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My 6-year-old is terrified of having x-rays taken. He knows it won’t hurt, and that all he has to do is hold still. But simply the presence of the large machine, or even the mention of an appointment beforehand, can upset him. More times than not, his reaction mystifies nurses and technicians. If he cries or screams, they try to correct his behavior by saying things like “there’s no reason to cry,” or “I didn’t do anything,” or, “no ouchies!” They have difficulty accepting that he is terrified of the experience and can’t relax until it’s over. He is traumatized by it and has a traumatic reaction to it. The ones that “get it” aren’t stunned by his elevated emotions. They stay calm and get the job done.
“There are wounds that never show on the body that are deeper and more hurtful than anything that bleeds.” Laurell K. Hamilton
Trauma comes in all shapes and forms, created by a variety of one-time, multiple, or long-lasting, repetitive events: physical or sexual abuse, military service, neighborhood crime, car accidents, racial or gender discrimination, workplace harassment, the death of a loved one, and a natural disaster, to name a few. Even just listing these makes my pulse quicken. People can also succumb to second-hand trauma, meaning they’re hurt by listening to someone else’s story, helping someone go through something difficult, or witnessing something awful on the news.
This is a massive topic with many factors to consider, so I’m just scratching the surface with these basic suggestions. Treating Post Traumatic Stress Disorder (PTSD) is best left to the experts, but that doesn’t mean you won’t encounter it when you step in to help a friend in need.
My recent experience has been rooted specifically in medical trauma, but I’ve learned universal lessons that can help any friend having difficulty letting go of painful memories. In my son’s case, it’s hard to separate what’s brought on by his thoughts, and what’s embedded in his nervous system, flooding him with fear even when he’s not in danger. Helping a friend deal with trauma involves understanding where it comes from, having the patience and fortitude not to be affected by it, and guiding them back to a safe space.
Pay attention
For trauma victims, triggers are everywhere. What may appear as a minor inconvenience or mild stimulus to you, can have a profound impact on your friend. After the hundredth time a nurse or doctor entered my son’s hospital room, sometimes in the middle of the night, he began to dread the metallic click of the door latch, or the mechanical whirr of the automatic hand sanitizer in the hallway. Even my wife and I were jolted out of a deep sleep by the simplest sounds. At night I wake up sometimes to the sound of phantom beeping–the beeps aren’t real but the plunging sensation in my stomach is, and I have to breathe deeply and ground myself before falling back to sleep.
Most of us wouldn’t shriek at the prospect of having our arm squeezed by a blood pressure cuff, but it used to bring my son to tears. He’s never been able to tell me explicitly why, but I imagine it makes him feel powerless. It strips him of his bodily autonomy, and it’s only a matter of time before a nurse comes in to do it again. Likely it’s even simpler–he associates the squeeze of the pressure cuff with being afraid.
A lot of his behavior didn’t make sense because my reactions were based on my own expectations. He wasn’t behaving the way I wanted him to, and it confused and frustrated me. It helped to watch other people interact with him, and see what assumptions they naturally made as to why he acted the way he did. Through trial and error, I began to see what was lying under the surface, and from there, learned how to help him more effectively.
“People start to heal the moment they feel heard.” Cheryl Richardson
Inform
Trauma victims can often lose control of their imagination, or become trapped in frightening flashbacks, creating a dark reality they can’t escape from. It helps to communicate details about their current situation, so that they can ground themselves in the here and now. When someone’s security is shattered, it can leave them deeply distrustful. When you point out something simple about their environment, and they recognize it to be true, it can cause them to lower their guard. Don’t smother them with information. Keep sentences short and simple. State facts like “I’m here” and “you’re safe.”
Avoid using words like “just,” as in “we’re just driving on the freeway” or “we’re just watching a movie.” This suggests that their feelings are wrong and inappropriate, when it’s likely their behavior is completely out of their control. You’re minimizing their experience. Don’t let the tone of your voice suggest that you’re shocked or disappointed by their behavior. Don’t shame them into silence. Recognize their feelings and allow them to happen. These are normal reactions to abnormal events.
De-escalate
The goal is to ease someone’s trauma, not correct it. Few are capable of erasing the damage bad memories can cause, and as a friend, it shouldn’t be your responsibility (unless you’re the one that caused it, but that’s another chapter). If your friend is being forceful with their expressions of trauma, an equal amount of force won’t fix it. If you can’t think of something to say, or talking to them doesn’t seem to be helping, project a calming presence. Be with them, in the moment.
If your friend’s surroundings are contributing to their trauma, get the heck out of there (if you can). Get moving. Take a walk, play a sport, or go for a swim in a friend’s pool. Search for activities that are rhythmic and engage both their arms and legs. And if you’ve entered a conversational space that your friend tells you is traumatic for them, believe them! And change the subject.
My wife and I participated in a trauma program in which we learned some mindfulness techniques that can be helpful. One is using your 5 senses to bring you back to the here and now: list 5 things you see, then 4 things you hear, 3 things you feel, 2 things you smell, and 1 thing you taste. An even simpler one can involve planting your feet on the ground, and running your thumb over your fingertips. Both of these exercises may help in recentering to the present moment and environment.
Being weighed down by trauma involves losing hope in a more stable future. By supporting your friend, by staying by their side, you’re beginning to show them such a thing exists. Keep telling them that they are not alone, they are not at fault, and recovery is possible and anticipated.
“There is no greater agony than bearing an untold story inside you.” Maya Angelou
The advice in this chapter is for those who encounter their friend’s expressions of trauma unexpectedly, or know they’re going to spend time with a friend that’s having trouble managing their painful memories and need someone nearby for comfort and guidance. But if your friend’s trauma is debilitating enough that it’s interfering with their work, their family, or their closest relationships, please defer to the professionals. Unburdening someone’s trauma is not a challenge you should take on by yourself. Ultimately your friend will have to let go of that weight on their own, but it’ll be easier with you by their side, sharing your unconditional love and support. Understanding and accepting that your friend may have a post-traumatic reaction is the first step in letting them know that you’re with them on their healing journey.
Let’s talk it out.
If you have a friend working to overcome trauma, I’d be grateful to learn from your experience. Let me know in the comments.
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