In this podcast we discuss an educational program called Emotional CPR (eCPR), a form of peer support anyone can use to assist youth (or adults) in emotional crisis.

Our guests are Oryx Cohen and Briza Gavidia of the National Empowerment Center, a Massachusetts-based nonprofit whose mission is to carry a message of recovery, empowerment, hope, and healing to people with lived experience with mental health issues, trauma, and/or extreme states.

Oryx Cohen, M.P.A., is a leader in the international mental health consumer/survivor/ex-patient (c/s/x) or Mad Pride movement. Currently, Oryx is NEC’s Chief Operating Officer. Among other responsibilities, he organizes the national Alternatives Conference every three years and assists states that have an underdeveloped consumer/survivor voice to find that voice and then work toward transforming their mental health systems to become peer-driven and recovery-oriented. Oryx is also a lead trainer for Emotional CPR, or eCPR, and has conducted over 50 eCPR trainings around the world.

Prior to joining NEC, Oryx was Co-Director of the Western Massachusetts Recovery Learning Community. There, he helped to spearhead an innovative peer-run approach focusing on recovery, healing, and community. Oryx is also the co-founder of Freedom Center, the Pioneer Valley’s only independent peer-run support/activist organization.

Briza Gavidia is a certified Youth Emotional-CPR (eCPR) Educator. She is 21 years old and is a student at Fullerton College majoring in sociology. Briza is currently employed in a program assisting the elderly with daily activities. Her goal is to work in the mental health field so she can give young people real hope for a better future. She loves sharing her lived experiences with trauma and how she is tackling these challenges so she can become a stronger person.

The following transcript has been edited for length and clarity. Listen to the audio of the interview here:

Miranda Spencer: What is the National Empowerment Center? And how does it differ from conventional mental health centered organizations?

Oryx Cohen: The National Empowerment Center is a national, peer-run mental health organization. We’re one of three National Technical Assistance Centers funded by SAMHSA. And one of the major things that makes us different is that we are peer run, so all of us have our own lived experience with mental health issues, trauma, and recovery and healing.

Our lived experience makes a huge difference and influences what we do. We’re also different in the sense that we come at things from a more holistic perspective rather than a medical perspective. So, we’re not all about diagnosis and treatment and things like that. We’re more about community-based approaches, holistic healing, peer support.

Spencer: What is eCPR and how does eCPR fit in with the Empowerment Center’s mission?

Cohen: ECPR stands for Emotional CPR and the C is Connection, the P is Empowerment, and the R is Revitalization. Emotional CPR is our core training at the National Empowerment Center, and it teaches anybody how to better support someone else who’s going through an emotional crisis. So, it’s a practice, really a way of being. And we’ve also found that it not only works in those crisis situations, but it can be a way of life. So it can help within your family, with coworkers, neighbors, just in your daily life.

Spencer: Can you break down the acronym?

Cohen: Sure. When we talk about connecting, that’s really the foundation of Emotional CPR, of being with someone, supporting someone, even just communicating better with another human being. And it’s really more at a heart-to-heart level rather than kind of a head-to-head, thinking level. So, the emotional part of Emotional CPR is really important: connecting on that emotional level. So, you think about it as connecting through feelings first.

And the P for empowerment, emphasizing the power piece of it, recognizing that there are power imbalances in our society, but that everybody is a whole person. Even in our worst moments, or darkest moments, we see people as whole people that have power.

And how do you access empowerment? We feel like this authentic, heart-to-heart connection can go a long way. Because we can’t empower someone else. But we can create an environment and energy that allows people to feel their own power. So, empowerment is a huge part of eCPR.

And empowerment also involves choices. A lot of times, when people are in crisis, they don’t have a lot of choices, or they’re told what to do, so eCPR tries to give people choices in what they want to do for themselves.

And R, revitalization, that’s hopefully where we want to get to: feeling more energy or feeling a sense of groundedness, a sense of connection with other people. Wanting to live, wanting to do different things in life, that’s kind of the end goal.

Spencer: What are the origins of eCPR?

