Recently I facilitated a meeting with a group of Lifeline counsellors on how to feel more confident working with suicidal callers.

One of the things we all thought it important to stress was the need for ‘debriefing’. We all know how demanding it can be to work with callers contemplating suicide particularly if they have already taken some action that could result in death!

Debriefing offers us the opportunity to come back into balance, and not carry into our own future a residue of difficult feelings like anxiety, anger, grief, or powerlessness.

What things need we keep in mind as we ask for, or offer to another, the opportunity to debrief?;

Surely top of the list will be the recognition that it is normal to feel upset or disturbed in some way after working with a caller in a suicidal crisis.  To come close to these life and death decisions is demanding.; We might say that learning to be more comfortable at these times means learning to allow ourselves to feel uncomfortable.  However, sharing these upsetting feelings with another person is the best way to normalise them.

Another important aspect of debriefing revolves around the question:  how realistically am I facing any limitations involved in the situation?  And there are three sorts of limitations that might apply:  namely, the limitations the caller imposes, limitations of the situation itself, and my own personal limitations.

The caller clearly restricts the range of helping strategies a counsellor can call on because of the person-at-risk’s depression and at least part-option for dying.  Although sometimes we may feel frustrated by these limitations, nevertheless our encounter with them need not leave us believing that somehow we could, or even should, take responsibility for them.  We can do only what we are permitted to do.

The situation itself can sometimes impose limitations.  For example, the caller’s ID may be masked; it may be difficult to immediately obtain outside help.  For this part of the debriefing process, it is important to identify what is outside my own control.

Usually it will be around the issue of our own personal limitations that we might feel most anxiety.  We can feel overwhelmed with inner questions about what I might have done differently, or better.  Or have thoughts like  “if only I had…”;  “I’m no good at this…”; “somebody else should have taken this call…”

While it is tempting to believe that crisis situations require us to respond with the calm of a Divine Being or to possess a Superhuman Efficacy, nevertheless what we are is all we have.  The debriefing process assists us to find trust in what we have done, and into believing in the value of the connection we managed to make with someone who needed us to be real.   And sometimes that “being real” includes being a person who feels uncertain about what to say or what to do. 

But let us not focus just on the limitations we may have brought to this or that particular encounter with a person in crisis.  We have also brought skill and a heart that cares.  Sometimes this will have immediate effect, sometimes not.  There is however, nothing better to offer.

The debriefing process also offers us the opportunity to identify what are “my” feelings and what are the client’s feelings that I also feel.  This concerns the less conscious part of our interactions. 

So when we empathise or are really “with” someone who feels desperate, that person will project his/her desperation, guilt, self-hatred, powerlessness, (or whatever), into us who are their helpers.  (It is our willingness to receive these projections, and offer them back to the client in a more tolerable fashion --as opportunity permits-- that is one of the main ways we assist.)

The result for the counsellor is that I can feel these projected feelings as weighty, and care needs to be taken so that we can firstly acknowledge them, but then identify them as not “my own”.  I will still need to share these feelings as I debrief, and the knowledge that they are not my own will help to protect me from self-misgivings.

I recently read Regeneration by Pat Barker.  One of its important themes concerns the way in which an army psychiatrist, William Rivers, helped men (among them poets Siegfried Sassoon and Wilfred Owen) recover from “shell-shock” during the First World War. The story recounts how Rivers himself suffered physical and emotional symptoms arising from his willingness to engage with men who experienced ongoing horror from their wartime experiences.

Unfortunately, there seemed to be little chance for Rivers, the carer, to be cared for.  At one point in the book, Rivers symptoms were so strong he was advised to take a holiday but no reference was made to any direct and helpful attention to the burdens he was carrying.  As such this powerful story is negatively instructive.  What was hardly understood back then is better understood now.  As counsellors, we owe it to ourselves, to one another, and to our callers/clients to keep ourselves safe and protected, by acknowledging our own need of others.  The process involved in doing this we call debriefing.

The following is a more detailed plan for debriefing session that the Lifeline Support Team developed at a recent meeting: