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Firefighter Ministries Articles
| Anger Takes a Physical Toll |
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Anger is an
emotion most individuals face from time to time. Situations that are
beyond our control, such as difficult calls can make one angry
especially if the outcome had unfavorable results. As humans, we make
mistakes and those mistakes can anger other humans. There are many
reasons that we become angry. Anger is a normal emotion that we feel.
What is not normal is for individuals to feel angry most of the time or
all of the time. It is also not normal for an individual to express
their anger in a violent or destructive manner.
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While anger is a
normal emotion, reactions to anger can quickly get out of control if one
does not know how to correctly release these feelings. Never, under any
circumstance should an individual take out their anger through physical
violence that is directed at either another human or an animal. Here are
some healthy tips for dealing with feelings of anger.
Sometimes it can be difficult for some
individuals to catch the symptoms of anxiety. One can become so
overwhelmed by their feelings and their
This self-test is provided by Firefighter Ministries Understanding Panic Disorder & Anxiety, A Disorder That Affects Emergency WorkersBy
Rose Cummings, Chaplain Your problem could very well be panic disorder, or panic attack, which is the core feature of the disorder. Panic Attacks are fears or discomforts that strike suddenly. It happens mostly in areas or situations where you should feel perfectly safe, but your surroundings become a direct threat and your body reacts to that threat. If you have a lease for the following symptoms you may be experiencing panic attacks. 1. Sweating 2. Shortness of breath 3. Heart beat rapidly 4. Feeling unsteady 5. Choking or smothering sensations 6. Numbness or tingling 7. Faintness 8. Trembling or shaking 9. Nausea or stomach pains 10. Feelings of unreality 11. Fear of losing control 12. Feelings of dying or going crazy These discomforts can become very intense: Unfortunately, in most cases, once the attack is over, you may begin to believe that it was an isolated incident, the placing these issues on the back burner can lead to other and more serious side effects: A). Avoidance: You may stop any activity that seemed to trigger the attack, for example, (driving, riding in elevators, going out, work, socializing with others). Soon your work life becomes hard to deal with it will not keep the attacks from happening. B). Anticipatory Anxiety: This is triggered by merely thinking about the possibility of having a panic attack. If this develops it could even call the person to become reclusive. C). Agoraphobia: This is a fear of being in places or situations from which escape mighty difficult or embarrassing. This can drive someone to avoid public places, crowds, or travel by plane or bus. Who gets it? Statistics show that twice as many women as men experience panic disorder. The disorder can begin as early as your 20s. Sometimes a serious event such as a death of a parent or child will trigger the first attack. The National Institute of Mental Health states that all the in Americans will experience panic disorder sometimes in the last. Some studies show that panic disorders wanted families, which support the idea that the condition may pass genetically through the generations.50 % to 60 % of people with disorder will also experienced depression at least once doing their lifetimes. How to treat Panic Disorder There are too many treatment for people with panic disorder. They are medication and cognitive behavioral therapy. Medications such as Prozac help 70% to 90% of people with panic disorders. Cognitive therapy consist of 5 key elements. a) Monitoring the illness b) Relaxation techniques c) Rethinking the symptoms d) Exposing situations that trigger the disorder Each treatment is effective and can be chosen by the person's preference. Continuing medical education is helping more physicians to recognize the disorder. Earlier detection is now reducing the complications of the disorder. If you have experienced any of the aforementioned symptoms see a doctor, confide to your department Chaplain, your church clergy, or family. There is nothing to be ashamed or frightened about. It doesn't care if your rich or poor, young or old, male or female. It can strike without warning and can be very intense in nature. You can start leaving your life again with effective medical treatment.
FF/ EMT PAUL L. MARSHALL
Throughout the time honored tradition of firefighting and
the new age world of Emergency Medical Services, there have been other people
in dire need of another person's help. We as professional lifesavers, have
answered the call time and time again. It is a profession that requires a
special breed of both men and women to accomplish it's many challenges-
situations that require intense and immediate concentration to complete.
In this same time span as we rush to yet another
call, we all, including myself, try to forget the last negative situation, or
block the faces of tragedy that haunt us from a previous call. Unfortunately,
by planting these feelings deep inside our minds and hearts, it tends to seed
the very base of negative emotions.
Everyone deals with emotions in a very
different manner. Some people feel the answer is to become dependant on
alcohol, and "drown their feelings". Some people choose drugs-
calling it " a break from reality" - both of which in most cases
eventually becomes worse, causes family problems, and leads to the loss of
their jobs..( and any licenses pertaining to).
But in extreme cases, which seem to be on the
rise across the nation, some of our brothers ans sisters are turning to
suicide as an answer to no longer have to deal with those faces or
remember the bad situations.
