Morgan Noll
February 10, 2020 1:35 pm
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Trigger warning: This story discusses trauma, PTSD, and suicide.

You probably recognize this sentiment from countless maid-of-honor speeches or long-captioned-appreciation posts: Friendships are a combination of highs and lows. That’s because any strong friendship, especially the long-lasting ones, experience hard times just as much the good times. And as much as some of us wish our friendships could be reserved for just celebrating the everyday joys, it’s great to have a friend who helps us navigate traumatic experiences.

Over time, most people learn how to support their friends when they’re going through everyday issues, like dealing with a breakup or navigating job troubles. But when a friend is dealing with a serious trauma, the same methods don’t always apply. Why? Because trauma is complex and everyone experiences it differently, there’s no one right or wrong way to offer support.

But the more you understand what trauma is, the more equipped you’ll be to help support someone else and take care of yourself in the process. According to Psychology Todaytrauma is a response, whether it’s emotional, cognitive, physical, spiritual and social, that follows an event that’s perceived as life-threatening. It can be caused by incidents like sexual assault, physical or emotional abuse, witnessing violence, natural disasters, death of a loved one, and more. The book from the Substance Abuse and Mental Health Services Administration, Trauma-Informed Care in Behavioral Health Services, claims that this response could be cause by a one-time, prolonged, or multiple events, and can affect individuals differently:

Being a friend to someone with trauma can be difficult and at times overwhelming, especially if you’re dealing with your own. So we consulted trauma experts to better understand how it manifests and affects relationships, how to be a supportive friend to someone experiencing it, and how to discover methods for setting boundaries and practicing self-care along the way.

How can you offer support to a friend experiencing trauma?

For someone presently experiencing trauma, licensed clinical psychologist Ashley Doukas says one of the most important things they need is to be heard and validated. As friends, we don’t have all the tools that a therapist or other licensed professionals might have, but we do play an important role as someone who can just be there and be present.

As their friend, you also shouldn’t stress about getting it exactly right all the time. Dr. Doukas explains that people can get intimidated when someone comes to them with a trauma because they’re so worried about saying the wrong thing. But, “If you’re there, you’re hearing them, and you’re loving them…then that’s really what most people need,” Dr. Doukas says. “It’s more important to be there for them than to pull back because you don’t know what to say.”

When should you refer a friend to therapy?

Anything that brings up concerns for someone’s safety can be an indicator that they should see a professional. If someone is having suicidal thoughts, self-harming, or abusing substances, those are all things that should be dealt with professionally, and not solely within a friendship. Though it can be a tough conversation to have, it’s okay to bring up the idea of therapy with a friend experiencing trauma as long as you do so with care.

“Start off with saying how much you care about them, how much you want to help them, how much you want them to get better and how much you want them to heal,” trauma expert and therapist Karen Landmann, says. She also says it’s okay to plead human weakness and explain to your friend that even though you care deeply for them, you’re not able to offer them everything they may need, and they may benefit more from therapy.

Dr. Doukas adds that it’s okay to be direct in these conversations. If you’re worried your friend may be experiencing suicidal thoughts, she explains that it’s perfectly fine to ask directly, “Are you having thoughts about killing yourself?”

“People are super afraid to ask those kinds of questions, but if you ask directly and non-judgmentally [oftentimes] people will answer it,” Dr. Doukas says.

How does trauma affect relationships?

For friends and partners of someone who’s experiencing trauma, it’s important to have realistic expectations for what that relationship will look like. Although it’s perfectly possible to maintain close relationships throughout the process of trauma, the symptoms of trauma can affect relationships in sometimes negative ways.

Dr. Doukas explains that someone with fresh or unresolved trauma may do things like withdraw socially, or act out aggressively or irrationally. “That can be painful for the people around [the traumatized person], but it’s nobody’s fault,” Dr. Doukas says.

In these situations, it’s important to be patient and understanding of the friend who is experiencing trauma, and to try not to take their actions too personally. Dr. Doukas also emphasizes the importance of drawing on a broader social network not just for the person who is dealing with trauma but for you as well.

When you’re in a position where you’re very up-close to someone else’s experience of trauma, it’s important to pay attention to the ways it’s affecting your mental health as well. As the helping friend, it’s possible to experience something called vicarious trauma.

What is vicarious trauma?

Dr. Doukas explains that vicarious trauma can happen “when learning about somebody else’s firsthand experiences changes your own sense of safety in the world or negatively impacts your functioning and mental health.”

She explains that signs of vicarious trauma can look a lot like symptoms of depression or PTSD, including trouble sleeping, changed appetite, social withdrawal and isolation, aka “changes in what we would consider basic signs of mental health.” Vicarious trauma most often occurs when people are repeatedly exposed to traumatic events, Dr. Doukas says. So it happens most frequently to those in helping professions, like police officers, first responders, and even therapists.