Cohen: Emotional CPR has been around for over 10 years. And it started just after Mental Health First Aid came out. And Mental Health First Aid is a training that was developed in Australia by mental health professionals. A few of us folks with lived experience—psychiatric survivors, as some people call ourselves—saw the Mental Health First Aid training and did not like it, to be honest. They felt it was very clinical and was just teaching lay people how to make a lay diagnosis and then refer on to professionals, but nothing about how to support someone in the moment of a crisis.

And so we figured, who better to design a training than those of us who have been through those experiences? And we know what has worked for us and what can work for other people. And so that’s how the original curriculum was written. A group of about 20 people at that time came together and wrote the original curriculum for Emotional CPR. And we’ve been adapting and adjusting it ever since.

Spencer: Is it an alternative to conventional mental health care or more of an adjunct to it?

Cohen: It could be both. I think that it’s better as an alternative, to be honest. But we really feel like the trainings are for everyone. So that includes people who are currently working in mental health professions. We’ve trained folks at state hospitals, and we’ve trained psychiatrists and social workers. And we’ve also just trained members of the general public.

Spencer: Would anyone using it ever refer someone into the mental health system? Or is the idea to help them to stay out of it?

Cohen: No, it’s not about referring. It’s all about what the person in distress wants. So, there are times when someone in distress says, “Hey, I really want to go to a hospital.” I can say, “I’m nervous about that,” or whatever. But ultimately, it’s the person’s decision. As a supporter, it’s not my job to argue them out of that. So, I would support them in that decision, and be by their side the whole way if that makes sense. It’s a different way of doing it.

Spencer: In what setting would eCPR happen? For example, who participates in eCPR and how and when would you find yourself offering it?

Cohen: Well, it was originally designed for those really big crisis situations, like someone’s feeling suicidal or hearing really distressing voices or really super sad or angry or anxious. So, in those situations, it definitely can work, and it has worked. I’ve heard several examples of eCPR basically saving lives—even the most extreme example of talking people out of jumping off a building.

But like I mentioned before, it can also be used just in day-to-day life. I try to practice Emotional CPR with my children. I have an 11-year-old and a 13-year-old, and I try to practice it with my wife. And I feel like when I do that, it makes my relationships better. So, it doesn’t necessarily have to be a crisis situation to be able to try to connect with someone on an emotional, heart-to-heart level.

Spencer: I understand there was recent research on the effectiveness of eCPR. There was a journal article that seems to show a positive effect on mental health practitioners. Can you talk about that?

Cohen: This research was done on the online version [of eCPR], and it was done with the participants in the trainings itself. So, we haven’t yet been able to do any real research on people practicing that outside of the trainings, which would be a great thing to have. But this is definitely a start.

The research shows that practitioners or mental health professionals had the greatest results with mindfulness awareness, which is interesting, and a lot of other really great effects from the training, including increase in a sense of belonging, decreased loneliness—which if you think about it is huge. Because what a lot of people have been going through with COVID, is a profound sense of isolation. So, to have something that you know makes people feel like they’re a part of a group and decreases that isolation is huge.

The research also found that we are teaching what we hope to teach: that people are coming across with a greater understanding of how to support someone else in a crisis. So, although we don’t have that research following people who have been trained and then seeing how they practice it, and how that’s impacted people outside of the training, we do know that folks are learning what we teach them, and then feeling more confident and being able to support people who are in crisis.

And it’s great to have a peer-reviewed, published article, which means that we’re basically an evidence-based practice at this point.

Spencer: How can a person learn more about eCPR or be trained in it?

Cohen: Well, we have a website that’s dedicated solely to emotional CPR. And that’s www.emotional-cpr.org. You can contact us through the website. There’s also a list of upcoming trainings on that website. Many of them are open to the public. So, if you see a training that you’re interested in, you can feel free to contact us or just register. A lot of the trainings that we do are free because we are funded by SAMHSA.

Spencer: Let’s get Briza on here. So, tell us a little about who you are, and talk about the National Empowerment Center’s youth programs in general.

Gavidia: My name is Briza Gavidia. I have been practicing eCPR actually since I was a child because my grandmother was a trainer. And she taught me everything I know about eCPR. So ever since I was a kid, it was something I was incorporating in my life. And when I was about 13 years old, I went to my first eCPR training in person, I was observing. It wasn’t a full training; it was actually just like a preview to see if people were interested. But I was so amazed and moved when I saw the trainers demonstrating eCPR in front of all these people. And I saw how other people reacted to it, and how people were crying in their seats, people were hugging each other. And I was like, “Oh my gosh, what is this!”

