HOW THE STEPHEN MINISTER CAN BE OF HELP
TO THE DEPRESSED PERSON
St. Paul’s Lutheran Church
301 N. Main Street and Spruce
Doylestown, PA 18901
October 1, 2007
PRESENTER: Ruth Z. Deming is a psychotherapist with a master’s degree in Group Process & Group Psychotherapy from Hahnemann University. After working for 13 years at 2 agencies, she received a substantial grant for her nonprofit support group – New Directions for people with depression, bipolar disorder and their loved ones – and works fulltime for her group. A Jewish woman who loves teaching, she is also a published poet and writer. She enjoys giving classes such as The Ancient Art of Breadmaking and Writing Poetry for the Ones You Love. Click on NewDirectionsSupport.org. Phone: 215-659-2366, ext. 4.
PROGRAM: HOW THE STEPHEN MINISTER CAN BE OF HELP TO THE DEPRESSED PERSON. This interactive presentation will discuss how you can help a person through difficult life changes. Loss engenders a range of emotions including anger, sorrow, fear, frustration, regret and resolution. The caregiver’s most valuable tool is being a good listener. You as a caregiver will use your vast repository of lifetime experience and intuition to aid a person in need. We’ll also discuss the difference between clinical depression and grief. Oftentimes a care-receiver may also need the help of a professional, so we’ll discuss tips to identify these special cases.
GUIDELINES FOR HELPING YOUR CARE-RECIPIENT
INTRODUCTION: From childhood on, the human being possesses the strong and fundamental attribute of wanting to help his fellow man. You have all stepped forward as Stephen Ministers to strengthen and enhance your caregiving skills. Just as no two snowflakes are alike, please remember that no two individuals react the same when confronted by life’s tragedies. Resiliency is the rule of life and your role is to help rekindle the resiliency in your care-receiver. Remember, though, that while your help is paramount, you can’t do everything by yourself. Resiliency comes from within. It can be sparked or jump-started by you and others, but the person must help herself. Therefore don’t feel frustrated (easier said than done) if the person’s progress is slower than you wish.
In all societies, a team of helpers forms around the “wounded” individual. Establish what role YOU play on the team. The care-receiver is in charge of her own case. This is important to remember. The Receiver is in the lead and everyone should follow her wishes. She usually knows what’s in her best interests.
Use your own feelings to guide you. Trust yourself. Everything that’s written here is a SUGGESTION. Only YOU know what’s best to do “in the moment.”
Life is filled with joys and sorrows. Sorrow and anger are perhaps the most difficult to deal with. Listening is the most valuable helping tool. Just listen in silence. Use encouraging body language and refrain from interrupting.
You’ll notice how the care-receiver holds the keys to her own recovery, and is actually leading you toward how to be of utmost help to her. Because of her grief, however, she may have difficulty unloosing the needed ingredients to help or console herself. Grief can rarely be expressed without another’s help. It must be accompanied by someone like you willing to share in the journey.
Encourage your CR to share her story with suitable people. The more a person tells her story, the more she will “process her emotions.” (Do you remember The Rhyme of the Ancient Mariner?) Silence is not golden. It makes people sick. Think of a beautiful flower in a garden who shines out from morning till night. Passersby will stop to admire, to ponder, to imbibe beauty. The flower will be happy she has shared herself with others. She is reaching out just like the CR.
All of this is part of “processing our emotions.” Our emotions are living entities and must be expressed. Otherwise they will fester and we will become ill. Although invisible, emotions are transparent. How do we “read” them?
We experience another’s feelings – or lack of feelings – through (1) body language and (2) voice. Through feedback and training we can become adept at “reading” emotions. Emotions you’ll hear in the voice are: sadness, frustration, regret, anger, fear, and happiness. The human ear is exquisitely tuned to recognize emotions because that is how we communicate. The eye also possesses exquisite sensitivity. (Note, for example, how you can detect what’s going on in a football game with the volume off. That’s universal body language!)
