don't Explain.
As deeply as I cry out "Why?", I know there is no rational explanation. My "Why?" is more a longing for God to hold me in his arms and give me some comfort than it is a question I want answered. I don't want you to try to give me answers. What has happened is absurd. It is surely not as God intended life to be. It doesn't make sense. God didn't cause it. The devil didn't cause it. It could not have been God's will.
Therefore, let us together try to explain the cause of the tragedy as factually and honestly as possible. I want God, and you as my pastor, as companions who will stand with me in my longings, not as sources of explanation.
Don't take away my reality.
My pain seems unbearable to me and yet, in light of what has happened, it feels right that I should be in pain. I know it is uncomfortable for you. I know you want to take it away. But you can't, so please don't try. The pain is a sign to me of how much I have loved and how much I have lost. If I have doubts, I am angry , understand that these are normal reactions to a very abnormal situation. I will not always be like this, but I am now. These are my feelings. Please respect them.
Help me deal with forgiveness with integrity.
Understand that if my faith is important to me, I will struggle with the issue of forgiveness. I will remember all the times I've been told that I must forgive. And yet, something deep within me resists forgiving someone who has not even said, "I'm sorry."
I wonder if I am the appropriate one to forgive that person who has harmed or injured someone I love. I don't feel obligated to forgive; I don't even feel that I have the right to forgive in those circumstances. But yet, I feel uncomfortable in my resistance to forgive.
I am also troubled by the difference between forgiving and forgetting. I desperately want my loved ones who has been killed or injured to be remembered. I resist anything that threatens the memory of one who has died. Therefore, even if I do decide at some point that I can honestly and with integrity offer forgiveness, please don't ask me to gorget what happened. It is impossible to forget, and, to me, it is very undesirable as well. Even Jesus said "Remember me" when He was dying on the cross.
Understand that forgiveness is far more than just saying three words, "I forgive you." If I say the words, they must be true. I must speak them from the depths of my very soul with absolute integrity. Don't push me to say the words just to satisfy you. I can only say them if I come to really mean them.
Stay close.
Just as a one-year-old child learns to walk with someone close by to steady him when he stumbles, stay close enough so I can reach out and steady myself on you when I need to. Understand me need to grieve, my need to withdraw, my need to agonize, but remind me that you're there to lean on when I want to share my pain.
Remember me... for a long time.
This loss will always be a part of me. I'll need to talk about it for years to come. Most people will be tired of hearing about it after a period of time. Be the person who will invite me to share my feelings about this after others have moved on to other concerns. If my loved one has died, mention his or her name from time to time and let us remember together.
Don't be frightened of my anger.
Anger isn't nice to be around. But it's part of what I'm feeling now, and I need to be honest about it. I won't hurt myself or anybody else. I know my anger doesn't threaten God. People get angry in the Bible. Even God got angry at certain things. The one to worry about it the one who has experienced violence but hasn't become angry.
Listen to my doubt.
You stand for faith, and I want you to, but listen to my doubt so you can hear the pain it is expressing. Like anger, doubt is not pleasant to be around, so people will want to talk me out of it. But for right now, let me express the questions which are measured by the depth of the loss I feel. If I cannot doubt, my faith will have no meaning. It is only as I move through doubt that a more meaningful faith will develop.
Be patient.
My progress will not be steady. I'll slip back just when everyone thinks I'm doing so well. Be one to whom, on occasion, I can reveal my weakness and regression. Let me be weak around you and not always strong. I'll make it, but it will take much longer than most people think. I'll need your patience.
Remind me this isn't all there is to life.
My pain and my questions consume me. I think and feel nothing else. Remind me there is more to life than my understanding and my feelings. Speak the word "God," not to dull my pain, but to affirm life. I don't want God as an aspirin but as a companion who shares my journey. Stay beside me and remind me of that Eternal Presence which can penetrate even my grief.
Helping Others: Christian Layperson's Help
If someone you know has been the victim of a crime, here are some do's and don'ts for helping them recover and process this event in their life and relationship with God:
Do...
Pray continually for the person, and for your conversations and contacts that you may be a healing agent by the Holy Spirit.
Don't...
Christian Clergy Help
If someone in your congregation has been the victim of a crime, here are some important care guidelines and principles for pastors and clergy.
Clergy and Victims of Violent Crime. Dr. Wayne Leaver. C.S.S Publishing Lima, OH; 1990.
A Manual for Clergy and Congregations. David & Anne Delaplane. U.S. Dept of Justice
Spiritual Dimension in Victim Services (Scott Beard 843-577-2687)
Helping a Neighbor in Crisis. ed. Lisa Barnes. Tyndale Pub. Neighbors Who Care, 1997.
To help another with forgiveness:
Don't assume you know how to define forgiveness. It is not forgetting (which places the victim in potential danger), not reconciliation (when there was no prior relationship), not justifying offender's behavior, not absolution of offender's responsibility, not retribution, not seeking compensation, and not trusting the offender. It is releasing the need to control the outcome of the aftermath, recognizing and confronting the evil done, regaining control from the offender, ending any cycles of repetition (mental, emotional, physical, and spiritual) that give the offender power, is primarily for the healing of the victim not the freedom of the offender, is something the victim is owed and can claim, and is normally successful after going through the grief process related to the loss inflicted by the crime.
For those struggling with forgiveness:
The following material was re-printed from No Time for Goodbyes by Janice Harris Lord, ©1987
Without a doubt, you will be called upon to rethink your concept of forgiveness after a loved one has been killed (or you have been the victim of a serious crime). And if you're going to survive the trauma without keeping your stomach tied in knots for years, you will need to decide how you can deal with the offender and maintain your integrity.
In killings in which the offender was also killed, the issue of forgiveness can be avoided somewhat. For those in which the offender is alive, especially if the criminal justice system is involved in the case, the issue cannot be avoided.
Society tends to forgive easily. It is so eager to forgive that it doesn't require remorse on the part of the offender. Many homicides are plea-bargained in the criminal justice system with offenders being advised by their attorney to "plead guilty" to a lesser offense in return for more lenient sentences. At the same time, the offender is instructed not to make contact with the victim's family because it might imply an admission of guilt. Does society and the criminal justice system really believe that such a plea is genuine remorse? Apparently so, because it is all that is required.
Your family may say, "If only he would look me in the ye and genuinely say 'I'm sorry.' it would mean all the world to me." The common response to such a statement is that "only a vengeful family would put an offender through that." To you it may be a very significant component in justice with integrity.
Some victim families, when shown genuine remorse by an offender, have offered forgiveness even though they can never forget. Many cannot forgive. Most are unwilling to offer a "cheap grace" to offenders- a gesture of forgiveness which has no real meaning because the offender has shown no remorse and made no commitment to a change in behavior.
You will need to decide, based on your own life experiences and religious convictions, what to do about forgiveness. It is a difficult task. If others imply that you should offer forgiveness, tell them it is an important matter and that you will handle it in a manner that your integrity allows.
Stages of Grief
The work of grief cannot be hurried. It takes a great deal of time, usually a year or more. It may be the purest pain you have ever known. What is happening to you (as a crime victim) is, of all things, natural.
The following are stages of grief commonly experienced. You may not experience all of these, and you may not experience them in this order. It is important to realize, however, that what you are feeling is NATURAL; and with TIME, you will begin to heal.
Shock:
Some people experience shock after a crime, saying things like "I feel numb," and displaying no tears or emotion. Sometimes there is denial. Gradually the bereaved become aware of what has happened, and they are able to express their emotions. Other people don't go through a prolonged stage of shock. They are able to express their emotions immediately.
Emotional Release:
At some point a person begins to feel and to hurt. It is very important not to suppress your feelings (anger, sadness, fear, etc). Suppressed feelings often surface at a later time in unhealthy ways. Shared feelings are a gift, and bring a closeness to all involved.
Preoccupation:
Despite efforts to think of other things, a grieving person may find it difficult to shift his/her mind from thoughts about the crime. This is not unusual and, with time, should not be a problem.
Physical and Emotional Distress:
These distresses may come in waves, some lasting from 20 minutes to a full hour. The most common physical distresses are:
Closely associated with the physical distresses may be certain emotional alterations. The most common are:
These emotional disturbances can cause many people to feel they are approaching insanity, but these feelings are actually NORMAL.