And right in that moment, that’s when I knew Oh, eCPR is really important. And this is something that I want to do for the rest of my life. And I knew also I wanted to be a trainer so that I could also connect with other people and share it with other people.

Spencer: Let’s back up a little and have you tell us something about the NEC’s youth programs. And where does eCPR fit?

Gavidia: Well, we just created youth eCPR maybe a year and a half ago. They got a few of us together to give our input on how we could change eCPR a little bit so that it would fit younger people ages 16 to 26. So, we had younger people to kind of talk about, okay, how could we change eCPR in a way that young people can connect with it, because the original eCPR trainings are two days, but they’re many hours. And younger people have shorter attention spans. So, we kind of had to cut it down to like a whole week, two and a half hours each day. And that was perfect time to connect with the younger people, but also not lose their interest.

And also, we have topics that are a bit more current for what younger people would want to talk about. And we have more interactive activities, also to keep the younger people engaged.

Cohen: I’ll help out a little bit with this part of your question, which is how does this fit in with the other National Empowerment Center youth programs. We have a Youth Coordinator, and her name is Shira Collings. I would say youth Emotional CPR is probably the biggest part of our youth programs, but we also have a youth leadership webinar series that we do every couple of months.

So, we bring in someone representing a youth organization or someone who’s done work with youth, someone who is a youth themselves. And they talk about what does it mean to be a young person who is a leader. And how can we support the development of new youth leaders? How can older adults support younger people? And that series has been really fabulous. Briza’s actually presented on one of those webinars talking about youth eCPR. But the topics have been pretty broad.

Spencer: This question is for both of you. Why are youth involved in eCPR? Why is it helpful to have someone that is a peer rather than an older person?

Gavidia: Yeah, that’s actually a really good question, which is why we decided that for youth eCPR, we would have people that were younger training the youth, because I think it is really hard for young people to be open with adults that are, you know, older, because I think they were told their entire life “You’re too young, this is how things are, you have to listen to what we say.” And you can’t change the status quo.

I think young people are really changing, especially with the mental health movement. They’re really changing how things were in the past and challenging the practices. Because how people, “cure” mental illness is much different than how young people view it now, because now we don’t see it as “Oh, it’s a bad thing that needs to be pushed away.”

Now, young people are trying to say, “Hey, I deal with this, and why is that wrong? Why should I have to listen to what an older person says when they tell me to take medication, or when they tell me that I need to seek psychiatric help, when all I want is to talk and communicate how I feel?”

So, I think that’s why it’s really important to have fellow youth training youth, because we can relate to how they feel. And we understand the new generation, and the new pressures that young people have when it comes to school and being perfect. And especially when it comes to social media. Social media is a whole other thing in itself, because a lot of older people don’t understand the pressures of social media and how social media can really make you feel depressed or anxious. And young people understand that. So that’s why we’re able to connect with them.

Spencer: Is the technique or the content of eCPR different for young people than adults as far as what you would say or do?

Cohen: I’ll jump in, because I wanted to follow up on the last one. We do have some trainers who can do the youth eCPR who are older adults. So that is an option. But we found the most powerful trainings have been done by youth, for youth. And when I look at the evaluations from those trainings, they just blow me away. They’re just so powerful. And I know Briza has been a part of a lot of those.

And younger people have shared things that they’ve never shared before with anybody else in these trainings. And it’s a really amazing healing experience.

As far as the question you just asked, it’s the basic core curriculum that we use for the adults, but it’s been adapted for youth. And then we’ve created a youth journal that youth can write in and make it their own. They can draw, they can write, they can take some time, think about questions, and jot some thoughts down before they participate, things like that. And I think the journals have been great as well.

Gavidia: Yeah, it is just easier to understand. And they give them more time to process it, and then come back the next day and express what they wrote down.

Spencer: Is this just the person that’s being trained to give eCPR or are you referring to the person on the receiving end?

