Crisis Theory in Behavioral Health:
Moving from stasis to developmental adaptation…
Michael Bütz, Ph.D.
Aspen Practice, P.C.
Corey Schwinn, LCSW
Washington County Psychotherapy Associates
Linda Chamberlain, Psy.D.
Pasco-Hernando Community College
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Our Background
Michael Bütz, Ph.D.
Aspen Practice, P.C.
Corey Schwinn, LCSW
Washington County Psychotherapy Associates
Linda Chamberlain, Psy.D.
Pasco-Hernando Community College
This presentation has been adapted from an earlier version given at the Society for Chaos
Theory in Psychology & Life Sciences, 14th Annual International Conference, Milwaukee, WI
on July 16, 2004 written with Karen Kesselring and David Whalen; we gratefully acknowledge
their earlier contributions.
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Presentation Background
 “Crisis Planning” in-services
across 4 county Region over
the past 2 years,
 Working with a very busy
regional crisis services
system,
 Used the “kinder – gentler”
approach to introducing
crisis theory and nonlinear
dynamics as these concepts
are somewhat unfamiliar,
 And, snappy titles…
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Warning: Avoid if at all possible!
 In our culture, that is, here in the United
States,
 Stresses or emergencies are often seen as
leading causally to interpersonal crises (James
and Gilliland, 2001, pp. 9-10)…
 And, these experiences tend to be regarded as
something to avoided!!!
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Warning: Avoid if at all possible!
So, how about a ‘little’ existential crisis?
 That’s like being a ‘little’
pregnant,
 Or, being ‘mostly dead…’
For those of you, ‘gripping’ for this odd reference, see the movie The
Princess Bride (circa 1987), and reference character Miracle Max and the
notion of ‘mostly dead.’
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Consider,
if
you
will…
Consider if you will…
Consider if you will…
 Given these warnings, one may be left to ponder the
question….
 WHY TAKE UP CRISIS THEORY AS AN AREA
Consider
if
you
will…
OF STUDY AND, PRACTICE…?
Consider if you will…
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So, Why Crisis?
 In essence, it is the seed from
which all developmental processes
unfold,
 And, crises are markers in time, a
representative embodiment of all
significant change processes…
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So, Why Crisis?
“The significance of a crisis is in its
temporal telescoping of development.
Major alterations in pattern may occur
in a relatively short period and may
subsequently remain stable for a long
time.”
Gerald Caplan 1964
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So, Why Crisis?
And, common crisis descriptors, that…
 Inappropriately continue to focus on:
 Homeostasis,
 Equilibrium,
 And, static developmental notions of
crises…
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So, Why Crisis?
 Besides, it’s the Big Picture…
 Crisis
Theory truly belongs to no one
discipline, theoretical perspective,
modality of treatment or model of care.
 Moreover, Crisis Theory applies
regardless of the point of service; that
is to say the individual, couple, family,
community or even nation.
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The Problem:
Wrangling Linearity…
 Colleagues in Crisis Theory:
 Still
see stresses or
emergencies leading causally
to interpersonal crises…
 Remember the whole avoid the
“crisis experience” deal?
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The Problem:
Wrangling Linearity…
 Yet, the field also acknowledges that crises
are:
 Multi-determined
 Present unique opportunities for individuals,
families, communities and larger social
systems…
 Shorthand acknowledgement:
Danger – Opportunity…
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The Problem:
Wrangling Linearity…
 In fact, ‘most’ mainstream crisis theorists
acknowledge this, and use this symbol as a
central theme:
 Aguilera, 1998;
 Gilliland and James, 2001;
 Hoff, 2001.
 And, make use of this Chinese symbol to
represent the phenomenon of crisis, that while
there is “danger,” there is “opportunity” for
adaptation and growth.
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Theory: The ordinary language…
 Discussing matters scientifically, they
naturally lend themselves to certain
descriptions, words, mathematical
expressions and the like.
 Here we will make use of words to
represent states of existence, though
undoubtedly in the future more refined
descriptions would be preferable.
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Theory: The ordinary language…
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Theory: The ordinary language…
“Mathematics essentially means the
existence of an algorithm which is much
more precise than that of ordinary
language. History of science attests that
expression in ordinary language often
preceded mathematical formulation, i.e.
invention of an algorithm.”
von Bertalanffy, 1968
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Crisis Theory Proper…
What is a crisis?
 According to leading authors on the topic
(Hoff, 2001; James and Gilliland, 2001), in a
clinical context a crisis is:


