Working With Difficult Interactions

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Some examples of confrontational statements are listed below^⁸. A Warning! These phrases are confrontational in nature. This is intentional as they are designed to provoke the Difficult Caller who is resisting change to make a choice to embrace change. However, as they are confrontational they may evoke a response from the Caller you either will not be ready to respond to or comfortable with. Do not attempt this form of confrontation unless you are sure you will be able to address any response the Caller may make to them. Often the Difficult

Caller is comfortable in their situation and will resent your attempt to make them consider changing it. If this does happen it’s OK because once the interaction with the Caller ends maybe they will think back and look at their situation with a new insight.

"As I hear what you're saying, I begin to sense a pattern. It seems you've been repeating the same thing over and over again. Can we talk about how you see that as helpful?"
"You seem to see yourself as a (victim, bad guy, loser, second class citizen, unwanted child, etc.). Let’s talk about how you came to see yourself that way?"
"I get the feeling that as painful as being a (victim, bad guy, etc.) is for you, you get something out it. Let’s talk about the benefits of being in that position?"
"It seems you shoot yourself in the foot every time you begin to get what you want. Do you have an idea about what makes that happen?"
"You really seem much more comfortable with doing what you've always done. That's more familiar. When you try something new, you seem to be frightened. Let’s talk about what makes new things so scary for you?"
"From what you have been saying it seems you're really saying you're afraid to change. Tell me about that."
"It seems staying the way you've always been is easier even if it gets you into trouble sometimes."
"It seems you have a sense of what its going to take to change and you're not so sure you want to do all that."
"It seems you really want to prove that I can't help. Then you can sort of sit back and say 'Well, I tried. Nobody could help me'. Is that your goal"

Point Out Behaviors and Their Results

Often when we actively listen we become “passive” in the interaction. We spend so much time focused on the empathic piece we forget that there are tangibles the Caller is relating to us that we can use to assist them. One tangible is behavior. For example let’s consider the Caller who seems to be content with relating their past again and again even after you let them know you understand where they are coming from. It can be helpful to point out (concretize) what is happening. We might say something like: “It seems that you keep returning to what has gone on for you in the past and we have spoken about how we understand that was painful for you. It seems discussing the past is more comfortable for you than trying to make new changes.” The Caller’s response to this would most likely be that they are not happy with the past and will proceed with dealing with moving on.

Focus On Focusing

Client Centered interactions are usually described as being non-directive. In practice that is an accurate and appropriate description. This most likely where the concept of “talking is good”. The reality is that talking with the idea of coming up with a solution is good; talking with the intention of simply hearing one’s voice is neither good nor cathartic.
When a Caller seems to be focusing on talking about every event that has occurred in their lives as opposed to the issue at hand it is helpful to encourage them to focus on moving forward. The way to do this is to acknowledge that it seems there has been a lot that has affected their lives. The next step is to point out your “read” on what the core issue is and encourage them to work with you in deciding how they are going to resolve it. Which brings us to…

“I” Is a Letter Not a Person

The Crisis Intervention process maintains that the two persons involved in the process are equals. Once we use the personal pronoun “I” we cancel that equality. We need to realize that anytime we say “I” we present a judgmental, exclusionary stance to our callers. While it may not be possible to eliminate this particular pronoun from our vocabulary, it is desirable we attempt to communicate with our callers on a generalized, inclusive level. This is a difficult yet extremely powerful concept to master. Think about it a bit. As a suggestion you may want to think of “I” in terms of “you” or the inclusive “people”. As an example: Instead of, “I think you need to talk to your worker”, we might say, “In a situation like this some people might think about talking to their worker."
Another reason for refraining from “I” is that its use places the responsibility for the success or failure of the Caller’s outcome on your shoulders. This can be frustrating for you and does nothing to foster the Caller’s growth towards independence.
“Is Normal To…”?^⁹

Like us, each of our callers has their own concept of normal. Mathematically, normal is a point of perpendicularity tangent to a specific type of curve. There are statistical normals, cultural normals, societal normals, political normals. . .In short there are many kinds of “normal”. All of which makes as much sense to us as it would to our callers.

When asked about normal we need to answer with the caller’s viewpoint in mind. If the caller thought their situation normal they probably would not be on the phone with us. Their calling indicates the situation feels less than normal to them. This means we would not judge their sense of normalcy by saying something is or is not “normal”. More appropriately, we could reply that their call indicates they feel the situation does not feel normal for them and they feel uncomfortable being in the situation. In short, nothing is normal. . . situations are either comfortable or uncomfortable. When we insert our judgment as to what is or isn’t normal we can create an argumentative atmosphere which is not conducive to situational resolution.
Another thought about normalcy stems from our tendency to judge a Caller's behavior during the call as being normal. This is exemplified when we tell a Caller who cries during a call that it is normal to cry. We must remember that while we, as crisis workers, may see tears as normal in a given situation the caller may not feel the same way. A more appropriate response would be to observe that people sometimes cry when in situations such as the Caller’s. We would then reflect the sadness or isolation the tears represent.

Questions and Answers

While there is a need for questions in the Crisis Intervention Process it is important to limit their use. The reason for this is that our Callers have probably been asked bunches of questions before they contact us. Hearing another barrage of questions serves to create an “Oh boy, . . .Here we go again” atmosphere that serves to distance the Caller from the Process. A valuable rule of thumb is to ask yourself, before you ask a question, “Will the answer to this question help me help the Caller?” If the answer is yes go right on ahead and ask. If not, then don’t ask it. Additionally, it is preferable to ask questions in an open-ended manner or to attach them to an applicable reflection. In this manner the Caller is engaged in the information gathering process as opposed to feeling interrogated. Questions that can be answered by a yes or no response are not acceptable except when addressing issues of personal safety, abuse, or suicide.
Another thing to keep in mind about questions is that when you are dealing with Callers who are calling for purposes other than Crisis Intervention (read Sex-grat and Prank Callers) you provide them a road map for the “successful” completion of their mission. If you are sensing the Caller is not being genuine do yourself a favor; don’t ask questions.
As for answering questions: Callers have a natural curiosity about us, our services, and the agencies we refer them to. Answering their questions is usually not problematic but it can be helpful to have a sense of the reason for the question before answering it as certain Difficult Callers use questions as a means of engagement. Also, keep in mind is that “I don’t know” is an appropriate response. Let’s take a quick look at some typical questions.

“Hi . . .How Are You?" - Politeness is usually the driving feeling behind this question and we have the tendency to politely reply that we are OK. While this might be appropriate we need to be aware there is a risk the caller may get an, ”I’m OK . . .you’re not” message. Realizing we want to interact with our callers as equals we need to respond in an equivocating manner. This is not an easy one but something like, “It’s nice of you to ask . . .how are you? It sounds like you’re feeling . . .” allows the caller to feel heard and opens the door to interaction.
“Can I Talk To A Male / Female?” - This is another very common question and the response to it is usually covered by an agency policy. However, even if covered by policy, it helps to explore the Callers motivation for asking the question. First of all most of our Callers are looking for help and getting that help is more important to them than who gives it to them. If they are looking for a person of a particular gender understanding the reason may provide valid insight as to the reason for their call. Also, this is a canard frequently used by Sex-grat Callers. When a female answers the phone they will ask to speak to a male. A reply that no males are available gives them the green light to “do their thing”. Before answering yes or no try to have an understanding of the reason for the question.
“Do / Don’t You Give Advice?” - While advice giving is the purview of Dear Abby our Callers see us as advice providers. Unfortunately, while advice is a piece of what we do, this perception skews the equality between Caller and worker. Additionally, it places the onus of the success or failure of the outcome on our shoulders. Also it is helpful to keep in mind that advice is generally something the giver sees as a viable course of action. That does not mean the Caller will see it that way or that said advice would be appropriate for the Caller. One way to respond to this question is to explore what advice the Caller has received previously to determine what has and hasn’t worked. This will give you a clearer indication of which way to proceed with the call then simply saying you do or don’t give advice.
“If I Need, Can I Call Back And Talk To You?”- Once again the answer to this question is usually covered by agency policy and there are times when it is advantageous that the Caller speak to the same worker. But there are a number of issues surrounding the answer to this question.

First of all if the answer is “Yes” is it because of policy or is it “Yes” because you feel a responsibility for the Caller? If it is the result of a sense of responsibility you are placing a weight on your shoulder that can become quite burdensome.

Another issue is that a positive reply cuts down the resource pool available to the Caller. What does the Caller do when you are not available? Additionally, many of our contacts are calling us because the one person they relied on is no longer available to them. By setting ourselves up as the replacement for that person we sow the seeds for potential disappointment should we become unavailable.

A third issue a positive answer raises is that it can interfere with the success of the Caller’s planned outcome. Even after we do our remarkable work with the Caller the job is not finished. The Caller must finish the process. By making ourselves too available we create the potential to inhibit the growth process we have initiated with the Caller.

With all this in mind it is possible that our response should be more involved than a simple “Yes” or “No”. The response should include an acknowledgement of Caller’s satisfaction with the interaction, a review of the plan, a statement that the next steps may not be easy, and an appreciation of the Caller’s ability to follow through resolve the issue confronting them.

