Uplift your Night Episode #5, Mental Health: Supporting yourself and others

Here is the transcript of Uplift your Night Episode #5 on October 8th, 2020 with Valencia Myint, Counsellor and Founder of Confide In.

Hello, everyone, nice to see you all tonight. I am Marie, I am Uplifters’ Founder and CEO. Thank you so much for joining me tonight. We will have a very special guest and I’m excited to introduce her to you. So let me introduce Valencia. Valencia is a counsellor and . a mental health advocate. She’s supporting people on their life journey, advocating to increase awareness on mental health topics to break the stigma in seeking help. She works with refugees, migrant workers, trafficking victims, abuse victims and people going through difficult times and currently providing support services online. We are super, super lucky to have someone like Valencia with us tonight.

Valencia: Hi Marie. Thanks for having me. Thank you for the introduction.

Let’s start with our first question for Valencia. How to recognize someone who struggled with mental health. So you can see they are stressed, maybe they seem anxious or depressed or lonely. But they haven’t  asked you for help. So how can you react?

Valencia: Before I answer, I just wanted to say good evening to everyone, wherever you are in Singapore or in Hong Kong, it’s really good to meet you all. And thanks for the first question. So not everyone will reach out for help, as we know, right? So for us to recognize someone who is struggling, it really does help to be observant about that person. So the first and foremost thing is to notice a change in the person, maybe they’re behaving differently to what you know before. So for example, maybe they are withdrawing from like social situations, for example, you’re not really seeing them so much anymore. Maybe there’s changes in their routines. So for example, changes in their sleep behavior, or like their appetite, maybe they’re eating a lot more or a lot less, feeling really fatigued, overly tired a lot of the time, a loss of enjoyment in the activities that they used to enjoy doing. So that’s kind of behavioral differences, or changes, but then there can also be very, like very much emotional changes as well. Maybe they are being more emotionally reactive, or non reactive. Maybe expressing more negative thoughts, for example, feeling hopeless, or worthless, or a loss in concentration, low mood, for example. Even things like suicidal ideation, or action plans. You notice maybe they’re more tense than they were before. So all of these things that are changes in your state, and it can also be a prolonged change in state as well. So for example, maybe this is taking place for like a few weeks or maybe even months then that’s also something to be aware about. So really, it’s kind of differences in people’s states. And if this is a prolonged state as well. The important thing also is to notice, not only differences in other people, but also in yourself as well. Just to be mindful of yourself, if there are things which you feel that things have changed for you and a little bit, it’s also good to be mindful about these changes, too. And maybe what led to it. Another thing which I wanted to touch on on this question as well is the stigma that is associated with mental health, particularly in certain communities. For example, like a lack of awareness, or knowledge of the topic, it’s something that we don’t talk about culturally, or even in our society, or even in our religion. All these kinds of differences can dictate maybe whether or not this is something that is normal to talk about. So on top of this, it’s also differences in language, maybe, because when it comes to talking about mental health, we talk about feelings a lot. And I know in some languages, a lot of the English words for our feelings may not be directly translatable. So it’s also kind of language barriers and talking about how we’re feeling or what we’re going through. So I think for that, it’s really the best to try to normalize conversations around mental health, try to talk about it as much as we can using language that is kind of similar to what we’re feeling, or at least to try to translate it in the best way that we can.

I think the first step is to acknowledge it and it’s not as easy as it seems. Just acknowledge that you’re not feeling well. Recognizing if it’s just a bad moment or if it’s something more serious can be difficult.  So what is the difference exactly between mental health and mental illness?

