Tag: ptsd

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A recent series of tragic deaths has underscored how traumatic events can claim lives years after the fact. Three people affected by mass shootings—the father of a girl killed in the Sandy Hook Elementary School shooting in December 2012 and two students who survived the Marjory Stoneman Douglas High School shooting in February 2018—have died of apparent suicides.
In the wake of these incomprehensible losses, it’s clearer than ever that trauma can lead to years-long suffering. If somebody you love has survived a traumatic event, be it public (like a natural disaster or terrorist attack) or private (such as a sexual assault), you may not be sure how best to be there for them on this journey. While survivors can have very different responses to trauma, interpersonal support is one of the core pieces of recovery, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).
Here, several trauma counselors and one trauma survivor explain how to help a friend or family member who has been through something horrible. Exactly what they need from you will depend on your relationship and evolve throughout their recovery, but the suggestions below are a good place to start.

1. Validate their trauma.
“Acknowledge that what has happened to them is terrible,” Daniel A. Nelson, M.D., advisory board member of the USC National Center for School Crisis and Bereavement (NCSCB) and medical director of the Child Psychiatry Unit at Cincinnati Children’s Hospital Medical Center, tells SELF.
You can do this by saying something like, “This is a truly horrible thing that has happened. I can see you’re in an incredible amount of pain.”

It might feel like you’re saying something obvious, but this affirmation can be reassuring. “It’s about articulating that you see they are in pain and that you are OK with holding that pain,” Katherine Marshall Woods, Psy.D., a Washington, D.C.-based psychotherapist in private practice and adjunct professor of clinical psychology at George Washington University, tells SELF.
This was helpful for Manya C., 53, who was sitting in the bleachers across the street from where the first of two bombs exploded at the Boston Marathon in 2013. She appreciated when people confirmed that it really was a devastating event. “Just letting me know that they [understood] that … was validating,” Manya, who advocates for and speaks about those who are psychologically impacted by trauma, tells SELF.
2. Listen.
You might feel a natural urge to fill the silence when you want to help but don’t know what to say, says Dr. Nelson, who has counseled survivors of traumatic events including the Oklahoma City bombing of 1995, the September 11 terror attacks, and the Marjory Stoneman Douglas High School shooting. This typically comes out of wanting to “fix” the situation, Dr. Nelson says.

But you can’t “fix” someone’s trauma, especially not by talking non-stop. It’s better to be present as they work through their feelings. “It’s really hard to mess up if you’re just intent on listening,” Dr. Nelson says.
Manya remembers breaking down sobbing, seemingly out of nowhere, while at dinner with a friend a few weeks after the bombing. Her friend remained calm and stayed with her until she was done crying before asking Manya where her tears were coming from. “She didn’t tell me, ‘Don’t cry,’ or offer me advice. She just listened and was present,” Manya recalls.

3. Admit that you don’t understand.
Survivors are often reluctant to open up because they’re afraid a loved one will not have the emotional capacity to understand, says Marshall Woods, who has counseled active military personnel and their families in the Middle East and natural disaster survivors through the American Red Cross. Unless you’ve been through a very similar trauma, you don’t get it. And that’s fine. What matters most is that you’ll be there anyway.
Say something like, “I cannot begin to imagine what you’re going through right now, but I am here for you whenever you are having a hard time.” This kind of statement acknowledges the reality—that you don’t understand—while reinforcing your willingness to be there. “It’s a piece of security that can really help them feel safe,” Marshall Woods says.

Manya remembers how helpful it was when a friend expressed this. “Hearing her honestly say, ‘I don’t know what to do to help you, but I’m here’ was huge for me,” Manya says. “I didn’t know what I needed either. But I knew she was there to listen, and that started a really great conversation.”

4. Accept if they don’t want to talk.
It’s not unusual for survivors to prefer not to talk about their feelings, even with some of the people closest to them. Discussing trauma with someone who doesn’t understand can be draining. “There are things I don’t have to say to a survivor, for example, because they get it—things I would have to explain to a friend,” Manya explains.

