Learning to Listen

Learning to Listen…

Sooner or later, we all experience stress. Sometimes the pressures of a situation just seem like they are too much to handle. Other times, we just don’t know exactly what’s wrong except that something is bothering us. The more pressure we feel, the more out of control the situation becomes. What we need is someone to talk to about the situation. Even more important is to find someone, anyone, who will listen to us.

At some point in time, everyone is approached by a neighbour, a friend, a co-worker or a family member who wants to talk. Often that person feels overwhelmed and unable to cope with a problem (or many problems) and is starting to feel panicky. When this happens, what can we do? How can we help? Listening helps. That is what this booklet is about – how to help someone by listening.

Since suicide has traditionally been a taboo topic in our society, a depressed person often feels alienated, which only makes the problem worse. We could go a long way to reducing our suicide rate by accepting people as they are, by talking about feeling suicidal, and telling people that it is OK to feel so bad that you’d think about suicide. Simply talking about how you feel greatly reduces your distress and you can begin to see other options, and are much less likely to attempt suicide.

Active Listening Skills

What you need to know

Listening may be the most helpful thing that you can do for a person in trouble. When you really listen to someone you use more than just your ears…you use your heart as well. Listening to someone open up about a problem takes courage on the speaker’s part and patience on the listener’s part. Above all, it is important to remain non-judgmental.

How the person is feeling should be the focus of the conversation, so try to keep your personal thoughts to yourself, even though this may be hard to do. What matters is that your friend feels that you understand how they are feeling and why they are feeling this way.

How to do it:

There are two basic techniques involved in active listening:

Reflection
Open-ended questions

Reflection

Understanding how a person feels and being able to communicate that understanding are two different things. Reflection is the ability to listen to what your friend is saying and then repeat those feelings back using different words. By reflecting your friend’s feelings, you help your friend to feel understood. Reflection also allows you to be sure that you are really following the conversation. It is easy to get caught in the trap of trying to solve your friend’s problem before really listening to what they have to say. The best support you can give your friend is to let them know you understand. It may be comforting to share feelings.

Reflective statements start with phrases like these:: It sounds like…; It seems as if…; I hear you saying that…; I get the feeling…; It sounds to me like…; You seem to be…; So you’re feeling…

Reflect the tone and language used by the speaker.

A skill similar to reflection is called echoing. Echoing is just repeating the last thing your friend has said. This is good to do when the conversation seems to have lost focus or your friend has forgotten what they were saying.

Open-Ended Questions

Open-ended questions are ones which help someone to explore events, feelings and options. Open-ended questions cannot be answered by a single word. If you are not sure exactly what your friend is talking about, or what is bothering them, then ask an open-ended question. (Can you tell me more about…?). Open-ended questions are a great way to initiate conversation for a person who wants to talk but doesn’t know where to start. Asking these types of questions encourages your friend to expand on the problem, to tell you more about what is confusing or troubling them.

Try to avoid questions beginning with “Why”. These questions can sound prying or judgmental and may prevent your friend from opening up about their problem. Don’t make your friend feel interrogated, or forced to reveal more information than they wish to. Open-ended questions should invite your friend to offer whatever information they consider important.

Here are some examples of open-ended questions:: What does it feel like?; How are you feeling right now?; Would you like to talk about...?; Where would you like to begin?; Can you tell me what that means for you?; What have thought of doing?; How do you see things changing?; How do you feel when...?

The opposite of an open-ended question is a closed-ended question. These are answerable in one word and tend to halt the conversation.

Common Errors

Bad listening habits can be hard to break. Here is a short list of some common mistakes people make when listening to someone.

Dismissing the Problem:: “Don’t worry about it”, “Cheer up”, “That’s no big deal”
Blaming the speaker:: “Your priorities are all wrong”, “You’re just being lazy”, “You should have done…”
Ignoring Your Friend’s Feelings:: “You think you’ve got problems…”
Playing the Expert:: “I know exactly what you mean…” lending your wisdom can lead to over-identifying or trivializing their problem and takes the focus away from the speaker.
Making Assumptions:: Assuming they have both parents living together, or assuming heterosexuality.
Using Your Own Values:: This makes you judgmental.
Talking About the Wrong Problem
Giving False Hope/Raising Expectations:: “Everything will be better tomorrow”

Giving Support

Empowerment

The best listeners use more than just active listening skills when hearing a friend’s problems. They know how to empower friends, rather than rescue them. Sometimes when we are listening to a friend, we may start to see them as a victim – someone who needs our help. Although it is tempting to give advice, telling someone what to do takes away their control over the situation. Sometimes it is hard to know when we are “rescuing” a friend. Here are some examples of rescuing behaviour:

You have decided that you know what’s going on in your friend’s life without letting them tell you.

