In the midst of a crisis is the worst time to try to figure out what helps you. In crises, emotion-caused brain chemicals flood your brain, effectively making it impossible to think. Instead, your brain gives your emotions space for a free-for-all, which is not necessarily pleasant or safe.
It is therefore well worth your time to do crisis planning for yourself when you are in a good space. Many tools exist to help; one Emergency Standard Operating Procedures (SOP) is described and accompanied by a worksheet on pages 72-74 in FORGE’s Transgender Sexual Violence Survivors: A Self-Help Guide to Healing and Understanding, available at http://forge-forward.org/wp-content/docs/self-help-guide-to-healing-2015-FINAL.pdf. This SOP has a short check-list (Taken your meds? Eaten recently?) to identify common potential problems, and then lists, by category, immediate steps you can take to help yourself feel better.
That’s one approach. Recently FORGE came across a much more extensive and flexible planning guide prepared especially for those of us who may experience crises that may call for a much higher level of intervention. It’s called the Wellness Recovery Action Plan (WRAP), and is available at http://mentalhealthrecovery.com/wrap-is/
WRAP is designed to be filled out by an individual and then shared with their support people. It has nine parts:
1. What I’m like when I’m feeling well.
In the middle of a depressive episode or anxiety attack, it may be next to impossible to remember a time when you did not feel horrible. WRAP’s section one encourages you to remind yourself what life is like when it’s going well. This is also useful for people who come into your life during a low point. Not knowing you at your best may allow them to write off your current misery as your usual state. This section can help both you and your support team remember what’s possible for you. One user suggests adding a picture of you at your best, to give you and your supporters a visual reference point, as well.
2. Signs I need my supporters to take over.
Many of us go to one extreme (I’ll do it myself, darn it!) or another (I’m helpless and hopeless) — or both! – when we’re in crisis. Rationally thinking through your past experiences will allow you to answer this question for yourself and your support network: “If I have several of the following signs and symptoms, my supporters, named on the next page, need to take over responsibility for my care and make decisions in my behalf based on the information in this plan.”
In the third section the WRAP tool asks for names, connection/role, and phone number for multiple supporters. Specific tasks for each person to do are listed. This section also suggests listing the people you do not want to be involved in your care, and solicits directions on how you’d like supporter disagreements to be handled.
4. Medications/supplements/health care preparations.
This section covers who your health care providers and medications are. Medications or supplements to be avoided can also be listed, and there is space for additional comments.
5. Treatments and complementary therapies.
Here’s where aromatherapy, your massage therapist, and your other supports can be listed.
6. Home care / community care / respite center.
If you could have the best possible kind of care for you, where would it take place? Who would be involved? Who wouldn’t be involved?
7. Hospital or other treatment facilities.
If you had to be hospitalized, which hospitals would you want to use, in what order? Which ones do you not want to go to?
8. Help from others.
This is the section in which you can specify: “Please do the following things that would help reduce my uncomfortable feelings, make me more comfortable, and keep me safe.” There’s a section for general instructions and space to give specific individuals specific tasks. You can also specify what you know from experience does not work for you.
9. Inactivating the plan.
What signs or actions will show you and your supporters you are ready to be back in charge?
The form ends with space for your and witnesses’ signatures and the date the plan was made. The form also specifies that in the case of multiple plans, the most recently-dated one should be followed, allowing you to update your plan as your needs change.