Understanding People in Crisis

When the word crisis is mentioned we usually imagine an event or a situation such as an accident or emergency with feelings of panic and being out of control.  Actually, crisis is a normal part of life.  There are three types of crises: 

1. A developmental crisis is- a natural part of life where as we grow older we change from infancy to adulthood.  The psychosocial theory of Erik Erikson identifies the specific psychosocial crises we go through during each stage of our life span.  Each crisis demands a resolution.  Failure to resolve the crisis has significant impact on the continued development of personality.   
2. An evolutional crisis is a crisis that happens as we enter into a new role or relationship.  The forming of new systems of behavior and interaction that govern the new relationship or role is very stressful and can lead to a crisis     
3. A situational crisis is caused by an event or unexpected circumstance that impairs a person’s level of functioning.  

Crisis is a perception of an event or a situation as being overwhelmingly difficult so much so that it exceeds one’s personal resources, and the use of customary coping mechanisms no longer works (Gilliland & James, 1988, p.3.).  Crisis is different from stress.  Stress is a normal reaction, which involves physiological and psychological response to difficult situations.  We normally feel anxious during these times of stress.  Prolonged stress is dangerous to one’s health because stress causes emotional and physical strain on one’s body, which eventually affects the immune system.  Stress can result in ulcers, asthma, skin rashes, high blood pressure, heart attacks, etc.    

When does stress become a crisis?

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A normal stress can become a crisis due to how the person perceives the situation or event and how he views himself in relationship to his stressors.  Negative perceptions start one on the road to crisis.  The negative perceptions can be due to cognitive distortions or just very difficult circumstances.  

*Changing how the person perceives his problem is the key to crisis intervention.

 

If the perception is negative, it results in a negative self-evaluation, which leads to negative emotions (subjective emotional distress increases).  In turn, negative emotions can make the person more ineffective in problem-solving.  This negatively impacts their ability to use adequate coping strategies.  Coping methods fail to work and the level of functioning is lowered in all areas:  psychologically, emotionally, spiritually, socially and occupationally.  Normal function is impaired and can be recognized as lower than before the precipitating event occurred.   Other psychological dysfunctions may occur.  The stressful situation has become a crisis.

Later when the person is already in a lower functioning level and another crisis-triggering event  happens or even a minor stress, the person can become overly reactive and sensitive.  A whole slew of negative perceptions and negative emotions accumulated from previous stressors come back overwhelming the person.  This is how a minor stress can turn into a crisis.  The minor stress is “the straw that breaks the camel’s back.”  When a person has been carrying a heavy load for a long time, any additional load can cause the person to break down. 

 

Therefore a crisis is an acute emotional reaction to a powerful event or situation (called a precipitating event) that disrupts the person’s equilibrium and exceeds the person’s coping mechanisms and problem-solving techniques.  

Precipitating event:  An actual event in a person’s life that triggers a crisis state.  It can be situational or developmental.  We usually think of the precipitating event as the crisis itself, but psychologically speaking, the crisis is in the person’s response to the event.  For a highly stressed person, a minor stress can be a precipitating event.

Kristi Kanel suggests an ABC Model of Crisis Intervention

• A - The counselor must develop and maintain rapport with the individual in crisis.  This is done by attending to the person and listening empathetically, paraphrasing and reflecting feelings.
• B - The counselor helps the person in crisis identify the nature of the crisis and alter their thinking patterns and perceptions of the situation by giving support and validation.   
• C - The counselor helps the person identify effective ways of coping with the crisis, which includes resolution and finding support.

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Changing the perception of the situation (the determining factor that turns stress, disappointment or loss into a crisis) requires one to pay attention to the person, listen, and empathize with person.  Do not judge the person for overreacting or tell him that he is not acting in faith just needs to trust God more.  Instead, allow the person to talk about the situation, to describe how he thinks about it, how he feels about himself and God for allowing this situation to happen.  Allow him to grieve over his loss.  Explore the different emotions that this person feels, examine the degree of the intensity of this emotion, and what thoughts produce these emotions.  Examine how he perceived himself during the situation and how he perceives himself now.  Reframe these negative evaluations of the event by normalizing the situation and his reaction and helping the person to gain new insight into the situation. 

While problem-solving and exploring alternatives, consider the person’s resources and network of support.  Guide and empower the person to tap into those resources.  Teach the person adequate skills to be able to find some sense of control and courage to face his problem.  Here are some of the aspects where you will assess present resources that can help this person:

• Material resources:  Tangible things such as money, transportation, clothes and food.  How can these things help the person to cope with their crisis?
• Personal resources:  Intangible things such as intelligence, ego strength and physical health.  How are these things impacting the person’s handling of their stresses?
• Social resources:  A person’s friends, family and co-workers.  The more resources one has, the better the person will weather a crisis.  Who are people in the person’s life that he can count on in hard times that are willing to help?
• Spiritual resources:  The faith and beliefs of a person, including faith in God, the “theology” of their struggle and suffering, their spiritual disciplines and their spiritual community