As it comes to no surprise, this is
beginning to account for many of the losses we are experiencing within the
profession. Most of the Departments across the States have put C.I.S.D. (
Critical Incident Stress Debriefing ) Teams in place to help us all deal with
that particular call that might upset us more than usual, to also help us
release our pent-up aggression from all that we see and hear each day. We all
endure a great deal in the line of duty, both physically AND mentally, and
eventually it all catches up to us. I was once told that talking it out is the
best possible solution to a potentially hazardous situation. I believe this to
be true in all regards, whether you talk to one of the professionals of
your local C.I.S.D. team, or to a fellow brother who can relate and share his
feelings - in turn helping both of you.
The key is to know that there are
alternatives to you, and that most of the solutions mentioned aft are
only temporary - and could lead to the loss of yet another - you. Know when to
say you are upset and need help.... it is another part of being a professional
- realizing when to help the most important patient..... yourself.
Sadness affects us all from time to time. It is part of the everyday human repertoire. Sadness has many names and descriptions-people have "the blues," they are "long-faced" or "under the weather." Sadness is familiar to us, easy to approach. Depression, on the other hand, can be a paralyzing affliction that has a drastic impact on daily living. Speaking metaphorically, we might say that sadness is a superficial scratch, while depression is more like a wound that may require a tourniquet. Sadness can distort our vision, so that rich colors are dimmed, but depression blots out all light and leaves a blackened, desolate landscape. And while sad people may need to be comforted, depressed people need to be treated. Sadness is the easier condition to understand; we've all "been there." There is no stigma associated with being sad. Sadness is seen, heard and discussed everywhere. We can talk about it over dinner, at a sporting event, even at work with our colleagues. It is found in novels and on the silver screen, and television actors suffer through it on our favorite situation comedy. Because its reach is short, sadness always remains above the surface, never penetrating through to the depths of the human psyche. In addition to the dimensions of sadness, we know its origins. It started with a bungled interview, a perceived humiliation, some added stress at work or a disappointing blind date. We mull over the source, and shortly the unhappiness goes away. We reveal our discomfort to an intimate, and we rebound. We are like emotional clones of Charlie Chaplin: we trip and fall, then dust ourselves off and start all over again. Even when we are sad, we can continue to parent our children, function at work and still enjoy our hobbies. We may not be moving at the same pace, but we arrive at our destination just the same. In some instances, sadness can even be a positive or motivating force. It can nudge us to reevaluate our circumstances and empower us to view ourselves differently. Sadness can prompt us to challenge our reactions to life's events and trigger a new perspective. Depression is a different entity altogether. It is a serious mental health problem, and fortunately not as commonplace as sadness. Depression, sometimes called melancholia, is referred to in lay terms as a "nervous breakdown." Depressed people are not actually broken, but they are bending downward. And if sadness is like walking through a muddy swamp, depression is like flailing helplessly in quicksand. When it overtakes us, we feel powerless, lost, with no options.
You
Are Not Alone You Are
Not to Blame Depression is not a character flaw, nor is it simply feeling blue for a few days. Most importantly, depression is not your fault. It is a serious mood disorder which affects a person's ability to function in every day activities. It affects one's work, one's family, and one's social life. Today, much more is known about the causes and treatment of this mental health problem. We know that there are biological and psychological components to every depression and that the best form of treatment is a combination of medication and psychotherapy. Contrary to the popular misconceptions about depression today, it is not a purely biochemical or medical disorder. So What
Does Cause It? While depression may be related to feelings of grief after the loss of a loved one, those feelings are natural. Depression caused by medications or substance or alcohol abuse is not typically recognized as a depressive episode. Depression experienced after certain medical procedures (such as post partum depression) is recognized, though. Family history and genetics also play a part in the greater likelihood of someone becoming depressed in their lifetime. Increased stress and inadequate coping mechanisms to deal with that stress may also contribute to depression. From Mental Health Net Not all people with
depression will have all these symptoms or have them to the same degree.
