Acute Stress Disorder: How Can I Help Others Probably the most important thing you can do to help someone who is suffering from an acute stress disorder is to listen and then listen again. Someone with an acute stress disorder needs to tell his story over and over again, and then over and over again to get past the denial and the emotional numbness that we all use to protect ourselves from overwhelming events and feelings. When people say “just listen,” they underestimate how demanding and challenging listening can be. Listen, don’t spew comforting words When we hear anyone talk about something dangerous and threatening, we feel anxious. We feel even more anxious when a loved one is upset and emotionally out of control. We want to fix the unfixable and ease their pain. After a trauma, the event must be processed. Processing painful memories and the emotions they evoke means that we must share the person’s temporary helplessness, hopelessness and worthlessness. These depressive feelings also arouse our anxiety. When we try to say something comforting, the person probably will not feel understood and may withdraw or get angry at how we seem to minimize the horror of the trauma. “It could be a lot worse.” “She’s better off now.” “Don’t talk like that. You’ll lick this in no time.” “What were you doing there so late at night?” “You’ll get over it.” “I know how you feel...when I...” You may desperately want to find some comforting words, but there are none. Telling a person to stop feeling so badly only communicates that the feelings are too intense for you to handle, that there is something wrong with her and that she will have to go it alone. It helps to become aware of your own history of loss and trauma so you can be alert to emotions that might be particularly difficult for you to deal with. When these emotions surface, remind yourself to listen, stay with the person and be a big ear, not a big mouth. Your quiet presence is what the person needs most. Reach out and touch, help When you don’t know what to say and want to do something besides listening, try tapping the power of touch. Unless you know the person well, you may want to ask permission to hold his hands, put your arm around his shoulders or stroke his hair. You also can help him in practical ways. Trauma disorients, disorganizes and drains the survivor. Look for things you can do and ask if you can do it for him. Many times what you can do has nothing to do with the trauma. The tasks of everyday living may be too much to manage for the victim. Even if he can go through the motions of doing them, your help speaks of your support in concrete ways. Bring a meal or dessert, do the dishes, mow the lawn, feed the pets, make coffee, contact friends, vacuum or water the plants. As time passes, loneliness often sets in as family and friends move on to new crises and everyday events. Recovery is a long journey. It is important to check in frequently. It also helps to invite the victim to pleasant events or ask him to join you for a meal. Helping a child When a child suffers trauma, extra time to look, listen and touch are needed. The younger the child, the more we may need to watch her play and ask questions about what the dolls and tin soldiers are doing to one another. Book reading and storytelling related to the trauma can be very helpful. Ask the child to tell a story. If the story ends badly and the characters are anxious and depressed, show your appreciation for the interesting characters and plot that the child has created. Then explain that you would like to take a turn and retell the story with a different ending. Stories speak to the unconscious in very powerful ways. If you are a parent of a teen with an acute stress disorder, be aware that he may respond better to uncles or aunts and neighbors or scout leaders. An adolescent with the disorder is seeking independence just when such a trauma makes him feel very helpless and dependent. Self-help and therapy groups of fellow trauma sufferers also are ways to help a child, especially a teen. Helping an adult If your spouse has an acute stress disorder, you may feel rejected because your spouse is detached and unaffectionate. Remember that this numbness will pass as the trauma is processed. Be patient and listen, listen and listen some more. In larger communities, there are some support groups for family members of loved ones who have suffered common traumas. These also may help. The same things also are true when a parent suffers trauma. In addition, adult children who are trying to be helpful may need to be particularly sensitive to the parent’s response to the role reversal. Keep in mind that listening is crucial and being there for him can make all the difference. When a friend is traumatized, we may not have the time to provide the support she needs. Here, it is helpful to talk with the friend’s family members and share what you have learned about helping those with acute stress disorders. Frequent visits with a friend in person and then by phone are more important than lengthy visits. A co-worker suffering from acute stress disorders may be irritable or withdrawn. For someone who seems on edge, be especially patient, cut him some slack and ask what he would like you to do or how you can work together on the complaints he makes. For someone who becomes withdrawn, asking about the trauma can be important, but you may need to limit the details he gives you about the event and focus on his feelings and plans. This will keep you from crossing privacy boundaries and risking later embarrassment. © 2000 Ron Nathan, MD