You tell your friend what to do instead of offering support and letting them decide.

If you impose your own values you are being judgmental. A solution that works for you may not be appropriate for someone else. You may not know the whole situation and no two situations are alike anyway. Respect the decision your friend makes, even if you do not agree with it.

How to Empower Your Friend

After listening to your friend and exploring their feelings, you may want to explore possible solutions or “plans of action”. Ask your friend (using open-ended questions!) how they have tried to solve the problem or similar problems in the past (What sorts of things have youtried before?). By asking your friend about possible solutions or options, your friend can control the problem. Don’t be afraid to explore the various solutions with them! If your friend has no ideas for dealing with the problem, then you as an active listener may ask more directed questions (What do you think would happen if tried…? You mentioned... Do you think that might be a good thing to try?)

Don’t rush in with advice. It may help to focus on a problem on which both of you can agree. If your friend has many problems choose one aspect and deal with that first.

When you are empowering your friend, you are offering no new information. Using your active listening techniques, you are reflecting back the feelings, emotions and information that your friend has already told you. By really listening to what your friends say, you can help them to help themselves. Your friend is the one finding the solution – you are the guide!

Active Listening Checklist

You are listening to me when…

You really try to understand me even when I do not make much sense

You grasp my point of view even when it goes against your sincere beliefs

You realize the that the time I take from you leaves you a bit tired and drained

You allow me the dignity of making my own decisions even though you feel I am all wrong

You give me enough room to discover for myself why I feel upset, and enough time to think for myself what is best

You do not take my problem from me but trust me to deal with it in my own way

You hold back your desire to give me good advice

You accept my gift of gratitude by telling me it’s good to know you can help

Depression

Depression may be either reactive depression, which is an entirely normal reaction to difficult circumstances, or may be an endogenous depression, which is the result of a diagnosable mental illness with other underlying causes. It may also be a combination of the two.

Clinical depression is an illness. It can occur without people realizing they have it. Most people experiencing depression feel a sense of relief when they learn it is not a personal weakness. Depression can affect anyone. Four out of five cases of depression can be treated successfully. The first step for a person who suspects they may have depression is to see a doctor or health professional who is trained to diagnose depression.

Signs and Symptoms

A depressive disorder is a “whole-body” illness, involving your body, moods and thoughts. Not everyone who is depressed or manic experiences every symptom. Also, the severity of symptoms varies with individuals. Some of the indications that you or a friend may be clinically depressed include:

When a depressed mood continues for weeks, eventually interfering with work, school and social life
Persistent sad, anxious or “empty” mood
Feelings of irritability
Loss of interest or pleasure in activities once enjoyed
Changes in weight or appetite
Changes in sleeping patterns
Feelings of guilt, hopelessness or worthlessness, pessimism, helplessness
Inability to concentrate, remember or make decisions
Fatigue or loss of energy
Restlessness or decreased activity noticed by others
Complaints of physical aches and pains for which no medical cause can be found
Making negative comments about self
Recurring thoughts or fantasies of suicide or death

Sadness may not always be the dominant feeling of a depressed person. Depression can also be experienced as a numb or empty feeling, or perhaps no awareness of feeling at all.

If depression is not treated, it can last for many months, even years. It may build gradually or appear suddenly. It is important to realize that “cheering up” and “keeping a stiff upper lip” cannot make depression go away. Exercise, vitamins and vacations are equally unsuccessful treatments

A person with depression needs help from health professionals. Depression should be looked upon as a physical illness, not a personal failing. Friends and family should not feel guilty or responsible for what is happening. To make things easier for a depressed friend, don’t criticize, push, patronize or lose your temper. Be willing to listen, support and provide sympathetic understanding.

