...how sunlight can play with the bare branches of an early spring Ohio day and look amazingly like a late fall afternoon in Mississippi.
I was just looking out the window at some of the trees and shrubs that surround my house, and found myself remembering.....
I was driving down a Mississippi backroad somewhere near Kiln, and I stopped to ask for directions at a house where a number of men were working on cutting down some trees that had been torn out by the post-Rita tornados that had hit the area. I passed around Gatorade for everyone, and we sat and talked a bit.
As I was leaving, one of the men (who had a gorgeous Cajun/French name that I can't recall just now) pointed to a large damaged white farmhouse across the road, and said, "I really appreciate what all y'all in the Red Cross have done for us here in ol' Miss. If'n ever you need any help, y'all just knock on that farmhouse door -- even if it's 2:00 in the morning -- and I'll do anything I can to help y'all."
I hope that if that my house is ever damaged in a natural disaster, I'll have the wisdom and grace to extend an invitation to the disaster workers to knock on my door -- even at 2:00 a.m. in the morning.
Sunday, March 26, 2006
Sunday, March 19, 2006
Thoughts about Gestalt & Crisis Intervention...
Hi all!
It's been months since I've written, but I still continue to ....(what's the word?)...incorporate my experience down South into the rest of my life. Today I received a request from a list-serv that I belong to for information about Gestalt & crisis intervention. Here's what I wrote:
***************************
I spent two weeks last fall down in Southern Mississippi with the American Red Cross working with people who lived through Hurricanes Katrina and Rita (most of whom disliked being referred to as "survivors", so I'm avoiding that term). While I'm continuing to debrief about my own experience there (even 6 months later), I'd like to share some insights that I found helpful during my time as a Disaster Worker.
1. GESTALT IS PERFECT FOR CRISIS WORK
I found that Gestalt was a VERY powerful tool to apply when I was working in Mississippi, and the strongest part of this powerful tool was focusing on the "I-Thou" relationship in the present moment (physical process was a close second...keep breathing!). Both critical incident stress debriefing and counseling interventions were required -- with different interventions for different people.
There were other Mental Health workers where I was who took a decidely non-Gestalt, gung-ho, "See-this-clipboard-I'm-carrying-I'm-a-Mental-Health-Worker-and-I-can-fix-all-yo ur-problems" type of approach, which seemed to serve only to alienate just about everyone in the room, present company included (and taught me why mental health services often gets a bad reputation -- because we deserve it).
Deciding which interventions to "extend" to people before you meet them feels rather un-Gestalt (IMHO). The power of Gestalt, for me, lies in the focus on being present in the moment and being willing to engage in authentic dialog with people. Being fully present in authentic dialog is far scarier (for me). It would be so much easier to 'know' what do do...and less effective.
2. TO SUPPORT OTHERS, SUPPORT YOURSELF
When I was working in Mississippi, I quickly discovered that at some levels, the work was much simpler than I expected; while at other levels, it was completely exhausting.
The work was simpler in the sense that, as an experienced clinician used to working at deeper levels with long-term clients, I experienced many of the interventions I used in Mississippi as somewhat "light", and I was worried they they were too superficial.
When I sought feedback from the folks I worked with, they were strongly supportive of the Gestalt approach, saying things like "I felt like you were with me the whole time", and "You weren't trying to 'fix' me like some other people have done."
At the same time, while the work felt "lighter" then I usually do, I found myself quickly getting exhausted after only a few hours of doing such work (I'm used to working very long days). The learning for me: Crisis work is simple work. And very stressful.
3. MEET PEOPLE WHERE THEY ARE...HERE & NOW
Another thing that I would strongly suggest is taking a page from community based care -- go and meet the people where they are (a very Gestalt perspective, I think). While engaging in community-based care, the American Red Cross wisely suggested that we NOT identify ourselves as mental health workers to the general population, as doing so only seemed to have people trying to get AWAY from us as fast as they could (mental health treatment has a rather negative sigma here in the U.S....don't know how mental health services are perceived in the Phillipines - you're more of the expert on that, I'm sure. Adjust accordingly.)
If you're working at an evacuation shelter, I think the WORST thing to do is to set up a table/area as "Mental Health" and sit behind the table waiting for people to come to you (if that is the only thing you do). When I was working shelters, I found it MUCH more effective to simply wander around talking to people...one doesn't need to hang out in a shelter too long before you quickly begin to identify stress responses in people...'wandering' up to someone who looks stressed and starting a conversation often seemed to work wonders....far better than waiting for them to come over the the Mental Health table.
4. WORK IN COMMUNITY (a.k.a, "Teams")
I WOULD, of course, identify myself as a Mental Health Worker to the other workers in the evacuation shelter. The other workers can then act as more 'eyes and ears' - when they saw people getting stressed out, they would flag me (or one of the other Mental Health Workers) so that we could (hopefully) quietly intervene before things got crazy.
I also discovered that my role as "on-the-job-trainer" became very important, as I helped the non-Mental Health staff sort through what kind of situations needed to be addressed immediately and which ones did not. For example, I found that ANYONE crying AT ALL was often cause for quite an alarm among the shelter staff. Helping to debrief the shelter staff in the moment by educating them that (it almost seems silly to write this) it is normal for people to cry in stressful situations would go a long ways toward avoiding an escalation of the situation.
5. THE ZEN OF CRISIS WORK
In Mississippi, I learned that every interaction is important. (Very Zen). In addition to the more straight-forward mental health intervations, I had conversations with people around cooking, fishing, travel and even cars (which I know nothing about). These conversations typically felt fairly innocuous to me -- no big deal...
