Part I

General information for all listeners.

This guide is an unofficial training guide for listeners about chats involving harm. It is not a self-help guide for members. If you are not a listener you can still read this guide, but becoming a listener first is recommended as a starting point.

The guide is in many short sections. Most sections have a quiz at the end. You must correctly complete the quiz before you can move to the next section. There is no limit to the number of times you can retry each quiz.

To navigate back to a section you have completed, use the little square links along the top of each page.

Trigger warning: Part I is intended for all listeners and it has no detailed descriptions of harm. Part II contains more detailed examples and information that some listeners might find upsetting or triggering. It is OK to stop reading at the end of Part I.

Contents

Author: @RarelyCharlie.

Parts of this guide describe good practice in the opinion of the author, but are not necessarily consistent with other guidance at 7 Cups.

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The comic strip characters are Mimi and Eunice
adapted from originals ♡ CC-BY-SA Nina Paley.

What this guide is for

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This guide provides information and guidance for those listeners who are willing to chat with with members who talk about harm.

Harm includes harm in the past and present, and risk of harm in the future. It includes harm to members themselves and to others, also including harm to vulnerable people such as children, and harm that is a criminal offense.

The goals of this guide are to help ensure that, in the context of harm or risk of harm:

There are links to further information and to public resources that you can share with members.

Everywhere this guide uses the word “members”, the information also applies to guests.

The next section is a reminder about the purpose of 7 Cups.

The purpose of 7 Cups

7 Cups exists because there is an unmet need in the world for emotional support:

Our Goal: We are living in a world with an immense love deficit, which means that none of us is receiving the love we need to reach our true potential, to truly thrive. Our goal is to build a support system, a web, that can hold every member of our world. We believe that we can fill that love-gap for every person in the world, either because they are an active member of our community or because they are touched personally by someone who has been empowered by 7 Cups of Tea.

from Our Mission

7 Cups has values that describe how we relate to people. They have since been simplified, but our original values included:

We do not judge or look down on people. We recognize that people make sense in the larger context or story of their lives. Sometimes it can seem like people are making choices that do not make sense, but this is likely because we do not have all of the details. We understand that people are complicated and that life is not simple or easy.

from Our Key Values (archived)

Limitations

However, 7 Cups imposes general limitations on the emotional support its listeners provide. If a member clearly says they are actively harming themselves or someone else, then it is generally felt at 7 Cups that you cannot continue the chat.

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It is important to be aware that the word “actively” means “taking action”. A thought or fantasy is not an action. Planning to take action is not the same as taking action.

For example, someone might have thoughts about making carrot soup. They might clearly imagine the recipe or know exactly where to find it. But these things are not the same as buying the carrots, peeling them and chopping them. There’s an essential difference between thoughts and actions.

Distinguishing thoughts from actions

Some people find the distinction between thoughts and actions obvious, and some people find it difficult. There’s a recognized cognitive impairment called thought-action fusion that makes it difficult for people to distinguish between thoughts and actions easily, and if you suffer from it even slightly you might have to think more carefully than most people when trying to decide whether something is a thought or an action. There’s more about thought-action fusion in a later section.

Outside help

Listeners can sometimes provide members with factual information about sources of help outside 7 Cups, but there are reasons to be careful about doing this. For example, providing information can undermine the real purpose of 7 Cups. There will be more about this, too, later in the guide.

Also later in the guide, there are some reminders about exactly how listeners at 7 Cups go about providing emotional support.

After the quiz, the next section is a reminder about caring for yourself.

Self care

7 Cups very strongly encourages you to care for yourself as a priority at all times.

Boundaries

You should think about your personal boundaries, and make decisions in advance about the kinds of chats you are personally willing to take.

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You have to make these decisions in advance, as far as possible, because a chat that starts out being about one subject can very quickly change to some other subject. You will need to be able to take action to protect yourself immediately there’s a change of subject that goes beyond your personal boundaries.

If you haven’t already done so, take a few minutes right now to list the topics of conversation that lie outside your personal boundaries. You could write the list in your Notes. (The link provided here works for any listener, provided you are logged in to 7 Cups.) Check your list from time to time to remind yourself of it, and also to keep it updated.

It’s also OK to be willing to chat about any topic without restriction. In this case you don’t need any list. But you should still make the decision not to have any list thoughtfully and in advance.

When your boundaries are crossed

When a chat goes beyond your personal boundaries, consider handing it over to another listener who has different boundaries. You need the member’s consent and also the other listener’s consent for this.

  1. Tell the member that you are unable to chat about this subject.
  2. Tell the member that another listener might be available.
  3. If the member agrees, go to the Listener Support Room (the question mark button ? at the top right of the chat).
  4. In five words or less, tell the room why you need to hand over the chat. Do not share more details of the chat.
  5. When you have identified another listener, provide the member with a link to the other listener’s profile. In a chat this looks like 7cups.com/@NameOfListener
  6. Tell the member to press the Leave Message or Chat Now button in the listener’s profile.
  7. End the chat.
  8. Do not discuss the member with the other listener at any time.

If the member does not agree at step 3, tell the member that you have to end the chat, and end the chat.

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If you cannot find any other listener at step 5, ask the member to message a suitable listener from the Browse Listeners page. Provide the link: 7cups.com/BrowseListeners Explain that the page has a More Filters button at the top, which is useful for finding appropriate listeners.

There is normally no need to block the member. They might want to chat with you about some other topic in the future.

At any stage in all this, allow the member to continue the chat and avoid the problematic subject if that’s what they prefer. Some members value the relationship they have established with you more than the precise subject of the conversation.

After a difficult chat

After a chat that oversteps your personal boundaries, consider chatting to a peer supporter or a mentor about your own feelings. This is particularly important if your feelings persist or if you find yourself thinking about the chat long afterwards.

If a chat affects you emotionally, and this in turn affects your real-life relationships or your ability to live your life normally, do not hesitate to switch to your member account and chat with an experienced listener about what happened and how it affected you.

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If you have a therapist or someone else in the real world you rely on for emotional support, be open with them about the effect volunteering as a listener at 7 Cups has on you, but do not share any details of any chat.

After the quiz, the next section is a reminder about active listening.

Brief active listening refresher

This guide assumes you are still familiar with the initial listener training. Here’s a selection of exact quotes as reminders:

If any of these seem unfamiliar, take a few minutes right now to review the Active Listening guide before returning to this guide.

Emotional support

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The way listeners at 7 Cups provide emotional support is through active listening, allowing people to feel heard. Emotional support has a particular focus on feelings. The goal is to allow people to express their feelings and to know that their feelings have been heard.

Realistically, life is not simple or easy. People have both positive and negative emotions in response to the events of their lives. Listeners should allow both the positive emotions and the negative emotions to be heard equally.

In response to situations involving harm, people naturally have negative emotions. Listeners at 7 Cups allow people’s negative emotions to be heard.

Do not try to suppress members’ negative emotions or supply positive emotions. If you do that, you might neutralize a member’s natural negative emotions in response to harm, allowing the harm to continue.

For example, if a member tells you they are worried about causing harm, repeat back the worry they have expressed, just like the listener training says. Do not neutralize the worry or change the subject to something positive—doing that risks giving a “green light” to the harm.

Similarly, if a member tells you they are worried about being harmed, repeat back the worry they have expressed, just like the listener training says. Do not neutralize the worry or change the subject to something positive—doing that risks perpetuating the harm they are suffering.

After the quiz, the next section looks at why members sometimes talk about harm.

Why members talk about harm

Members talk about harm for a variety of reasons. They might be the person causing the harm, or they might be the person harmed, or they might be both.

Part II of this guide looks at examples of several reasons members might talk about harm. They are not necessarily the only reasons, but they illustrate the kinds of situations that members often find themselves in. For the purposes of this guide, the reasons fall into three broad groups.

Mental disorders

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Members who suffer from mental disorders are the first group. Mental disorders are, roughly speaking, disturbances in thinking, emotions and relationships that don’t have an identifiable physical cause. An example is obsessive-compulsive disorder (OCD).

When members with mental disorders talk about harm, the harm might not necessarily be real. This is because mental disorders can cause disturbances in thinking, and in some cases the disturbances are very severe. Members might be unaware that they have a mental disorder, or unaware of its precise effects.

Neurological disorders

Members who suffer from certain neurological disorders are the second group. Neurological disorders are, roughly speaking, disturbances in perception, thinking and relationships that are thought to have a physical cause in the nervous system (which includes the brain). For the purpose of this guide the relevant neurological disorders can be thought of as brain damage.

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When members with neurological disorders talk about harm, the harm might not necessarily be real. This is because neurological disorders can also cause disturbances in thinking, and in some cases the disturbances are very severe. Members might be unaware that they have a neurological disorder, or unaware of its precise effects.

Fantasy and truth

Members who are fantasizing or telling the truth are the third group. Fantasy and truth are grouped together here because in each case the member knows what is true and what is false, but the listener doesn’t. These members do not have any relevant medical disorder affecting their thinking. Some of these members might mix fantasy and truth in the same chat.

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All of this means that no matter what the member’s reason for talking about harm might be, a listener cannot rely on the harm being real. Equally, a listener cannot rely on the harm being false.

In some chats members do talk about real harm or real risk of future harm. In some chats members talk about fears and fantasies. In some chats members are not able to distinguish between what is real, what is fear, and what is a fantasy. And in some chats parts of all three are mixed together.

Your key skill

As a listener, you cannot diagnose any medical disorder. It’s easy to do the right thing: simply do not try to diagnose, and do not imagine that you can.

As a listener, you cannot judge what is real, what is a member’s fear and what is a member’s fantasy. It’s difficult to do the right thing. Your key skill as a listener is accurately reflecting the emotions that a member expresses, without attempting to judge the facts.

After the quiz, the next section looks in detail about thoughts and actions, and why they are sometimes confused.

Thoughts and actions

Thought-action fusion (TAF) is a cognitive impairment (a thinking problem) that affects many people in the population, both members and listeners. It causes thoughts to be confused with reality to some degree or other.

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For example, someone affected by TAF might believe thinking about a car crash before driving to work makes it more likely they will crash the car. Or they might believe mentioning the word cancer could make someone they care about more likely to develop cancer.

Mostly, TAF is mild. When TAF causes significant distress it can easily be treated by a mental health professional.

Members

When members are affected by TAF, it can make them genuinely believe they are causing harm, or at risk of causing harm, when the reality is they only have thoughts about imaginary harm.

In severe cases this is symptomatic of a mental disorder, a form of obsessive-compulsive disorder (OCD). There is more information about OCD in Part II of this guide. Listeners cannot diagnose or treat any mental disorder. Even if a member experiences TAF mildly, a listener cannot try to solve the problem.

When a member describes significant distress because of TAF, a listener cannot give advice or suggest how to solve the problem, but a listener can state a simple fact, like:

Member: This is eating up my whole life. I virtually can’t get in the car because I spend so much time worrying that I’ve killed someone.
Listener: That’s the kind of thing a professional can help with.

Listeners

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When listeners are affected by TAF, it can make them genuinely believe that a member who wants to talk about thoughts of harm is causing real harm, or is at risk of causing real harm.

In more severe cases, a member doesn’t mention harm at all but the listener imagines harm. Then the listener’s TAF makes the imaginary harm seem real. This could make the listener say inappropriate things to the member.

For example:

Member: Since we broke up I’ve been feeling sad. When I was younger I would have harmed myself at times like this.

(The listener imagines the member feeling so sad that she attempts suicide. TAF makes the listener think the member is really at risk of attempting suicide.)

Listener: You should see a counselor and call a suicide helpline.

Do not give members advice in this way, especially when it is based on your own imagination. Instead, repeat back the member’s feelings accurately:

Listener: The breakup has caused you sadness, but it’s not like when you were younger.

If you are aware that you experience TAF to some extent, take particular care to distinguish carefully between your own thoughts and reality that can be verified.

After the quiz, the next section looks at some unintended consequences that can occur when members have memory impairments.

Unintended consequences

If listeners do not stick closely to the techniques described in the initial listener training, they risk unintended consequences for members who have certain memory impairments.

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Memory impairments are universal in the general population. They affect members and listeners. For the purposes of this guide, the significant memory impairments are the ones that affect members.

These memory impairments are often associated with brain injury. For example, a member might have suffered a blow to the head in an accident, causing brain injury. Or the member’s mother might have drunk excessive alcohol while she was pregnant, causing damage to the member’s brain (fetal alcohol syndrome).

Similar effects are also associated with mental disorders that involve psychosis. A member who experiences psychosis may find it difficult to distinguish between reality and imagination, so if you suggest something and they imagine it, they might start to think it’s real.

Suggestibility

Suggestibility causes people to incorporate information that they see or hear into their own thinking. For example, a member has a red car:

Member: I love my car!
Listener: That’s great! Is it a white car?

(At this point the member imagines a white car, because that’s what the listener suggested. Now the member cannot remember what color their car really is, because their memory impairment allows the image of a white car to dominate.)

Member: Yes, I love my white car!

Listeners must not sneak suggestions into chats, because some members are vulnerable to suggestion. Of course, if it’s just the color of a car it’s not very important. If the chat is about some form of harm it can be very important.

Listener: Your car makes you feel good :)

Confabulation

Confabulation causes people to invent information that fills gaps in their memory. People who confabulate may invent different information at different times, making them tell you inconsistent things.

For example, a member who has a memory impairment is distressed because her father is becoming frail in old age:

Member: It makes me so unhappy that he isn’t able do as much for himself as he used to.

(The listener imagines the member is unhappy because she has to do the things her father can’t do.)

Listener: It’s not fair. What ways have you tried to get him to do his share?

(Now the member imagines herself trying to get her father to do his share, even though that’s just the listener’s fantasy.)

Member: I shout at him.

(But this is not true. She feels sorry for him and never shouts at him. The listener’s leading question, combined with her memory impairment, caused her to confabulate.)

Remember to reflect the things members tell you accurately:

Listener: You’re sad because he can’t do things for himself so much now.

Avoiding unintended consequences

To avoid unintended consequences, be very careful not to introduce new ideas from your own imagination into member’s chats. This is particularly important when there is possible harm, or risk of harm.

After the quiz, the next section looks at three categories of mental disorder that can be associated with chats about harm.

Mental disorders and harm—I

This section and the next look at six categories of mental disorder that can be associated with chats about harm. This is just an overview. There are further examples in Part II because the details might be upsetting or triggering to some listeners. First, depression, OCD and PTSD.

Depression

Depression is a very common emotional disorder. It affects how people feel about themselves and about life, making them unable to imagine the future in a positive and hopeful way. In a severe case, a depressed person might not be able to imagine tomorrow.

When depression is associated with harm, it’s usually about the depressed person causing real or imaginary harm to themselves. They come to 7 Cups and talk about the harm they have caused or feel they might cause.

Do not let your imagination make you think a member is at risk of harming themselves when in reality they have a disorder that makes it difficult for them to imagine the future, and they want their feelings to be heard.

OCD

OCD is obsessive-compulsive disorder. It is usually considered to be a thought disorder. It affects how people think about certain risks, different risks for each OCD sufferer. In a typical case, a person has uncontrollable thoughts (obsessions) about some risk, combined with thought-action fusion (TAF, described in a previous section of this guide).

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The thought disorder makes them confuse thoughts about risk with real risk. So they behave in ways (compulsions) that they think will reduce the risk and keep them safe. But although the behaviors do reduce real risk, they have no effect on the obsessive thoughts, and a cycle of thoughts and compulsions is the result.

When OCD is associated with harm, it’s usually because the OCD sufferer has thoughts about some risk of harm to themselves or others. The thought disorder makes them confuse thoughts about risk with real risk. They come to 7 Cups and talk about what they consider to be real risks of harm.

Do not let your imagination make you think a member is at risk of causing harm when in reality they have a disorder that makes them compulsively avoid causing harm, and they need their feelings about it to be heard.

PTSD

Post-traumatic stress disorder, PTSD, is a disorder affecting perceptions, thoughts and feelings. It is the result of actual harm (trauma) in the past. The name means “disorder that happens after traumatic stress”.

There might be continuing risk of real harm in the present and the future, and there might be continuing fears about possible harm in the present and the future whether or not there is real risk.

PTSD sufferers can experience a very wide range of symptoms and difficulties, especially if the PTSD is the result of multiple traumas or a persistent period of trauma.

Not all PTSD sufferers are aware that they suffer from PTSD, and the diagnosis sometimes emerges during therapy for some other condition, such as depression or OCD. However, not all people who experience events that seem like they might be traumatic ever develop PTSD at all.

Do not make assumptions about whether or not a member has PTSD, and do not either reinforce or challenge a member’s own thoughts about whether or not they have PTSD. Listeners should not get involved in diagnosis.

In all cases when a member might have a mental disorder, you cannot be sure whether they have a disorder or not, and if they do have a disorder you cannot be sure what it is. Ensure that you accurately reflect members’ feelings without judging them, either positively or negatively, and without diagnosing.

After the quiz, the next section looks at three more categories of mental disorder that can be associated with chats about harm.

Mental disorders and harm—II

This section continues the previous section, looking at three more types of mental disorder that can be associated with chats about harm: psychosis, personality disorders, and paraphilic disorder.

Psychosis

Psychosis is a disorder in the way people keep track of reality. It makes telling the difference between reality and imagination more difficult, or in severe cases impossible. Many of us have had the experience of waking from a dream and not being sure, for a moment, whether we are awake or this is still the dream. Psychosis is like that but all the time, or all the time on and off. And very often the dream is a nightmare.

When psychosis is associated with harm, it’s usually because the psychosis sufferer imagines doing harm or being harmed but genuinely thinks it’s real, or isn’t sure. The harm might be in the past, present or future.

People who suffer from psychosis might come to 7 Cups to talk about the harm they have caused or might cause. It’s sometimes because they feel guilt, or fear criminal liability, and sometimes because they are trying to work out whether the harm in their thoughts is real.

Do not let your imagination make you think a member is doing harm or is being harmed, when in reality they have a disorder that makes them unsure what’s real, and they want their fears to be heard.

At the same time, people who suffer from psychosis sometimes do cause harm, or are harmed by others. Sometimes what they fear is real. At 7 Cups what we provide is for their fears to be heard, whether real or not.

Personality disorders

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Personality disorders are effectively disorders of relationships. People who suffer from these disorders think and behave in unusual and ineffective or harmful ways towards other people. There is a wide range of personality disorders, and although current classifications do group them in categories, there isn’t complete agreement on whether the categories are all that useful.

When personality disorders are associated with harm, it might be because the sufferer causes harm to others without being fully aware of how harmful it is. Or it might be because the sufferer causes harm to themselves. Or it might be because other people cause harm to the sufferer in retaliation for the way the sufferer treats them.

Harm described by people with personality disorders might often be real, but as a listener you have no way to be sure. As usual, ensure that members’ feelings are heard and that you reflect them accurately without adding thoughts of your own.

Paraphilic disorder

Paraphilic disorder is a disorder of sexuality. It affects sexual fantasies, urges or behaviors (but not necessarily all three in the same person). When paraphilic disorder is mild, and the sufferer is able to live a normal life, it is known as paraphilia (not a mental disorder). When paraphilia involves children as the target, it is known as pedophilia.

When these disorders do affect behaviors they are often associated with criminal acts. However, the association between paraphilia and criminality is not all that strong. For example, most people convicted of sexual crimes do not suffer from this kind of disorder (although they might or might not suffer from other disorders).

When paraphilic disorder is associated with harm, it might be fantasy or actual harm. Listeners are unable to judge what is fantasy and what is actual harm.

People with paraphilic disorder might come to 7 Cups to talk about their fantasies, urges or behaviors. Listeners cannot make the judgment that fantasies and urges will result in behaviors.

Many listeners choose not to take chats that deal with sexual fantasies, urges or behaviors. If you do choose to take these chats, avoid positive judgments and also avoid negative judgments. Ensure that members who express their emotions are heard, and that their emotions are accurately reflected.