THE STEPHEN MINISTER ARRIVES AT THE HOUSE: THE VISIT
The first visit or two are crucial. You are making a secure connection; hopefully a bond. You’ll want to be warm and friendly, but not overly talkative. Feel comfortable with silence. It allows the CR to talk.
The purpose of your visit is to comfort the individual. This is best done by storytelling. The CR will be anxious to talk. If she starts to cry and she feels awkward, say, “It’s okay to cry.” You may wish to put your arm around her shoulders or touch her hand. Older people are often starved for touch so feel free to do so. Before touching you may wish to ask, “Is it okay if I touch you?”
Let the CR know approximately how long you’ll be there.
While in their home, subtly gather information about how they’re doing (is house messy? mail unopened? how does their voice sound when on the phone?).
I like to carry a small notepad inside my pocketbook and jot down notes. “Is it okay if I write down a few things?” Do an informal questionnaire. Let the conversation flow. During the course of the conversation obtain answers to the below questions. They will occur naturally in the course of the conversation. If not, just ask.
It’s okay to intersperse idle chitchat in the conversation as a way to relieve tension. Laughter is highly encouraged.
NEED ANSWERS TO:
– “When did you start feeling badly?” September, 2006
– “What happened?” Examples include (1) My husband said he wanted a divorce and he left home – (2) my wife died – (3) I learned I have diabetes and must change my diet – (4) my daughter is getting divorced – (5) my sister is using drugs – (6) I moved into an assisted living facility and feel useless – (7) I lost my job or I’m retiring and feel useless.
– “How has your life changed since this occurred?” (can’t go food shopping, can’t concentrate, can’t sleep, etc.).
These are a few concerns of modern times. All involve either natural life transitions or unexpected events that take us by surprise. People’s recovery times will vary. Their recuperation time in the past is the best judge of how they’ll respond.
Everyone wants to feel better immediately. The emotions, however, don’t work this way. Tell them this. Also say things like “Healing is a process. I’m here to help you as you heal. Some days will be better than others. Eventually you will see the light of day just the way you did after your brother’s death.”
A good support system is the most important ingredient for healing. Ascertain who’s on their support team. If it’s inadequate, see if the CR can suggest more people to call or to come visit and help with chores and errands or conversation. Have them write down the names of their team and stick it on the fridge. Have them display photos of people they love as a comfort.
While you can explain that “getting your old self back” or “getting strong again” will take time, ask what helped them in the past. If a spouse has died, perhaps you can arrange her schedule so as not to be home at critical times such as dinner time.
Ask how the individual spends the day. Everyone needs a life of meaning. Help them establish a schedule or To-Do list so that every day upon rising they’ll know what to do.
Ask “What things make you happy?” Incorporate them in their daily schedule such as listening to music, going to the library, visiting neighbors.
Rely on your common sense.
When comforting someone whose spouse has died from a long illness, let them know it’s okay to feel relieved after the death.
Thejection of divorce is a kind of death. Here the CR must be reassured that she is a beautiful, lovable person and there are many reasons to want to live.
Absorbing the intense emotions of your CR may be exhausting. Don’t feel pressured to say something brilliant or comforting. It’s not always possible. Feel comfortable with silence.
Ask if there’s anything helpful you can do while in the home such as taking out the garbage. Be aware that the CR needs to keep active herself so don’t do everything for her, but you can help out while there with chores or phonecalls she finds difficult.
If you are feeling OVERWHELMED by your CR, they most likely need the help of a professional. Discuss this with your team. Then bring it up with your CR. If they do see a professional, be sure to continue your relationship with them.
During times of sorrow, encourage the individual to stay active, and to get out of the house. As stated, help them write a To-Do List. Then help set up a team to accomplish it. Include their own family members and friends.
