In this episode of Finding Your Balance, hosts Tiffani Fritzsche and Kirk Fasshauer discuss how to start a supportive conversation with someone who may be struggling with their mental health. They explore why it can feel intimidating to speak up, practical ways to approach a friend or loved one with care, and simple communication tools like using “I” statements, open-ended questions, and active listening. The conversation emphasizes that you don’t have to have all the answers to help—sometimes the most powerful thing you can do is listen and create a safe space for someone to be heard.

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00:00 Tiffani

Welcome to Finding Your Balance, a mental health podcast. My name is Tiffani Fritzsche. I'm a licensed mental health counselor. I'm joined by my friend, Kirk Fasshauer, licensed clinical social worker. And we are getting into all things mental health. Today, we will be talking about how do you have a conversation with someone who might have a mental illness, who might be exhibiting symptoms, and you're wondering, how can I help?

00:23 Tiffani

I think for a lot of people, the hardest part is knowing how to start that conversation. Absolutely. It's not easy. And, you know, I think it's not easy for a number of reasons. One is, well, I don't really want to pry into somebody's personal life. I think also many people worry about saying the wrong thing.

00:48 Kirk

Not wanting to make it worse. Right. Exactly. I don't want to make it worse. I mean, what if there's nothing going on and it's just me thinking weird things in your head? Let me tell you, our spidey senses are extremely important. And if you're a friend of somebody, you're close to somebody that you're picking up on something, it's better to say something and be wrong than not to say something and have been right. When I think as friends.

01:17 Tiffani

We appreciate it when people care enough about us, even if it's uncomfortable, to say something. And I've heard you say before, you got to be okay with saying the wrong thing sometimes. You know, if you're not sure what to say, ah, what do I do? Say something. Yeah, exactly. Because you're picking up on something. And so, you know, and we'll talk a little bit more about this in another topic. But it’s really that…

01:47 Kirk

The situation is, this is an area where silence can kill, you know, if it's deep end kinds of things. We'll talk more about that later when we get into the topic of suicide. But say something. And the whole point of, you know, if you're wrong a little bit, that's okay. You're picking up on something. It's an opportunity to have a discussion.

02:13 Tiffani

with a friend. Just opening that door, I think the first step is really, you know, the approach. So if you're noticing something's not quite right, or maybe you don't know if it's quite right, you're just like you said, that spidey sense, the approach is…

02:27 Tiffani

Do I know this person? Do I have a relationship with this person? Maybe I'm not the right person to have this conversation, but I know that they're close with their RA or I know that they're close with this coworker or this other friend. So saying, hey, can you reach out to that person? But not ignoring something that you see is concerning. So having that approach and like when is the right time? Or even denial.

02:50 Kirk

Because some people will say, well, that can't be true. I'm not going to. No, that's not right. And they start to rationalize why not to say something. And again, that could be life-altering for somebody.

03:05 Tiffani

And so when you're approaching someone, of course, you know, common sense. You wouldn't want to bring up a sensitive topic in front of a group of people. You wouldn't want to bring up a sensitive topic that, you know, may need to be unpacked right when someone's about to rush into class or right when, you know, there's a transition. You want to be smart about it. As long as it's not, you know, not a crisis situation where you need immediate intervention, I think sometimes being aware of the environment is going to help you with a more successful reception.

3:34 Tiffani

when there's not a lot of distractions going on and maybe saying, hey, do you mind if we go grab some coffee after this? I'd love to check in with you about something. And just having that time to where that person has a…

03:48 Tiffani

a peaceful, relaxing environment where if they chose to become vulnerable and share what's going on, it would be an environment that's safe to do so. Right, right. And sometimes you'll be there and you're trying to get up the courage to say something. We call it doorknob therapy. So you leave the juicy parts to the very last moment because you're building up the courage to bring up this heavy topic. And so even in therapy, you know, you've got people that come in and…

04:15

In the arena where they should be talking about the heavy-duty things, they wait until the very last moment to bring that heavy-duty topic up and say, oh, by the way, I did this the other night. It was like, oh, wait, why didn't you bring this up early in the session? That's a whole session in and of itself. And there's various tactics we learn in our training to kind of work around some of that.