Post Traumatic Stress Disorder Posttraumatic stress disorder (PTSD)—once called shell shock—affects hundreds of thousands of people who have survived earthquakes, airplane crashes, terrorist bombings, inner-city violence, domestic abuse, rape, war, genocide, and other disasters, both natural and human made. People who work in the emergency field also experience PTSD due to the violent nature of the job. The Facts Posttraumatic stress disorder (PTSD) has been called shell shock or battle fatigue syndrome. It has often been misunderstood or misdiagnosed, even though the disorder has very specific symptoms. Ten percent of the population has been affected at some point by clinically diagnosable PTSD. Still more show some symptoms of the disorder. Although it was once thought to be mostly a disorder of war veterans who had been involved in heavy combat, researchers now know that PTSD also affects both female and male civilians, and that it strikes more females than males. In some cases the symptoms of PTSD disappear with time, whereas in others they persist for many years. PTSD often occurs with—or leads to—other psychiatric illnesses, such as depression. Everyone who experiences trauma does not require treatment; some recover with the help of family, friends, or clergy. But many do need professional treatment to recover from the psychological damage that can result from experiencing, witnessing, or participating in an overwhelmingly traumatic event. Symptoms PTSD usually appears within 3 months of the trauma, but sometimes the disorder appears later. PTSD’s symptoms fall into three categories:
Intrusion In people with PTSD, memories of the trauma reoccur unexpectedly, and episodes called "flashbacks" intrude into their current lives. This happens in sudden, vivid memories that are accompanied by painful emotions that take over the victim’s attention. This experience, or "flashback," of the trauma is a recollection. It may be so strong that individuals almost feel like they are actually experiencing the trauma again or seeing it unfold before their eyes and in nightmares. Avoidance Avoidance symptoms affect relationships with others: The person often avoids close emotional ties with family, colleagues, and friends. At first, the person feels numb, has diminished emotions, and can complete only routine, mechanical activities. Later, when experiencing the event, the individual may alternate between the flood of emotions caused by experiencing and the inability to feel or express emotions at all. The person with PTSD avoids situations or activities that are reminders of the original traumatic event because such exposure may cause symptoms to worsen. The inability of people with PTSD to work out grief and anger over injury or loss during the traumatic event means the trauma can continue to affect their behavior without their being aware of it. Depression is a common product of this inability to resolve painful feelings. Some people also feel guilty because they survived a disaster while others—particularly friends or family—did not. Hyper arousal PTSD can cause those who have it to act as if they are constantly threatened by the trauma that caused their illness. They can become suddenly irritable or explosive, even when they are not provoked. They may have trouble concentrating or remembering current information, and, because of their terrifying nightmares, they may develop insomnia. This constant feeling that danger is near causes exaggerated startle reactions. Finally, many people with PTSD also attempt to rid themselves of their painful re-experiences, loneliness, and panic attacks by abusing alcohol or other drugs as a "self medication" that helps them to blunt their pain and forget the trauma temporarily. A person with PTSD may show poor control over his or her impulses and may be at risk for suicide. Treatment Today, psychiatrists and other mental health professionals have good success in treating the very real and painful effects of PTSD. These professionals use a variety of treatment methods to help people with PTSD to work through their trauma and pain. Behavior therapy focuses on correcting the painful and intrusive patterns of behavior and thought by teaching people with PTSD relaxation techniques and examining (and challenging) the mental processes that are causing the problem. Psychodynamic psychotherapy focuses on helping the individual examine personal values and how behavior and experience during the traumatic event affected them. Family therapy may also be recommended because the behavior of spouse and children may result from and affect the individual with PTSD. Discussion groups or peer-counseling groups encourage survivors of similar traumatic events to share their experiences and reactions to them. Group members help one another realize that many people would have done the same thing and felt the same emotions. Medication can help to control the symptoms of PTSD. The symptom relief that medication provides allows most patients to participate more effectively in psychotherapy when their condition may otherwise prohibit it. Antidepressant medications may be particularly helpful in treating the core symptoms of PTSD—especially intrusive symptoms
Starting A Support Group Jeffery Handleson is a seasoned paramedic who works for a major metropolitan fire department. On a hot July day, a vehicle that had turned down the wrong road struck his ambulance in a head-on collision. Jeffery and his partner were both severely injured and spent several weeks in the hospital recovering from their injuries. During his recovery, Jeffery developed Post Traumatic Stress Disorder (PTSD.) Not only did he have nightmares about the accident, but he also started having nightmares involving calls that he had made years ago. After months of counseling and medication, Jeffery began to heal, but he still felt like he was missing a component of his recovery. He had a strong desire to meet with other accident survivors who had experienced PTSD. After doing some research, he realized that there were no PTSD support groups available in his immediate area. At first he became frustrated, but he decided to turn his frustrations and all of the pain during recovery into something positive. He decided to start a support group for PTSD survivors. It took Jeffery about a year to get the support group off the ground, but five years later, the group is successful and attended by 20 or more individuals on a regular basis. So how does one start a support group? Here are some helpful tips you might take into consideration: How To Start A Support Group:
Tips:
5. Place chairs in a close circle so that all members can hear and interact.
Critical Incident Stress Debriefing; What You Should Know
Christian Crisis Counseling According to Discover Magazine a 90-mile an hour fastball reaches the plate in 4/10's of a second. The batter has 1/10 of a second to decide whether he will swing. To a counselor, the moment the message comes through to him that he or she is being sought to intervene in a Crisis Situation, incredible processes begin to take place tat demand insight and action. Unlike me batter at the plate, a counselor is dealing with another person's life. A human being is an incredible creation of God; with its 206 bones: 639 muscles, 4 million pain sensors in the skin, 750 million air sacs in the lungs; 16 billion nerve cells, and 30 trillion cells in total, the human body is remarkably designed for life. Our body is controlled and coordinated by over 16 billion neurons and 120 trillion “connection boxes" packed together into an unfathomably complex set of neuro-passageways. The system is much like a modern nation interconnected by billions of telephone wires. All of this in a brain and spinal column that weighs slightly over 3 pounds! In comparison, a bee has only about 900 nerve cells, an ant only 250. The large-gauge fibers, nerve impulses flash along at more than 200 miles/hour. All told, the human brain and nervous system is the most complex arrangement of matter anywhere in the universe. The whole body system, functions as a unified whole to enable a human to run, sing, remember, create, and achieve the myriads of other phenomenal tasks we usually take for granted. Perhaps that’s why the Psalmist could cry out in Psalm 139, -I am fearfully and wonderfully made, such knowledge is too wonderful for me." The late Francis Schaeffer wrote in his book Genesis in Space and Time, "Men today cannot any longer answer the crucial question: Who am I? Man has lost his unique dignity. In contrast, I stand in the flow of history and I know my origin. My lineage is longer than the Queen of England. It does not start with the Battle of Hastings. It does not start with the beginnings of good families, wherever or whenever they lived. As I look at myself in the flow of space-time reality. I see my origin in Adam and in God's creating man in His own image." When we begin to intervene in a crisis situation, our perspective is critical in terms of our assessment and treatment of the one with whose life we are dealing. I. SOME INSIGHTS TO REMEMBER A. The Uniqueness of Christian Counseling "Christian counseling is unique because it accepts the Bible as the final standard of authority. As a result, Christians are not left to explore and dissect the myriads of philosophies and their own logic and to happen then, by one chance in a million to hit upon a correct system of right and wrong. B. The Objectivity of Christian Counseling "Christian counselors desire the welfare of their clients in the same way that secular counselors do, but a Christian counselor believes that a person's welfare depends on his relationship to Christ. There are absolute standards. A Christian counselor is not willing to help a counselee feel good in a way, which contradicts those absolute standards. Divorcing a disagreeable spouse may make a counselee feel good, but a Christian believes that the way which seems so completely right at the moment, which in fact, does reduce tension and increase good feelings, will lead to personal death if it contradicts God's directions.” C. The Encouragement of Christian Counseling "The right word spoken at the right time can change a life. We are continually Involved in conversations with needy people. Imagine a tool so powerful that with it you could lift the level of another person's moral life, improve the quality the service for Christ, balance the wavering, lift the fa11en, enlighten the ignorant, turn back the wayward and much more. A good word of counsel is exactly that potent. By this I mean a deliberate, personal word to another for his upbuilding" (See Eph. 4:29. NASB) D. The Responsibility of Christian Counseling "Some come for counseling who want their lives to continue pretty much status quo but without the problems they present. They are not willing to submit to a total transformation. To be honest with them, the counselor must tell them to go out and suffer some more. As long as they are trying to bargain with God they might as well forget it, when they are willing to drop their conditions and meet His, then they are candidates for deliverance and will probably continue in counseling until they are set free.” E. The Humility of Christian Counseling “It's important to never be drawn in over your depth. As much as you would like to help every person that comes your way - it isn't possible. Now and again you're going to meet people with problems beyond your capacity to assist, and if you don't recognize this, and you strive to help everyone who has a problem, then it won't be long before you'll be needing help yourself One well-known counselor, Dr. Gary Collins, says 'One of the most significant ways in which we can help people is to refer them to someone more equipped and better able to help them than ourselves.' This is not an admission to failure, but a mature recognition that none of us can help everybody, whenever you feel the problem you're facing in a person's life is outside the limits of your own insight, or experience, and then refer them to someone better able to help. They will not feel rejected when you hand them over to someone else, provided you assure them of your continued support in prayer, and an occasional meeting together.” Recent studies have shown that between 25% and 50% of patients presenting with psychiatric complaints have significant medical illness coexisting with, aggravating, or causing their psychiatric complaint. Unfortunately, this is overlooked in a significant number of cases by both medical and psychiatric staff. A physical examination should be carried out routinely in emergency departments, unless the physician knows the patient and his physical health, when you are working with someone that you suspect may be having physiological disorders that could be causing their emotional disturbance, do not hesitate to direct them to a medical doctor and/or an emergency facility. A high index of suspicion for physical illness, organic brain syndrome and the effects of drugs both prescribed and non-prescribed, is necessary. In addition, the patient's past history and family history of disease should be elicited. A good rule of thumb when dealing with any crisis situation is to ask if the person is at present seeing a medical doctor, is on any medication of any kind, or has been acting in an unusual manner in the past 48 hours. A routine medical checkup is strongly encouraged when unusual or bizarre behavior has come on rather rapidly and unexpectedly. II. SOME INSIGHTS ON INTERVENTION STRATEGIES There are a variety of ways to begin the actual Intervention Process. Counseling models use various approaches. For this course we will use a simple formula that Dr. Jerry Howell has developed that will be reinforced on each of the topics dealing with the separate topics through this course. The formula is called REACT. REACH OUT EMPATHIZE ASSESS THE SITUATION CONFIRM YOUR ASSESSMENT TEACH ALTERNATE ACTION DE-stress the Crisis The most obvious thing about a crisis situation is that emotions, stress and confusion are running high. It is therefore important to de-stress the crisis as much as possible. Throughout the course we will specifically show how to apply the REACT formula to each of the crisis situations presented. Understandably. This is a spiritual battle we're engaged in (Eph. 6:1O-18) and not to be seen as simplistic. 1. Reach out Make contact. A recent study in the components of communication indicates that the spoken word comprises only 7% of the interpersonal communication process. The breakdown of the components of communication is: spoken word 7.0%, body posture and gestures 38.0%, voice tone and inflection 55.0% This means that it is important to be conscious of what we are communicating nonverbally to the person. Voice tone should be soft and calm but not monotone. Inflection should convey acceptance and compassion. Body posture and gestures should express concern for the person. Somehow you have to make contact with the individual in crisis and step into their situation with grace and assurance as to direction. Understandably, this is assuming that you have been sought to be involved or have a responsibility that enables you to assist the person without their wondering, “What is he doing?" Reach out - make contact2. Empathize Reduce anxiety and allow the person to ventilate his or her feelings. This is where it is important to know how to listen, listen to what is really going on inside of this person. Dr. Selwyn Hughes comments, ”This means making contact with a person's feelings. It involves walking alongside the counselee rather than leaping ahead to find a possible solution. It is not important to search for the solution at this point. This is a mistake many beginners make when attempting to counsel a person in a crisis situation. They try to start giving answers before they ever really understood the problem. People want to know how much you care before they care how much you know. All I’m seeking to do at this stage is to interact with the person who is hurting verbally and emotionally. 3. Assess the situation Focus on issues that the person is facing - use good questions. At this phase of the counseling process, you're gathering information trying to settle the muddied waters, seeking to clarify “W hat is happening?" "What’s going on?” At this point I would suggest that it be simply a way to pick out which of the areas is creating the primary crisis and then centralize on three key questions: When did your problem begin? What are the effects of your problem? When is your problem most pronounced and when is it least pronounced? Here, you want to boil down the crisis. It’s often helpful to restate what the Individual has said to you with a type of restatement or reflective listening. In the first, restating, the counselor repeats exactly, word for word, what the client has said, changing only the pronoun and the verb tense. In the second, rephrasing, a counselor restates in his or her own words the most important part of what has been said. This allows the person the opportunity to hear what he has just said to you and gives him an opportunity to rethink and evaluate his statements. At this point, you ought to be able to have a good clear picture of what the crisis is that you're facing. Assess the situation. 4. Confirm your assessment Sort out and interpret facts and check for accuracy. At this point, you want to clarify your understanding of the crisis and confirm that the facts are accurate and certain. “Did Mr. Jones die at 2 p.m. this afternoon?" “Who is missing?" “This is the primary issue that is distressing you?" Each of these questions seeks to confirm that you have the data clear in your own mind. Untold embarrassment is prevented for all parties if you are in possession of accurate, detailed facts and how these facts relate to the person or persons with whom you are dealing. 5. Teach alternative action Discover alternatives and redirect thinking to problem solving. Here's where you must help the person list the effects and alternatives to the crisis he or she is facing, and come up with some clear specific strategies that will lead him or her in a Biblical direction. a. Affect of the crisis. List how this crisis is affecting this person. b. Alternative action. List alternatives to problem solving that address one issue at a time. Here's where you must be very specific and prioritize this list into a plan of action that is solution oriented. c. Assess referral potentiality. Decide if yourself can deal with this situation with a few sessions of counseling, or whether you need to refer the person to a medical facility, or a professional counselor. Throughout the course I will add depth and dimension to this five-point formula. It is not to be seen as a cure all, but rather what it is designed to be. An Intervention Strategy Guidelines to enable one to REACT to a crisis, so as to encourage and assist those who are in need.