Valencia: Yeah, that’s a good question. I think a lot of people get a little bit kind of confused about this. And it’s important to differentiate between the two. So mental health is with everybody, right? Just like how physical health is with everybody. And mental health is defined as kind of an emotional and psychological well being. So good mental health relates to the ability to cope with the normal stresses of life. So mental health, I guess, we can think of it like it’s on a continuum. So it ranges between good mental health and maybe kind of mental health issues. So in a lifespan, we vary in this position on this continuum. So, for example, we have maybe good days, we have bad days, you know, we kind of go through ups and downs. And that’s very normal, right? I think, a lot of society right now, especially with social media, we don’t see the bad side, because a lot of most people want to, like showcase the good things which are going on, but really behind the scenes, like everyone experiences these good and bad moments. And when it comes to a mental illness, this is something that is diagnosable, remember. So a mental health, like problem or issue may not necessarily lead to an illness. So, for example, we speak about depression, a lot of anxiety and things like that. And these are illnesses, which are diagnosable, and they are also treatable, as well. So the important thing to remember is that mental health is really what everyone has, and it’s not something that is a bad thing. It’s just something to be mindful about and to acknowledge.

We have a question from team leader Ody. How can a simple person like me who is not a professional like you can express or support help to someone who reached out to me about emotional health? I just want to be sure I’m saying the right thing. I know the right thing to say is to ask a professional but not everyone is open to it. They are shy. What comforting words should I say to them?  And can I say that they need professional help? If everybody’s coming to you to ask for support, and at some point it’s just not your job, and you don’t know what to reply.

Valencia: Yeah, we’re actually going to cover this a little bit later in quite a lot more texts. So maybe we could go directly to that in a way. I think that the first thing is that really, especially being in a community, I think a lot of people especially being a community leader, as well, a lot of people do come to you for emotional support, and things like that. So really anyone and everyone can help initially, it’s kind of like we call it a psychological first aid. And so it’s at the initial stages, maybe even before like professional help is sought, or maybe even some people may not be willing to seek professional help yet, but then you can always kind of be there as an initial support so that the person doesn’t feel alone, you know. So there is an acronym that can be used, which may be helpful in this kind of situation. And it’s called ALGEE, it’s  A, L, G, E, E. So it’s kind of like an an action plan, which is like a flexible thing, it’s not really something that you have to do in order, but it’s just a kind of guidance for people to be aware of. And if someone is coming to them with maybe an issue and you want to provide some initial support, then it’s some kind of a guideline, so to speak. So the A is  to approach about your concerns, and also to assess and assist with any mental health crisis. So what do we mean by approaching with your concerns, obviously, this is maybe someone that you know, that’s in your community, you have observed, maybe some changes in them, and you’re quite concerned about their well being. So you want to approach them with the concerns that you have? So the first thing to be mindful of is, I call it kind of the five W’s, you know, so who, what, why, when and where? Would you like, are you the best person to be approaching this person? Because maybe you recognize that there’s a change in this person. But then maybe there’s someone that might be better suited to approach them, because maybe they’re a bit closer, that kind of thing. So you have to think about whether you’re the right person to do so. And in terms of what are you going to be talking about, you know, like your observations on them your concerns? And why are you concerned, and when would be a good time to talk to them. So for example, in like a confidential place, somewhere that is comfortable for them, maybe not somewhere out in the open, where there’s a lot of other people around where maybe it’s a sensitive thing, they don’t really want to talk in such a big group. And  that leads to kind of where to talk about it, like are you going to go somewhere that’s a bit more private. And then, then that way, you kind of setting up the scene to talk to this person. And later on, we’ll come a little bit more in depth in terms of assessing and assisting with potential crises. So by crisis, it’s like someone who is in an urgent situation, maybe having some kind of suicidal ideation, and things like that. So the first thing would be to approach the person. The L, which is the second letter is to listen and to support non judgmentally. We want to really provide a kind of atmosphere where this person is being listened to. And they are not feeling like they’re being judged for what they’re feeling, maybe what they’re thinking or what they’re going through. So for example also, one thing to remember is that as humans, we are quite biased people, like we have our set values, our set biases, it’s important that when you’re approaching a person to kind of remember to maybe put those things aside, because maybe it can kind of impact how we respond to a person. So we want to make things quite open ended, very non judgmental, to listen actively, and to be respectful, you know, and be empathetic about their situation. And to maybe even normalize the situation, you know, like speak from your own past experience, like oh,  I’ve kind of felt something like that before, like, I knew someone who went through something like this before, and they were able to get through that as well. So it’s also kind of, you know, your language, both kind of verbally and your body language. And also to kind of try to empower the person as well, you know, remember that it’s not just listening, right? It’s more than just that. It’s more kind of active listening, I guess, like you are listening to them, you’re not being judgmental about their situation. And you are responding in a way that is very open, you’re letting them share their thoughts with you. But also to remember that you also need to kind of set boundaries for yourself, to know that, you know, what they’re telling you is not your responsibility to take on on your shoulders, you know, but you are there as a support. So this is the listening aspect. When someone kind of comes to you, then you, you’re providing that space, where someone is feeling like, oh, there is someone who cares about me who wants to listen to what I’m feeling or what I’m going through.

