Proposing a Phone Number System to Prevent People from Harming Themselves

Now I have done a lot to support others whether by posting on public threads or via private conversations. And when the needs were there, I talked to the desperate people. I am not here to argue or to trash people's intent with a holier-than-thou attitude. Like I posted at the beginning of my post, you folks are noble people to be willing to offer help to these suicidal people unconditionally. But there is no need to trash or bash others who are proposing alternatives or options for members who are willing to help with a more structured and collaborated effort. To be a effective counsellor, patience and acceptance of difference of opinion is very important. I am not here to knock down any one's idea. I am proposing some ideas of my own and sharing my experiences. If we don't have patience or more receptive of different opinions ending up bashing or calling out members who have been providing supports where they can, I don't know if we are prepared to take on those desperate, emotional folks who may lash out at us if we say something they don't like. I learn this as being a reality from reading Dr. Burns' book that very often, while counselling the patients with emotional issues, the patients can turn the anger, frustration and negative emotions to him when something he said wasn't well received. Again, I admire those who want to proceed on this unconditionally. You are the heroes and heroines and I speak my heart.

 

I believe that people on this forum have a much deeper, better understanding of what tinnitus is, than a random person from a suicide hotline. However, I don't think people with tinnitus have a monopoly on misery, and based on my experiences with other kinds of chronic pain, I think that people who are suicidal as a result of tinnitus are not that different from people who are suicidal as a result of other kinds of unpleasant, unfixable conditions.

I also believe that people who are specifically qualified and have experience manning a suicide hotline, are going to be better able to deal with and talk down someone who is suicidal, regardless of the reason for them being suicidal.

I have also been around support forums of one kind or another for a very long time, and I have seen several attempts at a "hotline" like this blow up like a live grenade, sometimes with tragic results. So, as much as I respect the altruistic intent behind people stepping up to staff an impromptu hotline, you can't convince me that it's ever a good idea to have amateurs trying to take calls from people on the brink of suicide. (In all fairness, many suicide hotlines are staffed by volunteers, but in those cases, specific training is provided, and people with clinical qualifications are always available as an escalation.)

 

Yeah guys , let's focus on the positive outcome a discussion like this has , everyone pitching in their experiences etc.
That is VALUABLE ...not something to start fighting about , different opinions are awesome

 

Some interesting developments in this thread. I spent a few years working for a UK mental health charity on a helpline for people experiencing mental health related distress, and have a few observations that may be useful. I am not trained as a counsellor, but I worked alongside trained counsellors in the same job role and learned a lot. Much of what I think will echo the hugely insightful input from @billie48. If any of these observations seem negative, please don't think I am against the idea that has been floated. There are problems and issues that need thinking through with any undertaking like this, and I only mean what I say to be helpful. I don't feel I want to take any calls myself due to my own current issues with depression, and also not feeling that my attitude to my own tinnitus is positive enough for me to advise others. But I hope my input might be useful in other ways. I'll try to be concise, but the issues are huge.

- I think intending to not take calls from people who are suicidal is a wise intention. Supporting people who are suicidal throws up huge complications. On face value, it does mean not being there for some people who perhaps need support the most. Having said this however, you will end up talking to people who are having suicidal thoughts - it is inevitable, even though they may not say so explicitly. For example, I have suicidal thoughts pretty much every day and have done for the last 2+ years since my tinnitus got worse, although I don't broadcast this regularly.

If somebody having suicidal thoughts related to their tinnitus were to discuss their tinnitus in depth then the suicide issue might possibly come out, and if it did then how that was handled might then have big implications for their state of mind. Anyone taking calls needs to think all this through before starting, and it would probably be best if there was some kind of agreed protocol for dealing with these issues. (I'm not suggesting a script, but a structure for how to deal with this is useful as once you go there it can quickly get messy and cause more harm than good).

- It is easy to get passionate about helping people, and can be hugely rewarding when it goes well. It can also be a lot more difficult than it might seem. People in distress can be hard work. They do not always think or talk rationally, can easily misunderstand things that are said to them and take offence, become argumentative, or worse simply bottle up a percived insult that then eats away at them. It can be as simple as you betraying a little frustration in your tone of voice. If things start to escalate it can be really difficult, and take real self-control, to rescue the situation. A passionate/fiery temperment can be a wonderful thing to have in many situations, but giving one-on-one support to somebody in distress it can be a problem. A calm, level head is much more useful to you and them.