“Can I Call Back Anytime?” - The short answer: “Sure you can call anytime”. But like the previous question, we don’t want to run the risk of creating an inappropriate dependency. When replying to this question structure it in such a way that allows the caller to understand that contacting you is only the first step in solving their problem and they need to allow the plan time to succeed. However, if need be, your agency is available whenever they are in need.
“What’s your name?”- We may be tempted to say we don’t give out our names or provide the requested information. While this might be appropriate, we risk having our message be heard as, “It’s none of your business." Worse, it may force a struggle over the caller’s right to know or not know the requested information. A more powerful way of responding might be to say, “It can be scary to share what your going through with a stranger . . .Let’s talk about what’s making you hurt." This identifies and focuses the caller on their fear and loneliness and lets them feel heard. Thus the name issue is usually forgotten. Keep in mind that most Callers seeking help could care less about your name. They view you as a facilitator not as a personality. All they want is help with their problem. If they are persistent in asking this question it might be helpful for you to explore their motivation for calling keeping in mind this is a common ploy used by Sex-grat Callers.
“Can We Talk About Anything?”- We tend to answer this question with an immediate, “Yes” or, “We’re here to listen." In both cases these are well meaning, but not honest, replies. Depending on the caller's motivation and subject matter there are some things we will not address. If we attempt to explain this to the caller the call’s focus might become, “Well is this or that OK and if that ain’t OK is whatchamacallit OK?” Possible replies may be, “Sounds like you have something on your mind you want to talk about” or, “It sounds like you feel upset no one will talk to you about what is going on for you." Responses such as these allow you to discover what the caller has to say without trapping yourself in an inappropriate situation without invalidating the caller. Many Sex-grat Callers will open their interactions with this question.

THE VOICE

Those of us in the field have two voices. One is the voice we use day in and out to order lunch, scold the kids, talk to our friends and so on. The other voice, “THE VOICE”, is the one we use to engage and interact with our Callers. It is generally smoother, softer, and lower than our regular voice. When dealing with someone we feel is a Difficult Caller if can be helpful to alter this voice to suit the situation. A screaming Caller will usually lower their volume when you do an “almost whisper” when talking to them. A clinically distant affect will usually dissuade the Sex-grat Caller as will silence. It is important to not let THE VOICE express what you are feeling by is volume or intonation.

Know When To Say “No”

It’s funny but when we learn the skills necessary for Crisis Intervention we seem to delete the concept of “No” from our consciousness. It seems we assume “No” is judgmental and therefore inappropriate to use in our interventions. Interestingly, we continue to use “Yes” which is equally judgmental. The truth of the matter is that “No” within the proper context is an appropriate response and, perhaps more importantly, a more honest response. Some examples:

The friendly neighborhood Sex-grat Caller asks, “Will you talk to me while I masturbate?” Somehow, responding, “It sounds like you are lonely” doesn’t address the situation. The correct response is “No, that is not the purpose of this line. Goodbye.”
You’ve given the Caller a referral that will address their presenting issue, which they explained to you, ad nauseum. You try to close the call and the respond they need to tell you yet one more thing about their past. You let out a quiet sigh & listen to the same iteration of events you’ve already heard at least five times. Alternatively you can say, “No. It’s not necessary.” Then restate their issue back to them citing that they have previously agreed you understood the situation so further clarification on their behalf is not needed and suggest it is now time to stop talking about the situation a take action by utilizing the provided referral.

So there we have it The Ten Simple Rules For Working With Difficult Callers. Actually, they are actions you have most likely integrated into your “style” but by addressing them in this manner we can consciously develop new ways to use them in situations with Difficult Callers. Will using them ensure that you will never have that, “Why did I have to pick up THIS call?” feeling. No but they can help you feel less helpless and frustrated with Callers who are on your Difficult Caller List.

That said, let’s look at some Do’s and Don’ts in addressing Difficult Callers.

Do maintain a professional distance. The anxiety and frustration of the Difficult Caller can be contagious and disabling. The situations they describe are tragic. Their pain is palpable. Their intense level of anxiety can be intolerable. The disturbed Difficult Caller creates a tornado about themselves that seems to suck in everything around it. If you begin to feel as overwhelmed and anxious as the Caller you have not maintained the emotional buffer. While this situation is representative of a high level of empathy, it is not helpful to either you, as the Worker, or the Caller. When this does happen to you, reflect the sense of being trapped by the “situation” to the Caller. Then address the specific facts regarding the Caller’s situation that is making them feel this way. To prevent this requires a high degree of self-monitoring. Supervision can serve as an excellent means for maintaining boundaries and restoring a professional perspective.
Do recognize that interacting with Difficult Callers is a fertile ground for intense personal reactions on the part of the Worker. The experience these Callers have in dealing with hotlines makes them quite capable in plugging into the vulnerabilities or strengths of the Worker. Strong reactions to these Callers, either positive or negative provide them a means to exploit the worker and should be discussed in supervision.
Do keep your expectations of what can be accomplished in the interaction realistic and share them with the Caller. There is no way any one of us is going to cure a psychosis or long term situation in the span of a single or several phone interactions. Acknowledge that you understand they would like all the bad things to go away. Then explain to the Caller that we can realistically only deal with the anxiety of the moment and its immediate cause.
Do keep your interventions focused, pragmatic, concrete, and oriented toward problem solving. The Difficult Caller, overwhelmed by their situation, does not have the tools to effectively problem-solve. It is appropriate to make direct suggestions for dealing with the crisis of the moment, caution or urge the Caller not to do something, or actively encourage the Caller to seek appropriate help.
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