It’s easier said than done, right?  It’s very hard to listen to someone without, you know, being willing to give too many advice and then you’re not really listening. 

Valencia: I think maybe what people feel is that like, okay, someone’s coming to me with a problem. I feel like I have to solve this.. Yeah, there is that urge, right, the initial urge where you’re like, Okay, I want to get this person out of this. And, but then I think sometimes what we kind of oversee is that some problems are very difficult, or maybe not on you to solve as well. Because remember, like a person is telling you maybe just a portion of what’s going on, maybe they’re not at that point in time, maybe you don’t know the full story yet. So it’s kind of hard to also try and kind of solve this, because maybe it’s no, it’s also not your problem to solve, but it’s something that you are kind of supporting them with, you know, so it’s also like part of a bigger picture, which maybe, maybe you might not know, at that, like know about at that time. But yeah, I think that’s a very initial kind of urge that you have, especially because, I mean, obviously you care about the person, you want to help them. And so this would be how you would help them. But I think it’s just to be mindful of, you know, your kind of responsibility in this and whether or not it’s really for you to provide that solution so to speak. Yeah. And so this leads me on to the G which is to give support and information. So I think it’s also helpful to give the person options. Informing them that help is available to reassure them, you know that there is a hope for recovery, in that sense, a way to cope with things. And just going back to that emotional support, fact, you know, just to really kind of be there, show support, and just especially, because people can feel like they’re alone in these times, and it’s just good to know that you’re you’re not alone, I think that kind of gives a little bit of a boost, in that sense of a little bit of a motivator, that at least, you know, there is help out there. And that I’m not alone.

I think it’s the less is more approach. It seems we’re doing so little by just saying we’re here and not giving any advice that’s not diving in. But it’s more right? Just saying we’re here is actually more helpful than trying to solve the problem for the person.

Valencia: Yeah, exactly. And I think for us as maybe helpers, maybe you feel like you haven’t done so much. Because you haven’t seen anything that has changed or whatever it may be that you may want to see. But then for the person receiving it, I think it does speak volumes, just, like just looking at some of the comments. Just even being there to listen, is a great help. And sometimes it’s just really just a platform where okay, someone can just say whatever it is, and then that really sometimes is like a bit of a relief, because it’s like that emotional burden that you’re carrying and then it’s kind of a bit of a release for some people just to kind of talk about it, and have someone listen and be kind of open about it and not to judge you for what you’re going through.

We have a comment from Fidelisa. She says listening is the best way to comfort someone who is in depression. Fidelisa is also one of our team leaders. And they are doing so much amazing work for their peers and supporting them. We have another question: What is the best approach if the person urgently needs help but is hesitant to speak up?

Valencia: Well, I think if it’s quite urgent, then maybe you might have to take some measures,  it depends on what the urgent is, because if you’re talking about a crisis, for example, like there are maybe exhibiting quite suicidal tendencies, then maybe you may have to just kind of take more drastic action, right, like maybe to call emergency services. So if it’s very urgent like that, then you may have to take drastic action on behalf of that person. But if someone is kind of having maybe some issues, and it’s not that kind of urgent situation, but then they maybe don’t want to talk to you, or they don’t want to say anything, then I think that the best approach would maybe to just kind of like ask them, you know, like, why is it that you’re not willing to speak up? And just to continue being an encouragement for them to try to say something or encourage them to maybe speak to someone at least? If it’s not you, then maybe could it be someone else? Provide options. Is there someone that maybe you would be comfortable to speak to, if it’s not myself, then at least they will know of the other people they could speak potentially to, whether it’s the various organizations that can be contacted, or maybe even professional help, for example. So that’s also something to just kind of explore options with them and not to kind of force them to speak if they don’t want to, but to continue encouraging them and giving them the options and also following up with the person as well helps, maybe slowly, they will kind of get to a place where they’re feeling more comfortable, to speak up. 