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“…an acute emotional upset arising from situational,
developmental, or sociocultural sources and resulting
in a temporary inability to cope by means of one’s
usual problem-solving devices…”
“…crisis is a perception or experiencing of an event or
situation as an intolerable difficulty that exceeds the
person’s current resources and coping mechanisms.”
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Crisis Theory Proper…
“…will one day make a systematic
study of the unfolding of the
significant ideas in this transitional
period, assuming that events
confirm our prediction that we are
witnessing the beginning of a
metamorphosis…”
Caplan, 1964
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Crisis Theory Proper…
 Lindemann (1944)
 Studied
responses to Coconut
Grove Fire
 Identified emotional responses of
people exhibiting signs/symptoms
that resembled mental illness –
initiated discussion on “crisis…”
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Crisis Theory Proper…
Janosik’s description of Lindemann’s work
(1994) emphasized equilibrium as a
central concept as well:
 Disturbed equilibrium,
 Grief therapy or grief work,
 Client’s working through the problem
or grief,
 Restoration of equilibrium.
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Crisis Theory Proper…
 Despite Lindemann’s limited treatment of
‘crises’ per se (1944, p. 141), Caplan
afforded him important status stating that he
“developed the fundamentals of ‘crisis
theory’ as a conceptual framework for
preventative psychiatry” (1964, p. 10).
 Yet, it was Caplan who subsequently
identified that the response to a crisis
situation involved the assessment of what
was termed an individual’s “equilibrium” or
“disequilibrium” (1964, p. 38-41).
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Crisis Theory Proper…
“The normal consistency of pattern,
or equilibrium, is maintained by
homeostatic re-equilibrating
mechanisms, so that temporary
deviations from the pattern call into
operation opposing forces which
automatically bring the pattern back
to its previous state.”
Caplan,1964
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Considering Caplan…
 Non-linear focus?

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“If the scale is quite small, e.g., if the
pattern is inspected from minute to
minute, it appears to be in constant
change and movement. But a longer
interval will show that the pattern
continually reverts to a certain mean. If on
the other hand, a much longer interval is
taken, the pattern will be seen to change
to a greater or a lesser degree.”
Caplan, 1964
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Caplan’s Legacy
 Current researchers and theorists have
pointed out that using equilibrium and
homeostasis for describing the
condition of any living being and/or
system is, at best, problematic:
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Caplan’s Legacy
 “Natural systems collect information over time that
is stored and exerts an effect on both their current
and future activity. Therefore, it is impossible in a
natural system to ‘start over again’ or return to a
baseline. Time cannot be reversed, nor can the
inevitable changes that occur over time be
undone.”
Chamberlain (1995)
 “It’s essentially meaningless to talk about a
complex adaptive system being in equilibrium: the
system can never get there. It is always unfolding,
always in transition. In fact, if the system ever
does reach equilibrium, it isn’t stable. It’s dead.”
Waldrop (1992)
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Caplan’s Legacy
 Adaptation and the irreversibility of time are critical
elements -Time is the medium in which we adapt,
that is, we adapt across time, and time changes
both individuals and systems irreversibly.
 ‘You can never go home.’ That is to what ‘home’
once was in the past – ‘home’ changes without
the individual, and the individual changes as
well.
 As concepts, equilibrium and homeostasis provide
a false set, an illusion that an individual or system
returns to a certain level of functioning, perhaps
even a so called ‘baseline.’
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Caplan’s Legacy
 From a systems perspective, von Bertalanffy
squarely addressed both equilibrium and
homeostasis:

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“We may also say that homeostasis is
inappropriate as an explanatory principle for
those human activities which are nonutilitatrian
– i.e., not serving the primary needs of selfpreservation….symbolic rather than biological.”
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Caplan’s Legacy

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“Every living organism is essentially an open
system. It maintains itself in a continuous
inflow and outflow, a building up and breaking
down of components, never being, so long as it
is alive, in a state of chemical and
thermodynamic equilibrium but maintained in a
so-called steady state which is distinct from the
latter.”
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Caplan’s Legacy
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Crisis Theory Proper
– Is it Proper?
 We are left to consider the possibility that
behavioral scientists have mostly got it wrong
theoretically in Crisis Theory – missing the
difference between first and second order change
(Hoffman, 1981, pp. 50-66);
 That clients can never return to baseline,
equilibrium or homeostasis, and a pill will not
“smooth out the personality” (Kramer, 1993)…
 Moreover, It is unlikely that a clinician, talented
though they may be, is able to ‘re-set’ an
individual or a system ‘back’ to a certain point
or ‘room temperature’ via negative feedback.
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Getting back on track…
 So, what may be useful in considering how
individuals and/or living organic systems adapt to the
world around them, ‘good, bad or otherwise,’ as well
as how systems grow and change over time?
 Historically two schools of thought have in
combination, and separately, ‘fit the bill,’ for building
such a model - Cybernetic Theory (Wiener, 1961) and
General Systems Theory (von Bertalanffy, 1968).
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Getting back on track…
 Basic to both is that these theories describe
how systems are able to grow and adapt
through elegantly simple explanations.
 While Cybernetic Theory uses negative and
positive feedback to indicate how systems are
encouraged to ‘do less of one thing, and more
of another;’
 General Systems Theory (hereafter GST)
describes how systems move through
progressively more developed and
differentiated “steady states.”
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Getting back on track…
 Simply put, Cybernetic Theory describes
negative feedback as a mechanism that
focuses on slowing, halting or dampening the
behavior of a system; for instance, a
thermostat – when the room reaches a
certain set point and shuts off.
 Positive feedback, on the other hand,
encourages or promotes more behavior from,
and/or information, to come into the system;
for example a third-base coach in baseball
waving the base runner on toward home
plate.
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Getting back on track…
Negative Feedback & Positive Feedback
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Getting back on track…
 Systems thought, Cybernetics, GST, and other
conceptions, describe individuals and systems as
decreasing or increasing feedback accordingly via the
description of being a closed or an open system, i.e.
closed or open to more information.
 Closed, in that he/she is ‘not listening to what I am
saying,’ open in that he/she ‘hears me, and
understands.’ Take for example our base runner.
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Getting back on track…
Should the runner stop on second base and ignore
the base coaches’ exuberant encouragement to
run home, the runner may be said to be closed to
the information the coach is conveying; while if the
runner accelerates toward home base in response
to the coach the runner is described as open.
 Whether or not a system is open or closed and
exchanges, energy, information or matter with the
external environment is critical (von Bertalanffy,
1968, pp. 158, 161-163) as the ability to do so
defines the individual or system as living – open.

