I’m sitting back and letting myself be in awe for a moment at how messed up the world is on so many levels and in so many areas that I even have to write this piece. The same way that I mentioned in the drugs 101 piece here that we often have to rehab ourselves, very very often, we are put in situations where we are also the ones literally saving our loved one’s lives. Many people are out here doing heroics for themselves and their squads with little to no support from medical and mental health professionals due to financial reasons, systemic and interpersonal bigotry, etc. Queer people & people of color (ESPECIALLY queer and trans people of color) are often doing the healing work in our own communities because there’s often no culturally-competent, ethical, and affordable providers around. This piece covers how to support your friends and loved ones as they work to recover right after a trauma and/or a crisis while also trying to find appropriate medical and mental health professionals. You are not their therapist or their doctor, but you can give them short term support while they are trying to lock down long term professional help. This is definitely a in the mean time and in between time kind of piece.

Before I get into crisis intervention, I’m going to list and link a few related pieces that I think you should read before doing this kind of emotional, psychological, physical, etc. labor for your loved one(s). One important thing to learn and never forget before taking on this kind of work is: The best way to help and the best place is start is ALWAYS asking the person in crisis what kind of support they need and going from there. Your role isn’t to save them (savior complexes both take the humanity out of the people you are trying to help and treat them like children. They are grown adults. They don’t need you to tell them how to live or need you to baby them. They aren’t SIM characters. They just need a boost while going through a rough situation like you would in their place). One more time: Your goal is NOT to rescue them. Leave that savior mess at the door. Not only will taking on that unnecessary burden burn you out, frustrate you, and possibly turn into resentment over time…it’s also not what the person in crisis needs or probably even wants. They may not know what they need at first, but go at their pace. This isn’t about you. It’s not about you “wanting your friend back” as soon as possible so you can hang out like you used to. It’s not about you wanting to see them happy because it makes you feel better. This is about their healing, at their pace, with them at the lead. 

• Boundaries 101: This piece covers what boundaries do and how to start setting solid personal boundaries. This intro piece to how to set boundaries will help you be able to be there for your friend(s) while also saving enough physical and emotional energy for yourself.

• Boundaries 201 Part 1: This post explains how to take the ideas and skills learned in the intro to boundaries piece and how to apply them to your family life and other close relationships. Specifically, how to set boundaries around toxic and/or abusive people in your life.

• Boundaries 201 Part 2: This Part 2 explains how to use boundaries as tools to make your relationships with your loved ones even stronger and longer-lasting.

• Mindfulness: This piece covers how mindfulness strategies and techniques can help you become more aware of your emotions and what’s going on in your body and mind. When dealing with a crisis situation, one might feel tempted to block out emotions and try to power through the crisis. This might be a decent very short term solution, but what happens when there’s crisis after crisis back to back in your life? Now, it’s been months and/or years of dealing with different kinds of crisis going on and you have no breaks. Pushing down your emotions doesn’t make them go away. They just come out in other ways like constant body pain, mood swings, poor sleep, poor eating, being easily agitated, high blood pressure, etc. Emotions and stress that are never handled can literally kill. 

• Suicide: A significant number of people in crisis can experience a wide range of suicidal thoughts/feelings: wishing to not be alive, wanting to fall asleep and never wake up, thinking about specific ways they could end their lives, etc. This post explains what suicide is, the difference between thinking about suicide and being at risk of actually doing it, bodily autonomy, and suicide prevention. Understanding what suicidality really is and what it really means will help you figure out how to give your loved ones the kind of support they need.

• Mental Health and Hygiene: This piece talks about the the impact that mental health can have on our routines/hygiene habits and practical suggestions for if/when you notice changes in your ability or your loved ones’ abilities to keep up daily routines. This may be very important especially in the beginning of the crisis situation. Being able to have empathy for the person in crisis and for yourself, a caretaker, is going to be incredibly important.

• Self Care: This post covers what self care is and how to build and maintain a solid, healthy relationship with yourself. Everyone involved is going to need to pay special attention to self care. The person in immediate crisis may need help finding and/or going back to the self care strategies they have used in the past. Caretakers will need to continue Investing in themselves and doing what they need to do to recharge and love on themselves while showing love and empathy to others. 

Establishing Safety

The first part of crisis intervention involves creating a safe space, both literally and figuratively, for the person in crisis. Depending on the situation, especially if they just experienced something traumatic, the person literally might not feel physically safe. They might look really alert, tense, and/or seem totally unable to relax. They might check the locks and windows at night. It may be really hard for them to fall asleep or stay asleep all night because of scary dreams, memories, anxious thoughts, etc. So an important first step involves working with the person in crisis (as a team. Don’t assume. Don’t put words in their mouth. Remember, they take the lead.) to create a space where they feel safe enough to sleep. 

