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.
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