What
we as Crisis Christian Counselors need to give those who come to us for
help. HOPE AND DESPAIR. Bible Verses for Hope Hoping is a realistic and adaptive response to extreme stress or crisis in which the person acquires a patient and confident surrender to uncontrollable, transcendent forces. As a general existential condition with subdued ego feelings, hoping contrasts with wishing, which implies more urgent ego claims and controls aimed at particular objects and goals. It also differs from the self-assertiveness of optimism. Similarly, despair may be regarded as a more objectless and profound depressed state of being than, for example, grief, which attaches to specific loss. Despair and hope are better seen as in complex dialectical relation than as simple antonyms. Through history the terms have carried a complexity of meaning. The Greeks and Romans had a skeptical or cynical attitude toward hope. The OT speaks about as often of trust as of hope; in the NT the word hope prevails. The Apostle Paul makes faith and hope distinct and coequal parts of his triad of abiding virtues. Popular opinion associates hope with almost anything upbeat. Despite dictionary definitions, expectation cannot be equated with hope; nor can the latter be defined as desire. Though despair means literally “un-hope,” it cannot without qualification be equated with depression, sadness, or a melancholy mood. For Kierkegaard, despair includes a kind of spite; for Tillich it comes close to lack of courage; for many existentialists it indicates a state of inner emptiness or meaninglessness; and popular usage brings despair close to inconsolable grief. 1. Phenomenology of Hoping. Against a long tradition in the psychological literature that sees hoping as part of one great impulse of desiring, the Christian existentialist G. Marcel, in a phenomenological study of hoping, finds it to be very different from wanting, hankering, craving, and other synonyms of wishing. By shifting from the noun hope to the verb hoping, Marcel takes the latter as a psychological process or activity that can be studied introspectively and objectively. Under what circumstances can hoping occur? When a person feels caught or is visited by a calamity. For when everything goes well and as wished, there is no reason to hope. In modern parlance, hoping is a response to stress of a kind and intensity that does not allow escape, denial, repression, or other form of psychic refutation. Examples are incurable or terminal illness, severe losses, physical or mental captivity, dire threats to one’s physical or mental integrity, or being severely curtailed in one’s action radius. On the whole, good reality contact and reality testing are prerequisites for hoping. What is the content or object of hoping; what can a person legitimately hope for? On this point Marcel draws a sharp line between wishing and hoping. Wishing is generally directed toward distinct and circumscribed, if not concrete, objects: a desired birthday present, money, a suitable mate, perfect health, special knowledge or skill, or, as the popular phrase goes, “the moon.” The farmer wishes for rain after a drought; the breadwinner wants a salary raise. The more specific the object, the more likely it is that wishing is indulged. In contrast, the object of hoping is a global, more or less existential condition rather than a thing: one can hope to be delivered, to be set free, to become enlightened, to be understood, to be reconciled with others, to be forgiven, to die a good death, no matter how grim the present reality is. Using the nature of the object as criterion, a great deal of what popularly passes for hoping thus turns out to be wishing. 2. Dynamic Psychology of Hoping. a. Ego dimensions. With these phenomenological distinctions in mind, a dynamic psychology of hoping would contrast the impulsivity, restlessness, and determined ego feeling in wishing with the relative quiescence, relaxation, and subdued ego feeling in hoping. Wishing involves determination and attempts at control; it is aided by willing. Hoping is closer to an attitude of surrender to uncontrollable, transcendent forces, whose power must first be acknowledged and whose benignity is assumed. The “I” in wishing is an action center, a claimant, and often an operator; in hoping the “I” has a degree of modesty and is open to unexpected revelations. Marcel distinguishes hoping also from optimism; the latter leads often to argumentative self-assertion as against the opinion of others. Optimists (like pessimists) see situations only from their own mood-determined angle and are prone to say: “If you could only see things the way I do, you would.…” Hopers lack the arrogance of optimists (and pessimists) and do not elevate themselves above others; they remain humble and respectful vis-à-vis the facts. Hence, in hoping one shuns prediction and does not claim rights or certainties. b. Developmental dimensions. The psychoanalyst William Scott has constructed an early developmental sequence that runs from waiting, via anticipating and pining, to hoping. Hungry infants wait for the hallucinatory image of food to become an actual sensation; they learn to anticipate the satisfaction that is under way; and they may later come to pine for the mother who, they know by now, will typically satisfy her children. Hoping, according to Scott, allows the inevitable waiting to be peaceful and relies on the mother’s own need to give to her child what she can. Hoping also derives from accumulated experiences that convey the lesson that it takes time for favorable change to occur. Scott’s infantile paradigm moves from primitive wishful thinking in terms of hallucinated content at one pole to the beginnings of reality-oriented thought and interpersonal attitudes at the other. c. Temporal dimensions. Scott’s psychodynamic developmental sequence squares well with Marcel’s idea about the role of temporal dimensions in hoping. The hoper is future-oriented in the sense of seeing reality as a process and therefore essentially open-ended. For a hoping person the future is open to novelty because reality is seen as resourceful. Lest this vision deteriorate into blind optimism or magical thinking, it is useful to reflect again on the differences between the objects of wishing and hoping. Whereas hoping is open-ended and trusting toward its object, wishing is concrete and insatiable; even the sky is not the limit when one considers the lavishness of accumulated human fantasies about mansions in heaven, inexhaustible supplies of beer in Walhalla, or pleasure maidens in paradise—all of which are extrapolated from past terrestrial experiences, with considerable embellishments. 