Chapter

Emotional Support

On-the-Ground Support

Many Occupy sites are establishing a variety of support teams to address the emotional needs of protesters; we deeply respect their (our, your) ongoing openness, compassion, and commitment to dialogue, people, and the Occupy movement. This section offers tips for approaching distress and disturbance on the ground at Occupy through a radical mental health lens.

Ongoing Spaces and Trainings

Create a Support area that is separate from, although possibly nearby, a Medical area and offers a space for people to process distress and madness in a way that is safe, calm, politicized, and creative. It could be staffed with volunteer peer supporters, massage therapists, counselors, acupuncturists, mediators, listeners, and/or social workers. It could be stocked with art supplies, books, stories, and other materials that help people explore what is going on for them through a range of means and from a range of different perspectives. The more diverse the better!

Form a group whose purpose is to support the emotional well-being of all involved. In some Occupy sites, groups working on this have called themselves “Support,” “Emotional First Aid,” and/or “Safer Spaces.” Some of these groups may focus on specific areas within the emotional health framework. These groups may form a Safety Structure connecting with groups such as Security/Community Alliance, Medics, or Empathy/Nonviolent Communication groups to develop creative ideas and collaborate on a sustainable encampment/protest. Emotional support folks might consider wearing an easily identifiable item such as certain color armbands.

Together these groups may create protocols for dealing with crises that the various Working Groups involved agree to follow. For instance, when faced with people yelling at one another, rather than immediately calling for Security, some Occupy sites call first for Support. The emotional support people try to de-escalate and assess the situation. If needed, then Security may be called for. Try to keep your focus on support and inclusion, as opposed to security and exclusion.

Host teach-ins with the on-site protesters that both reduce fear and “Othering” around distress and madness and promote emotional well- being as holistic, collective, political, and in many ways created by the community through the development of an atmosphere that supports expression, connection, and nourishment. Encourage people to set up peer-support groups around social and emotional well-being.

Recognize that you/we are protesters too! Many activists quit being active because they become exhausted, burned out, and/ or traumatized. It follows that we need to both witness personal experiences of suffering—and honor the long-term sustainability of protest and revolution—by taking care of ourselves and each other. When it comes to emotional support, we must all practice what we preach; process is the product. If things gets rough for you, if you’re feeling upset or triggered, never hesitate to step out and/or talk with someone. Do shifts in pairs or small groups, hold regular meetings to think/talk through or role-play challenging situations, and designate specific times for debrief and recreation.

Psychological First Aid

Psychological first aid documents ideas for responding to urgent situations in which someone is experiencing marked distress or madness, whether a panic attack during a march, trauma following police brutality, or an aggressive on-site disturbance late at night. Above all, the people who engage in psychological first aid must not be afraid of emotional intensity. They need to be able to enter it with the person, while remaining one hundred percent present and conscious of their interaction and surroundings.

Safety: Build the person’s sense of safety and control by removing them from harm’s way and possibly the scene. Embody a sense of community, compassion, inclusion, security, and shelter: Ask, “What do you need right now?” or “How can I help you in this moment?” Right off the bat, meet their basic needs (food, water, ice, tea, a phone call, and/or medical attention). You might try giving simple either/or choices (“Would you like a piece of fruit or a Luna bar?” or “Can I get you a cup of tea or some ice water?”) This gives people something to focus on and a sense of control in the simplest form, without overwhelming them with too many choices. Be clear and concise with your communication, and reduce any other stressors, including bystanders and extraneous support people.

Comfort: Practice stress reduction/management through techniques such as breathing and body awareness. Ask them what’s up/what happened, but be cautious of re-traumatization: let them lead the conversation. Provide soothing human contact (first asking consent to physically touch the person); comfort and console. Validate their experiences as common and expected, without minimizing what they are going through. Remember that feelings are always subjective, and therefore always one hundred percent real.

Language: Be aware of, and sensitive to, your language. Consider that many occupiers may find clinical language to be triggering and oppressive. Remember that people come from diverse backgrounds and perspectives, and language is often used as a tool to marginalize and control, and our movement is still developing a compassionate language for describing altered states of mind that respects people’s subjective experiences. Try to be humble when judging another person’s state of mind. Stick to concrete descriptions and the words the person uses, and be aware that some things that may seem helpful can actually be harmful. For example, do not say, “Lets talk about something else,” “You should try to get over this,” “You’re strong enough to deal with this,” “I know how you feel,” “You’ll feel better soon,” “You need to relax,” “It’s good that you are alive,” “It’s a good thing you didn’t get arrested,” or “It’s a good thing you got out of there before they whipped out the rubber bullets.” These comments could pathologize and exacerbate the traumatic experiences of the person you are trying to support.

