The experience of a traumatic event is possibly the most misunderstood, avoided, ignored, denied and untreated cause of human suffering. The word “crisis” however, refers not to the traumatic event or experience, but to how an individual perceives and responds to the event.

When we have been traumatized, it is often because we have found ourselves in a situation from which we could not escape and our natural defence mechanisms have been overwhelmed. We have felt stuck, frightened and sometimes frozen in fear and helplessness.

No two people are alike and different people respond in different ways to such events. What is harmful or overwhelming to one person may be harmless, menial or even exhilarating to another.

The key lies not necessarily in the gravity of the event, but in how the person perceives the situation and the extent to which he/she is overwhelmed by it and unable to respond adequately.

The difference in people’s ability to respond in the face of such events depends on many factors originating in their personal history, age, upbringing, life experiences, temperament and even family dynamics. For example, something as simple as a sudden noise like thunder or shouting could be traumatic for some. It is their perception of the event, not the event which causes trauma.

We tend to think of crisis as a sudden unexpected disaster, like a car crash, natural disaster, or other cataclysmic event, but these can vary substantially in type and severity. In reality, some people might find that a simple event, like an early childhood experience, minor surgical or dental intervention, or even a small incident such as falling off a bicycle or being left alone, could severely diminish their ability to cope.

Situational events such as a job loss, financial crisis, the loss of a loved one, bullying, violence, separation or even an existential crisis where inner conflicts arise around a person’s life purpose, direction or spirituality could prove to be traumatic and precipitate a crisis.

During crisis a number of symptoms may be experienced, but they vary from person to person. All symptoms will inevitably cause substantial stress to the person.

The stress symptoms fall mainly into five fields of experience:

• Cognitive: forgetfulness, blaming, poor concentration, mental blocks, feeling out of control, lack of interest

• Behavioural: procrastination, sleep and eating disturbances, accident prone, restlessness, poor productivity, the inability to commit

• Psychological: anxiety, fear, boredom, depression, fatigue, apathy, aggression, irritability, bad temper, mood swings, flashbacks,

• Physical: tightness in chest, increased heart rate, the experience of being disconnected from our body and emotions, trembling, nausea, sweating, susceptibility to minor illnesses.

• Spiritual: questioning faith, stop practising faith, new found faith, anger at God.

All this may sound like doom and gloom but on a more positive note ‘Crisis’ and the ‘Opportunity for Change’ aren’t really that different. Each is a critical point during which events could turn either for the better or for the worse.

Crisis can be seen as an opportunity for change and growth. Any mishandled opportunity or situation whether personal, corporate, national or international, can easily become a crisis. However, a well-managed crisis becomes an opportunity and a turning point. The important factor is not the challenge itself, but how it is handled.

Sadly, it is true that not everything can be fixed, no matter what the cause; trauma is trauma, pain is pain and loss is loss, and too often nothing on earth can replace what we have lost or ease our grief.

“There seems to be some connection between the places we have disowned inside ourselves and the key to where we need to go. Life as usual has arranged a way in which we’re not allowed to leave anything behind that is not somehow resolved” − David Whyte

However, feeling supported, a new perspective and a different attitude or course of action can go a long way to helping recovery and bringing healing, solace and hope.

A crisis counsellor can help you come to terms with the crisis you are facing and teach you the skills necessary to cope.

Crisis Resolution Malta (CRM) was set up in December 2010. It is made up of a team of professionals from different backgrounds ranging from counsellors, psychotherapists, psychologists, psychiatrists, doctors, priests and lawyers.

The goal of the CRM service is to help ease needless suffering and confusion and to prevent long-term effects of trauma, such as Post Traumatic Stress Disorder (PTSD) or anxiety disorders. It aims to assist its clients through their crisis and into a period of more positive perception, empowerment and change.

The CRM members are trained to assess each call in order of emergency and to intervene on request. Clients are then supported to process the event, circumstances, as well as their thoughts and feelings. They learn and discuss the normal responses to traumatic events and are provided with information, education and symptom management techniques.

Step 1. What you need to do is to trust that help is there and change is possible… REACH OUT.

Then a crisis team member will help you by:

Step 2. Assessing the situation

The crisis counsellor will listen to the client. Together they will assess the situation and evaluate a plan or treatment strategy.

Referral may follow in order to take care of your immediate needs and safety requirements and to effectively cope with the stress of the crisis.

The CRM counsellor is there to help define the problem, offer a source of emotional support and empathy, and ensure your well being both physically and psychologically.

Step 3. Crisis Counselling

Counselling is intended to be quite brief, and doesn’t usually last more than a few weeks. The interventions are focused on minimizing the stress of the event, improving your coping strategies, and directing you towards appropriate actions and skills.

Step 4. Offering Support

Dealing with emotional crisis is a lonely and often difficult challenge, and we are faced with huge stressors in the process. As a result, one of the more important elements of crisis resolution is to offer support, stabilization and coping resources. CRM is there to listen and offer acceptance and reassurance.

Step 5. Creating necessary structure and medical care when necessary.

During times of distress there are some activities and routines which can provide comfort and support. These do not include alcohol, self-medications or the intake of other drugs. Unfortunately people often resort to these as a means of coping. Substances should only be taken under medical supervision, when needed, and in order to prevent physical and psychological breakdown.

The CRM team provides the client with the medical expertise required to assess, treat and implement these needs.

Step 6. Education

People who are in a crisis are overwhelmed and in need of information about their current condition and the steps they can take to minimize damage. The CRM counsellor will offer education and guidance.

Also, while the situation during crisis often seems desperate and endless, the counsellor offers hope and an understanding that their reactions are normal and temporary – In times of duress it is healing to be reassured that we can eventually return to normal functioning.

Some of the educational issues that might be addressed during counselling are:

• Developing and discovering one’s potential and coping skills: practical solutions, growth attitudes, positive thinking, and stress reduction techniques might be complemented with therapeutic interventions.

• Self-observation and awareness.

The symptoms of trauma come to us through our bodies. It is important to become aware of and learn to trust them and to consider them an internal wake up call.

If we learn to observe and listen to these calls, to increase the awareness of our bodies, and finally how to use the symptoms we can begin to heal our trauma.

Low self-awareness, for example, not realizing the impact our behaviour can have on those around us, or even on ourselves can contribute to prolonging a crisis. Sometimes issues related to difficult family dynamics and poor communication can prolong a crisis.

It is important to increase awareness, and see the problem and how we are contributing. Then we are lead to new choices that promote recovery and wellness.

• Challenging irrational beliefs and unrealistic expectations

Our thoughts, especially those we don’t want to look at, contribute to how we feel and what we do next in response to our feelings. Gaining the ability to re-frame our thoughts, feelings and reactions is an important phase in healing and change.

• Facing our fears and emotional pain

A crisis is sadly a time of fear, sadness and confusion and how we respond is critical. It’s often the time to face our deepest fears. When we do, we discover that we can survive and overcome.

Though it may take time, patience and perseverance to resolve a crisis successfully, there is hope, and in the process and challenges people may become empowered beyond their imagination and grow stronger, wiser and more resilient. Eventually the pain will fade.

The CRM service is available to anyone, of any age, experiencing any sort of personal, emotional or mental health crisis. The service is available on a 9am to 9pm hotline, seven days a week.

If you feel you are in crisis, and finding it hard to cope, please do not hesitate to reach out. CRM is here to help you. Please help them to help you.

Call Careline number 9933 9966 or send an e-mail to [email protected] and one of the members will get back to you as soon as possible.

Ms Bonnici is a Gestalt psychotherapist; she works in private practice and is an active member of Crisis Resolution Malta