04:41

help people who are trying to manipulate the time for more time sometimes. But it's, yeah, they're tough topics on both sides of the fence. You know, the person…

04:54

who needs to hear it, who's experiencing it, and the person who's wanting to help. And I think it's a different set of skills sometimes. So as a clinician, we have hard conversations every day. And when, you know, you put on your therapist hat, you know, you're ready. But maybe you don't have a therapist hat. Maybe you have, you know, a sister hat or a friend hat or a roommate hat. And you're like, ah.

05:14

I don't feel equipped. I don't know how to have these hard conversations. So there's very simple principles that we can go over now. One of them, so, you know, you identify something's not quite right or you're concerned it might not be quite right. You open the door. Hey, are you okay? Now you want to make sure, I think what has served me well over time is using I statements because whenever you do open that door and you have that conversation, we really don't want it to seem accusatory or like an interrogation.

05:43

And so I like to use I statements and it would sound something like this. Hey, you know, I care about you. I noticed that, you know, you didn't come to class yesterday and I didn't see you in class last week.

05:55

I'm just worried. Is everything okay? Right. And so I'm putting the weight of, you know, I'm worried. I noticed those I statements. And it's out of a place of concern, not what's wrong with you? Why have you not been coming to class? Right. So you're correct. And I talk about I statements when I do trainings in active listening. So, you know, I statements, they're these little sentences that have a structure to them that are pretty powerful. So using your example, the I statement, you know, and they're disarming.

06:24

You know, they don't put the other person on defense. They're actually more apt to hear that and actually listen to what you're saying when you use those I statements. So the I statement is I and then the feeling. So I'm nervous or I'm worried. And your example is worried, right? When I haven't seen you in class for a while. So there's the behavior. So there's I and then a feeling because or.

06:52

You identify the behavior that's causing the emotion. And oftentimes you can tag on to that. What's the corrective action or what can we do? In your example, you just say, is everything okay? So you open the door with an open-ended question. Well, that's a closed-ended question. But it at least opens the door to start a conversation. Somebody might say, no, I'm fine. I like to joke about that.

07:21

when people say fine a lot. If you're fine, I'm starting to get worried when you say fine a lot because fine, frustrated, insecure, neurotic, and emotional. I'm worried. But that is like the go-to. Oh, I'm fine. Everything's fine. So you said open-ended versus closed-ended. Tell me more about that. So when you start the conversation,

07:45

Because a lot of people think, oh, you do a lot of talking. And it's like, no, actually, counseling is a lot more listening than it is talking. And so active listening is a whole set of skills you can learn.

08:00

little things you can do. And open-ended versus closed-ended questions are one of those areas in active listening. Open-ended questions are questions, well, how was your day? That's an open-ended question. Can't be answered with a yes or no. Can't be answered with a yes or no. That's a closed-ended question. Yes, the yes and no. So, you know, in training new counselors and things like that, getting people to…

08:24

engage in conversation, even in negotiations. I train negotiators as well. So that, you know, if you're asking too many closed-ended questions, you're probably, as the person trying to help, start to feel a little frustrated. And that's maybe because you are asking too many closed-ended questions. And what that does is it boxes the person in to a particular answer. And so you don't get a lot of information.

08:49

open-ended questions, tell me more about that, allows the person to actually tell their story. And often people in crisis, they just want to be heard. So they want to tell their story. They want to tell their side of the thing. The other part of active listening is being nonjudgmental. It doesn't matter if it's right or it's wrong. It's that person's experience, that person who's sharing that information. It's their experience.

09:15

Trying to say, hey, this is how I saw it. This is how I see it. And we've got to be open enough to recognize your experience may be different from my experience, even though we watch the same thing. Well, and I think right there as an active listener, the listener has to be very aware of what is your goal here.

09:36

My goal is not to convince you to do anything. My goal is not to make you agree with me. My goal is to create a safe space to where you feel comfortable talking and opening up. And like you said, it's not about how I feel. It's not about what I think. It's not about anything other than I see a concern.

