This week’s guest post is Part 4 in a five-part series that looks at how to fill the gaps in our current mental health care system on an individual basis. Lucy Merriman has been guiding us through information about mental health crisis hotlines, basic skills needed to offer support to a person in crisis, and in-depth information about how to guide someone to the other side of whatever they are going through. These posts contain some seriously valuable information, and whether your friend is in a full-blown crisis, or they’re just having a bad day, these tools are excellent for anyone who wants to be a better source of support.
CN: mental health crisis’, mental health management, discussion of abuse, emotional content
Welcome to Part 4 of our five-part series dealing with the mental-health crisis in America. If you’re just joining us, my name’s Lucy, and I’m a trained volunteer at the crisis hotline in my home county in Ohio. The place I live is one of the geographic areas The United States Department of Health and Human Services has said has a severe shortage of mental health professionals.
In Part 1, I talked about my personal story dealing with a mental health crisis, and my experiences on both sides of the phone.
In Part 2, I went over the first elements of helping someone in your own life work through a mental health crisis: embracing a calm, compassionate mindset, setting boundaries, and assessing danger.
In Part 3, I started talking about processing. Processing is the key to helping someone through a crisis state and out the other side into calmer waters. Processing is a big, well, process! So, I ended up breaking these steps up into two articles. Part 3, covered reflecting, validating, and asking. This post, Part 4, continues to explore processing by talking about educating, normalizing, and comforting.
Educating, normalizing, and comforting are all aspects of processing that help people feel heard and cared for. Educating and normalizing become easier to do after your friend has already told you their story, which is why these steps are in the second half of the emotional processing method. Since educating and normalizing involve you doing more of the talking, it’s important to wait until your friend is done with their story to take these steps; otherwise, you risk making them feel talked over.
On the other hand, comforting is something you can potentially do at any point if it seems like your friend needs it, so don’t get stuck on the rigidity of the steps here.
Alright, so, let’s get into depth about the educating, normalizing, and comforting aspects of emotional processing.
Educate Your Friend If They Have Misconceptions About their Crisis
Even though it’s important to prioritize your role as a counselor above other roles while you support your friend during a mental health crisis, including the role of “educator,” there is a very narrow scope of education that can be helpful when someone is in a crisis.
It can help to educate your friend about what is “normal” versus “not normal,” especially when it comes to symptoms of mental or physical illness, or when they are describing an abusive situation or relationship.
Often, people in abusive relationships or families, even ones they have since left, genuinely do not realize that their situation is or was abusive, rather than merely painful. Likewise, a person who has obsessive thoughts, nightmares, insomnia, or poor executive function, may believe that everyone else has the same struggles and thoughts but others simply deal with it better than they do.
If your friend implies that they believe that an abusive situation is normal, or that their symptoms are things everyone has, it is good to politely interject and explain that their experience is NOT normal; it is serious or extreme.
While this could potentially be frightening, it has often been my experience that hearing factual information has been a great relief to people. Being able to see their situation in contrast to other people’s emotionally healthy relationships, or mentally-well minds, can illuminate the situation and relieve some burden that comes from wrongly blaming themself for their problems.
An example of education could involve hearing your friend mention that their partner repeatedly belittles them and calls them insulting names, but then they say something like, “Well, every couple argues.” In response, you might say, “Yeah, every relationship has some friction, but insults and making you feel small and hurt aren’t loving things to do. They’re aggressive. And if someone continues to do aggressive things to hurt you, and they have power over parts of your life [your emotional life, your home environment, your finances, etc], that’s actually emotional abuse.”
If you feel like something in your friend’s perception is off, but you’re not sure what the issue is, education can also involve using Google to look up accurate information from professional sources. So, you might say, “I’m not sure if that’s normal; let’s check that,” or, “That sounds like abuse [or symptoms of a mental illness] to me; can I look up some information with you?”
For example, the National Institute of Mental Health and the National Alliance on Mental Illness are both professional-quality resources that can help someone figure out if their symptoms might warrant a visit to a doctor. And one source I love using to talk about abuse with people in the midst of it is the website LoveIsRespect.org.
Normalize your Friend’s Experience
In addition to educating, normalizing can also help a person in an abusive situation, or someone dealing with mental illness symptoms. If a person in crisis learns that their situation is something many people have dealt with and come out the other side of safely, it can help soothe them. When someone hears that others enduring the same thing felt the same pain, yet found a way to safety, that knowledge sometimes gives them the courage to continue to process and potentially begin to problem-solve. Normalizing works even if their situation is not “normal,” or “okay;” no matter how bad it is, it’s not terrible in a unique or insurmountable way.