For instance, Landmann has both a personal and professional understanding of vicarious trauma. She was in New York City and trained in trauma at the time of 9/11, so she became a constant resource for those who lost loved ones and were experiencing it from the attacks. She says she experienced vicarious trauma from being overexposed and doing non-stop trauma work. “I gave more than I could and I crashed,” Landmann says. As a result, she had to take a medical leave from work to prioritize self-care and rejuvenate.

While vicarious trauma can certainly happen to a friend in the helping position, Dr. Doukas doesn’t want to alarm people to worry that simply hearing about a friend’s trauma will directly cause vicarious trauma. Sometimes, you’re simply experiencing empathy for a loved one, and that’s perfectly normal.

To recognize the difference between empathy and vicarious trauma, Dr. Doukas explains that when you’re just feeling empathy for a loved one, you may feel sadness and pain for that person, but “your life still feels like your life.” However, if you’re not able to distance your feelings from the directly traumatized person and those feelings become unmanageable, “then that could be a warning sign that you’re taking on too much,” she says.

Landmann emphasizes the importance of self-awareness in these situations. “You have to be aware of when the scales tip and you may need to see a therapist yourself or a support group for friends and family of people who have suffered trauma,” she says. To help evaluate your position, she also recommends checking in with someone who is more distant removed from the trauma situation, so they can help you assess your well-being.

How can you help a friend with trauma when dealing with your own?

If you’ve experienced trauma firsthand and you’re now in the position of helping a friend through something traumatic, it’s important to check in on yourself. Dr. Doukas advises that the helping friend evaluate where they’re at with their own trauma with questions like this: Have I had therapy for my trauma, if needed? Have I processed the trauma? Do I feel ready to hear or talk about trauma? How present and disturbing does my friend’s trauma feel? For someone who has their own unresolved trauma, “It’s going to be a lot more important for that person to be setting different kinds of limits,” she says.

Landmann explains that “we have to take care of ourselves first.” Even though it may be a more comfortable instinct to try to focus all of your care onto your friends when they’re struggling, ultimately, knowing your limits and setting boundaries will create a healthier environment for everyone.

How to set boundaries when helping a friend through trauma

1Identify your limits.

Naming your limits is all about saying what you can and can’t do. That could be something as simple as stating your availability. For example, you may tell a friend that there are a couple days you’re available to come over that week, but other days where you can’t. Your limits could also be topics of conversation. If there are topics that could trigger your own past traumas, it’s okay to say that you don’t want to discuss them with your friend.

2Tune into your feelings.

“Your feelings are what indicate what boundaries you need,” Landmann says. If you’re feeling overwhelmed by secondary trauma to the point where it’s affecting your own ability to function, then you may need to pull back and set different boundaries, so you don’t put your own mental health at risk.

3Start by setting small boundaries.

Setting healthy boundaries can take some time, especially if you have been in relationships that had unhealthy boundaries in the past. Landmann says it’s okay to start small and focus on just one change at a time. That might mean saying no to one thing during the week or sending a text to reach out to someone else for support.

4Seek support from others.

Whether that support comes from another friend, therapist, or a dedicated group, it’s beneficial to have an outlet that isn’t so closely connected to a friend who is experiencing trauma.

5Be assertive but kind.

When people we love are involved, it’s easy to forget our needs or put them on the back burner. So an important part of establishing boundaries is to keep asserting them over and over so that it becomes the norm. “You’re allowed to have boundaries. You’re allowed to say no. You’re allowed to do what’s right for you,” Landmann says. While it’s easier said than done, it’s an ever-important reminder to keep in mind to avoid mental health burnout.

6Practice self-awareness and make self-care a priority.

“You have to figure out what your needs are as the person who is helping and not only make it about the needs of the person who’s traumatized,” Landmann says. If you feel yourself getting overwhelmed or emotionally burnout, you may need to give yourself some space from your friend and take some time to regain your energy. Though it may seem like the person who’s dealing with trauma firsthand has more needs than you, it’s important that you still prioritize your own needs to keep yourself healthy and strong.

How to practice self-care when helping a friend with trauma

Whether you’re dealing with trauma firsthand or helping a friend who is struggling, Landmann says it’s important to prioritize self-care so you don’t get mentally burnt out. This means scheduling your self-care rituals into your calendar, as this will it become a normal part of your routine.

When Landmann took a medical leave to recover from her vicarious trauma, her self-care rituals involved swimming, taking drawing lessons, going to the movies, and getting another cat. While self-care will look different for everyone, sometimes, it’s just about spending the time doing the things that make you happy, like making sleep a priority, eating healthy meals, or getting outside whenever you can.

If you or anyone you know is experience suicidal thoughts, please reach out to the National Suicide Prevention Lifeline, day or night, at 1-800-273-8255.

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