09:56

approach you because I care, and I'm creating that space to where you feel heard. And I think it's so frustrating sometimes because, as you mentioned, people who are in a mental health crisis, a lot of times they do want to be heard, but it's also very difficult to initiate that communication, even though they desperately want to be heard. And so being the listener, being that friend, whatever hat you're putting on, you're being aware and just creating that space to where that person can

10:26

have that conversation, but they might not be able to start it. Right, right. And so you starting it is huge. So we talked about active listening. We talked about opening to questions. Another thing I think that is so helpful is something called encouragers. Yep. And encouragers can be really tricky because depending on how you use them, you can encourage the person to talk more or you can actually encourage them to talk less. Right. So you've got to be mindful of how you use them. You don't want to overuse them. So if you overuse them, that tends to shut people down because it…

10:55

Gives the message you're not really listening. So we call them minimal encouragers. So we use them all the time. You just demonstrated one. Yeah. Really? And what that does, those are the little messages we send to the person who's talking that we are listening. I don't want to interrupt you because you're on a flow here. You're telling your story.

11:20

So the minimal encourages are beneficial. Open-ended questions. Reflecting is another technique in active listening. Reflecting is where you say to the person back exactly what they said, word for word. So why that's important is because people in crisis, they get tunnel vision. The blinders are up and they're in a certain mode, more emotional than.

11:50

you know, rational. So when emotions are running the show, we don't always hear what we're saying. We don't always mean what we are saying. And so when that happens and you reflect back exactly what they said, it gives that person the opportunity to say, yeah, that's right.

12:09

Like, you've got it. Or, no, that's not what I meant at all. It gives them an opportunity to go, oh, wait. And it helps them to self-correct a little bit because they may be blowing it way over here when it's just a little anthill, not a giant mountain. So that's good with reflecting. And then there's, you know, we call them effective pauses or silence.

12:32

I see this happening with a lot of first-time counselors. They think the job is all about asking questions, so they ask questions, and they're not really listening. They're formulating the next question, and they ask the next question. It's like time out. Ask the question and just be quiet for a little bit. Let that kind of sit with the person.

12:52

for a moment. That's so hard though. It is. That silence. That is something people need to learn. So you can hear from my voice, my twang, if you will. So I'm a Southern person. I grew up in the South and Southern people, you know, in this moment, let me speak for all Southern people. It can be very hard not to fill that gap because silence is awkward. It is. Right. And one thing that I had to learn through the course of learning how to be a counselor is

13:19

It's usually awkward for both people. Correct. And I'm going to allow myself to sit in that awkward and feel that awkward and be okay with the awkward because awkward isn't bad. But it's not my job to fill that silence. And especially working with teenagers, I find a lot of times if I can just hold on because we're both feeling it, they'll fill in that awkward silence because they're waiting. Now, there's a couple of encouragers.

13:46

that I use, and I know that you use because I've seen you use them. One is the practice of, they call it fronting, and different people call it different thing, but it literally is taking your body and facing that person. And that sounds so simple.

14:01

Of course you would do that. But think about how many times we're in conversations with people and we're multitasking or we're looking away or we move away our body and it doesn't feel nice. It doesn't feel like we have that whole person's attention because we don't. Correct. But if you're having that intentional conversation, it's important that your body language work like that. And the other thing is nodding. And so research has showed that most people feel really good about.

14:29

the triple nod. So when you're looking and you're talking and we're doing three very slow nods, it just feels like, okay, they're listening to me. I'm being heard. Now, if you take those same three nods and you speed them up, what does that make you feel like? Oh, I got to wrap this up. And so I think that we can use the right encouragers, but if we use them the wrong way, that message gets misconstrued. Yeah. And so, right. You know, these are things we learn in

14:59

our schooling and in our practice, you know, because schooling covers some of it, not all of it, you know, but what you said about the facing, call it squaring off.

15:13

So that we are shoulder to shoulder. We have an open stance. We lean into the person and we're present at that moment. And then we have to try to relax. So many things to do at one time. So if you're mindful of this and you're in our training, we learn to do it. And at the beginning, I remember, oh, my God, there's so many things to think about just sitting here having this conversation. And I got to figure out what I have to say, too.