So it’s for example, even if the person rejects you, it’s a good idea to just come back from time to time and check how the person is doing.

Valencia: I think so. It’s kind of like a caring approach as well. You want to make sure that they’re not getting much worse so to speak. And, of course, this really depends on the urgency of the situation. Like I said, if it’s a real crisis situation, you may have to take more drastic measures. But if it’s something that’s not so urgent in that sense, then it’s just kind of finding out maybe why they were reluctant.  And maybe trying to also help with the misconceptions, you know, like giving them the reassurance that there is help out there, if they are ready for there are options and then kind of following up and seeing just checking in like any friend would do really.

We have another question from Fidelisa. When anxiety affects someone. I’m not sure if you mean what you should do or how you can detect it. Maybe we can reply a little bit around these lines? 

Valencia:  Absolutely. I think with anxiety, it’s typically when you’re finding a kind of shift in your daily routine, like you’re finding your daily routine a little bit more difficult to carry out. This may be when anxiety is affecting you a little bit like for example, maybe you’re withdrawing from certain situations, or you are avoiding certain situations. Maybe when you’re feeling the effects of anxiety, like emotional stress, or physically you are feeling some changes, like for example, with anxiety, some of the physical changes can be like a fast heart rate, or your breathing is faster. You start sweating, feeling quite uncomfortable. I think maybe this is when you can be a bit mindful about anxiety, like what it is that you’re feeling. And also knowing what it might be that’s triggering that, like is it the situation you’re in, or maybe some thoughts that you’re having that’s leading to that? Typically, anxiety comes from the fear of something. So it’s good to ask yourself what is it that I’m afraid of, or worried about or feeling uncertain about? And if you’re finding that this is really affecting your daily routine, then this is something to just recognize in yourself, you know, if you’re sleeping not so great, your eating, appetite is changing. Yeah, these kind of changes. It’s also good to be mindful about.

Thanks, that is very helpful. We have another question that is a little bit related. So I’m just going to show it now, how to distinguish between the experience of stress and the experience of mental illness? 

Valencia: I think with mental illness as such, it is something like I said earlier that it is diagnosable. Typically, it’s something that maybe you’re experiencing for a prolonged time, for example, months, on ends, you know, like a very consistent state that you’re feeling. And so just to clarify that the experience of stress does not mean that you are mentally ill. Right? So stress is a very normal reaction. For humans, or for animals, actually,

it’s like a protective mechanism, right? So, for example, if we, if we face danger, then we have a stress response because we have to either protect ourselves, or we have to run away to try to protect ourselves, right? So stress is a very normal reaction for people. It’s only when it can be like, a negative effect on us, maybe we’re always feeling stressed out for things, which maybe,  it’s kind of  a prolonged kind of state of stress, then that’s when it can become like a negative effect on us. So, yeah, so stress, it can be something that feels like short term, and then once like the situation kind of gets a bit more settled, then maybe we feel less stressed, right. So, stress can be like very much ups and downs. We feel stressed on some days because maybe something is coming up, like, we have some big presentation to do or we have to talk in front of a big group of people. This can be like a period of stress, but then maybe once that is over, then we’re not feeling so stressed anymore. So, yeah, so then these kind of stressful moments, it does not mean that you are having like a serious mental illness.

Thanks a lot for the distinction.  It’s a very important topic for our community and we can show it in the number of viewers tonight which is very high. We were going through the AGLEE model a little bit earlier, and how to help people who come to you for support. So we had gone through the A for approach, L for listen non judgmentally, G for give support and information. And we were at the E, which is I think, quite related about when you can’t really support anymore.