Remember that in all cases when a member might have a mental disorder, you cannot be sure whether they have a disorder or not, and if they do have a disorder you cannot be sure what it is. Ensure that you accurately reflect members’ feelings without judging them, either positively or negatively, and without diagnosing.

After the quiz, the next section looks at chats based on fantasy, and chats about actual harm.

Fantasies and actual harm

Members sometimes describe harmful events that might be fantasies or truth, or some mixture of fantasies and truth. Listeners are usually unable to judge what is the truth and what isn’t.

Sometimes, however, very outrageous fantasies are obviously fantasies. Sometimes fantasies are based on well-known works of fiction, such as movies and TV shows, and these might sometimes be obvious to listeners.

Reasons for sharing fantasies

Members’ reasons for sharing fantasies are not usually clear. One reason might sometimes be loneliness and lack of self-worth, because they feel a fantasy about harm is sure to get attention but if they are just themselves no one would want to chat to them.

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Sometimes fantasies contain elements of truth. The situation might be that a member feels the truth difficult to talk about, so they talk about a fantasy first, and then mix in parts of the thing they really want to talk about. So at the start the chat can feel very uncomfortable because you feel you’re just being told a fantasy, but if you stay with it sometimes you end up in a very real chat about something the member finds difficult.

Another reason members sometimes chat about fantasies of harm is as a deliberate hoax, maybe to overcome feelings of inferiority.

And another reason is to test 7 Cups to see whether they are believed and accepted when they mention something shocking like harm. If 7 Cups passes the test, and they are believed and accepted, then they might return using a different identity to chat about what’s really troubling them.

Reasons for sharing the truth

Members who are really causing harm, or at risk of causing harm, might chat to a listener about it hoping to get advice on how bad it really is and how guilty they should feel.

You don’t have any way to distinguish between the member who is telling a lie to test how judgmental 7 Cups is, and the member who is telling the truth to find out how guilty they should feel. Your only option, therefore, is to believe and accept the person without giving the “green light” to possible harmful behavior.

Members who are really causing harm, or at risk of causing harm, are very likely not to admit to it at all. They chat about something else entirely. Do not change the subject of any chat to satisfy your curiosity about whether a member might be causing harm but not telling you.

After the quiz, the next section looks at resources you can provide to members.

External resources

It is sometimes appropriate to provide a member with a link to a resource outside 7 Cups.

The best way for this to happen is if they can search the Internet themselves for a helpline or website that is local to them and specific to their needs. There are thousands of services globally, and no central directory other than Internet search.

Listeners at 7 Cups are not required to provide Internet search services to members, no matter what the circumstances are.

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Do not provide any external resource link to a member unless they have clearly indicated their need for it. In particular, do not provide a resource link based on something you yourself said to the member earlier in the chat, or something in your imagination.

Members who have known medical conditions often have their own information about local resources they can access. Do not provide international or national resources to members who have access to more appropriate local services.

Helpline numbers found on the Internet are often out of date or operate restricted hours. Finding a helpline number does not mean the member can get help there.

While a member contacts an external resource, offer to keep the chat open, if possible. Offer to chat again later to provide emotional support (but not to chat about a topic that lies outside your boundaries).

Do not contact external resources yourself on behalf of a member.

Countries

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People from all over the world use 7 Cups. The top three countries in terms of visitors per month are the US, India and the UK. About 40% of visitors are from other countries.

Before you provide a national resource link, ask the member what country they are in. Ask carefully, because this question might make a member suspicious you are trying to trace them.

Do not give a member a resource link in the wrong country. In particular, do not provide a resource link in your own country to a member who might be in some other country.

National resources

Immediate risk of death or serious injury (local emergency services)

Suicidal thoughts

Mental health helplines

International resources

Suicide helplines directory

Children’s helplines directory

Mandatory reporting

Some organizations and some legal jurisdictions require certain people to report certain crimes to the authorities if they come across evidence or have suspicion of them.

7 Cups does not have any mandatory reporting.

In theory, your local laws might make reporting mandatory in some situations, but 7 Cups is not aware of any legal jurisdiction that has mandatory reporting for 7 Cups listeners.

If you think your local laws do make reporting mandatory, check with a local lawyer or legal advice service to establish whether it applies to listening at 7 Cups. Note that at 7 Cups you have no information about who any member is or where on the planet they are.

If you are a member of a professional body, the body might have a mandatory reporting requirement. Check with the body’s legal department whether the requirement applies when you are a volunteer at 7 Cups, not working in any professional capacity, and not in contact with identifiable individuals.

If you can establish beyond doubt, based on written evidence, that you are subject to a mandatory reporting requirement, tell 7 Cups by e-mail, from the address you used to sign up as a listener, to community@7cups.com.

After the quiz, the next section contains a checklist of do’s and dont’s.

Do’s, dont’s and issues

Here is a checklist of seven things to do and seven things not to do:

Do’s

Dont’s

Issues

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This guide attempts to give clear and consistent guidance about matters that are not always clearly or consistently explained elsewhere at 7 Cups.

Other guidance and advice to listeners may sometimes conflict with this guide, and with each other. In particular, the following issues are not universally agreed:

That’s the end of Part I of this guide. After the quiz, there is an introduction to Part II.

