Ask HN: Has anyone (un)successfully staged an intervention? | Hacker News Reader

Ask HN: Has anyone (un)successfully staged an intervention?

6 pointsl33tbro22 comments

Buddy's going through it. Would greatly appreciate hearing what worked or what didn't for people who have been there for a friend in crisis.

No, I don't want the 'seek professional help' etc advice. He's already SSRI'd up the wazoo and I'm losing him.

I've invited him to stay for a week and I need to make it count. What was your experience?

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For me, nothing worked and I lost them. It carved a canyon in my heart. Me and friends spent many months trying different things. What was apparent is that participation is necessary. If they don't want to be helped they basically can't be helped. Some people got basically isolated because they were too forceful. At that point what seemed key for me was to keep trust so I could intervene in the last minute, and so they don't shut you out. Be proactive in the critical time. If you want to intervene, know exactly what you're going to do, who to call, have a plan. I think it might be better to get someone put in a ward than to lose them, even if you're blowing up their life in the process. It was a question I mauled over for days.

If they're planning to leave, I felt that they should consider walking away from the things causing them pain. You can make a living being a surf lifesaver or a forest warden or collecting unemployment. If they're planning to leave, and, as I would speculate, they've tried nothing, maybe you can get them to try some stuff if they can lean on you as a fallback? You may as well quit your work and skydive or hike or travel or do whatever if you're going to end it, and some people have life changing experiences doing those things?

Cognitive behavior therapy is apparently surprisingly effective to engage with people who are interested in changing and recognize there is a problem.

If things are looking desperate maybe something insane and mind altering like microdosing ketamine or LSD or something, as these actually do change people a bit. If there's nothing to be lost, I'd try it.

I don't have any answers or advice. Good luck.

There were some observations in this thread that was posted here a week ago.

https://news.ycombinator.com/item?id=37994348

Maybe it's true, maybe not, but he did work in psychotherapy and they're something to consider.

One other note that I have is that I get wary about people who say "just listen; people want to be heard", as this was not sufficient in my case, but I acknowledge that every case is different.

The feminists in my forensic psychology course would have absolutely roasted that guy and his “ugly truths” post. I don’t consider myself to be a feminist, but I thought some of his “ugly truths” were out dated and I thought the appeal to gendered stereotypes was pathetic, especially coming from someone who claims to have authority in the field of psychology.

I'm sure they would. I think there are points worth considering at least in there. If the only takeaway is that you need to talk to different people differently then that is valuable. This guy has seen many people and couples and I have not so it was interesting to see his observations, even if they may not hold water.

Agreed, listening is important step, but was not a solution in my case either.

Sorry you lost this person. Super awful and I'm very sorry you are internalizing blame.

In terms of a plan for my buddy... God I just don't have a clue.

My friend is losing his wife/kids and likely moving back in with his folks. He's pretty medicated and has, in my unprofessional assessment, a high degree of learned helplessness from years of unemployment and doctors trying to sort him out.

He loves art, science, and culture (which we connect on), but I don't feel like sitting around and shooting the shit about post-war American art is going to help him. Nor do I think a 'wake the fuck up or else' is called for. But in the right context, maybe it is?

All I know is his mental health is going to plummet when he loses his identity of being an active father and husband. He barely moves all day as it is, but moving back home I think will break him.

Suicidal ideation weirdly isn't what I fear (even though it is very possible). It is more becoming a perma-zombie and vanishing into this abyss that has emerged. He really is in decline.

Coursera has a Hopkins institute course called "Psychological First Aid" which is "aimed at first responders to provide a supportive presence, mitigate acute distress, and assess the need for further mental health care". Useful for dealing with when people are breaking down or having a mental health episode of some kind. More importantly it teaches you what _not_ to say, with nice role played examples.

Is this person on heated tobacco or vapes? I have seen people destroy their mental health with these things because they overload on nicotine without realizing it.

I'll check this out, thank you. No, this person just has a poor diet and patterns, depression, and severe learned helplessness (my diagnoses).

Give the person the space to be heard in their own time. Don’t try to force a conversation but be ready to listen when they’re ready to talk. When I say listen, I really mean just listen. Sometimes when people are in bad headspaces, the stuff they talk about is uncomfortable for others to hear, but sometimes they just need to feel heard.

It’s common for people to want to offer solutions, and sometimes practical problems really do need practical solutions, and other times some problems just need to be heard.

Thanks. This is good advice. The whole people needing a hug and not a lecture thing has been looping a little in my brain.

