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NOW POTENTIAL


In considering the now potential in
crisis, emphasis is first given to the “potential,” which refers to what might
or could happen.  What is the worst
possible outcome of the crisis?  Could
the individual or someone else in his total situation die?  Could someone get hurt?  Could there be some other similarly serious
consequence?  Could the individual’s
situation become so deteriorated or so permanently messed up that no amount of
help or concern could return it to its pre-crisis state?  The potential of the crisis lies somewhere
between no bad consequences or effects and the serious injury or death of
someone in the total situation.


The “now” in the now potential
refers to the immediacy or emergency quality of the crisis.  We need to know how quickly things might
deteriorate or get worse.  How quickly
might the potential be actualized?  Will
it take a week, a few days, a few hours, or could the worst possible outcome
occur almost immediately?  This “how
soon” is the “now” in the now potential. 
As we intervene into crises by trying to find out what happened and by
developing a picture of the individual, his total situation, and the
interaction between the two, we simultaneously need to consider and develop a
judgment about the now potential of the crisis. 
How bad could it get?  How soon?


Let me tell you about a situation
out of my own experience.  It seemed, at
the time, like a real crisis.  Looking
back, the obvious flaw in my judgment was my failure to recognize that the now
potential was very nearly approaching zero. 
The summer between my first and second years in graduate school was
spent as a program director at a YMCA camp. 
About ten-thirty one evening, I was sitting in the dining hall with most
of the camp staff, trying to make time with the camp cook.  (I married her a couple of years later and am
still married to her; so that worked out pretty well.)  At any rate, it was girls’ camp that week,
and all the campers and staff were girls (except for one college-age boy who
helped in the kitchen and the camp director, who was gone that night).  Sure! 
I thought it was great.


One of the younger counselors and
two of her friends came running into the dining hall in near hysteria, and
about all we could get out of them for a minute or two was “He’s dead.  It’s a dead body.”  They had tripped over what they thought to be
a dead body on the footbridge across the river. 
With some embarrassment, I must admit that I became nearly as panicked
as the girls.  It seemed like a real
crisis; I really do not want to go into the details that led to four police
cars and seven deputy sheriffs being in camp. 
Remember the guy who helped in the kitchen?  Well, it seems that he and his girl
friend….They had not moved when the kids tripped over them because they were
not supposed to be out there in the first place.  A crisis? 
I sure thought so at the time, but on looking back, I can see that even
had there been a dead body on the bridge, the now potential was pretty low.  Dead bodies tend to stay in place and not
make much trouble.  Also, the likelihood
of a dead body on a bridge in a summer camp is fairly remote itself.


However, specific note must be made
of crisis situations that should always be interpreted as holding high now
potential.  For example, any reference to
suicide, whether or not it initially seems to be a serious report of someone’s
intention to kill himself; any report of a strong impulse to abuse or
physically injure a child; any report of a drug overdose; any report of bizarre
or unusually strange behavior; or any report of a “bad trip” with drugs should
always be seen as a serious crisis with significantly high now potential.  Alternatively, reports of continuing but more
serious marital difficulty, concerns about poor schoolwork or unsatisfying
interpersonal relationships, continuing but more serious difficulty in managing
or controlling the behavior of children, or experience involving a somewhat
increased sense of discontent and restlessness should be seen as holding less
significant now potential.


Since threats of suicide, comments
about suicide, and situations in which suicide appears to be a significant
possibility frequently come up in crisis intervention practice, some special
comments about the dynamics of suicide are in order.  First, the now potential in suicide
situations is critically high.  Clearly,
someone could die.  Later in this text,
we will discuss situations and circumstances that can prompt people to feel
like killing themselves.  Here we want to
think about what is going on within the individual when he is considering
killing himself.  Most typically, people
who are suicidal appear to be extremely depressed, somewhat withdrawn, and
express feelings of futility and despair. 
At other times, however, people may talk about suicide in a light and
casual way.  In some cases, references to
suicide may be very indirect and not appear to be particularly serious.


Next, having recognized the high
now potential in any suicide threat, we want to keep in mind the fact that
people very rarely kill themselves in the presence of other people.  This is true despite the sensational news
coverage given to people who have shot themselves in front of their family or
friends.  Suicide is almost always a
solitary act.  It thus becomes important
to make sure that a potentially suicidal individual is not alone.  If he has come to our office or drop-in
center, we will either stay with him or make arrangements for someone else to
stay with him until the suicidal crisis has passed.  If he calls us on the hot line, we will try
to learn if he is home alone, if there is someone who could come over to stay
with him, if there is some place he could go where there are people, and so
on.  If he has called us on the telephone
and if we can get no assurance that he will go to a friend, we should make
every effort to find out where he is. 
Once we know where he is, we will waste no time in getting someone to
him.


A situation with a real and
immediate possibility of suicide is one of the very few in which we would call
in the police.  If the only way to get
someone to the individual is to have the police knock on his door, then we will
have the police do that.  If we have
overreacted, however, the individual will probably never again place any faith
and confidence in us.  He will probably
be very angry and may well say very negative and destructive things about us to
his friends.  The only way to avoid this
is to run the risk of under reacting.  To
under react is to run the risk of having a dead client.


What has happened to the person who
becomes suicidal?  Clearly, he has turned
his anger in on himself.  This fact comes
as a surprise to many newcomers to crisis intervention.  Ask yourself, “What is the most angry,
aggressive act an individual can carry out?” 
He can kill someone.  There is
probably no act more expressive of extreme anger than murder.  Most people would not be able to kill unless
they had temporarily lost their senses or had gone into a violent rage.  This kind of intense anger is something most
people would find difficult to express directly.  Suppose, though, that they were angry with
themselves for something they had done or something they thought they had
done.  Suppose this led to their feeling
unable to cope with their life situation, face their family or friends, or
otherwise deal with things.  Since there
is no way to work things out or to make things better, the anger turns in on
the individual.  At the extreme, that
anger causes the individual to kill himself. 
Sometimes this intense anger may be focused on an individual, a member
of the family, a friend, an associate, or on the world in general.  Because the individual in crisis feels unable
to take out his anger directly on someone or cope with his situation, he may
take it out on himself.  Whatever the
reason or circumstances, suicide is always an expression of extreme
internalized anger.


In the crisis intervention process,
the goal in suicidal situations is to enable and encourage the individual to
express his anger, talk about what has made him mad, verbalize his
frustrations, and generally “get it out where he can deal with it.”  Working with people in suicidal crises is
difficult, but you will be able to help them. 
Your efforts should be to get them to externalize their anger, tell you
what frustrates them, talk about things that have made them angry, deal with
their resentments, think through the situations and relationships with which
they feel unable to cope.  If they can
verbalize their anger, focus their bad feelings on specific people and
situations, and make plans about coping with their life circumstances, they are
well on their way to getting through the potentially critical crisis.




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