- I would suggest a time limit for calls. At the organisation I worked for the time limit was 50 minutes. There are times when this is hard (and feels wrong) to enforce, but experience taught me that it was definitely a good thing. It can be hard to stay focussed beyond that sort of time, and focus is definitely what you want. A time limit helps you to provide structure - a beginning, middle and end. It helps to preserve your mental resources and ability to engage in depth. Sprawling, open ended calls might take a big toll on the person giving support, and lead to burn-out / lack of empathy. Having a time limit imposed as a policy - eg. 'TT Phone Buddy Rules' helps avoid any implication that you are uncaring if the caller wants more time. A lot of information can be exchanged in 50mins / 1hr and remember you want the caller to process and retain what you talked about.

- Related to the above, a difficult or emotional call can cause emotional problems for the person giving support. It can be useful/important if the person giving support also has access to support should they need it. Giving everything you've got to try to help someone and getting nowhere can be really tough to deal with. To give an extreme example, imagine discussing somebody's suicidal intentions in depth for 50mins and at the end of the call they tell you they have the means and now intend to kill themselves. Forget the legal ramifications for a minute and think about the emotional ramifications. What do you do with that knowledge? Could you have done things differently? I've been in exactly this situation numerous times, and believe me it is bloody hard to cope with, certainly on the first few occasions. I was lucky however in that I was working alongside people who had also experienced exactly this and who were skilled in giving support, so could then support me. What if you don't have that? Can you cope? This might not happen so often with tinnitus sufferers as with people with mental health problems, but do not rule it out unless you are actually prepared to end a call as soon as somebody mentions suicide.

- As I think was mentioned earlier in the thread, beware of dependency. If someone is unhappy and talking to you makes them feel a bit better, what are they going to do next time they are unhappy? You will probably find that some people quickly learn coping skills, new attitudes and ways of thinking from you and gratefully move on with their lives. Others find themselves temporarily calmed by the exprience of talking to you, but a day or two later are upset again and want to repeat the formula. You would be surprised how quickly people can get hooked, and it can be bad for them as well as you. This is obviously more likely to happen when people are fairly alone in life, but I'd guess that even for others having a connection (finally!!) with someone who understands tinnitus might become compelling. Probably won't happen in most cases, but something to be aware of nevertheless.

- Take notes. This is really useful. Whatever your intentions when you start out, if taking calls becomes routine it is easy to forget a detail that somebody has said a few minutes before. Taking notes allows you to refer back to things that people (and you) have said earlier without asking them to repeat themselves. It also good practice at the end of a call as part of the process of winding it down, to recap on what you have discussed. This reinforces the key things you have covered with the caller and helps them remember them. It also gets them prepared for the call ending and helps them to feel it was worthwhile when they see the ground covered.

- A useful skill for reassuring people is 'reflecting back' - where you repeat what they have just told you using different words. Don't overuse this or you just come across like a robot, but if you do it well it reassures people that you have understood what they said, and feeling heard and understood is often half of the battle with support.

- A really important thing is to remember that the call is about the caller not you. While your own experience will obviously inform what you say, it is frustrating for someone if they ring up to talk about the problems they are having and you spend a lot of time talking about yourself. In the job I had (and in counselling generally) it is seriously frowned on to talk about yourself at all. In this current context I would suggest that some talking about your own experience might be useful, but would advise to be very conscious of the extent to which you do this. Your experience is valuable, but theirs might well be very different. What worked for one person might not work for another, so make suggestions, but don't insist on anything. You need to be at least as open-minded as you hope the caller will be.

I strongly believe that openness is the most important attitude/attribute if anyone wants to help others in this sort of way. It is much too easy to think you know the answer and that people who differ are wrong. Be especially wary of this attitude: "I'm happy, you are not, therefore I must be right and you wrong." This attitude used to be seen on Tinnitus Talk a lot thanks to one particular ex-contributor, and it caused a lot of damage. It is really easy to fall into this trap when faced with someone who you think is struggling beause they cannot see things your way. But be completely clear... THIS IS EMOTIONAL TYRANNY! I don't use that kind of emphasis often, but here it is definitely warranted. Good intentions do not excuse emotional tyranny. You can do more harm than good if you do not understand what this means. (Phrase borrowed from Jeffrey Masson).

Sorry for rabbiting on. I feel like I've barely scratched the surface. I hope what I have said is useful.