15:39

But for people who are doing it every day, it will happen naturally. In our counseling training, we're learned to observe it, be aware of it, of what's going on in that dynamic, and partially to make it purposeful. We do it on purpose because that sends a psychological message of safety.

16:00

I'm here. I'm squaring off with you. And you matter to me. And you matter, right? And that can sometimes be pretty intense if you don't know what's going on. As a counselor, I'm doing this on purpose. I know what's going on. I'm going to be focused on you. Everything else around me doesn't matter. And in some environments, that's not a good thing because I talk about this with some of the law enforcement folks that I train. I said, no, you don't want to do that because you're in an environment that's…

16:28

You need to be aware and things like this. In an outpatient setting where I control the environment, different story. So, yeah, it's extremely important to let that person know, I'm there paying attention to you. Well, and it's so simple, but it's also just as hard. But I will say that's why it's called active listening because you are very actively participating in that listening process.

16:58

Right. So you had mentioned something before about, you know, we do that because we want to show that we're attending to the person and not. I have had practitioners sitting there in the medical profession, sitting there typing away, tell me what's going on with you, and they're typing away, not paying attention to the person.

17:22

I've had some people tell me that seems very impersonal and it's like distracting. And I'm asking a question, like you said, are they really listening to me? They're typing away. You tell them about a medication you have, they're looking it up right there. So there's good and bad with the technology. That's one of the bad, I think, especially for our profession where we are trying to connect with people. These laptops are very beneficial.

17:50

They help us get our documentation done quicker and sooner. However, it's not conducive to the connection that is the magic of counseling, and that is the conversation with two people. So starting that conversation, right, and then having the conversation, and then now that you've had it, gosh, what do you do with the information that you got?

18:13

A lot of times having that active listening is disarming. And it does create that safe space where that person feels heard. And they may share, what do you do with the information when they share it to you? Right, exactly. And that's going to depend. It's going to depend on, hey, they're talking about a breakup with a boyfriend, girlfriend. And that might be just a conversation between you and them. And just taking the time. That's the other thing. When you start to engage in listening, if you're being…

18:41

If somebody is actually listening to you, it feels good. It's like, oh, my God, I'm letting all this go because they were listening to me. And so they don't want it to end. So they let the conversation go on and on and on because they're having, A, it feels good to let that story out and share that information and release. And now they can kind of problem solve if that's.

19:05

Maybe what's going to happen with a breakup with a boyfriend, girlfriend is maybe there's some problem solving. Maybe there's something else we can do to distract you, get you into something else if that's the case. But if there's something more serious, you know, know what some of the resources might be available to you in your community, on your college campuses, in your neighborhood, in your…

19:31

hometown, your city. It doesn't have to be, you know, just one thing. It could be a combination of things, too. It might be, hey, let's go spend some time with friends. So your peer group is one level. Family. Maybe some people, I mean, many people have a good connection with their family. Some don't. So maybe it's the peer group that's more important.

19:53

If it's not the peer group, what about, you know, people have church families. Do you go to church frequently? Is there somebody in your church group that you kind of connect with? It might be somebody in the clergy who is your minister, pastor, rabbi, what have you, that you want to share with that they're close but not so close. I can kind of share some other things there.

20:15

But as you as we look at it, it's kind of like a bubble or a target. You know, you start off in that center circle and you start to go out further and further out. That system of support. That system of support. And so who's in my neighborhood? Do I have friends in the neighborhood, the church? And then the health professionals, you know. Well, and when you're having that conversation as the active listener, I think sometimes it can feel overwhelming because.

20:41

It's not uncommon to hear a problem and feel the need to fix the problem. Exactly. Right? And what we have come to find, and I think, you know, it's a hard lesson to learn, is that people don't need to be fixed. They need to heal. And healing happens in relationships. And sometimes, and sometimes, sorry to interrupt you, but sometimes the person doesn't want it fixed. They just want it to be heard. And that right there, I think, is one of the biggest.