Causes of Depression

No one knows what causes depression. However, several factors, alone or combined, may contribute.

The life events that are most often associated with depression are varied, but the distinguishing features of suchevents are loss of self-determination, empowerment, or self-confidence. More profoundly, a loss of self; of the abilities or activities that a person identifies themselves with.

There are certain periods in one’s life when we are more vulnerable to depression. These include:

Periods when family, work or school pressures are high
3 months following childbirth
Menopause
Death of a loved one
Retirement
Loss of a job or key relationship

All these are times of major changes when we may not be prepared psychologically or financially to deal with increased stress.

Some people may have an inherited tendency toward depression. For these people, the stresses they encounter and the way they handle stress may cause depression.

Depression causes a biochemical imbalance in one or more neurotransmitters – important brain chemical mes-sengers that transmit information across various pathways of the brain. The resulting alteration in brain chemistry is similar to temporary, normal variations in brain chemistry which can be triggered by illness, stress, frustration or grief. It differs in that it is self-sustaining and does not resolve itself upon removal of such triggering events (if any triggering event can be found). The alteration continues, producing depressive symptoms and through those symptoms enormous new stresses on the person. (Depression triggered by loss of a spouse leads to being too depressed to work or communicate, which leads to loss of job, etc.)

After one to three years, a more normal chemistry reappears, even without medical treatment. However, if the alteration is profound enough to cause suicidal impulses, a majority of untreated depressed people will attempt suicide and as many as 17% will eventually succeed.

Who it Affects

Depression can strike anyone, but most often it begins between ages 24 and 44. This is a critical period in life when the demands of career, relationships and family are high and constantly changing. Thoughts of real or perceived inadequacies or failure may surface.

Other high risk groups include high school and college students. Their depression can be hard to recognize because it may resemble normal teenage problems such as changes in mood, irritability, risk-taking behaviour, and troubles with friends, school or work.

Elders also have high rates of depression. Their sad moods, fatigue and withdrawal from life can be mistaken as part of the normal aging process. Depression may be linked to the death of a spouse, admission to a nursing home, prolonged illness, or a major operation.

How Family and Friends Can Help

The most important thing anyone can do for depressed people is to help them get appropriate diagnosis and treatment. The second most important thing is to offer emotional support. This involves understanding, patience, affection and encouragement. Engage the depressed person in conversation and listen carefully. Do not disparage feelings expressed, but point out realities and offer hope. Do not ignore remarks about suicide. Always report them to the doctor. Depression can shut down the survival instinct or temporarily suppress it. (Depressive suicides give less warning, need less time to plan, and are willing to attempt more painful and immediate means, such as jumping out of a moving car. They may also fight the impulse to suicide by compromising on self-injury). Invite the depressed person out. Be gently insistent if your invitation is refused. Encourage participation in some activities that once gave pleasure but do not push the depressed person to undertake too much too soon. The depressed person needs diversion and company but too many demands can increase feelings of failure.

If You Are Feeling Particularly Depressed

Do not set yourself difficult goals or take on a great deal of responsibility. Break large tasks into smaller ones, set some priorities and do what you can as you can. Do not expect too much from yourself. Perfectionism leads to increased depression. Try to be with other people. Do not make any major life decisions such as quitting your job or getting married or separated while depressed. If pressured to make such a decision, explain that you will make the decision as soon as possible after the depression lifts. You are not seeing yourself, the world, or the future in an objective way when you are depressed. Your negative thoughts are not a rational way to think of things. The feeling that nothing can make the depression better is part of the illness of depression. Things are probably not as hopeless as you think.

Suicide

People usually attempt suicide to block unbearable emotional pain, which is caused by a wide variety of problems. It is often a cry for help. Most suicidal people give warning signs in the hope that they will be rescued, because they are intent on stopping their emotional pain, not on dying.

Signs and Symptoms

The signs and symptoms of suicide are similar to those of depression. They may also include:

Increased use of drugs or alcohol
Withdrawing from family and friends
Poor impulse control – impulsivity, fighting, self-destructive acts, recklessness
Suicidal “gestures” such as slashing, small overdoses, playing with firearms or ropes around the neck
“Finalizing” activities such as giving away prized possessions, writing wills, saying “goodbye”, “clearing the air” over personal incidents from the past
Preoccupation with themes of death in poetry, music, stories and movies
Threats of suicide or previous attempts
Undiagnosed/untreated clinical depression
Recent suicide of someone close

Low self-esteem is a common factor.