Connectedness: A sense of isolation can be extremely distressing in and of itself. Keep or get people connected to their friends, communities, loved ones, and the broader Occupy movement. With their permission, you may need to make contact with people on their behalf. Provide pathways for them to gain social support from others who are coping with the same traumatic experience. Offer material about the different resources and services available both within and beyond Occupy, taking care to explain that their experiences are unique, contextual, transitional, and can be engaged with a diverse range of approaches.

Self-determination: Talk with people about their situation. Using your best judgment, give them information that they want about what happened/is happening/will happen. Clarify things only to the extent that you are absolutely sure; do not set people up for unreasonable expectations. For example, it is better to say “I don’t know, but I can try to help you find out where your friends are” rather than “I’ve heard that the National Lawyers Guild lawyers are getting everyone out tonight!” Start turning their care back over to them. Develop a plan of immediate first steps for what to do when they leave, using practical first steps and do-able tasks, before brainstorming with them about how they might start to plan for longer-term support if needed.

Active listening: We all have two ears and one mouth; we should be listening twice as much as we speak. Remember that people often just need and want to be heard more than anything else. Make it clear that you are listening:

= Body language: leaning in, eye contact, facial expressions, minimal fidgeting

= A compassionate presence: calm, soothing tone of voice; minimal encouragement (saying yes/ nodding/ summarizing/ mirroring/ reflecting); let them drive the conversation—start with a clear and open mind, and do not come to the conversation with expectations; occasionally repeat what you are hearing in your own words; ask questions to clarify if necessary; do not interrupt; be very careful with humor (no sarcasm)

= Active understanding: avoid asking “Why?” and “Why not?”; do not judge; silence is okay, but be sure to continue eye contact or (again, consensual) touch

Suicide, Violence, and Hospitalization

If someone seems suicidal, speak with them. Listen to their feelings, before telling them to do anything. Ask directly if they are considering killing themselves. Ask if they have a tool or a plan. If so, ask if they can trust you enough to share the plan, or to give you the tools they were going to use. Also, ask if they have executed the plan already (this can happen in the form of taking pills). It is also beneficial to ask something like, “Have you felt this way before? If so, how did you overcome this feeling?” This enables you to see how the person was able to get better in previous episodes. Most of all, take it very seriously. Read about suicide risks and signs. Call the local suicide crisis hotline and talk over the situation with them.

Hospitals are not a panacea, and can sometimes make things worse. While it is harder to kill yourself in a hospital than outside, it still happens. Someone who is kicked out of the hospital due to insurance or other policies may then kill themselves in the end. If the suicidal person is hospitalized, have a support team visit during and after hospitalization. Ideally, the person being hospitalized makes the decision to go; in many states, it is not possible to admit someone without their consent.

Don’t take the decision to hospitalize someone lightly. How bad can a few days or weeks or months in a psych ward be? Worse than jail? For some, yes. Inpatient hospitalization often inflicts physical and emotional abuse upon patients, with scars and medical bills that can last a lifetime. Once hospitalized, many patients are sucked into a revolving door of psychiatric care as their personalities are dissected and pathologized under the gaze of the psychiatric magnifying glass. If possible, provide an alternative space to a hospital. Some have found that time at a spa or even a hotel room, with friends present around the clock, is far more effective than a hospital stay. Perhaps the suicidal person would like a healing ceremony of sorts.

It is impossible to judge the level of risk of suicide. If nothing else, do not keep it to yourself. Speak with crisis workers. Keep a close eye on the person. Encourage them to come talk to you and other emotional support people as often as they want. Be especially worried if, after earlier confiding their suicidality, they seem to suddenly withdraw or act especially happy. They may have made a decision to kill themselves, which may be giving them a sense of peace.

Don’t diagnose violent behavior. When support gets called in, it’s often because someone is being disruptive or harmful to others. This could be anything from loud, off-topic rants at a meeting to physical or sexual violence. When someone is acting in harmful ways and the cause isn’t immediately apparent, it can be tempting to try to “diagnose” them and to conflate actions taken to prevent them from harming others with actions taken to help them. But confusing the two can be really hurtful, both to the person you’re trying to help (a lot of the trauma around psychiatric abuse stems from the fact that coercive and hurtful things were done in the name of helping the person) and to people in mental distress who are not harming others but may get lumped in with those who are.