Creating a safe space for sleep might include: 

• Creating a comforting nighttime routine to rebuild the sleep pattern/cycle

• Using nightlight or having a dark room, depends on the person’s preference

• Avoiding physical activity (that might take the heart rate up and trigger a panic attack in some people) or anything stressful right before bed

• Watching calming TV, reading, music, etc. around bedtime

• Warm baths or showers before bed

• Meditation and/or other kinds of mindfulness right before bed

These are suggestions, not hard and fast rules. Again, the person in crisis would know what is comforting and helpful for them. They might not be able to sleep alone. They might be afraid to be alone in general. They might need to talk about what happened a lot. They might need a lot of alone time. You can be their support in getting whatever they possibly need to feel safe and secure.

Coping Skills

Relatedly, your loved one(s) in crisis is going to need help dealing with what they are going through. This might look like helping them remember the ways they have coped with crisis situations in the past. A crisis counselor, at some point, would make a quick list of their past coping skills. That’s basically their current options right now. Are those coping skills still working? Does the person need an upgrade to those skills and/or brand new ways of handling stress, etc.? One of my former clients used to call his coping skills “tools in my toolbox” and I always thought that was a great way to describe it. Look at the different ways you handle stress and problems as tools that can be kept, upgraded, and/or replaced. The right set of tools can really make the difference while someone is trying to get back on their feet.

Some other suggestions on getting by on the day-to-day while in crisis include:

• Take it day by day with everyone being as gentle as possible with themselves and each other. And being forgiving of one’s limitations. You are possibly not going to be able to do everything in 1 day. You are probably not going to be able to move with the same energy immediately like you did before the crisis. And that’s ok. Healing takes time. How much time? However long it needs.

• Listen to your body and don’t force anything. Sleep when you’re sleepy. Eat when you are hungry. Move when you have the energy. I talk about how to strategize getting stuff done with your limitations (instead of despite your limitations…because working with yourself is just easier) in the mental health and hygiene piece I linked at the beginning so check that out for information.

• Many ppl use alcohol and other substances (legal & illegal) to help them fall asleep, coping with anxiety, etc. I would ask that, if you feel the need to get that kind of help, please try to keep in mind that it’s a short term bandaid and can only be useful while you’re getting other self care strategies together and/or using multiple other self care techniques at the same time. Whatever is making it difficult for you to sleep, etc. will still be there when the sleep medication/substance wears off. So take this time to start getting prepared to deal with whatever is at the root of your sleep, etc. issues. That way, if/when the side effects of the sleep medication/substance start to outweigh the all the benefits, you already have a Plan B in place.

• Talk to people you trust. Whether that’s your friends, family, therapist, social group, etc. Venting and/or working through your feelings and thoughts is an important tool for many people.

• Keep a journal (or notes on your phone/computer). It could be a helpful way of working through thoughts and feelings. It’s also a great mindfulness and grounding exercise. Crisis situations can often make people feel uncertain, confused, disconnected, etc. and being able to return to your thoughts and reflect on that at a later time (alone or with people you trust) can be a great way to clear up what is feeling foggy.

Safety planning 

Check out the depression piece here for more info on safety planning and links to resources/hotlines. This is a basic safety plan, with open ended questions to assist people in customizing their own unique plan for their situation.  

Step 1: Identifying the situation.

What are some signs that let you know you’re starting to feel hopeless, sad, frustrated, etc? Do you feel it in your body? Do you feel tired all the time? Do you lose your appetite or eat more than usual? Or is it more in your head/thoughts? Do you get racing thoughts, for example?

Step 2: Self-soothing.

What are some things you can do to cope with these feelings/this situation? How did you get through difficult times in the past? What stops, if anything, you from you using these coping skills now and how can you get around whatever is in your way? 

Step 3: Looking for help.

Who can you ask for help? And what kind of help do you want from each person? Friends, family, case workers, etc. Do you wanna vent or process feelings/thoughts/memories/nightmares? Do you need to leave home for a couple days? Do you need someone to make sure you eat? Do you need help going to the Dr? Do you need money or transportation? Do you need help filling out paperwork?

Step 4: Emergency services

Do you feel comfortable calling emergency services? If you don’t, who can you call that you trust to get you to a safe place? What hospital would you want to go to in a worst case scenario? It’s better that you choose than to have a stranger choose for you. How would you get to the hospital if needed?

The fact of the matter is, more often then not, marginalized people have to heal ourselves. And many times, especially for queer and trans Black people, it is friends and chosen families who are relying on each other to survive traumas, personal crisis, systemic oppression, health issues caused by environmental racism, etc. Squads and chosen families are out here doing their best to hold each other up long after biological families have failed them and all while the system works as it was intended to. Shout out to y’all. This piece is dedicated to the work you all do. And hopefully in this piece, you saw a healthier way to do what you have always been doing.

Thanks for reading. The next piece will cover termination: for people wondering if they should and/or how they should end their therapeutic relationship with their therapist.