How Can I Help? Emotional First Aid for Non-Professionals
When your life is turned upside down by the death of a parent, the folly of a child or the unfaithfulness of a spouse, the first person you turn to is likely to be not a psychotherapist but a sister, aunt or neighbor. (As a male psychotherapist I hate to admit it, but when looking for a sympathetic ear people typically turn to women.) If a person in distress comes to you for emotional support, what can you do? On other occasions, you may be the one reaching out. Someone you care about has suffered a grievous blow. You feel you should do something, but wonder what that might be.
One’s instinctive—and correct—initial response is to listen sympathetically. You may be able to interject that you went through a similar experience, or observed it second-hand with your parents or relatives, but the most important thing you can do at the outset is to listen with all of your being. This means putting aside any solutions that come to mind and resisting the impulse to ask how anyone could be so foolish as to end up in such a situation. Instead you just let the other person know that you are fully engaged in listening, understanding, and empathizing.
We talk about the healing power of love without knowing quite how to put that love into action. Active listening allows the other person to feel understood and validated. Zen master John Tarrant has written, “Attention is the most basic form of love. Through it we bless and are blessed.” Deepak Chopra has written, “Love is attention without judgement. In its natural state attention only appreciates.” Active, attentive listening conveys a number of essential healing messages:
- You are not alone. (Even if I can’t remove your pain or alter your circumstances, I stand beside you.)
- Your words matter. (In extreme circumstances, a person have the sensation of crying out without anyone hearing. Your presence as an active listener allays that fear.)
- It is safe to feel your feelings. (When profoundly troubled, we may be reluctant to listen fully to our feelings for fear that if we do, we’ll lose control. A calm listener offers a safe environment in which to hear what our feelings have to tell us.)
Depending upon the situation, the appropriate next step may well be to get the person physically out of the house. You can guess that the person who called on you for help has already spent a fair amount of time experiencing grief, or anger or fear, and after sharing these feelings with you will probably not benefit from dwelling on them indefinitely. Instead of trying to fix the problem—and in the case of death or infidelity, there isn’t much you can actually do—you can often provide service simply by suggesting a change of scenery that the person might not seek without your encouragement. You will know whether a movie, a quiet meal or just a relaxing walk would be most appropriate.
Think of the physical setting of a hospice. Ideally a person in a hospice looks out on woods or fields or a lake or some other restful view. One should not underestimate the calming influence of nature. “Merely being in nature for brief periods— or even simply having it in our view—can reduce the stress hormone cascade and improve immune defense. Nature is like a little drop of morphine for the brain.” (Selhub, Eva M. and Logan, Alan C. (2012). Your Brain on Nature: The Science of Nature's Influence on Your Health, Happiness, and Vitality. HarperCollins e-books.)
Once the intense emotional reaction begins to subside, but not before, you can help a person take a more rational perspective on the issue. Our physical response to emergencies—the so-called “fight or flight” response—includes shutting off the pre-frontal cortex. In an emergency, our brains are just too slow. As mammals, we rely on the more rapid chemical reactions of our hormonal systems to save our skins. The appearance of being dazed or confused in the aftermath of an emergency reflects this phenomenon. Our much-vaunted intellect has simply been taken off-line. A person administering emotional first-aid, by providing a context of calm and security, can actually assist in restoring the flow of blood to the reasoning portion of the brain.
When sufficient time has elapsed—and this may require considerable time--you can help provide the gift of laughter, commonly referred to as “the best medicine.” This will obviously not be your first, or even your second, response, but laughter can make a significant contribution toward healing. Laughter requires the ability to look at the discrepancy between what ought to be and what is and to accept that gap with humor. As a sympathetic friend you will be able to convey the distinction between “laughing at” and “laughing with.” Being able to laugh at a situation indicates being far enough away to be able to start coping with it creatively.
Once this distance has been achieved, one can start seeing the “lesson” in a challenging experience. Part of the emotional first-aid you provide includes steering a person away from mistaken conclusions. It isn’t “God’s will” that a spouse dies or chooses to separate, that a bank forecloses on a mortgage, or that a child develops a drug problem. Nor should one dwell on sentences that begin “If only I had …” Nor does one “deserve” ill fortune as proper punishment for one’s misdeeds. As a non-professional, you need to avoid being put in the position of substitute therapist, but as a level-headed listener you can provide the distressed person with a needed “reality check” when his or her reasoning seems to go off the rails.
Eventually you might brainstorm possible responses. As always with brainstorming, you try to generate as many ideas as possible, ridiculous as well as practical, without judging their potential effectiveness. Laughing at some of the more outrageous ideas may have the useful side effect of harmlessly discharging impulses towards revenge or self-pity. Having many options on the table—both practical and frivolous—can assist the distressed person to distinguish reasonable courses of action from wishful thinking.
When it comes to implementing actual solutions, you will do well to remember one of the basic principles of life-guarding. A person drowning will grab any potential support that presents itself, including the lifeguard. An inexperienced rescuer, approaching someone thrashing in the water from the front, may well end up being pulled under. An experienced lifeguard always approaches from behind in order to pull the disabled swimmer to safety without putting the lifeguard at risk.
A person in grave distress may attempt to grab onto any potential support, and the need of a person in distress may not be commensurate with the limits of your ability to give. You may find yourself faced with extravagant requests and perhaps experience guilt when you hesitate to fulfill them. Can the person in need move in with you, for example? You may not ever have imagined that eventuality when you agreed to provide a sympathetic ear. How much responsibility can you take on in caring for your friend’s children, aged parents or cats? Is there a limit to the financial support you can provide? Keep in mind that, when overwhelmed, people may unconsciously disregard your personal boundaries. Always remember the situation of the drowning swimmer. You need to consider carefully what you can and cannot do, and be prepared to set limits.
Everything I have written to this point has been framed in the context of care for another person, but the same principles apply to self-care, the advice I would offer clients in coping with their own distress between our sessions. Sympathetic listening to oneself may take the form of journaling. I encourage clients overwhelmed by their feelings to “write the rant” without pausing to correct their grammar, edit profane language, propose an analysis or seek a solution. Those measures may come in time, but for the moment you simply need to give voice to your feelings. The sympathetic listener cannot be present at all times, but the option of writing in one’s journal is always available.
Seeking distance from the problem—both physically and psychologically—will also help to alleviate your distress as well as fostering the objectivity you will require to come up with practical solutions. If you are able to discover an element of humor in your situation, you are well on your way to escaping from the “slough of despond,” to borrow John Bunyan’s eloquent phrase. The question of personal boundaries also has a place in self-help as you discover your own position between the extremes of those who believe they deserve nothing and those who believe they deserve everything.
To regain mental health, those in situations of severe distress may require professional help from a psychotherapist, but you have the power to offer psychological first aid, either for another person or for yourself.
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