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Getting back on track…
 Both theories complement each other
in emphasizing the limitations
equilibrium and homeostasis face as
explanatory metaphors.
 These theories highlight the fact that
biological systems really never return to
any “set point,” per se; that time moves
on and systems adapt or do not adapt.
 That living systems never truly return to
what they once were - as it is very
difficult to unscramble an egg…
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Integrations, and the Edge…
 There have been models, largely in family
therapy, that do discuss both Cybernetics and
GST, exemplars are:
 Halpern, Canale, Gant and Bellamy, 1979
 Selvini-Palazzoli, Boscolo, Cecchin, and
Prata, 1978
 And though, von Bertalanffy was familiar with
Prigogine’s work (1968), his novel concept of
“far-from-equilibrium,” modified the way
scientists approached this topic (Prigogine
and Stengers, 1984).
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Integrations, and the Edge…
 Still, others in behavioral health entered the fray,
and began to describe the benefits of using the
language of nonlinear dynamics for crisis
practitioners.
 Chamberlain, 1995
 Ramsay, 1997
 Chamberlain was one of the first, and offered the
following:
 “Suicidal behavior may serve as a means of
preventing change (chaos) and maintaining
stability (order)….a suicide threat may also serve
to destabilize a family that is not adequately
responding to change and is somehow ‘stuck’ in
more of the same when a difference is needed.”
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Integrations, and the Edge…
 Chamberlain went on to describe the basic
iterative cycle described in various forms earlier
from different vantage points, that is the
process of individual or systemic
transformation, in stating that (p. 122),
 “…reorganization can occur that establishes
a new order using its own energy. The
system, however, must first interact in some
new way either within itself (between
different elements) or with the environment.”
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Integrations, and the Edge…
 She also supplied a host of novel readers with
some of the fundamental concepts and
language through basic ‘laws’ of the nonlinear
paradigm “generated by our perception of
phenomena, not by the phenomena itself”
(1995, p. 121).
 In a similar vein, Ramsay (1997), provided
language and process descriptions, but he
added a critical element – defining what may
be healthy or unhealthy development…
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Integrations, and the Edge…
 “The loss of equilibrium orderliness in complex systems does
not mean they are governed by randomness; they do have
“upper thresholds of stability that, if transgressed, produce
critical instabilities” (Laszlo, 1985, p. 35). These instabilities
occur when sudden or anticipated events of a minor or major
nature trigger a system to branch or transition toward a new or
different state of equilibrium. The vital instant when a branch or
fork in the evolution of a system occurs is called a bifurcation
and “though causality operates at every instant, the branching
takes place unpredictably” (Briggs & Peat, 1989, p. 145). Over
time, thousands of bifurcation points, some planned, others “out
of the blue,” become critical milestones in the “healthy”
progression or “pathological” regression of a system.”
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Integrations, and the Edge…
 Ramsay makes a critical point, that one of the greatest
advantages to a nonlinear systems description is how
the arrow of time is revealed,
 Or, how directionally a system may “de-evolve,” or in
more familiar behavioral therapeutic language
regress…

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“The greatest advantage of the far-from-equilibrium model
is its capacity to accommodate the directional duality of
devolution (entropy) and evolution (anti entropy) of system
processes. The two directional nature of the model fits
much better than the original equilibrium model with the
commonly described danger and opportunity
characteristics of a crisis.” (Ramsay, 1997, p. 32).
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Hence, the Basics…
Developmental Stage & Adaptation
Life Cycle of Corn
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Hence, the Basics…
 Each stage:
Resembles the previous
 Carries the struggles & successes
of the previous
 Carries with it new behavior & level
of adaptability

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Hence, the Basics…
 Crisis represents developmental
movement of some sort…
Steady State
Progression



Steady State



Developmental
Movement
Regression
Adaptation
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Our approach, nonlinear…
Cybernetics – feedback (-/+)
 GST – progressive steady states
 Nonlinear Dynamics
 Chaos
 Complexity

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Our approach, definitions…

Nonlinear Dynamics:
 An umbrella term for a whole variety of nonlinear
phenomenon such as chaos, complexity, emergence and
fractals to name a few…

Chaos:
 “Originally used by the Greeks to describe the limitless
void, it is now used to describe unpredictable and
apparently random structures.” (Davies, 1989)