Part II

Examples

Trigger warning: This section of the guide describes fictional scenarios that may possibly involve harm. Some listeners might find some of these scenarios upsetting or triggering.

If you are aware that you might be upset by some of the subject matter here, proceed with caution.

To skip to the end of the guide, where there are some links to further reading, click here: Skip to Conclusion

This limited selection of scenarios is intended to illustrate some of the very wide range of circumstances in which chats can involve harm. Although many of their titles are also medical diagnoses, this does not imply that listeners can diagnose.

Depression

A member is chatting about motherhood:

Member: I really can’t do this. There’s something wrong. I just know I’m going to end up harming my baby.
Listener: You have a definite feeling you’re going to harm your baby.
Member: Yes.
Listener: In what way do you feel your baby might be harmed?
Member: I don’t know. I’m just so worried all the time that she’ll come to harm and it will be my fault.
Listener: There’s nothing specific that you think might happen to her, but you have this constant worry.
Member: Constant worry, yes.
  (long pause)
Member: My doctor says everyone feels this way.
Listener: It’s like your doctor doesn’t take your worry very seriously.
Member: Yeah. He’s a good doctor but idk.

Postnatal depression often affects mothers of young babies. Listeners cannot diagnose or try to solve the problem.

In this chat the member reports thoughts about the baby coming to harm, but does not report any actions that could harm the baby. A doctor is aware of the situation, and there’s no indication he’s concerned.

The listener doesn’t confuse thoughts with actions, doesn’t start imagining things, and accurately reflects what the member says. This is just a normal chat where a member shares her feelings and a listener listens.

Further information

You can find out more about postnatal depression by watching this video, made for World Mental Health Day 2016 (5 minutes):

Somebody was finally understanding me.

Listeners at 7 Cups are here to understand.

OCD

A member is chatting about her anxiety:

Member: There’s no help for people like me. I just can’t control my thoughts when I’m around young boys. I’m only telling you because I know this can’t be traced.
Listener: Yes, it’s safe to tell us anything here. What kind of thoughts do you find yourself needing to control?
Member: Well, sexual thoughts. The irony is, because I’m a woman everyone trusts me. I have to be so careful not to get into in a situation where I might do something.
Listener It’s a constant worry that you might do something sexual.
Member: Yes.
Listener: Because you have sexual thoughts that you might not be able to control.
Member: I can’t control them. Believe me, I try.

Harm OCD, and specifically pedophile-themed OCD, are types of obsessive-compulsive disorder in which people fear causing harm and suffer from obsessive thoughts about it. Because of their obsessions, they compulsively avoid any possibility of causing harm. Listeners cannot diagnose or try to solve the problem.

In this chat the member reports thoughts about harm but not actions. The listener doesn’t confuse thoughts with actions, doesn’t start imagining things, and accurately reflects what the member says, for the most part.

The listener makes one small slip at the end by saying “might not” when the member already said she “can’t” control her thoughts. This makes the member think the listener is trying to play down the seriousness of her problem, so she corrects the listener.

This is just a normal chat where a member shares her feelings and a listener listens.

For some people in developed countries there is, in fact, help for people like this member, but listeners do not try to solve members’ problems.

Further information

You can read more about OCD in this article from the journal Advances in Psychiatric Treatment: Cognitive–behavioural therapy for obsessive–compulsive disorder.

The most common obsessions concern:

The article includes a case study about a woman (Ella, page 442) who has obsessive thoughts about being a pedophile.

Note that the paper is written for professionals and is included here only for information. Listeners must not try to provide psychotherapy.

PTSD

A member is chatting about “relationship stress”:

Member: I can’t bring myself to talk to her about it.
Listener: Something within you prevents you telling her.
Member: Yeah. It’s like I don’t trust her
  But that’s not right. I do trust her. I just have this feeling that I shouldn’t trust her.
Listener: You trust her really, but you have this feeling you shouldn’t.
Member: Yeah. I trust her really.
Listener: But you still can’t talk to her.
Member: No.
  Story of my life, really.
Listener: It’s always been like this?
Member: Pretty much ever since I can remember, yes.
Listener: That feeling of not being able to trust goes way back.
Member: I suppose.
Listener: How did it affect you back then?
Member: I don’t like to think about it, really.
  I don’t like to remember stuff.
  A lot of things were done to me but it was long ago and I don’t want to dredge all that up.
Listener: Things people did to you in your past that you prefer not to remember.
Member: Yeah.

Many people struggle with present-day difficulties because of harm they suffered in the past, and an inability to trust is just one of many common symptoms of past trauma. Listeners cannot diagnose PTSD or try to solve the problem.

In this chat the member hints at being harmed in the past, but there’s no indication that anyone is being harmed right now. The listener avoids imagining things and accurately reflects what the member says.

Towards the end the listener asks an open question inviting the member to talk about past events, but the member backs off, and again the listener accurately reflects that.

This is just a normal chat where a member shares his feelings and a listener listens.

