Finding Me: Avoid Escalating the Crisis

Written by Andi Bazaar, Hugo-licharré Freimann, Mark J. Levstein, Tydalé-Oliver Schofield and Yevhn Gertz | Sept 22, 2023

What we often think of as “identity crisis” is usually repressed emotions coming to the surface/doubts stemming from anxiety or depression because they are strong, we have a sense of losing the “self” but it is actually not identity related.When we recover, that “self” is back.

One of the most frustrating by-product of the society we live in is that we are taught to tie our self-esteem with external factors, whether it is education, what contributions we make to a group or our families. I often hear from parents in sessions: “why should they feel good about themselves? they don’t do chores and their marks are low?"

We tend to forget that self-esteem has nothing to do with what we can do for others, our intelligence or work ability. It is an internal process that is unconditional. Then, we have adults who hate themselves and burnout because their job performance dipped or their marks got lower. A normal process (we all burnout from time to time) turns into a mental health crisis that shatters our self-esteem.

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If there is one thing that we can conclude from this health crisis, it is the value that our governments place on life. Many leaders have shown their true colours and valuing money more than life, it is really sad to see these types of sacrifice for the economy.

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One of the things I love doing during these hard times is to read about people going out of their way to help others. While most of the news won’t cover them, they are still there. A crisis is always a time when some of the best in humanity comes out and it makes me feel happy.

I was interviewed today by a student about mental health crisis response. Here is my answers to their questions on why, when emergency response is needed at all, sending trained peers with shared lived experience along with an EMT is better than sending police.

Most people in severe mental health crisis are not threats, people displaying unusual behavior or experiencing altered states of consciousness are not inherently violent or criminal. There is a threshold for when an emergency response is even useful, avoid escalating the crisis.

How to respond to a crisis as a community member and how to know when to escalate is a topic for a different angle, assume for now that an emergency response is needed beyond the capacity of those who are around.

SAFETY IS PRIORITY

Interruption of harm is distinct from supporting someone in an acute crisis or providing long-term support, mental health crisis should be treated as a community issue and a health issue "not a criminal justice issue."

Often mental health crisis is the result of multiple, unaddressed issues with a person's ability to comfortably exist in their environment. Short + longer-term support should involve addressing these conditions, not punishing the person for their reaction to those conditions.

People in mental health crisis have agency, their behavior is a response to their internal and external environment. It has its own logic, challenge the assumption that people need to be coerced into treatment for their own good also that their resistance to care is irrational.

If people are resisting support, it is because they do not feel safe or comfortable with the type of support being offered. If people know that you are going to violate their autonomy if they go with you or provide information, they are not irrational for not doing so.

• People in crisis may communicate in ways that are unusual, but they still communicate. When a responder is nondirective and attuned to the information the person is providing with their behavior, they are able to figure out what to do to create an environment of safety and choice.
• People in severe enough crisis where an emergency response is warranted usually do want support, they can't always communicate what kind and they don't want to be coerced. If you establish safety and offer options that are relevant also viable, they usually will consent to engage with you.

Altered states may be the result of an underlying medical issue, once safety and consent have been established, if there is a cause for concern about immediate life-threats, the person who is seeking support should be checked out by an EMT who is not an agent of state surveillance.

EMT's and police are not equipped to provide mental health support, EMT's assess for life threats — once there is consent. I advocate for a trained peer from the community who shares lived experience with the person in crisis to be the one to offer non-coercive, non-directive support.

Someone with lived experience with the type of crisis a person is experiencing will have a much easier time connecting with them, connection and safety are what is needed when someone in crisis "not coercion."

Loss of autonomy is at a core of many of the reasons people experience mental health crises, threats to people's autonomy intensify their response. People experiencing mental health crisis are also often sensitive to environmental stimuli.

When you send a team of multiple, uniformed officers with weapons, they use loud voices, disregard consent and make a big scene, what that serves to do is make people in crisis suspicious, defensive and afraid which undermines any attempt to create safety.

A goal of crisis support should be avoiding transport, not coercing it. If home isn't safe, they can consent to go somewhere equipped to support. Jails and emergency rooms are not good places for people who are sensitive to environmental stimuli, we need to create safer environments.

LET’S TALK ABOUT "IDENTITY CRISES"

We often hear that term being thrown around but it is rarely really defined in terms of the processes that we go through and even whether it is a good or bad thing, so what are identity crises and what can we do about them?

The main thing to remember is that we are never stagnant. Changes occur all the time even when we try to resist them, those changes are integral to our development and to the information we gather from the environment and those around us.