Complexity
 “A kind of an abstract phase transition called ‘the edge of
chaos,’ you also find complexity: a class of behaviors in
which the components of the system never quite lock into
place, yet never quite dissolve into turbulence, either.”
(Waldrop, 1992)
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Our approach…
Transformative Crisis Intervention (TCI)
 Always working toward transformation
fully considering the coherence and
energy of the individual or system,
 Honoring the behavioral health and
nonlinear dynamics literature that has
been laid down before, incorporating a
“lessons learned” stance given current
vernacular,
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Our approach…
Transformative Crisis Intervention (TCI)
 And focusing on a growth model,
acknowledging that development may be
represented by a variety of “psychiatricappearing” states, such as an anxiety,
depression, disorientation, and periodic
regressions.
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Transformative Crisis Intervention
Filling Gaps…
There are a number of gaps, and terms that
may be ‘miss-ques’ in the theory that exists on
the overall flow of the growth process.
Terminology
Though von Bertalanffy has made use of
steady states, and describe an adaptive
process by using such terms, in the face of
nonlinear dynamics, a more descriptive term
is required.
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Transformative Crisis Intervention
Terminology


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Dynamic Steady States both honors von
Bertalanffy’s contribution to the field, as well as
describes the ‘dynamic’ nature of a stable state
informed by nonlinear dynamics in a
developmental framework.
Transformative States is also a required
introduction, not explicitly described in earlier
GST, and more fully describes unstable states
with cybernetic properties, bifurcation cascades,
complexity and chaos as transformative
processes.
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Transformative Crisis Intervention
 These terms represent developmental
movement through successive states…
Dynamic Steady State
Progression



Dynamic Steady State



Developmental
Movement
Transformative State
Regression
Adaptation
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Transformative Crisis Intervention
A Constant Striving – No Matter What…
 Another premise here is that whether or not it is
evident, that individuals or systems are constantly
striving to adapt - regardless of whether or not they
are successfully adapting.
 When systems lack either coherence or energy, or
both, they may exist in a phase of development in
which they toil at the edge of complexity without
adequate transformative resources to make use of
complexity, no less, chaos, as a transformative
process.
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Transformative Crisis Intervention
A Constant Striving – No Matter What…
 Resource Structural Maladaptations describes this
process, wherein the system lacks the metabolic
and structural properties that would enable it to
continue on its developmental path .
 Resource Structural Maladaptations may also be
may also be viewed as somewhat dangerous if left
to cycle too long, akin to a kayaker being caught in
what is termed colloquially as a ‘keeper-hole,’ as the
system may begin to run out of energy and call upon
its own structure, physical or psychological, to
maintain it...
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Transformative Crisis Intervention
 Striving, via a Resource Structural Maladaptations
(RSM) may prove to be a risk to a system akin to a
fever left uncontrolled – by the act of attempting to
heal itself, it harms itself.
Dynamic Steady State
Progression




Developmental
Movement



Dynamic Steady State
Transformative State
RSM
Regression
Adaptation
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Add In Nonlinear Dynamics…
INSERT ATTRACTORS THAT CORRESPOND
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Add In Nonlinear Dynamics…
Dynamic Steady State



Transformative State



Developmental
Movement
Progression
Regression
RSM
Adaptation
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Nonlinear Dynamics
Informed Approach...
Two forms of transformation:
Chaos
 Complexity
Inherent problems, coherence and energy…
 Systems may use chaos as a
developmental/transformative process, but
the energy and structural costs are great,
another process that may be used is
complexity when either are not sufficient for
this more costly form of transformation
Bütz, 1997 (pp. 64, 132-142).