3. Despair. The difference in object between wishing and hoping may also be used to distinguish negative states such as sadness, grieving, and despondency from despairing. In sadness and grief some specific loss may be pinpointed, but despair is often without object. Kierkegaard held that despair over something is not yet properly despair. Similarly, it is held that in profound clinical depressions patients are unable to say what they are depressed about—theirs is a pervasive condition of gloom. Yet, in support of Kierkegaard’s observation that despair has an ingredient of defiance or spite, clinicians can frequently find a hard core of self-righteousness behind the presenting gloominess of depressed patients. The depressed patient is somewhat like the arch pessimist who bitingly insists that: “If you could see things my way, you also would despair.” Despair isolates the individual or, as in certain forms of depression, pits person against person. In contrast, hoping—with its global object—does not pit the hoper against others but is more often than not a shared experience, even a contagious one. 4. Pastoral Theological Implications. These stark theoretical contrasts between hoping and wishing, global and specific objects, altruistic and egocentric attitudes, and modesty and pretentiousness may have to be softened in any individual case. Since in psychodynamic theory the mind is seen as stratified (i.e., operating concomitantly at conscious, preconscious, and unconscious levels and engaging in both primary and secondary process thinking), it makes sense to approach hoping and wishing, and hoping and despairing, as zones on a continuum, with most cases a mixture. If, by definition, hoping presupposes a rather accurate reality assessment of an untoward condition and a tragic sense of life, the process also involves a worldview or an ontology. This is one reason why hoping is theologically and pastorally an important human function to assess, both generically and in the individual case. a. The practical importance of hope. As helping professionals know, a hopeful attitude can mitigate or stem the ravages of illness, while a despairing posture is likely to hasten a malignant process. Surviving in concentration camps has reportedly sometimes depended on hope, belief, or trust. Thus, there appears to be a margin of attitudinal influence on the physiology, mechanics, or field of forces that determine a condition and its outcome. To take such psychological effects on the outcome of any disastrous or malignant process into account, the world needs to be conceptualized as a process that is open to novelty and is creative, while otherwise orderly and lawful. Does a person who hopes have some kind of process view of reality (and of his or her own existence), even if only intuitively? And does the hoping person, again perhaps only intuitively, realize and prize the positive effect, however small, of hoping on his or her condition and its outcome? On empirical grounds, both questions merit an affirmative answer, which is reinforced by the typical desire of friends and professional helpers to “give hope” or “bring hope” to the sufferer. Hope is apparently considered an asset, sometimes a healing agent, and often is at least a palliative. b. Ultimate issues in hoping. Biblical literature offers an interesting distinction between apocalyptic and eschatological thought that runs parallel with wishing and hoping respectively. Apocalyptic thought is full of concrete imagery derived from past and present experience and often involves a revenge motif: God will reverse the roles between oppressors and victims. The evildoers will be punished, and the downtrodden will be exalted in quite concrete ways. In contrast to such specificity of object derived from extrapolations from the past, eschatological thought is of extreme sobriety and leaves the arrangements and disclosures entirely to God. In the Pauline “Now we see through a glass darkly.…” view, no concrete object is specified; nothing is arranged by human fantasy; no revenge is emphasized. The eschatologist lets God be God and asks for no more than God’s presence in the last hour or the age to come. Consequently, the hoping/wishing and apocalypse/ eschatology distinctions can provide pastoral clues to the role that promises play in the mental or spiritual life of anyone. Some persons appear to know exactly what “their” God has promised them, and they will, if need be by extortionist prayers and threats, hold the heavenly Father to His promise! They let their fantasy supply the realization of every wish and read the fantasy as a divine promise: family reunions in heaven, freedom from care, or an angelic existence. Others are content with the promise of God’s abiding presence in their life and death; still others assume no divine promise toward themselves at all. Thus, notions about providential promising can give a carte blanche for wishing, offer grounds for hoping, or restrain the fervor of desire. These different positions, in turn, suggest variations in such character traits as demandingness or feelings of entitlement versus humility. Psychologically, as Scott’s paradigm shows, hoping for the infant relies on a belief in the mother’s benevolent intention; she is seen as wishing to satisfy her child. A theological paradigm for hoping similarly requires trust and confidence in a God who has benevolent intentions toward creatures, possibly augmented by incarnational demonstrations thereof. A metaphysical paradigm for hoping would have to insist on some cosmic benevolence that ultimately transcends the obvious malevolence by which existence is tainted. In all paradigms of hoping there is a belief (despite insufficient objective demonstration of its tenability) that the world, the cosmos, is a process and thus has a forward edge moving into the unknown, the not-yet-revealed, the creative—in a word, into the transcendent that can throw new light on or even alter present conditions. Despite its resistance to proof or demonstration, this belief can be subjectively very strong and abiding; its presence and intensity (barring pathological reality distortion) suggest that the person has experienced “good mothering” leading to trust. The great psychological, theological, metaphysical, and pedagogical question is how such realistic trust and soberly grounded hope can be safeguarded from distortion by wishful thinking and delusional schemes that “promise the moon.” Bibliography. *D. Capps, Agents of Hope: A Pastoral Psychology (1995) S. Kierkegaard, The Sickness unto Death (1941). *A. D. Lester, Hope in Pastoral Care and Counseling (1995). G. Marcel, Homo Viator (1944). K. Menninger, “Hope,” American J. of Psychiatry, 116 (1959), 481-91. P. W. Pruyser, “Phenomenology and Dynamics of Hoping,” J. of the Scientific Study of Religion, 3 (1963), 86-96. W. C. M. Scott, ed., Selected Contributions to Psychoanalysis (1957). P. Tillich, The Courage to Be (1952).