The sorrow must be fully discussed. All aspects. No tear left unshed. Don’t pry. It’s similar to transplanting a geranium into the ground. We gently lift the roots and the soil but we never tug or disrupt what’s already there. We don’t want to cause more trauma. The wounded person is experiencing trauma. But again, they are resilient and will heal.
Clinical depression most likely requires referring the person to a psychiatrist and trained therapist, in contrast to normal Grief which can be done with friends and the Stephen Minister.
Clinical depression, simply put, is a whole-body illness with chief symptoms being loss of energy, inability to get out of bed in the morning, loss of appetite, loss of pleasure, poor concentration, can’t make decisions, overly tired, insomnia, and in severe cases not wishing to live, thoughts of suicide or wishes of death. Physical symptoms such as headache, stomachache or backache often accompany depression.
Important to ascertain whether client has suicidal ideation. We can do this by being direct (“Are you thinking of harming yourself?”) or indirectly by saying something like, “My friend Mary was so distraught when her husband died she expressed feelings of doing away with herself. Do you ever feel this way?” If the answer is yes, ask “Do you think you would act on your feelings?”
The clinically depressed person may indeed feel suicidal. Tell the person, “This is your depression speaking, not you. I am wondering if we need to call in professional help.” More about this later.
Use the term “we” as it makes the CR feel cared for and less alone.
Especially at risk is a person whose spouse has died. Resiliency is best achieved by citing reasons for them to continue living. This is where you’ll ask them about their family members, friends, hobbies. And also, “what sorts of things do you always wish you’d done but never had time to do?” Then explore the possbility of their returning to their love of art or volunteering.
If the CR is feeling true depression they will have difficulty accomplishing their major work whether it’s being a housewife or an officeworker. Depression interferes with one’s life. Discuss the possibility of seeing a psychiatrist for medication. Explain the benefits. “I know a man who felt really terrible but we hooked him up to a psychiatrist and within a month he was beginning to feel his old self again.” Also tell them they don’t have to take meds. They can see a doctor and get his opinion and still not take it, if desired. Depressions are self-limiting, meaning they abate by themselves. The time length however is uncertain. Taking an antidepressant will hasten the healing process. It is not habit-forming but must be taken under orders of a physician, including the stopping and starting of same.
If a person is suicidal they must have professional care. Again, their wish to die is the illness speaking, not them. Reinforce this over and over again. Be available, if you feel up to it, for spontaneous phone calls from them if they’re in dire need of comfort. This scenario, fortunately, is extremely rare.
Creative ways to deal with loss include journaling – buy a pretty journal and write down feelings good and bad (“out of the head and onto the paper”); write poetry about the loss; buy a punching bag; exercise; buy clay from craft store and fashion clay; buy acrylic paints or colored pencils at craft store and draw. You can also buy color- by- number books and fill in with colored pencil, a good distraction while healing occurs.
Music can help with a person’s mood. Encourage them to buy new music CDs, which will also serve to get them out of the house.
Encourage leaving home at least once a day. Our home is our worst enemy as well as best friend.
Scenic car drive. Hop in the car and drive with the radio on. And perhaps buy a cup of tea along the way.
Do volunteer work. Get out of the house with ComingOfAge.org which offers numerous opportunities.
Meet new people. Familiarize yourself with your church’s activities and reiterate their need for volunteers.
Rent funny movies when ready.
Use the “I” word when listening. “I imagine it’s very difficult waking up without your husband.”
Use the “we” word to bolster your alliance with the CR and offer hope. “Nadine, we’re going to call your doctor right now to find out the test results.”
Ask “what has helped you in the past?”
Suggest the CR keep a record noting her daily activities. In this way you can both chart her progress.
Find inspirational literature and keep it handy.
Your library or Stephen Ministries can help you select good books or inspiration tapes. Click on StephenMinistries. org.
The Old Testament and the New offer inspirational literature.
Browse Barnes & Noble or Your Local Library for comforting books.
Spare no expense in selecting healing books during this difficult time.