21:09

The biggest things of sometimes you just need to feel seen and feel heard. And maybe the friend saying, hey, what's going on? Just having that space to decompress. And sometimes if you're a verbal processor, like that's all you need, just talking it out. And now that the stress is lower, so now you can problem solve. It's really hard to problem solve when you have no emotional margin. And so decompressing will give you that emotional margin. Sometimes it's past that.

21:38

I think one of the biggest gifts is to look at that friend or that person and say, what do you need? Yep. What do you need? Right. And maybe what they need is I just need to like word vomit. And maybe they say, I don't know. And in that moment, knowing.

21:55

knowing to read the room and being willing to say, well, what do you need? I think not having the weight of responsibility to fix that person is so freeing. And it takes a lot of the pressure off to engage because I don't want to ask a question that I'm not prepared to hear the answer to. Yeah. People get the deer in the headlight look and then they get anxious. And then when you're anxious, you're not listening.

22:17

Yeah. You're thinking, how do I solve this problem? And that, I think, is the problem. Sometimes with new therapists, when I first got into the field, you know, you'd hear a question and it's an easy struggle to step into of I start problem solving and I stop listening. Yep. Because I can't do both at the same time. And the moment I start problem solving, I'm not active listening anymore and I'm missing things. Yeah. And sometimes vital things, you know. So and people.

22:43

We jump to problem solving because it's a little more concrete. Oh, I can fix that. And there's that piece to it as well. It's a problem. I can fix it. Here's a solution. So when you sit down and have this conversation, be ready to actively listen. Don't always go to problem solving. I think fight that urge. It's a strong urge. It's a strong urge.

23:11

The step there at the end would be, or as you're listening, what you said, what can I do for you? What do you need? What do you need? What would you like to have happen even? And that kind of gives that person some empowerment to make a decision. I really don't want anything. I just want somebody to listen to me. Yay. That was me. Problem solved, right?

23:40

They get to define what it is that needs to be, quote, unquote, fixed. There may be nothing you can do for me right now. Or if you're not really sure about resources and you're both kind of struggling, you know, there is a resource out there that everyone can use, and that's 211.

24:00

is kind of a directory for all human services kind of things, whether it be need for housing, need for food, need for counseling, need for any type of support, clothing, what have you, financial guidance, things like this. 2-1-1 is a good resource no matter where you are in the country. They have a directory of how to tap into those things. So if you find yourself kind of stuck, like, I don't know, just, you know.

24:29

Hey, let's see what they have to say. Two on one. As we go into the season, we'll talk more about, you know, all kinds of things, suicide prevention, mental health awareness, you know, additionally. But I think sometimes as that active listener, when you hear the information, not knowing what to do with it, a lot of it is going to depend on what that person tells you. Maybe you're going to say nothing. I just needed to get it out. Thank you for listening. And we're good. Maybe they're going to say.

24:56

I really don't know. And then you open that door of, you know.

25:00

Can I help you? Can we problem solve together? Now, there may be a situation where they tell you something and right away, it's very clear. Right. We're in a crisis. And what can be really tricky is when it's clear to you that we are in a crisis now, but that person doesn't want to do anything about it. And so in later episodes, we'll talk more about what to do in those situations. But I think just for now, one of the important things to know, whether you are the person experiencing that mental health crisis.

25:29

or whether you are the active listener, you're not alone. Right. And so when you are in those situations, there are resources you can call for direction. Absolutely. And we've talked in a couple of episodes previously about how to distinguish between, you know, is this a true mental illness kind of situation? Is it a mental health kind of crisis? Or is it just a bad day kind of thing? So we've talked about that even in our first season off and on in various areas.

25:54

And maybe it's as simple as connecting someone to the right resource. Maybe it's connecting someone to emergency resources. But there is always a next step. And it's okay if you don't know the next step. What you need to know is how do I reach out to find that next step? And you mentioned 2-1-1. There's also 9-8-8. 9-8-8 for those who might be hurting real bad emotionally and they need to reach out. That's the national hotline for suicidality. The national lifeline is 9-8-8.

26:22