Crisis counseling is not long term and is usually no more than 1 to 3 months. The focus is on single or recurrent problems that are overwhelming or traumatic. If a trauma or crisis is not resolved in healthy manner, the experience can lead to more lasting psychological, social and medical problems. Crisis counseling provides education, guidance and support. Crisis Counseling is not a substitute for individuals who need and are not receiving intensive or long term psychiatric care. Crisis counseling may involve outreach, work with in the community and is not limited to office appointments. There are many descriptions and a great deal written about crisis intervention and crisis counseling. Regardless of the theory and author, there are universal "elements" in the process by which a crisis counselor can help people face and move past distressing and traumatic events in their lives. The 8 Elements of Crisis Intervention Education. There is a natural ability within most people to recover from a crisis provided they have the support, guidance and resources they need. The very heart of crisis intervention is to face the impact of a crisis. In most cases, a crisis involves normal reactions, which are understandable, to an abnormal situation. An effective crisis counseling provides information, activities and structure that will help us recover and move past the crisis. More importantly, crisis counseling will insure that you do not prolong a crisis and it will help insure you do not create more problems in your life and the lives of others. Confrontation through information and discussion may be an important part of crisis intervention.
Observation and awareness. A crisis in our life can be the result of low self-awareness or not recognizing the impact our behavior has on others as well as the impact it has on our self. Increasing your awareness can lead to choices that promote recovery and wellness. You can't help yourself if you cannot see the problem and how you may be contributing to the crisis. In some cases, family dynamics and communication problems within families can prolong a crisis. Discovering and using our potential. Every crisis represents an opportunity for personal growth and to discover our highest potential and true self. The greatest hero in any crisis is the person who does not believe he or she is a hero, but is never-the-less prepared for the challenge by the undiscovered qualities and abilities that are only discovered when we are facing tragedy and the "inevitables" of life. While support is important, this does not mean that the person in crisis should not be allowed, encouraged and sometimes required to make decisions and take action to resolve the crisis and improve the quality of their life. Understanding our problems. It is the fundamental intention of all people to do the best they can with the resources and abilities they have during a crisis. During any crisis, it is important to recognize or discover our true and deepest intention. You must keep your intentions in mind no matter what you do or how unskillfully you may act. While our intent is usually to make life better, our behavior can be misguided, misunderstood and less effective than we would hope. Self-understanding as well as understanding how others may keep us "stuck" are important keys to recovery. Creating necessary structure. The most important aspect of crisis intervention and counseling is to provide a social "container" for our experience that will allow us to express, explore, examine and become active in ways that help insure the crisis is not prolonged. For each of us, there are necessary activities and routines in our life during times of distress that provide comfort and support. These do not include alcohol, medications or other drugs. Medications should only be used to prevent a physical or psychological breakdown. The purpose, duration, frequency and potential impacts must be defined. Challenging irrational beliefs and unrealistic expectations. Few people, during times of crisis, have the necessary skills to fully examine what they are thinking, what they assume and what they expect from their self and from others. Our thoughts, especially the ones we don't look at, contribute a great deal to how we feel and what we do next in response to our feelings. Breaking vicious cycles and addictive behavior. Many crises are the result of vicious cycles or addictions. For example, drug and alcohol use can not only destroy our life, but it will confuse how we actually feel about our self, others and the world around us. One cannot know how they feel and what they truly want if their feelings are modified by chemicals, medications, alcohol and other drugs. A painful crisis can lead a person to avoid and escape how they feel. Unhealthy escape and avoidance of emotional pain and distress may involve the use of medication, drugs, alcohol, sex, thrill seeking, parties or working excessively. Taking the role of a "victim" can cause others to rescue the person in crisis. Prolonging the crisis by refusal to deal with a crisis can create supportive relationship. When a person becomes dependent on others and "escapes" to feel better, a vicious cycle can develop. Vicious cycles start with behaviors that are intended to avoid or escape emotional pain, but ultimately these avoidance and escape behaviors create more problems or the same problem we are trying to avoid. The behaviors found in a vicious cycle can actually prolong a crisis. Create temporary dependencies. During a crisis, it is often helpful to form brief relationships with others in order to gain support. Crisis counseling and intervention are very helpful and necessary. A healthy dependency is usually temporary and will always lead to increasing independency. Unhealthy dependencies are long term and create increasing dependency rather than independency. Facing fear and emotional pain. A crisis is a time of fear or sadness. How we respond is important. There is "monster" in the world for every person who "runs" in response to their fear or sadness. When we face the darkness in our life, and we are not destroyed by our fears, or sadness, we eventually discover there are no monsters. We discover that we can survive. In time we discover that our pain will fade. Facing emotional pain is the most healthy response. This does not mean we should make our self miserable. But we should not expend a great deal of energy and become involved in activities that help us avoid how we feel and what we think. When people suffer, it is important to help them feel less alone in the world. It is important to help people in crisis solve the problems in their life. People in emotional pain need to be empowered and supported.
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