Yeah, people don’t need lectures. They just need to be heard, and feel the connection that listening without feeling judged builds. Kudos to you for making the effort for your friend though too! People don’t do that often enough.

Curious if this is something you have actually done personally and if you had success with a major intervention

I wouldn’t call it a “major intervention” because I would consider anything that was a major intervention to involve some professional guidance. Especially if someone is suicidal or at risk of some other form of serious self harm.

However, I have applied this advice with someone I love, who was doing not too well last year. They were in a pretty bad place mental health wise, and I was really worried. I just spent a lot of time being with them, whether they wanted to talk or not, and when they did start to talk, I made sure I actually listened. They are doing a lot better this year. Can I say that it’s directly because I listened? No Is that a major intervention? No. But what it did was build a much stronger relationship with a lot more trust and I think that is pretty helpful.

So if you are counseling someone about suicide, it isn’t serious if you aren’t a professional? I don’t get it. Is a crisis not serious unless someone has a professional assigned?

I think a crisis is serious if someone is contemplating suicide/self-harm whether a person providing support is or is not a professional.

I personally think if someone is in that much of a crisis one should however seek professional input… however… OP said “I don't want the 'seek professional help' etc” so I’ve kind of tried to work around that here.

I think you’re just misunderstanding what I mean. That may be because I haven’t communicated my thoughts effectively enough, or you don’t like my suggestion at all… but yet you haven’t seem to provide a good alternative either..

I don’t think I agree with your top level suggestion if someone is in serious crisis, so I wanted to see if you had some particular experience.

Your follow up rubbed me the wrong way, but perhaps you simply misspoke when you said:

> wouldn’t call it a “major intervention” because I would consider anything that was a major intervention to involve some professional guidance.

Maybe you meant to say you recommend professional help if things are serious, but instead you said it isn’t serious unless a professional was involved. A lot of people don’t have or want professional help, land lots of non professionals find themselves with friends and loved ones and n crisis. A lot of people finding themselves making an intervention, even if that is only to convince someone to see a professional

Ok, well what would you do for someone in crisis then? How would you help someone?

Im not confident enough in any proposal to make a casual recommendation. I don’t want someone else’s blood on my hands from giving flippant advice.

I can say that from my experience, knowing people care about me was important, but so was getting an honest reality check. The realization that I can’t blame others or my circumstances for my misery was fundamental for pulling out of a really rough patch that lasted several years. One key learning I had was that Only I am ultimately responsible for my own happiness. Nobody owes me happiness and neither does the world.

The sentiment down thread recommending someone should consider walking away from the things causing them pain before taking their lives really resonated with me, because that was another breakthrough I had.

I had to lean that depression and addiction are a choice. Blaming others, circumstances, and feeling helpless is just a lazy cop out to avoid taking responsibility for my own emotions.

That said, people’s issues are different. What helped me might send someone else over the edge, so I don’t want to make a recommendation.

Similarly, some people might just need a friend to listen. Other times if you just listen you might miss the last chance to save a life.

> I had to lean that depression and addiction are a choice

I was actually under the impression that genetics accounted for about 40-60% of a persons risk of addiction. I’m not so sure about depression but I was under the impression that genetic and neurobiological factors were also significant in the aetiology of depression. Maybe I just need to hit my textbooks again, and read a few papers. It’s definitely not simply a matter of choice or a moral failing of the person who is experiencing these things.

I’m glad for you knowing people care helped you work through your own struggles. I wonder how they showed you that they cared?

I dont think those genetics numbers are right, but it is really besides the point. Im not moralizing or even talking about how you get there. Im talking about what you can do about it once you are there.

No addict has ever gotten clean without choosing to try. Staying clean requires choosing to do so each day. If you dont make a concerted effort, it doesnt magically happen by itself. A friend, family, or therapist can cant do it for you. They might help you, but you have to actively take control of your life.

Same for depression. you cant get better without trying, and you wont get better if you dont try. It really is that simple.

In either case, if you believed you have no choice in the matter, you are 100% doomed. I would never tell an addict that they have no choice, no control, and they are predetermined to fail everything they try.

It doesnt matter how stacked the chances are against people. The only 100% predictor of outcome is the actions you take moving forward. People who stay clean chose that every day. Those who dont, are not. Same for depression.

Fair point

I’m seeing a lot advice to just only listen. But when I’m just there silently listening my counterpart they would just angry why I only there in silence.

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