Valencia: So E is encouragement of  appropriate professional help. So I think that the word appropriate is quite important here. Because for you being the initial kind of contact to this person, I guess you would be the person that would also know the story. So if you feel like maybe the help is not, maybe they would need a bit more help, then it’s just the encouragement of that there is professional support out there. And that there is appropriate professional help as well. So according to the situation, maybe they may need to go to like a doctor to get a referral or maybe to see a counselor, that kind of thing, or even to be referred to, you know, one of the organizations which can refer them on as well, because maybe you may not know where exactly to go. But then these organizations, for example, you guys Uplifters are the organizations helping migrant workers would have the knowledge of kind of where to refer people to and kind of following on from that, it’s also encouraging other support as well. So for example, your community support. Also support of  friends, family, religious group members, people who are kind of within the social network that you have, that can provide a kind of social support. widen and also on top of that, it’s also the self care, taking care of yourself and implementing this kind of self care routine, which is also helpful as well, just to like, for example, to maintain a balanced diet, to do exercise, things like that. It’s also just to take care of yourself. That’s another thing we sometimes forget about.

Thanks a lot. That was very comprehensive. I would just look at the comments before we move on. We have a lot of questions. I’m not sure we’re going to cover everything.  So I suggest we’re going to concentrate on our listeners’ questions tonight. Because it’s important that we are here for you tonight. Don’t hesitate to ask your questions and the things you wanted to discuss and we can always reschedule another one. It’s an important topic.

Valencia: Yes, exactly. What should we do if we are suffering from anxiety? I think it’s first and foremost, it’s good that the person is recognizing what it is that they are feeling or thinking leading to anxiety. So, some of the things which may help is to utilize relaxation techniques or grounding techniques when it comes to the feeling of anxiety because oftentimes, maybe we are forgetting to breathe, our breathing is very quick, we’re not getting enough oxygen in and with that our mind kind of becomes a bit, you know, racing with many thoughts and things like that. So, a technique is like a deep breathing technique, which may help in terms of relaxation to ground yourself. And what I mean by this is to pay attention to your breathing, to take deeper breaths, and it may even help to kind of count the breathing. So when you breathe in, it’s like counting to three, and then releasing after the count, and then counting to three again. So, sometimes this may help. Again, it’s not something that may help everybody but it is something that is used as a relaxation technique. And a few of the techniques to do with grounding is also mindfulness. I know some people use mindfulness meditation techniques as well, and that’s really something that can be helpful. Of course it takes time to practice, right? Like don’t expect mindfulness to come in like one night. It will take a lot of practice in terms of being aware of the present, like to be present with yourself. And more importantly, without the judgment, you know, maybe we feel frustrated with ourselves, why am I not able to do this. And we get frustrated with ourselves and that’s, I think mindfulness is something that needs to be practiced. And without having judgment on yourself, like maybe your mind is wandering and then you’re frustrated with yourself, why is my mind wandering but then that’s okay. You know, like try to bring it back to the present because the thing with anxiety also with that is a lot of thoughts to do with maybe the past or the future, you know, like something that’s stressed us out in the past and maybe it will do this again in the future. And this is kind of bringing it down to, to the present, to be present with yourself. Like you can do it in your daily routine, just to check in with yourself in the morning or in the evening. Even like when you’re doing your walking, your daily routine, you’re brushing your teeth just to practice that during this daily routine. Because sometimes these actions it’s so like on autopilot we just do it without even thinking about it. So when we’re doing it, we’re thinking about all these other things which may lead to anxiety and it’s just kind of bringing things back down to the present really.

I guess that’s also the same advice if you want to prevent depression, right? These kinds of techniques and mindfulness. The fact is it’s not in the middle of the storm that you learn how to swim, right? So you need to practice before.