Drug use, mental health, emotional trauma, or other unmet needs are at the root of a lot of problematic behavior. Understand that these are coping strategies that may have had some purpose – your goal is to figure out alternate ways to get these needs met without the problematic behavior. Remember that fear and anxiety may heighten the tension, so try to remain calm and avoid accusations and blame.

An alternative approach for dealing with violent disruptions is to first concentrate on meeting the needs of the community by leading the disruptive person out of the common space. Talk to them patiently and ask them what’s going on while escorting them to a calmer setting. If that doesn’t work, you may have to physically separate the person from the altercation, but verbal de-escalation should always be the first and second choice. Once the person is in a space, physically and/ or emotionally, where they are not likely to harm others, only then can you focus on their needs. Ask them what they need, and see what you can do to help them get more local resources or connect with their support network. Whatever action is taken to help them should be with the person’s full consent.

If someone is physically attacking people, groping people, or stealing stuff, the community may decide to take further action to protect itself. These situations are extraordinarily complex, and there is no formula that applies in all contexts. Unfortunately, we do not all share a compassionate language for thinking and talking about these issues. Wherever possible, try to involve the offender’s friends and allies when formulating a response, and listen to the voices and stories of ex- prisoners and psychiatric survivors when considering difficult actions.

If there is a weapon involved, try to convince the person to give it to you. If they will not, and if trying all your de-escalation or intervention tactics, and those of others in the group, does not work, it may be necessary to call for police assistance for the greater well-being of all. Perhaps that person can return another time, but at the moment, they are not acting in a way that is conducive to everyone else’s health nor their own.

If considering hospitalization or incarceration, take responsibility for your decisions and be clear about your motives—it’ll make your presence more effective. Don’t send someone to the hospital or call the police because it’s “better than doing nothing.” Let people know about community resources, and together figure out ways to meet their needs without harming others. Calling the police or sending someone to the emergency room for mental health concerns should be a last resort, after consultation with friends and allies. Consider first the potential ramifications including imprisonment, deportation/ loss of immigration status, increased depression, undue medication, shame, a prison record, loss of custody/visitation rights, interruption of life, loss of anonymity, and health care debt, as well as further scrutiny of protests, police brutality, sensationalist media representations, and so on.

If someone is hospitalized or incarcerated, follow through by organizing visits and other communication. When they come out, help them process why the support team made the decisions they did. Try to be receptive to their critique and/or anger and/or gratitude.

Try to see every action taken by those within the movement, whether positive or negative, welcome or unwelcome, as an opportunity to come together as a community and support one another. Choosing to alienate others or ourselves in times of stress creates a snowball effect of hurt feelings and hurtful actions. However alone we may sometimes feel, we are all in this together.


Navigating Crisis

When It All Comes Crashing Down

When you or someone close to you goes into crisis, it can be the scariest thing to ever happen. You don’t know what to do, but it seems like someone’s life might be at stake or they might get locked up, and everyone around is getting stressed and panicked. Most people have either been there themselves or know a friend who has been there. Someone’s personality starts to make strange changes, they’re not sleeping or sleeping all day, they lose touch with the people around them, they disappear into their room for days, they have wild energy and outlandish plans, they start to dwell on suicide and hopelessness, they stop eating or taking care of themselves, or they start taking risks, being reckless, and may (in rare circumstances) become frustrated and violent towards themselves or others. They become a different person. They’re in crisis.

The word “crisis” comes from the greek word krisis meaning “decision” or “judgment.” A crisis is a moment of great tension and meeting the unknown. It’s a turning point when things can’t go on the way they have, and the situation isn’t going to hold. Could crisis be an opportunity for breakthrough, not just breakdown? Can we learn about each other and ourselves as a community through crisis? Can we see crisis as an opportunity to judge a situation and ourselves carefully, not just react with panic and confusion or turn things over to the authorities? While everyone must be held accountable for their words and behavior, it is our collective responsibility to create a space for this to occur in a way that promotes movement, not containment, in people’s lives.

 

Crisis Response Suggestions

Work together.

If you’re trying to help someone in crisis, coordinate with others to share responsibility and stress. If you’re the one going through crisis, you may want to reach out to multiple people whom you trust. Human connection can be very healing for a crisis. The more people you have to support you, the easier the process will be and the less you will exhaust your support system.

Try not to panic.