While it’s OK (and encouraged) to ask if your loved one feels like speaking, respect that they may not want to, Dr. Nelson says. Part of being a good support system is being there for them regardless of how much they will or won’t share.
If your loved one is still navigating how much they’re comfortable sharing, Marshall Woods recommends figuring out a verbal or non-verbal cue they can give you to back off when they need space, no questions asked.

5. Keep checking in.
Survivors often get a lot of support immediately after the traumatic event, but attention from the media, the public, and loved ones tends to dwindle soon after. “It feels like other people have gone on living their lives normally as if the trauma has not even happened, when it’s still very much alive for them,” Marshall Woods explains.

Let the person you love know that you’re still continuing to think of them by checking in accordingly. “Knowing that someone has their eyes on them can be a real source of support and security,” Marshall Woods says. She also suggests offering to sit in silence with the person if they don’t feel like talking but don’t want to be alone.
Manya’s family members called her every day for longer than she expected after the attack. The conversations weren’t long, but the constant reminder of their presence and concern was comforting. “It meant a lot to me just to get those calls,” she says.

6. Offer to help limit news coverage.
If your loved one has been through a highly publicized trauma, such as a mass shooting, the early deluge of media coverage may continually retraumatize them. If you think they’re having this problem, you can ask if they want help limiting their media exposure. You can do this by changing their news alerts and muting certain hashtags or words on Twitter, for instance. This helps some people feel safer throughout the recovery process, Marshall Woods says.
But it’s possible your friend may want to stay up with the news coverage because it helps them feel less alone. “They [may be] grateful that people are taking notice of the pain they’re experiencing and that people are grieving with them,” Marshall Woods explains. So, even if your friend is visibly upset by news stories about what happened, keep in mind that this may be a part of their healing process.

7. Avoid clichés.
Looking for a silver lining can be great in many situations. The aftermath of a trauma usually isn’t one of them. “When someone is feeling this pain, you need to meet them there,” Marshall Woods says. “You want them to feel better now, but that is not the reality of where they are.”

Urging your friend to be optimistic or not “dwell” on the tragedy communicates that you’re not accepting how they’re feeling. What you mean as an expression of hope (“Things will get better!”) can come off as a dismissal of their suffering and make them feel misunderstood. “Usually when the individual hears something like that, they think ‘You’re trying to fix me, and you don’t know the first thing about what’s wrong,’” Dr. Nelson explains.

8. Help them find mental health support.
If you’re concerned for your loved one’s well-being—like if they are struggling to eat, get out of bed, go to work, or otherwise function months after the event—you can offer to help connect them with some professional resources like a therapist or support group, Dr. Nelson says. (Even if they are currently receiving mental health treatment, if it doesn’t seem effective, you may be able to help them find a better option.)
This is also a good idea if you begin to feel overwhelmed with the level of support they need from you. “Sometimes it’s really hard to hear these stories,” Dr. Nelson says, “and it’s important to have the proper tools to metabolize it.” Friends and family of survivors can even experience secondary trauma, according to SAMHSA. It’s OK to be mindful of your limits and communicate those needs in a compassionate way.
In that situation, Dr. Nelson suggests saying something like, “What you’re telling me sounds like it really deserves the appropriate level of support, and it may be more than I know what to do with. I would love to know you’re with somebody who really knows what they’re doing. Can we hit pause and work on finding you that help?”

9. Be patient.
The aftermath of trauma is complex, evolving, and inscrutable at times—not just to outsiders, but also to the people who are in it. “Trauma generally is an experience of something that is so chaotic that our brains really struggle to … make meaning out of what has happened,” Marshall Woods explains.

Be prepared for emotions to be intense and fluctuating, Dr. Nelson says. Also keep in mind that your loved one may struggle to understand why they are feeling the way they are, or to even know what it is they’re feeling. This was Manya’s experience in the first few months after the bombing, before she was diagnosed with post-traumatic stress disorder. “At the time, ‘I was thinking I should be better, I shouldn’t feel like this,’” she says.
You can’t speed up the recovery process for your loved one, but you can remain a steady, patient, and adaptable source of love throughout. “It can be a rollercoaster,” says Manya. “But people should understand it’s normal to feel this way and that they can heal.”