In teenagers, additional symptoms include:

Anger and hyperactivity
Acting-out behaviour

Often these symptoms are ways of coping with physical, hormonal and social changes because the teen lacks the verbal skills to express emotions and finds their problem minimized by adults. Such behaviour can have lifelong consequences (pregnancy, jail, dropping out of school) which result from truancy from school and/or sexual promiscuity.

A person displaying these signs usually wants help and needs your attention and understanding. If their problems seem too overwhelming, suicide may begin to be seen as the only way out. Suicide is a permanent solution to a temporary problem.

The triggering event usually involves a significant degree of loss of some sort. Feelings become extremely intense, incomparable to any other experience. Both high and low achievers can be affected. Depending upon each individual, risk factors may include:

Significant changes in relationships, well-being of self or family members, body image, job, school, university, house, locality, financial situation, or world environment.

Significant losses including death of a loved one, loss of self-esteem, loss of a valued relationship, loss of employment, or personal expectations.

Real/perceived abuse including physical, emotional, psychological, sexual, social or neglect.

Suicide is the second leading cause of death for people aged 15 to 24, surpassed only by accidents. More than10% of high school students have undertaken at least one non-fatal suicide behaviour. Gay or lesbian youth are six times more likely to try to kill themselves than heterosexuals.

Friends and relatives may be deceived by the casual way (“I wish I could just jump out a window”) that profoundly depressed people speak of suicide or self-mutilation. They are not casual because they “don’t really mean it”, they are casual because these things seem no worse than the mental pain they are already suffering. A formulated plan (“I’m going to jump in front of the next car that comes by”) should be taken as an immediate medical emergency which may require hospitalization.

Prevention

Attempts at suicide, and suicidal thoughts or feelings, are usually a symptom indicating that a person isn’t coping. This is often as a result of some event, or series of events, that they personally find overwhelmingly traumatic or distressing.

Individuals who want to kill themselves are not suicidal forever. With proper help, the hopelessness dis-appears and the individual can begin to cope effectively again. You can help by recognizing the warning signs and getting them help quickly. Reassure your friend that you want to help them, but suggest that you need to involve some mental health professionals in order to ensure their safety.

In many cases, the events in question will pass, their impact can be softened, or their overwhelming nature willgradually fade if the person is able to make constructive choices about dealing with the crisis when it is at its worst.

Be aware that an improvement in mood after depression can signal that the decision to commit suicide has been made.

Intervention

A person attempting suicide is often so distressed that they are unable to see that they have other options. We can help prevent a tragedy by trying to understand how they feel and help them look for better choices that they could make. Suicidal people often feel very isolated. Because of their distress they may not think of anyone they can turn to, furthering this isolation. If you are worried that your friend is in immediate danger do not leave them alone. Take them with you to find help or stay with them and phone for help. The more people you involve the better the chance of saving the individual from permanent harm.

If someone you know tells you that they are feeling suicidal, above all, listen to them. Then listen some more. Tell them, “I don’t want you to die.” Try to make yourself available to hear about how they feel, and try to form a “no suicide contract”, i.e. ask them to promise you that they won’t commit suicide, and that if they feel that they want to hurt themselves again, they won’t do anything until they can contact either you or someone else that can support them. Take them seriously, and refer them to someone equipped to help them most effectively, such as a doctor, teacher, community health centre, counselor, psychologist, social worker, youth worker, minister, etc. If they appear acutelysuicidal and won’t talk, you may need to get them to a hospital emergency department.

Suicidal people, like all of us, need love, under-standing and care. People usually don’t ask “are you feeling so bad that you’re thinking about suicide?” directly. Locking themselves away increases the isolation they feel and the likelihood they may attempt suicide. Asking if they are feeling suicidal has the effect of giving them permission to feel the way they do, which reduces their isolation. If they are feeling suicidal, they may see that someone else is beginning to understand how they feel.