...and I can't begin to tell you HOW MANY TIMES people would come up to me later and say some variation on:
"Thank you SO much for talking about [insert topic here]! I felt SO much better after having a NORMAL conversation."
I learned to not underestimate the powerful healing that occurs for people when they can have 'normal' converations in the midst of a an enormous crisis. Every true conversation (read: genuine contact) is important in a crisis.
Pardon the length of this post. I hope something in my words help support you, and don't hesitate to contact me if I can be of further help. You'll be in my prayers.
Best of luck.
Peace,
Tim
*****************************
Food for thought.
It's been months since I've written, but I still continue to ....(what's the word?)...incorporate my experience down South into the rest of my life. Today I received a request from a list-serv that I belong to for information about Gestalt & crisis intervention. Here's what I wrote:
***************************
I spent two weeks last fall down in Southern Mississippi with the American Red Cross working with people who lived through Hurricanes Katrina and Rita (most of whom disliked being referred to as "survivors", so I'm avoiding that term). While I'm continuing to debrief about my own experience there (even 6 months later), I'd like to share some insights that I found helpful during my time as a Disaster Worker.
1. GESTALT IS PERFECT FOR CRISIS WORK
I found that Gestalt was a VERY powerful tool to apply when I was working in Mississippi, and the strongest part of this powerful tool was focusing on the "I-Thou" relationship in the present moment (physical process was a close second...keep breathing!). Both critical incident stress debriefing and counseling interventions were required -- with different interventions for different people.
There were other Mental Health workers where I was who took a decidely non-Gestalt, gung-ho, "See-this-clipboard-I'm-carrying-I'm-a-Mental-Health-Worker-and-I-can-fix-all-yo ur-problems" type of approach, which seemed to serve only to alienate just about everyone in the room, present company included (and taught me why mental health services often gets a bad reputation -- because we deserve it).
Deciding which interventions to "extend" to people before you meet them feels rather un-Gestalt (IMHO). The power of Gestalt, for me, lies in the focus on being present in the moment and being willing to engage in authentic dialog with people. Being fully present in authentic dialog is far scarier (for me). It would be so much easier to 'know' what do do...and less effective.
2. TO SUPPORT OTHERS, SUPPORT YOURSELF
When I was working in Mississippi, I quickly discovered that at some levels, the work was much simpler than I expected; while at other levels, it was completely exhausting.
The work was simpler in the sense that, as an experienced clinician used to working at deeper levels with long-term clients, I experienced many of the interventions I used in Mississippi as somewhat "light", and I was worried they they were too superficial.
When I sought feedback from the folks I worked with, they were strongly supportive of the Gestalt approach, saying things like "I felt like you were with me the whole time", and "You weren't trying to 'fix' me like some other people have done."
At the same time, while the work felt "lighter" then I usually do, I found myself quickly getting exhausted after only a few hours of doing such work (I'm used to working very long days). The learning for me: Crisis work is simple work. And very stressful.
3. MEET PEOPLE WHERE THEY ARE...HERE & NOW
Another thing that I would strongly suggest is taking a page from community based care -- go and meet the people where they are (a very Gestalt perspective, I think). While engaging in community-based care, the American Red Cross wisely suggested that we NOT identify ourselves as mental health workers to the general population, as doing so only seemed to have people trying to get AWAY from us as fast as they could (mental health treatment has a rather negative sigma here in the U.S....don't know how mental health services are perceived in the Phillipines - you're more of the expert on that, I'm sure. Adjust accordingly.)
If you're working at an evacuation shelter, I think the WORST thing to do is to set up a table/area as "Mental Health" and sit behind the table waiting for people to come to you (if that is the only thing you do). When I was working shelters, I found it MUCH more effective to simply wander around talking to people...one doesn't need to hang out in a shelter too long before you quickly begin to identify stress responses in people...'wandering' up to someone who looks stressed and starting a conversation often seemed to work wonders....far better than waiting for them to come over the the Mental Health table.
4. WORK IN COMMUNITY (a.k.a, "Teams")
I WOULD, of course, identify myself as a Mental Health Worker to the other workers in the evacuation shelter. The other workers can then act as more 'eyes and ears' - when they saw people getting stressed out, they would flag me (or one of the other Mental Health Workers) so that we could (hopefully) quietly intervene before things got crazy.
I also discovered that my role as "on-the-job-trainer" became very important, as I helped the non-Mental Health staff sort through what kind of situations needed to be addressed immediately and which ones did not. For example, I found that ANYONE crying AT ALL was often cause for quite an alarm among the shelter staff. Helping to debrief the shelter staff in the moment by educating them that (it almost seems silly to write this) it is normal for people to cry in stressful situations would go a long ways toward avoiding an escalation of the situation.
5. THE ZEN OF CRISIS WORK
In Mississippi, I learned that every interaction is important. (Very Zen). In addition to the more straight-forward mental health intervations, I had conversations with people around cooking, fishing, travel and even cars (which I know nothing about). These conversations typically felt fairly innocuous to me -- no big deal...
...and I can't begin to tell you HOW MANY TIMES people would come up to me later and say some variation on:
"Thank you SO much for talking about [insert topic here]! I felt SO much better after having a NORMAL conversation."
I learned to not underestimate the powerful healing that occurs for people when they can have 'normal' converations in the midst of a an enormous crisis. Every true conversation (read: genuine contact) is important in a crisis.
Pardon the length of this post. I hope something in my words help support you, and don't hesitate to contact me if I can be of further help. You'll be in my prayers.
Best of luck.
Peace,
Tim
*****************************
Food for thought.
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