Valencia: Yes, exactly. In terms of prevention, it’s also being able to kind of educate yourself on what, what depression is, and also taking care of your own mental health, trying to incorporate these self care routines as well which help in terms of prevention, taking care of yourself, practicing that kind of self compassion as well. You know, like treating yourself like how you would treat a friend or a loved one. And also like being aware of, you know, what are the kind of things which make you feel bad or make you feel stressed out and how to kind of cope with certain situations. Another thing is to try to increase kind of emotional resilience, to be able to cope with a stressful situation and to kind of go back to how you were like before this crisis. So having that emotional resilience is also something, which is kind of preventative as well. But then these kinds of things, it does kind of take some time to build up as well. 

We have so many things that we could explore. Furthering resilience is clearly a big topic, right? We have a question from Janelyn and I think it’s an important one for everyone. What do you do when you listen to someone’s stories and you hear both his difficulties and you get affected and you feel for them and so how can you protect yourself? 

Valencia: That’s a great question. Thank you, JaneLyn, I think you know, when we have spoken so much about how to help people and that sometimes we forget about ourselves and I think the first thing to remember is to take care of ourselves before we can take care of others. Right? So even before, you know, we are helping someone, we need to also make sure that we ourselves like we are okay. And that, you know, we’re taking care of ourselves like even before, during and after supporting someone emotionally. The thing with emotional support is that it is very emotional. It can be very taxing, it can be very emotionally draining. So it’s good to be aware of ourselves, you know, our emotional states, like how we’re feeling because helping others who are in distress can make us feel very worn out. You know, maybe we’re feeling very frustrated, we’re very angry. But we can be angry. We can be stressed out. And this is something that I think we do need to deal with. And in terms of, by protecting ourselves, it’s also helpful for us to to also reach out for help when we needed, you know, like to also maybe talk to someone else of course maintaining the confidentiality, the other person, but you know, like knowing that there are people around you as also, you know, sometimes for the ambassadors, for the leaders, knowing that there is support for you as well, that, you know, you are having this role to support the community, but it’s also knowing that you yourself, like you have that support too. And it’s, it’s important to deal with something like that, because if we notice that and we don’t deal with it, then it can cloud your judgment and how, how you’re dealing with people in the, in the future. Maybe like you’re getting like compassion fatigue, for example, like you’re getting quite tired. And that can also affect, you know, your ability to help others, to be empathetic, to be able to listen and respond in that way that we spoke about, you know? So again, I think the same things also apply like practicing what is good for your mental health and for your moods, like talking to someone, physical activity, maintaining a balanced routine, implementing relaxation techniques or even sometimes journaling, like writing things can help people as well. It can be cathartic. But it’s also important, I think, to know and create the boundaries. You know, like if someone is telling you something, you need to know that it’s not your responsibility to take on, on your shoulders and that there are boundaries, you know, like there are things which that person needs to be taking responsibility for, and it’s not on you to shoulder that burden. And it’s not on you to solve their problems, it’s for you to provide that support and provide some options for the person and to make sure that they’re not in like a crisis situation. So it’s also good to maintain, I think the boundary setting is very important as well. 

Well, I guess that’s always a challenge, right?. Because we all want to help so much and to recognize the moment it’s okay to say no, I think it’s a challenge for most of us. 

Valencia: Yeah, it is. And that’s very understandable. And I think it’s just very normal to feel that way, so don’t feel stressed out or feel bad that you’re feeling this way and that maybe you’re feeling a bit tired. Like that’s okay. I think emotions get the better of ourselves at times. And it’s okay to kind of just take a step back from it sometimes and seek some support yourself and then go back to it when you’re in a better kind of mindset. I think it’s important to take a break and then during that time, you can always like, that person can always be referred to someone else within the community as well. 

That’s a lot of very good advice. It’s almost 10:45 so we’re going to take maybe one more question before we wrap up.  One comment is how you can handle it if you receive bad news from your family and you’re struggling working with your own employer. 

