The purpose of this post is to open a conversation about how we view people calling for help as either in crisis or not in crisis. It is a challenge for us all to think about the moment we have said, or have heard others say, “Why do people who are not in crisis call crisis lines”?  It is a call to ask ourselves if the work we do, day after day, has limited our view of what a crisis is.

Before moving on think about how you typically define crisis in your work.

What is a crisis? I think if we asked each other we would get a number of different definitions. To help with this I did some look ups. Here’s what I found and what I hope provides some food for thought and discussion:

Simple Definition of Crisis – Merriam Webster
: a difficult or dangerous situation that needs serious attention

Full Definition of crisis – Merriam Webster

plural crises [play] \ˈkrī-ˌsēz\

  • 1 a :  the turning point for better or worse in an acute disease or fever b :  a paroxysmal attack of pain, distress, or disordered function c :  an emotionally significant event or radical change of status in a person’s life <a midlife crisis>
  • 2 :  the decisive moment (as in a literary plot)
  • 3 a :  an unstable or crucial time or state of affairs in which a decisive change is impending; especially :  one with the distinct possibility of a highly undesirable outcome <a financial crisis> b :  a situation that has reached a critical phase <the environmental crisis>

Marsha Linehan – A stressful or traumatic moment, short term and the desire is for resolution NOW.

Different Definitions of Crisis From a More Clinical Perspective:

How do different experts define crisis? A number of different approaches and definitions exist. Many focus on how a person deals with the event rather than with the event itself.

  • “People are in a state of crisis when they face an obstacle to important life goals—and obstacle that is, for a time, insurmountable by the use of customary methods of problem-solving.” (Caplan, 1961)
  • “…an upset in equilibrium at the failure of one’s traditional problem-solving approach which results in disorganization, hopelessness, sadness, confusion, and panic.” (Lillibridge and Klukken, 1978)
  • “…crisis is a perception or experience of an event or situation as an intolerable difficulty that exceeds the person’s current resources and coping mechanisms.” (James and Gilliland, 2001)

What is interesting, and what might be different from where many of us might land, is that the words “Suicide” or “Homicide” are not mentioned here. What that points to is that a crisis can occur that does not immediately threaten physical safety.  That made me wonder if, given the nature of our work, we might get to a point where we restrict our view of what a crisis is to only the most physically dangerous situations?

Moving forward with that thought might open us as clinicians to recognize all crises as events during which an individual is unable to access support or coping mechanisms we might think of as typically available. Our clinical work might then help stabilize the situation and in doing so possibly avoid the situation ever creating any physical risk.  Recognizing this and that the risks of suicide or homicide may be the result of unstabilized crisis, rather than the crisis itself, might give us many more opportunities to be helpful in very important ways.

Questions:

  1. How do we identify a person in crisis?
  2. How might our own perspectives get in the way of recognizing an other’s crisis?
  3. What is our role with a person seeking help related to crisis?
  4. How do you avoid having the nature of our work stop you from recognizing the impact of what might not measure up as a crisis against the backdrop of some of the emergent work you do?
  5. What might be the value of recognizing the impact of crisis that do not immediately threaten physical safety?