Friday, November 25, 2005

On crisis intervention

"What am I going to do now?" The question came from the daughter of one of my parishioners. Her own young daughter had been critically injured in an accident, and I had been called to the trauma center to be with the family.

While I don't enjoy trauma situations, I've learned to be very comfortable managing them. In many situations I am relatively passive, but in traumas I tend to take as much control as the situation and the people allow. Because -- for the people involved -- so much of their lives is suddenly out of control, I want to bring as much control back into their lives as I can.

That begins with the physical setting. Are people wandering about? I try to bring them together in one room, have them sit down, and in general bring some order to the chaos they are feeling. Where possible, I act as a liaison between the medical staff and the family. Because I often have access to the emergency room itself, I will go in frequently and find out what is happening. (In major trauma centers that's not always possible.) When medical people are with the family, I try to anticipate questions or provide clarifications where I sense the family is not really hearing what is being said.

Obviously, I try to provide what spiritual resources I can. "May I pray with you?" And I pray for the patient and the family -- especially that they might know Christ's peace and protection. I don't usually read scripture in these situations. Later, but not during the crisis. It's too easy to find some proof text that they're not ready to hear at this point.

I also try to make the family as physically comfortable as possible. Does anyone need some juice or coffee?

Once the immediate confusion subsides and the family begins to settle in for the long wait, I have learned to let the various family members cue me in to how I can help. As people move about, I will often talk to people individually and give them the opportunity to let me know how I can help them. "This is really a tough time, isn't it?" often opens up a conversation. But I have also learned that not everyone wants to talk, and I try to honor their privacy. This is often frustrating to hospital staff who want me to "do my job" and "say something 'spiritual' to make my parishioners' pain go away." Of course, no one says that directly to me, but I know that's what they're often thinking. But I have found that people will let me know how I can best help them through this long process.

The simple truth is that these situations are often incredibly painful for family members, and as much as we would like to, we can't relieve them of that pain. We can be with them in their pain, but we can't take it away.

The most frequent question is, "Why did this happen?" and is expressed in a variety of ways. As gently as I can, I try to let people know that I don't know why. I think most people know that, but they need to ask the question anyway -- and I encourage them to ask even if I can't give them a very satisfying answer. But along the way, I stress that even though we don't know what's going on, GOD does -- and He will be with them. I also try to assure them that God didn't do this to them -- that He's not punishing them by harming their loved one. As bizarre as that sounds, I find that a lot of people in crisis just assume that it is a punishment from God for something they've done (or not done).

As time goes on, I talk about how angry they're feeling -- toward the person who might have caused the accident, toward God, toward the medical staff, toward the patient, and toward themselves. I let them know that God can handle their anger, and I may even talk about times that I have been angry with Him. I listen to their hurts and questions, but I don't try to respond to all of them (again to the frustration of staff or other family members who don't think they should be talking like that!). I tell people that they are going to have all sorts of "crazy" thoughts -- and I assure them that they are not crazy. Their systems are just on overload.

Throughout the process I pray with the family or with individuals as I feel it's appropriate. I am always impressed by the power of prayer -- not just for the patient but with the family. It truly is a means of grace.

Most of all, I simply try to be with my people in their pain. I doubt that they will remember much of what I've said, but I know they'll remember that I was there. And to that extent, they will remember that God was there also.

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