Hostile Reactions:
You may catch yourself responding with a great deal of anger to situations that previously would not have bothered you at all. These feelings can be surprising and they often make people feel that they are going insane. Anger may be directed at loved ones, friends, the doctor, the nurse, God, or the minister.
Often, too, there may be feelings, of hurt or of hostility toward family members who do not, or for various reasons cannot, provide the emotional support the grieving person may have expected from them. Anger and hostility are normal. Do not suppress your anger. However, it is important that you understand and direct your anger toward what you are really angry at, the fact that you've been victimized.
Guilt:
There is almost always some sense of guilt in grief. The bereaved think of the many things they felt they could have done, but didn't. They accuse themselves of negligence. It is important to remember that something was done to you. You are the victim, not the perpetrator. Guilt is normal and should pass with time.
Depression:
Many grieving people feel total despair, unbearable loneliness and hopelessness; nothing seems worthwhile. These feelings may be even more intense for those who live alone or have little family. These feelings are normal and should also pass with time.
Withdrawal:
The grieving person often tends to withdraw from social relationships. Their daily routines are often disrupted as well. Life seems like a bad dream. This is normal and will take some effort to overcome.
Re-entering Relationships:
After time, effort, airing of feelings, and a lot of love- the grieving person readjusts to his/her environment, re-establishes old relationships and begins to form new ones.
Resolution and Readjustment:
This comes gradually, the memories are still there- the love is still there- but the one begins to heal. You begin to get on with your life. It is hard to believe now- but you will be better. By experiencing deep emotion, and accepting it, you will grow in warmth, depth, understanding and wisdom.
You may find it helpful to put your thoughts about the crime down on paper. Sometimes people will write to the person they've lost, expressing their thoughts and feelings:
What I wish I had said or hadn't.
Ways in which you will continue to live on in me.
Choose ideas that have significance for you- ideas specific to your situation and relationship.
Some people simply use a journal as a place to express their feelings after a loss; their confusion and pain. A journal can help you work through your grief by giving you an outlet and way to express yourself. Once that is done, it can help you move on.
(Reprinted with permission from the Putnam County Chapter of the Compassionate Friends, Inc. August 2000 newsletter)
Common Responses to Grief
These are all natural and normal grief responses. It is important to cry and talk with people when you need to.
(reprinted with permission from the Putnam County Chapter of the Compassionate Friends, Inc. August 2000 newsletter)
Dealing with Grief
Grief takes time to heal. There is no quick fix and no easy remedy. However, there are some ways of coping and things to remember that will help you in your time of sorrow and recovery. Here are a few:
Helping Someone Else
Every person deals with grief differently. Therefore, there are no concrete ways to deal with a frend or loved one who is suffering from a loss. Below are suggestions, both of ways to help and things to avoid doing or saying.
Ways to Help
Special Considerations
There are some special considerations in dealing with men and children who are suffering from grief.
Men:
Children:
References:
Walton, Charlie. When There Are No Words: Finding Your Way to Cope with Loss & Grief. Pathfinders Publishing of California. Ventura, CA, 1996.
In 2009-12, 68% of victims of serious violent crime - rape or sexual assault, robbery, or aggravated assault - reported experiencing socio-emotional problems as a result of their victimization. For this report, socio-emotional problems are defined as the experience of one or more of the following: feelings of moderate to severe distress; significant problems with work or school, such as trouble with a boss, coworkers, or peers; or significant problems with family members or friends, including more arguments than before the victimization, an inability to trust, or not feeling as close after the victimization.
Victims who experienced severe distress as a result of a violent victimization were more likely to report the crime to police and receive victim services than victims with no distress or mild distress. About 12% of severely distressed victims reported the crime to police and received victim services, compared to 1% of victims with no distress. However, more than a third of victims reporting severe distress and nearly half of those with moderate distress did not report to the police or receive any assistance
from victim service providers. In addition, 50% of victims who experienced severe distress and reported to police did not receive victim services. It is not known if they were directed to or offered these services.
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