Valencia: That’s definitely a lot that’s going on because it’s things which are happening in your personal life and also in your professional life. And I think particularly with times like this, it’s important to know what support is around you, which is why I really go back to that support. Like during these times, I think it’s really easy to feel like a person or you yourself is feeling really alone. You cannot just stop in this situation. And of course your family is back home. It’s hard to get back to them straight away, particularly with this current time with travel restrictions and everything. And there was a problem going on at home as well. So during these times, it’s good to know what support is out there in terms of like reaching out and also to be mindful of as well of like maybe the changes that you are experiencing, like maybe are you finding it difficult to work as well? Or are you just finding it difficult to maybe wake up or get out of bed? Things like that, like your daily routine, is it becoming more effortful or difficult for you to get through, maybe changes in your routine as well. And knowing that there are people within your community and also organizations of Uplifters and others which you can potentially reach out to. And sometimes I think just talking through things like knowing about maybe what kind of options you might have it’s also good to explore as well and sometimes in this situation, if you’re finding it very very difficult then seeking help is also an option as well. And I know that there is also a fear in doing that. But it’s something that I think within the community as well, we need to kind of try to normalize these conversations to talk about it a bit more and maybe clarifying some of the fear that you’re feeling like, what is it that you’re fearing and what is it that you’re scared about? And maybe it’s something that we can kind of, you know,  to help with that fear, because maybe some of it is kind of a misconception about seeking professional help as well. So yeah, it does help to kind of normalize the conversation. 

One very last question. What is a mental health crisis and what do you do if we see someone who is in a crisis? From Lovely corner. She’s just an amazing woman doing so much for the community. She is asking what do you do when someone  is hurting herself when she is angry, does she need professional help? 

Valencia: Thanks. Lovely corner. I know who you are. So yes, I think that this, this would fall under what, what would be a mental health crisis, so to speak. So the crisis is someone who is in emergency needs, for example, before I was saying, Oh, like someone is having suicidal behavior or thoughts maybe non-suicidal, self-injury like hurting themselves and things like that. So I think with self-injury or self-harm there could be many reasons why a person is doing this. And sometimes so this comes with just educating ourselves on maybe what his reasons can be. So for example, some of the common reasons might be to manage feelings of distress. Maybe it’s a way for a person. Maybe it’s a way for them to punish themselves or to communicate personal distress to others. So of course for this kind of situation, we would kind of follow the action plan that I mentioned earlier. And it’s really kind of assessing as well,  like when you see it, don’t ignore that or don’t ignore the signs, for example, if it’s cutting or if it’s bruising or burns, for example. So it’s good to assess the situation. Like if it’s a really critical situation, like it’s really needing, you know emergency services, then I think that that would be something that would need to be sought out initially,  to contact emergency services, but it’s to kind of approach the person with your concerns. I think the important thing is to be calm and to be accepting of the person and their behavior, to discuss options again which would potentially  include seeking professional help because maybe for something like this it could be something that would more likely lead to the seeking of professional help. And this comes with, you know, discussing the options or discussing alternative options you know, to find maybe healthy ways to reduce their distress. But in most cases it would be the encouragement of seeking professional help for something like this. Particularly if it’s something that is a continuing behavior but then I think first and foremost it’s just important to be there and to be having a very calm and kind of open and accepting conversation about your concerns about this, if you’re observing it.

Can you please remind us what a crisis is exactly? 

Valencia: A crisis is when someone is in need of very urgent help. So if it’s if it’s suicidal behavior or thoughts for example, maybe someone is threatening to hurt themselves or kill themselves, maybe they’re having an action plan, experience or like expressing feelings of hopelessness, maybe like having a little reason to live. Like I said earlier, self-injury as well, so harm can be a crisis situation. Maybe panic attacks can be a crisis situation as well or you know, the effects of like drug and alcohol use which can lead to a crisis situation at that point too. So these kinds of situations where there is a need for an urgent help where maybe you, you may need to consider seeking for, you know, more emergency services. This would be included as a potential crisis situation.

Thanks a lot. It’s very, very nice to have such a good view of these complicated and sensitive topics to you again. Thanks to you, we have gained much clarity about it.  I think the time has slowly come to an end. We will go back to the comments later on and try to reply to all of you. Thank you so much Valencia for your time. It was very informative, very reassuring.

Valencia: You’re so welcome. Thank you so much for inviting me. And I know there’s so many questions to answer, but I think we’ll just have to go through them slowly later.

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