Do not be afraid to ask direct questions like: “Are you thinking of killing yourself?”, “Are you feeling so bad that you’re considering suicide?”, “That sounds like an awful lot for one person to take, has it made you think about killing yourself to escape?”, “Has all the pain you’re going through made you think about hurting yourself?”, “Have you ever felt like just throwing it all away?” These clarify the situation for you and let your friend know that you are open to discussing the topic of suicide.

Never describe anyone as “crazy”. This has strong negative connotations, probably isn’t helpful and is more likely to dissuade someone from seeking help which may be very beneficial, whether they have a diagnosable mental illness or not. Ask your friend if they have ever tried killing themselves before, if they have a plan, and if they feel that they no longer have a support system. If they say yes to two or more of these questions, they are at high risk of committing suicide. Answering yes to one of these questions indicates medium risk, and no to all indicates low risk.

It’s also important to take the person’s overall response into consideration when interpreting their answer, since a person in distress may initially say “no” even if they mean “yes”. A person who isn’t feeling suicidal will usually be able to give a comfortable “no” answer, and will often continue by talking about a specific reason they have for living. It can also be helpful to ask what they would do if they were in a situation where they were seriously considering killing themselves, in case they become suicidal at some point in the future, or they are suicidal but don’t initially feel comfortable about telling you.

Remember that what happens is ultimately their responsibility. Get yourself some support too, as you try to get support for them. Don’t try to save the world on your own shoulders.

Previous attempters are more likely to attempt suicide again, so it’s very important to get unresolved issues sorted out with professional help or counseling as necessary. Some issues may never be completely resolved by counseling, but a good counselor should be able to help a person deal with them constructively at present, and to teach them better coping skills and better methods of dealing with problems which arise in the future.

Postvention

Caring for the Caregiver

Now that you have gone to such great lengths to help your friend in a time of need, it is important to take care of yourself. Listening to a friend’s problems can take a lot out of you, and it is vital to remain emotionally healthy. There are several ways to keep yourself emotionally healthy.

Know the limits of one conversation

Sometimes you and your friend can solve a problem together. Other times a situation may have no solution. Don’t feel that you have to reach a solution at the end of each conversation. Just being a caring and concerned listener for your friend can be enough for the time being.

Know your limits as a support person

If a friend wants to talk and you cannot give your full attention at that time, be honest! Being a distracted listener will not help you or your friend. Make sure to set aside a time that is convenient for the two of you. Also, be aware that you cannot always provide all the help your friend needs. Use a referral to an agency if you think your friend’s situation warrants one. Don’t promise any more than you can give.

Talk about your reactions with someone

It may remind you of your own worries, or your friend’s problem may really move you. Perhaps it will trigger a past unhappy memory in your own life. When this happens, talk to another friend about your feelings. Or, call a confidential distress centre like T.A.L.K.

Suicide is often extremely traumatic for the friends and family members that remain – the survivors. In addition to the feelings of grief normally associated with a person’s death, there may also be guilt, anger, resentment, remorse, confusion and great distress over unresolved issues. The stigma surrounding suicide can make it extremely difficult for survivors to deal with their grief and can cause them to feel terribly isolated. Survivors often find that people relate differently to them after the suicide, and may be very reluctant to talk about what has happened for fear of condemnation. They often feel like a failure because someone they cared so much about has chosen to suicide, and may also be fearful of forming new relationships because of the intense pain they have experienced through the relationship with the person who has completed suicide

The most important thing to remember is that as an active listener, you can make a huge difference in someone’s life!

The content of this document is the responsibility of TALK

Feel free to link to this page, or to print out copies of this page for the use that it is intended, but please don't charge anyone for copies. It must be accompanied by the TALK logo, this notice, and the web page address (ie. keep it complete). If you would like copies in booklet form, please send your request to us using any of the methods available below. Copies of the booklet are distributed free within the local Kingston area.

Call us at 544-1771

T.A.L.K. Home Page

Mission Statement
& History
What are our goals?

Services &
Publications
What do we offer?

Volunteers
Who are they?

Community
Resources
Where else you
can go for help?

Telephone Aid Line Kingston (TALK)
P.O. Box 1325
Kingston, ON
K7L 5C6

Business:
(613)531-8529

Fax:
(613) 531-3312

Phone Line:
(613)544-1771

E-mail:
talk@kingston.net