Further information

Here’s a complex paper for professionals that discusses PTSD and Borderline Personality Disorder in terms of human attachment. It is included here only for information: Post-traumatic stress disorder and attachment

The paper includes some case vignettes, and here is one of them (page 174):

A Kurdish woman from Turkey with a diagnosis of complex PTSD presented to us with her small son, who had been referred to social services for failure to thrive. The mother had been severely beaten by the child’s father and, unfortunately for this little boy, when he became distressed, his eyes resembled those of his father. This triggered in his mother a reliving of her past experience of domestic violence, with all the anger and fear that this involved, rather than the comforting maternal behaviour the child needed.

People who have suffered trauma often need to talk about anger, fear and harm.

If we understand PTSD as resulting from the disruption of the attachment system, we can also understand why the lack of social support is the most important risk factor for this disorder.

Listeners must not try to provide psychotherapy, but listeners can provide vital social support.

Psychosis

A man is chatting about loneliness:

Member: I stay away from people mostly, in case things happen.
Listener: What things might happen?
Member: Well, I never know. I’m basically bad and it’s best to be on the safe side.
Listener: You can’t tell what might happen, because you’re a bad person, and you don’t want to take the risk.
  (long pause)
Member: I think I killed someone on Sunday at around 4 a.m.
Listener: You think you killed someone?
Member: Yes, it was in the paper.
Listener: The paper said you killed someone.
Member: No, the murder was in the paper. I don’t really remember doing it, but I’m pretty sure I must have pushed her in.
  In the canal.
Listener: You’re pretty sure you murdered her by pushing her into the canal.
Member: I’ve been sort of numb ever since I realized I must have done it.
  You’re the only person I’ve told.
  Will you report me to the police?
Listener: At 7 Cups we can’t report anyone.
Member: I could report it myself but the police they never believe me.
Listener: They didn’t believe you before.
Member: No.
  I’ve confessed to three murders. One last year, one in 2013 and one in 2011.
Listener: You don’t think they’ll believe you this time either.
Member: No.
  I should never have gone to the canal. I don’t know why I did it.
Listener: You don’t know why you went to the canal?
Member: I used to go there with my dad.
  He was a good man, my dad.

Psychosis is a symptom of various mental disorders that cause people difficulty telling the difference between imagination and reality at times. Sufferers might be completely normal between episodes, or they might have difficulties all the time. Stories in newspapers and on TV can trigger fantasies that then start to seem real, especially if there is a strong emotional aspect to the story, like fear or guilt.

In this chat the member feels he is guilty of four murders but the police never believe him. The listener avoids imagining things and accurately reflects what the member says. The chat soon moves on to reminiscences about the member’s dad.

A psychotherapist might wonder whether the member’s feeling that he is a bad man and his dad was a good man is significant in some way, but listeners are not psychotherapists and should only listen.

Further information

A person who suffers from schizophrenia wrote an article about confusion between thoughts and actions: Thought-Action-Fusion

During my episodes there were quirks and involuntary movements I was experiencing and disliked that I believed were a direct result of my thoughts. Sometimes I moved into people when I had no desire to move into them at all. I strove to filter and control every single thought I had and became extremely paranoid if I began thinking anything unscrupulous for fear it would become an action. It was odd I had an irrational fear of unscrupulous actions because I never made any major mistakes at any point before or during my episodes which could incriminate me on any level or cause me or anyone else any harm but this is just an example of how people with mental illness can develop extremely irrational thoughts because of fear.

Members who suffer from this degree of confusion can be difficult to relate to, but active listening allows them to process their thoughts and emotions in a supportive chat with a listener who is not trying to solve their problem for them.

Personality disorder

Wednesday, 7 p.m.

A member has been chatting about her eating disorder:

Member: So, I have all the pills here now.
  My little collection.
Listener: You have your collection of pills with you right now.
Member: Yeah. Last time I took too many and they all came up.
  So that’s a mistake to avoid.
  I don’t plan on waking up this time.
Listener: You hope to die this time?
Member: Yeah. Sure do.
  That’s twelve I’ve popped out. Do you think that’s enough?
Listener: I am not allowed to continue this chat.
  Do you have the number of a local suicide helpline?
Member: Befrienders crap? Haha!
Listener: If you tell me what country you’re in I can look up the number for you.
Member: Like I’m going to tell you where I am. You must be mad.
Listener: Or you can go to 7cups.com/crisis and look it up.
Member: 24 seems about right.
Listener: I have to end this chat now.
  Ends the chat
  Select a Conversation.

Thursday, 9 p.m.

The member is online again:

Listener: Hi! We chatted yesterday. How are things?
  This user is unavailable to chat with you, please select another.
  (Conversation blocked)

Listeners cannot diagnose, and it’s impossible to tell whether any member really has a personality disorder or not. Some members do communicate in ways that seem to prevent any effective human contact with listeners, and it’s possible that some of those members are suffering from severe personality disorders.

In this chat the member describes counting out pills, which is an action and not just a thought. She says she doesn’t plan on waking up and she has made a previous attempt. She says these things herself—they are not the listener’s imagination or the result of the listener’s suggestions.

This member is actively suicidal—taking action right now to end her life. 7 Cups does not allow listeners to continue chats in these circumstances.

