Clinical Psychology Concept of Crisis Physiotherapy Psychiatry

The Concept of Crisis (Clinical Psychology)

In this article we will discuss The Concept of Crisis (Clinical Psychology)

In this article, we will discuss The Concept of Crisis (Clinical Psychology). So, let’s get started.

The Concept of Crisis

A truism but an important one is that life proceeds through a succession of
human crises, some developmental and some accidental. Movement from one maturational phase to another necessarily involves transitional stages where established behavior pattems are no longer adequate to new demands and challenges. The skilled crawler is the stumbling toddler before he can become the successful walker. Psychosocial growth, as Erikson (1951, 1959) has described it, confronts the growing person with a sequence of developmental tasks. The successful resolution of each establishes necessary character traits of the mature person, including trust, autonomy, and identity, among others. Successful resolution of developmental crises (as well as accidental crises, which we will consider in a moment) also has the nonspecific effect of increasing the personality’s resources for crisis-management itself. Defensive and coping mechanisms grow out of previous crisis experiences and make the individual more adept in future ones.

Maturation thus involves a sequence of developmental crises, marked by
such events as weaning, entering school, menstruation, marriage, finding a vocation, menopause, and retirement Developmental crises, at least within particular cultures, occur in predictable sequence. Culture, however, critically affects the extent and manner in which such life changes are stressful. For example, Margaret Mead pointed out years ago (1928) that the emotional crises of adolescence might be particular to our culture that invests coming of age sexually with great importance by comparison the Samoan adolescent moves smoothly from childhood to adulthood in a permissive culture which allows early entry into heterosexual roles. Moreover, cultures change in time and what is true in one era may be different in the next, which can account for generation-gap conflicts.

Currently, this seems true in the area of adolescent sexuality where parents
remain American while their children have become more Samoan. Similarly, the crisis of vocational choice would hardly exist in a stable primitive culture or in a society where roles are ascribed by tradition or inhentance rather than achieved through one’s own efforts. Along with such developmental crises, there are in each life accidental crises also inevitable but less predictable. Sudden illness, the loss of a job the death of a loved one, happen without opportunity for prior emotional or practical preparation; so too, more dramatic events, such as earthquakes, fire, or other disasters which affect the lives of entire communities Nor is crisis limited to noxious events, promotion to a “better job.” with new demands and responsibilities, may be psychologically as threatening as the loss of a valued position. There are poignant stories of formerly happy but poor men who lived in misery after winning a lottery. What is critical is the impact of the new situation is psychological meanings and connotation of threat, the social setting within which it occurs and the
personality and coping resources of the individual, all of these in complex interaction determine the extent and intensity of stress responses. L Rapoport (1962) has described three interrelated conditions that produce the crisis state: (1) there is a hazardous event which threatens the individual: (a) the threat is more damaging if it is symbolically linked to earlier stresses that resulted in increased vulnerability or conflicts and (3) the person is unable to respond with adequate coping mechanisms “Stress” and “crisis” cannot readily be separated conceptually although some writers have attempted distinctions. Both terms refer to a condition that disrupts former adaptation and involves states in which there is threat capable of overwhelming the coping resources of the individual; therefore, emergency mechanisms are called into play. The consequence may be either effective functioning or disintegration and symptom formation (Basowitz, Persky, Korchin, and Grinker, 1955: Janis 1958: R S Lazarus 1966)

Life crises are a major reason why people seek psychotherapy. Typically some stressful event overwhelms coping capacities or reinstates earlier conflicts and the distressed person seeks psychological help. Focusing on the precipitating stress has been found to be an effective therapeutic technique which can establish the groundwork for continued psychotherapy oriented to more extensive character reorganization (Kalis et al, 1961). In many cases, of course, people pass through crisis states without seeking mental health professionals they may turn instead to lawyers, doctors, vocational or marital counselors, or even to friends and relatives. Crisis is universal and crisis intervention is everybody’s

Clinicians have rightfully pointed out that they have always been involved in crisis intervention, but it is only in the recent past that there has been focal concern among mental health workers with the crisis state and its clinical management, an emphasis of considerable importance in community mental health thinking. This has arisen largely from the work of Lindemann, Caplan, and their colleagues in the Boston area (Lindemann, 1944, 1956: Caplan, 1961, 1964; Parad, 1965)

A critical event in this development was the tragic fire in the Coconut Grove nightclub in Boston in 1943. The many dead and dying were taken to nearby hospitals Erich Lindemann, a psychiatrist on the staff of the Massachusetts General Hospital interviewed relatives at that time and on later occasions to help them in their grief (Cobb and Lindemann, 1943). From this experience, he formulated a concept of the grief reaction and conceived the fundamentals of crisis intenention methods (Lindemann, 1944, 1956). These principles were given fuller expression in Lindemann’s Wellesley Human Relations Service, which was an important forerunner and prototype of modern community mental health centers. Crisis theory and intervention methods were further developed in the writings of Gerald Caplan (e g., 1961, 1964) and his colleagues and students (Parad, 1965).

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