Emotional CPR

a review

Be kind whenever possible. It is always possible.

The Dalai Lama

When a young man in our circles killed himself, we started work on a suicide prevention program. When we heard of another suicide two months later, at the local community college, the need was even more apparent.

The Suicide Prevention Resource Center lists several risk factors for college suicide. At the top of the list is "relationship troubles." Another is "lack of social support." A big problem is that people don't seek help. One reason for that is the stigma associated with mental health challenges. For a suicide prevention program to be effective, it needs to address these issues. Here is one that does.

Emotional CPR, aka, "heart to heart resuscitation," is a form of peer-run, community-based mental health care developed by the National Coalition for Mental Health Recovery (NCMHR). It trains lay people (e.g., students and staff) in emotional crisis intervention, just as regular CPR and First Aid programs train people to help in physical emergencies. But it's much more than a temporary fix. It also builds community.

For a brief outline of eCPR, see their mini-brochure or fact sheet. Perhaps the best sense of what eCPR is really about, however, can be gained from this interview with the creators. In it, we learn that eCPR was developed by people who went through severe mental health issues themselves -- and came out the better for it.

In eCPR, the bottom line is that nothing is ever "wrong" with anybody. Emotional crisis is "a spiritual opening" and eCPR is "a way to be in community." In other words, someone freaking out is an opportunity for all of us to go deeper and get REAL with each other. It's not necessarily a cause for hospitalization (i.e., isolation) and "treatment" (i.e., medication). These things can sometimes help in extreme emergencies, but what people need more than anything is simply to know that someone truly cares about them. And for that, eCPR, with its focus on Connection (the "C" in eCPR), is more than treatment; it's prevention.

For contrast, it helps to know that eCPR was developed in response to another, more substantially-funded crisis intervention program called "Mental Health First Aid." MHFA is more about diagnosis and referral than emPowerment (the "P" in eCPR). And that's not surprising, given that MHFA is apparently backed by pharmaceutical companies. Empowerment doesn't sell pills.

As you hear in the video, it's rather shocking to learn that until relatively recently, there was no "recovery" model in the mental health profession. In other words, many mental illnesses, like schizophrenia, for instance, were considered incurable and only manageable by experts. Yet both the co-founders of NCMHR were diagnosed with schizophrenia, and both recovered from it. Being stuck in a sickness is good for business; not so good for us.

eCPR is a "trauma-informed" approach. It means that you don't focus on judging people on how they behave and labeling them accordingly. Instead, you try to understand why. Instead of asking (if only implicitly), “What’s wrong with you?” you ask, “What’s happened to you?" The difference between how these two questions feel is obvious. And that's the key to connecting with people. Like one reviewer says,

I loved the eCPR training because it teaches us to connect with others as individuals, not a diagnosis, and not using a pre-determined method. This training, unlike other trainings I have attended, teaches us to honor the individual and their unique experience/crisis.

Another attendee concurs:

A key idea of eCPR is that it is about connecting “heart to heart.” It uses our natural ability to relate to other people. It is not about using the various kinds of “relational techniques” many of us have learned in our mental health provider educations. Some of my classmates struggled a little bit to take their professional counseling skills out of the exercises.

After years of working with troubled people, we at The REAL Center know that the foundation for both mental health and strong relationships is empathy. Empathy means being in touch with what you and others are feeling and needing. We were excited, then, to read in eCPR's description of their approach: "by using our interior experience, we can help another person recover from an emotional crisis."

Like another reviewer says:

Not very surprising, perhaps, is that the deeper the issues, the greater the universality of experience... [that means that we] are enough, just as we are, to support each other and others... I recently saw posted, “What greater wisdom is there than kindness?” This to me epitomizes eCPR.

eCPR is inspiring to us because it's about respecting everyone as inherently self-healing. We are all struggling, and the only sickness, ultimately, is lovesickness. Together, we can not only avert tragedy but strengthen our community, making it a more joyful place to appreciate and cherish life and each other, every precious day.

For The REAL Center's own, NVC-based version of eCPR, see "Emotional First Aid."


We take care of our health, we lay up money, we make our roof tight and our clothing sufficient, but who provides wisely that he shall not be wanting the best property of all–friends?