In the second chat the listener learns that the member is apparently still alive, and still unable to communicate effectively, but it is not possible to know what happened the day before.

Further information

In this short video (less than 5 minutes) a professor of psychology at Toronto University, who is also a very experienced psychotherapist, talks about how to help difficult people:

If you’re offering something and it’s not taken, then perhaps you should be offering it somewhere else. And sometimes, if you offer a hand and the person won’t take it you have to stop offering the hand.

There are limits to what active listening can achieve.

Paraphilia

A member has been chatting about stress at work:

Member: Living on my own doesn’t help.
Listener: Loneliness adds to the stress.
Member: Yes, the office is my only contact with people. My only real contact. As opposed to imaginary contact.
Listener: You imagine contact with people.
Member: Yes, it’s all I can do, in fact.
Listener: Really? How come imagining is all you can do?
Member: Well.
  I’m on a register.
  Of sex offenders.
Listener: Oh I see. You committed a sex crime.
Member: I didn’t do any harm. I would never cause harm.
Listener: How come you were convicted, then?
Member: It’s just that I was seen. In the wrong place at the wrong time. Now people assume I’m a threat. I’m not bitter about that. I can understand it. But I’m just not a threat. Never have been.
Listener: People don’t understand you the way you understand yourself.
Member: No.
  People will never understand. But I can still imagine.
Listener: What do you imagine?
Member: I imagine being close to little girls. Playing. Telling stories. Being trusted. Being hugged. Things like that. It turns me on just imagining.
Listener: You imagine being loved.
Member: You could put it like that, yes.

The clinical term for inappropriate sexual arousal is paraphilia, and when children are the target the term is pedophilia. Paraphilia and pedophilia are not mental disorders unless they significantly interfere with normal life. Some people who experience paraphilia or pedophilia commit crimes as a result, and some don’t. Most people who commit sex crimes do not experience these conditions.

In popular journalism, including popular psychology websites, the term pedophile is often used loosely to to include people who commit sex crimes together with people who only have sexual thoughts, as if they are a single group. Medical professionals, however, are clear that they are two distinct but overlapping groups.

It has not been possible to estimate the numbers of people in each group, partly because stigma prevents people who experience paraphilia from admitting it, and partly because people who commit sex crimes often lie about their motivation.

In this chat the member describes his pedophilia, which he considers harmless even though he has been convicted of a crime. The listener reflects what the member says accurately, asks questions to understand the member’s situation better, and achieves a degree of trust from the member, allowing him to open up about his feelings. The listener avoids making either positive or negative judgments.

Further information

For some more thoughts about these highly controversial issues, here’s an article that discusses the latest edition of the official classification (in the US) of mental disorders, the DSM-5. The article is only an opinion piece, but it’s an informed opinion: Of Kinks, Crimes, and Kinds

Drunkenness was once understood simply to be a sin. Then it became a crime. Then a medical problem… A drinking problem can, after all, lead to real harm to oneself and to others. The very reason recovering alcoholics embrace the identity is because they recognize alcoholism as a serious disorder. It might make a lot of sense to think of sexual interests like pedophilia as being akin to alcoholism.

Domestic abuse

A member is chatting about relationship stress:

Member: It’s difficult, you know, to have a good relationship when I only see them once a fortnight.
Listener: Once a fortnight is not often enough to have a good relationship.
Member: I get very anxious when that time comes round, and it’s difficult to control my drinking.
Listener: You turn to drink when you’re anxious.
Member: Yes, my case worker says that’s what the drinking is all about. I need it to be able to cope.
  And now the girls tell me their mum is pregnant by her new boyfriend.
  So she won’t come near me because she says she’s afraid for the baby.
Listener: Do you feel you might harm the baby?
Member: Well, of course I wouldn’t harm the baby. I mean, what happened before was a one off. That could never happen again.
Listener: What did happen before?
Member: They said I tried to strangle her. But that was just
  It didn’t happen like that. She just wouldn’t shut up.
  It was a very stressful time for me back then.
Listener: You were very stressed at the time, and it could never happen again now.
Member: Yeah. Definitely not.

This situation contains several risk factors for domestic abuse, but listeners cannot carry out a risk assessment or try to solve the problem, and there is nothing to indicate actual harm happening right now. The best outcome is that the member gets effective emotional support allowing him to reduce his stress. This is exactly what listeners can provide.

In this chat the member seems to feel comfortable providing information to the listener, and the listener avoids making either positive or negative judgments.

Further information

Here’s a summary of risk factors for domestic abuse, on a UK charity website: Identifying Risk Indicators

The indicators…are research based and are known to be indicative of increased risk to the victim. They in themselves are not a measure of the likelihood of, or indeed the type of, violence that may be carried out.

Listeners must not think that reading a list on a website makes them trained to assess potentially harmful situations. Listeners must always beware of making positive judgments, which could be mistaken as a “green light” for harmful behaviors. And listeners must always beware of making negative judgments, which could prevent a member from getting effective emotional support.

Conclusion

You have now completed the guide.

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References

Here are some links to further reading. Most of these links appear in the guide and are repeated here for convenience. A few additional links are not in the guide. Some of this material was originally intended for professionals.