In practice, normalizing usually means telling a true story of someone in a situation that’s similar to your friend’s situation, who got through it. The story can be from another person who is famous, historical, someone you know, or even from your own experience. If your friend says things like, “I am never going to get out of this situation,” or, “I’ll only ever love abusers or live alone,” those are cues that normalizing might be helpful at this point in the conversation. Talking about someone who made it through the darkest place and into a safer, more loving life can give them hope.
Normalizing is trickier than other skills because it does involve talking more than listening. Remember that the crisis counseling session needs to be centered on the person in crisis, so, when normalizing watch for clues that you might have misjudged their needs and they actually want to speak more-- or that they are genuinely interested in what you’re saying. This is especially something to watch out for if you know you tend to be a storyteller who goes off on tangents!
In a conversation that isn’t face-to-face, it can help to pre-empt normalizing by asking permission. This can sound something like: “Do you mind if I tell you about my friend Macy? Because I’m hearing you say, ‘I am never going to get away from these intrusive thoughts,’ and she actually had intrusive thoughts too.” If they say yes, then go for it. If they say no, go back and ask them an open-ended question about their situation. And if there’s a long silence (or they don’t reply in text-based communication) treat it like a non-verbal ‘no,’ and go ahead and ask them an open-ended question to get things going again.
It’s also important to make sure that the story you tell when normalizing is basically the same, in content and in severity, as your friend’s situation. If your example is something more severe than what your friend is dealing with, you run the risk that your friend will think that, in comparison, their own issue is not actually serious or worth working through. If your example is less severe, sometimes your friend might feel minimized or misunderstood because they’ll infer that you believe that their situation and your analogy are equal.
Even though that’s not what you meant by it, when someone’s struggling with a depressive or anxious episode, their mind can twist things that you say into a reason to berate themselves. That’s not on you! But, to guard against it during a crisis, make sure you’re listening for what they need and normalizing by using similarly-serious analogies.
All that said, normalizing is an important tool in your toolbox. If your friend seems to want you to say something, educating or normalizing can be a good choice.
Comfort your Friend in a Way that Makes Sense to Both of You
Often a person in crisis might be soothed by a physical comforting act but they’re too embarrassed to ask, or they’re too overwhelmed to think of asking. Especially if the person is your friend, it can help to offer comfort in ways both they and you yourself are comfortable with. It’s important to remember that when it comes to physical touch specifically, personal experiences vary widely. So, try to ask verbally if someone wants physical comfort, rather than relying on non-verbal gestures to communicate.
if there are only certain kinds of comfort you’re okay with offering, you can ask in a close-ended way. Asking, “Do you want me to make you some tea?” or “Do you want a hug?” can be helpfully direct when someone is overwhelmed, and since you’re offering, they can safely assume that you aren’t uncomfortable with making tea or hugging.
However, it can also be good to ask in an open-ended way about comforting someone. “What would comfort you right now?” Your friend might have a simple idea that you’d never think of yourself, and being able to ask for that thing specifically can be empowering.
The Calm After the Storm
Processing is challenging! Ideally, by the end of emotional processing, a person who was previously in crisis, is now, if not at peace, then at least significantly less distressed. Processing can do someone in crisis a world of good. For some people, processing is as far as they need to go; after this kind of conversation, they’re a lot better.
For others, when someone finally begins to feel calmer after processing, they want to transition into concrete problem-solving and gathering resources. The “thinking brain” is safely back in the driver’s seat, which makes this stage an opportune time to make medium-term and long-term plans to deal with their problems.
In my personal experience calling into a crisis-line, after I made it through the emotional exhaustion of panic I was able to figure out a plan of what I would do that night (go to sleep without harming myself), what I would do the next morning (wait for the return call, take courage) and what I’d do the following afternoon (make an appointment with my general physician).
Part 5 is all about how you can help walk your friend through problem-solving, encourage them to make positive choices, and figure out what resources are available in your area.
In the meantime, I appreciate you reading this. Connecting your good intentions to concrete, helpful skills take practice and time, and I’m glad you’re out here making the effort. I know it can be tough, but take heart! It gets easier the more you learn and practice, and the easier it gets, the more people you’ll be able to help. In this way, you can genuinely make a difference by treating our communities’ mental health crises with something better than posters and platitudes.
About the guest blogger: Lucy Merriman is a poet and artist living with her friends in Ohio. Her poetry has been printed in Pif Magazine, and her personal blog, Welcome to Tree City, is a fun place where she interviews artists, posts contemporary art criticism, and is generally trying to figure the big stuff out. You can also find her on Instagram on @merriman_lucy. She likes people! She probably thinks you're pretty neat.