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Applied Theory
Case Examples…
 Applying
TCI:
 What are the Crisis Domains?
 What would be important to assess?
 What are the markers of adaptation?
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Nonlinear Dynamics
Informed Approach...
Two general outlines for those
experiencing crisis
 Person struggling w/no supports
and/or actively suffering from a mental
illness who need stabilization & support
 Person has good support system,
interpersonally woven together, who is
experiencing an existential crisis
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Nonlinear Dynamics
Informed Approach...
 Does the client have the internal structure &
external resources to push through the
crisis?
YES
NO

Provide Safety &
Slow Process
Progression



Regression
Adaptation
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
Dynamic Steady State
Developmental
Movement

Encourage &
Support
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Chaos
Complexity
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Coherence
“…tension due to frustration of need rises,
and this in itself involves problems in
maintaining the integrity of the organism
or group and may be associated with
feelings of subjective discomfort or
strain…”
Caplan, 1964
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Coherence
Goldstein, (1994, p. 49) addressing
organizational structure and drawing an
analogy between a Bernard system, also
focuses on the coherence of the system:

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“With regard to self-organization in human
systems, the two aspects of an organization’s or
work group’s boundaries are also necessary: the
boundaries must be firm enough to contain the
process of self-organization yet permeable
enough to allow vital exchange with the
environment.”
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Coherence
Coherence is a fundamental concept in
considering the development or
maintenance of the personality (Bütz, 1997,
pp. 199-202; Proskauer and Bütz, 1998, pp.
197-199).
Call it ego-strength, as in psychodynamic
theory, or coherence (Antonovsky, 1993); it
is an elemental concept – akin to energetic
fabric that holds cosmos together (Greene,
2004).
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Markers of Available Energy
 Considering energy, how is it we are able
to measure this within the individual or
system?
 Don’t reinvent the wheel,
 And, what are well known psychiatric
markers?
 Answer – Anxiety and Depression Of
Course…
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Markers of Available Energy
 Anxiety and depression are not only markers




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of available energy…
They are also developmental markers,
And, tell us where the system has been, and
where the system is at, at this point in time…
Consider Eeyore…
Or, Rabbit…
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Crisis Domains
 As cited by some authors in the crisis field (James
and Gilliland, 2001, pp. 5-6), Brammer (1985, pp.
94-95) introduced three crises domains:
 “There are normal developmental crises, such as
birth or a child going off to school. Situational
crises are associated with severe loss of status,
possessions, or loved ones. Existential crises
refer to the conflicts and anxious feelings
experienced when facing the significant human
issues of identity, purpose, responsibility,
freedom and commitment.” (Brammer and
MacDonald, 1999, p. 103)
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68
Crisis Domains
Existential
Developmental
Beliefs
&
Values
Situational
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Environmental
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69
An Early Matrix to Consider
 Caplan outlined escalation of crisis:
 Phase 1: “Initial rise in tension…” as well
as that persons usual methods of coping
to maintain “homeostasis”
 Phase 2: “Lack of success” leads to “rise
in tension” as well as a sense of
ineffectiveness
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An Early Matrix to Consider
 Caplan outlined escalation of crisis:
 Phase 3: “Further rise in tension” and the
“mobilization of internal and external
resources” using experimenting with new
methods. Active resignation on
“unattainable” goals & new levels of
awareness.
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An Early Matrix to Consider
 Caplan outlined escalation of crisis:
 Phase 4: Problem continues and does not
subside with usual coping skills –
“Breaking point” where “major
disorganization” with “drastic results”
occurs.
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72
An Early Matrix to Consider
 Halpern, et. al., included person-in-
environment:

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Human eco-system
 Internally (“intra-psychic”)
 Individually
 Primary Group (small clusters in society)
 Secondary Group (social/institutional)
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73
Considering the above Matrix…
 Internal structure
(Caplan Matrix; level of organization) &
 External resources
 (Halpern, et. al., Matrix; human ecoEncourage &
system)


Progression



Regression
Adaptation
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
Dynamic Steady State
Developmental
Movement

Support
Provide Safety &
Slow Process
Bütz and Schwinn 2004
Chaos
Complexity
74
Crisis Domains:
Updating the Matrix
Open
Internal
Structure/Resources
External
Structure/Resource
s
High Risk
Moderate Risk
Low Risk
Closed
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75
Principles in Action
 Case Studies
 Open vs. Closed
 Internal Structure?
 External Resources?
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76
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
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References
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
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