 

I have helped so many people over the phone from every emotion possible and every problem possible and suicidal people too and glad to have been their for them.
One person called me his guarding angel as said I saved his life that weekend ...lots of love glynis

 

I am not agreeing or disagreeing here with your post although to me it makes a lot of sense. I am just wondering why I see posters refer to an ex member or ex contributor rather than name the person to whom is being referred as in Dr. Nagler? Why dont you just say Dr. Nagler who is no longer on this forum said this or posted that and i didnt agree with it. For those who dont know his name they can look up his posts and read them and decide for themselves as to whether they agreed or not with his points of view and even the way he expressed his opinions. I am not taking any sides here.......

 

Some good stuff in this thread. Lots viewpoints aired. Some concerns that I don't share. Some that I do. In the end though may I outline a simple process that is already in existence, is being used, and as far as I know is free of legal ramifications, so long as humans are still allowed to talk to other humans...in this case by phone.

1. TT member A. checks out the 'general vibe' of another TT member B. over time (short or long) via their posts.

2. TT member A. comes to some sense that TT member B. may be someone they would like to ask more detailed questions of, say hello to, or feel might be of help to them in some way.

3. TT member A. sends a PM to TT member B. via normal protocol if that TT member B. is not blocking such action. "Hey howzit! I like your vibe, and general take on X, Y & Z, and was wondering if I could ask you some questions?"

4. TT member B. replies: "Sure, go ahead"... and the conversation begins. Which may flip to private email addresses, etc. too so no need to log in to TT. Etc., etc.

5. Maybe quite soon, either one of A. or B. may suggest a 'phone-call' to make things more time efficient, more personal, more supportive, whatever.

6. Two people then exchange phone numbers, and then have some phone conversations. Topics may include by this point...anything under the sun, including bizarre Republican candidates for president, tinnitus, "hard times" with life. Whatever. No-one is monitoring this if you are not on the NSA watch-list.

7. As far as I know, all of the above is 100% legal...and 100% up to the individuals talking with each other to decide how they want to react to any "situation".

All of the above has happened, and is happening already...many times. IF there is a legal or moral hazard with this, then I suggest it is time to find another planet - for all of us.

Oh...and as a footnote ref. my other post similar to this one. I still wish that more than just emails and even phone connections could be possible, as there is nothing to me like "in person" for feeling and experiencing "reality" with human inter-connectedness.

Best, Zimichael

 

Yes, it is possible I am overcomplicating things from my experience doing this in a more professional capacity with a different type of sufferer. The slow and steady getting-to-know-you process you describe @Zimichael obviously makes pitfalls less likely. I do wonder how well this process would work if a newbie felt the pressure of immediate distress, and also recall discussion that 'buddies' might be selected based on geographical closeness (as opposed to compatibility of personal styles). I expect in most cases everything would work out fine. There might be a few cases where things go wrong however, and thinking through how to avoid and/or deal with that ahead of time is no bad thing. Forewarned is forearmed.

I thought it unfair to name him directly since he is not around to defend himself. And also I was not arguing with any specific post of his - I did enough of that when he was around! I was rather illustrating in general terms how an apparent intention to help can have the exact opposite effect if done insensitively. I've seen how the attitude I talked about ("I'm happy, you are not, therefore I must be right and you wrong") can cause distress when it arises in the context of tinnitus support on this forum and also when it was displayed by past colleagues providing support to callers. I'm also aware of the dangers of this attitude from my reading around the history of psychotherapy and psychiatry, which used to interest me a lot. It is a really common mistake to make when someone sets him or herself up to provide help with life's difficulties to those who are coping less well. It arises from human nature and the power imbalance inherent in that relationship. My intention was to warn against that. The reference I made was only intended as an incidental illustration that might resonate with a few people who saw some of the effects it had, and certainly not to dredge up old disagreements.

 

@dboy ...well yes, I agree with you of course, though was figuring people would see the potential to "speed up" the process I described, maybe cut one or so steps out of it, and a telephone call could happen within hours...or less.

Indeed if someone in distress is going to "blind call" a TT member and needs to do it now, then the icon idea of a "buddy available" or whatever makes some sense. However, I see that kind of situation being very rare, as the person in distress has likely been on TT for long enough to have made some assessments of a few members they might call, as otherwise they would have just gone to a generic "S.O.S." help website, or the phone book.

If you Google: "Ringing in the ears - support", a Facebook group comes up first (below the ads) and Tinnitus Talk does not even appear on the first page. So, my conclusion is, someone coming totally cold into TT and requesting phone help from "icon member X" without some time on the site, is a low probability.

And yes, geographical location makes sense just because of time zones and phone-call expenses too.

Best, Zimichael

 

Whats the update on this?