**This week’s blog posts are dedicated to advocating for effective mental health treatment and educating patients, family, and friends in all areas of inpatient psychiatric care. The perspectives shared here are not that of a mental health professional, but rather someone with lived experience. Information shared may not align with every circumstance or viewpoint of readers, but is meant to offer guidance in an area that is often confusing and holds little resources.**

Oftentimes when we know someone facing a crisis, whether it be a close friend, family member, or just an acquaintance, we don’t always know the right words to say. We may also have a difficult time processing the crisis through our own emotions and actions and before long, the wrong words come out to the wrong people at the wrong time. Several years ago, I was introduced to something called the Ring Theory and it became a very simple tool to use in any crisis, mental health related or otherwise. It saves friendships, relationships with family members, and ourselves from embarrassment and bitterness.

Essentially, this is how it works:

1. Draw a circle with the name of the person in crisis written in the middle. In our case, this is the person being admitted to a psychiatric hospital. This is the first ring.
2. Draw a second circle and name the person(s) closest to the person in crisis in terms of relationship. This is most likely a spouse and any children.
3. Draw a third circle and name close family that is not part of the second circle, such as parents, siblings, very close relationships with aunts, uncles, cousins, or grandparents. For minors, this circle would actually be the second circle.
4. The next rings are completed unique to whomever is using the tool. For example, if the person in crisis is your family member, the fourth ring and beyond will people in relation to you from closest in relation to furthest in relation. These rings will likely be filled with people that may know of your family member but don’t know them directly, like your coworkers, friends, church leaders, and your personal therapist.
5. Using the tool: When communicating about this crisis and how it impacts you, the rule is “Comfort In, Dump Out.” What that means is anyone in a smaller circle than where you place yourself should only receive support and desire to understand. Anyone in a larger circle moving outward from where you are on the rings are safe to vent to, seek advice, and generally receive support from. The closest outward ring from you is typically the safest group to disclose details in confidence and less details should be shared the further you get from the center. Likewise, be accepting of negative dumping from anyone in a smaller circle than you, including the person in crisis. See below for a diagram of what this looks like.

In practice, this would look like a close aunt to their adult nephew in crisis phoning their best friend to entrust their emotions regarding their nephew being hospitalized. But when she is getting updates from her nephew’s spouse, she should refrain from expressing these emotions (don’t say “I can’t handle this! I have never seen him like this. What in the world are you going to do?”). She would offer comfort, help, and advice if solicited to the nephew’s spouse, and dump out the stress and fears and emotions to her best friend.

So what do you do if you are on the same ring as someone else? How do you communicate to other close family members? or what if one of your tight-knit group of friends is hospitalized? This is where judgment comes to play. Evaluate if factors exist that would place you or the other person closer to the situation or the person in crisis and apply the theory. Seek an outer ring connection to be safe if it is unclear. But, in reality, this most often looks like mutual support, a give and take from both people. Share when the other person is strong to support you and be strong when they need support.

As the rings go in, the emotional stress of the situation increases. This means the highest stress level outside of the person in crisis is usually the spouse and children. In the same respect, the further in, the harder it is to reach out. Many times, a spouse struggles to share with anyone how the situation is making them feel. My best theory for why this is, is because when they are in personal crisis, their closest confidant is usually the one who is in the center of the rings at this moment. The person they usually dump everything on should only be receiving support right now. It can leave a person feeling isolated, alone, and seeing their negative emotions build up. Empathy and understanding in the silence can go a long way, and providing practical help is sometimes the only avenue we can take to support.

In closing, there is one person that trumps all of the rings. And that person is your personal therapist. Having a therapist, you can always rest assured you are dumping everything to an appropriate person without question and you can ensure you are receiving the support you need to be better equipped to be an asset to the ones closer to the crisis. It is typically overlooked when someone has a mental health crisis that anyone other than the person in crisis is in need of professional help. In reality, friends and family members having an outlet in speaking to their personal therapist actually is in benefit to everyone involved. Practice using this tool in small ways and prepare for when it can be used in the hardest of days.

For more information on Ring Theory and its origins, please click on this link.