Cohen: This training is teaching people that then go out and do eCPR. So, we’re talking about the way we deliver that training. The practice of eCPR, I would say is the same for youth or adults. So in these trainings, we’re teaching people to then go out and support people in their communities.

And how we do that in the training is through what we call real plays. They’re not role plays, we’re not making up stories. Because, you know, if you’re supporting someone in the community, they’re not going to be making up a story, right? So, the best way that we found to practice Emotional CPR is for participants in the training to talk about some real experiences that are going on in their lives. It doesn’t have to be the worst thing that you’ve ever experienced. But sometimes people do open up in the training; they feel safe enough to open up and share some pretty tough stuff. So emotional CPR is being practised in the training itself.

Spencer: Briza, have you used eCPR out in the world with other young people?

Gavidia: I definitely use it every day, especially with my friends, because a lot of my friends are foster kids like myself. And they have experienced a lot of trauma in their lives. So, they will call me and tell me something in their family happened. And I would think back to eCPR and think, “What does this person need right now?”

And normally what people need when they are in a crisis, or if they’re reminded of trauma from their past, is open ears. They need someone to say, “I’m here with you, I’m listening. What do you need from me?” They just need someone to be there to listen. And that’s what I take away from eCPR and how I incorporate it in my life.

And I also work with the elderly. So I use it every single day at my job with the people I work with. I’ve been around older people my whole life. And when sometimes they’re sad, sometimes they feel lonely, again, the core of eCPR is to be there with someone. And when someone feels lonely, to listen to them, and make them feel like they’re heard.

Spencer: If I were a young person, and wanted some kind of help, but wasn’t sure what to do, where would one find someone that could do eCPR?

Cohen: That’s a really good question. And that’s [the] next step. Wouldn’t it be great to have a listing of people who practice Emotional CPR on our website? Our vision is that everyone, ultimately, is trained in Emotional CPR, so it wouldn’t be about finding someone who has been trained, it would just be that entire communities are trained.

We’ve gotten into, for example, entire school districts. We’re starting to do some more work in Franklin County, Massachusetts that could take off and hit all kinds of different sectors of that community. We’ve gotten into the curriculum in a couple of high schools in Vermont. So now students, as a part of their classes, take Emotional CPR.

So, if we keep on this path, maybe this will be something that everyone learns, and then you wouldn’t have to worry about who knows eCPR and who doesn’t, because it would just be like, “Oh, this is the way we do things in our community.”

Spencer: Can you think of any other youth-oriented groups that have had eCPR instruction?

Cohen: We’ve partnered quite extensively with Youth MOVE National. They’re one of the larger youth organizations. There’s an organization up in Vermont, called We R H.O.P.E that provides emotional support to students and they provide coaches pretty regularly, like a couple hours a day, for students that need this. Emotional CPR is now their core training.

Spencer: Is there anything else you’d like us to know or any stories you might like to share?

Gavidia: Well, I just wanted to touch on just how important eCPR is, and that it’s not us telling people “This is the way it is and you have to listen to us,” We just want to connect with other people, and help people to connect with themselves and connect with others, and learn how to be there for someone who’s in distress, how to listen, how to not talk over them, be present in the moment with someone else, and let them talk and let them express how they’re feeling.

But it’s also important that while we are teaching eCPR, teaching people how to be there for other people, we’re also teaching how to be there for ourselves. At the end, revitalization. When you connect with someone else, you empower yourself, you feel good for yourself as well. We talk about [how] our hearts are dancing with each other. It’s a two-people feeling, not just one. Because if you want to help someone else, you have to be genuine. And when you’re genuine, then you feel that in your heart, you feel the warmth of someone else expressing their emotions.

And emotions are so important, because I really do believe that without human connection, without human emotion, we’re just flesh and blood. We’re just bones, walking around numb. But once we make that connection with someone else, that’s when we have hope for living. And I really hope everyone can incorporate that in their lives, whether they take a training or they just Google eCPR and what it is, because I think every single person can benefit from eCPR.

Resources

Emotional CPR website

Webinar: Emotional CPR by and for Youth

Article on eCPR in the Journal of Participatory Medicine

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MIA Reports are supported, in part, by a grant from the Open Society Foundations

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