Crisis can be made a lot worse if people start reacting with fear, control, and anger. Study after study has shown that if you react to someone in crisis with caring, openness, patience, and a relaxed and unhurried attitude, it can really help settle things down. Often times this approach is derailed because the supporters themselves are exhausted and stressed. Above all, the people who engage in crisis support must not be afraid of emotional intensity and altered states—they need to be able to both enter it with the person, and remain one hundred percent present and conscious of their interaction and surroundings.

Be real about what’s going on.

When people act weird or lose their minds, it is easy to overreact. It’s also easy to underreact. If someone picks up a knife and is walking around talking about UFOs, don’t assume the worst and call the cops. If someone is actually seriously attempting suicide or doing something extremely dangerous like lying down on a busy freeway, getting the police involved might save their life, but it might also put them through more trauma from being forcibly locked up in a hospital ward. Likewise, if someone is cutting themselves, it doesn’t always mean they’re suicidal. People cut for a variety of reasons, most of which are deeply personal and incapable of being understood through diagnosis. Sometimes people who are talking about the ideas of death and suicide are in a very dangerous place, but sometimes they may just need to talk about dark, painful feelings that are buried. Use your judgment, and don’t be afraid to ask others for advice. Also, don’t be afraid to ask the person in crisis what they need. Sometimes you just need to wait out crisis. Sometimes you do need to make the difficult decision to take action to try to interrupt a pattern or cycle. What that action is can depend on a lot of things, like the person’s trauma history, their physical needs, and the availability of support networks.

Listen to the person without judgment.

What do they need? What are their feelings? What’s going on? What can help? Sometimes we are so scared of someone else’s suffering that we forget to ask them how we can help. Beware of arguing with someone in crisis: their point of view might be off, but their feelings are real and need to be listened to. (Once they’re out of crisis, they’ll be able to hear you better.) If you are in crisis, tell people what you’re feeling and what you need. It is so hard to help people who aren’t communicating.

Lack of sleep is a major contributor to crisis.

Many people come right out of crisis if they get some sleep, and any hospital will first try to get them to sleep if they are sleep deprived. Sometimes the psychiatric drugs hospitals provide can really help with sleep, but sometimes the lack of privacy and control in the hospital environment can itself cause or worsen insomnia. If the person hasn’t tried Benadryl, herbal or homeopathic remedies from a health food store, hot baths, rich food, exercise, soothing sound, or acupuncture, these can be extremely helpful. If someone is really manic and hasn’t been sleeping for months, though, none of these may work and you may have to temporarily seek out psychiatric drugs to break the cycle.

Drugs may also be a big factor in crisis.

Did someone who regularly takes medication suddenly stop? This can cause a crisis because of the severe withdrawal effects of psychiatric drugs, which often get (mis)diagnosed as people’s “mental illness” coming back. Ideally, someone quitting medication has a plan and support system in place to do so, but in the absence of such, try to respect their wish to go through withdrawal. The crisis may be physically necessary and may pass, although remember that a transition to no psychiatric drugs must be done carefully and slowly, not suddenly. If they are not deliberately trying to come off of their drugs, try to help them to get back on them.

Create a sanctuary and meet basic needs.

Try to de-dramatize and de-stress the situation as much as possible. Crashing in a different space for a few days can give a person some breathing space and perspective. Perhaps caring friends could come by in shifts to spend time with the person, make good food, play nice music, drag them outside for fresh air and movement, and spend time listening. Often people feel alone and uncared for in crisis, and if you make an effort to offer them a sanctuary it can mean a lot. Make sure basic needs are met: food, water, sleep, shelter, exercise, friendship, and if appropriate, professional (alternative or psychiatric) attention.

Calling the police or hospital shouldn’t be the automatic response.

Police and hospitals are not saviors. They can even make things worse. When you’re out of other options, though, you shouldn’t rule them out. Faced with a decision like this, try and get input from people who are thinking clearly and know about the person. Have other options been tried? Did the hospital help in the past? Were police and hospitals traumatizing? Are people overreacting? Don’t assume that it’s always the right thing to do just because it puts everything in the hands of the “authorities.” Be realistic, however, when your community has exhausted its capacity to help and there is a risk of real danger. The alternative support networks we need do not exist everywhere people are in crisis. If someone does get hospital or doctor care, be cautious about any diagnosis they receive. Sometimes labels can be helpful, but madness is ultimately mysterious and diagnoses aren’t scientific or objective. Labels can confine us to a narrow medical perspective of our experience and needs and limit our sense of possibility. Having a disease label is not the only way to take someone’s pain seriously and get help. If someone is hospitalized, try to visit them, or call if you can’t visit. Knowing someone on the outside cares for them can mean a lot.