Furthermore, we also don’t have one single identity but several aspects depending on the circumstances and the environment. For example, my work identity is different from my home identity different from my identity with my extended family, etc… sll of these form who we are.

As we grow, our identities change because our perception of the world changes. We all remember times when we said: “those grown up things are so boring, I don’t ever want to become like that” but then years later we accept it because we no longer see it from that same lens.

So "if changes are normal, then what are identity crises and are they even related to our identity?" — well, it is yes and no. Most of the time, it is our mental health that is not doing well and changing things too fast. Let’s say I start getting intrusive thoughts.

These thoughts are scary and I don’t want to implement them in my identity or how I view myself, I may define it as an identity crisis, but it is not. It is actually an anxiety response, intrusive thoughts are not meant to be integrated in our identities.

Most of what we call identity crises are actually related to mental health, the biggest one being trauma. When something traumatic happens to us, it shakes us to our core and redefines how we view ourselves and others. We may have thought the world to be a kind place.

Then after our trauma, we don’t like anyone or see more of the bad than good, therefore having to shift our views quickly and feeling like we are losing our identity that we previously held. This can create even more anxiety as we are readjusting.

However, there is one phenomenon which shifts our “identity” outside of our mental health and it happens through what is called cognitive dissonance. Let’s say I believe in religion X but I have values Y that don’t correspond with each other.

I can only go on having those two values for so long before I need to make a choice, this is because cognitive dissonance is painful for us and we can’t deny the existence of two very different values or actions. So we are forced to make one, this doesn’t all happen consciously.

We see that a lot in social media, men pretending to uphold values of being allies to feminism/equity but behind closed doors are very deliberately misogynistic. This is what cognitive dissonance is, for some people it will lead to a change.

For others, it will lead to pain when fully thinking about these dichotomies but refusing to change their actions. When we say, our conscience is “punishing” us, it is usually related to that cognitive dissonance.

In conclusion, what we consider to be identity crises are most often issues related to our mental health and not fundamental changes in our personalities or values. The exception is cognitive dissonance, which can force a quick change in us due to conflicting values/actions.

I hope that this part helped shed light on this and allowed you to have an answer to when people/ourselves talk about going through an identity crisis, this topic was by no means extensive but meant to provide a quick summary.

COPING & REDUCING SOME OF THE ANXIETY/DEPRESSION

I want to share another topic on coping and reducing some of the anxiety and depression that come with times of crises like these. Completely eliminating any form of anxiety or hopelessness is hard right now given what is happening, but let’s reduce it as much as possible.

The first thing I want to mention is the need to reconnect with the present, we can easily start projecting worse case scenarios in our minds, anticipating the worst because it would help us cope better. Unfortunately, it doesn’t help much. It won’t reduce grief or pain but it does add pain and grief in anticipation despite things being relatively okay in the present.

When we find ourselves slipping into that line of thinking or spacing out, we can use our sense to reconnect with our environment.

We can take 2 minutes and count sounds, use our sight to see different objects around us, touch fabrics of things around us. We force our brain to focus externally, thereby tuning out the overthinking and loud voices in our minds.

This is also a time where we need our loved ones more than ever. Talking will not cure our anxiety but feeling supported, loved breaks that barrier of loneliness. In the group supports that we had over the weekend, the feedback was overwhelming positive.

It wasn’t because we found a cure or solutions to solving this crisis, but because we realized we weren’t alone in feeling anxious or depressed. People enjoyed knowing others were going through similar battles and leaning on each other for this.

Externalizing is so important. If you feel lonely or feel like you can’t trust people around you, write a post asking for a support network, I will happily amplify it and I am sure many would love to be of support. There is nothing wrong in asking for help.

SELF-CARE IS ALSO CRUCIAL

I know I mention it a lot, but it is important. We may feel guilty in engaging in self-care activities while a crisis is happening but this pandemic has already been happening for more than a year. To preserve and build energy, we need to take care of ourselves. It allows us to be of help for longer periods of times rather than short bursts until we burnout.

“we all deserve to take care of ourselves regardless of external circumstances, it is an action that teaches us to love ourselves unconditionally!"

While it is important to offer our help, volunteer if we can, it is also okay to take breaks and steps back. It is also okay to realize that our current mental health doesn’t allow us to do that at the moment, there is nothing wrong with that.

If we overstretch ourselves, it can backfire on our mental health. Boundaries are more important now than before, a lot of people may seek to bypass them (even if accidentally). We can’t be there all the time and it is okay to postpone certain things until we gather energy.

Social media: "it is saving lives right now." — it is so amazing to see the empathy, the support, the organization that surpasses that of governments. It is also a place where we witness sickness and death on a daily basis, it is okay to limit our exposure.

When we are exposed to this all day and night until we sleep, we may see everything as just hopeless and fall into a darkness where we feel there is no solution, no way out. We may feel guilty having the privilege of being able to tune out at times but too much of it can hurt.

It is important to know our limits. For example, I reduced the number of private sessions this month compared to before to organize group supports and to rest more, my mental health is also wavering certain days and I try not to push too much past the limit.

"We don’t know how long we may be in this, we need some strength for more in the future. You are all amazing and it is important to remember that no matter how bad it gets!"

COMPASSION FATIGUE

Given how many people have related to the topic about compassion fatigue, I decided to make a whole topic about it.

• what is it?
• what we can do to protect ourselves and what we can do to get out of it?

FIRST AND FOREMOST, COMPASSION FATIGUE STEMS FROM EMPATHY

Empathy is a wonderful way to understand and relate to people around us, it is one of the best traits a person can have but it is a double edge sword. When we engage in empathy, we also take in the pain of others, their traumas and difficulties.

A lot of secondary trauma (wrote a post about it a little while ago) stems from having that empathy in many occasions. In times of crises like now, pain is all around us. There is a lot of suffering and we can’t hide from it given how pervasive it is.

That empathy can quickly become overwhelming because we want to help but so much can happen in one day or even one hour that simply hurts us too much. Compassion fatigue can start happening so quickly, whereas in normal times, it can takes months if not years before it develops.

It is important to realize what our limits are, many people are working way past their limit. When we are exhausted, we are more vulnerable. We don’t have our natural defences ready and we are more susceptible to being hurt by events in our environment.

Therefore, the most important aspect is realizing how much energy we have on a given day. One of the things I do is rate each day within an hour of waking up. For example, today was a 6. I had some energy but was feeling tired, in a day like today I focused on my engagements.

I didn’t try to do a lot extra because I know I didn’t have the energy for it, in days with lower energy I would be even more reluctant to engage in certain activities because I need to be functional in the long term.

Short-term bouts of going past our energy will mean a longer recovery time and a likelihood of burnout and compassion fatigue, so "how do we recognize when we are in a compassion fatigue?" — The main symptom is going to be "numbness."

We feel as though we have no energy left, that helplessness, we feel as though we can no longer relate to people around us. That empathy that was our strength seems to have vanished, we may even feel like bad people or we were just pretending because the empathy now left.

However, we don’t realize the sheer amount of energy that empathy takes and how easy it can go away when we have nothing left in the tank. It is important to realize that and to take a break, it can be a break from work, social media, volunteering, etc...

We need that in order to gather our energy again and regain that empathy even if we feel guilty we can challenge that guilt and continue with taking care of ourselves. When we put others way above ourselves, we no longer have the energy to take care of other people.

That’s why self-care and empathy go hand in hand. Self-care, externalizing and resting are the fuel that keep the empathy going. Without them, it will slowly whither until it is gone. However, that empathy is not gone forever. While it takes time to recover, it is still there.

It is important to take care of yourselves and take time off in order to continue having the energy to fight this crisis and also to value yourselves, being in touch with our level of energy and planning our day accordingly will do wonders in keeping us fighting longer.

I hope that this clarifies the concept of compassion fatigue and helps you understand it better and taking the time off when necessary to gather that energy for empathy.

A SPECIAL THANKS TO:

• Andi Bazaar (Writer)
• Mark J. Levstein (Co-Editor/Co-writer)
• Yevhn Gertz (Director Photography/Co-writer)
• Dr Oliver Schofield, MD (Consulting/Co-writer)
• Dr Seth Gryffen, MD (Consulting/Co-writer)
• Timothée Freimann schofield (Photographed)
• Clayton Euridicé Schofield (Editor/Journalist)
• Scott Wynné Schofield (Publisher)
• Henrie Louis Friedrich (Analyst)
• Jwan Höffler Conwall (Art Interior Design)
• Hugo-licharré Freimann (Ass Director/Co-writer)
• Shot at GQ’s Studios by José Schenkkan and Benjamin Schenkkan Joseph
• In appearance by "Hugo-licharré Freimann" (Model)
• In collaboration with "The Me You Can’t See UK" (TMYCSUK) / @tmycsuk