Supporting Someone Who Is Working On Their Mental Health, Part 4: The Process
The first three posts I have written about supporting someone who is working on their mental health have focused on being mentally healthy yourself, empathy, and empowering choice and voice. Today I will discuss what might be helpful for you to know about the process of therapy for anxiety and trauma.
My practice focuses mostly on women who are experiencing anxiety.
Very often, there are deeper thoughts and feelings that maintain anxiety. Anxiety is a normal emotion; it is necessary to keep us out of danger. Anxiety can be functional – it motivates us to do things well, be prepared, stay alert.
But we can end up feeling this sense of hyperalert so much that it starts to get in the way of our ability to relax. We need to be able to give our brains and bodies a break from constantly scanning for evidence that one of our worst-case scenarios is about to play out.
The work of addressing anxiety is a paradigm shift.
It is unlearning patterns that have become automatic and creating intentional responses to replace them.
This work may be a paradigm shift for you, the supporter, as well.
To do this work, we need to understand her unique triggers of anxiety and the individual ways she notices her anxiety showing up in her body.
We explore past experiences that created those triggers, as well as things that connect to them.
This is where trauma comes in.
I have written before that the experience of PTSD-like trauma is not the only way someone can experience something “traumatic.”
What makes something traumatic is the way someone interprets the event, which is based on the context of her individual situation, life experiences, the way her brain creates meaning, and the nuances of how the event played out.
Let’s use teacups as an example.
Say one person accidentally dropped a tray of teacups she had bought ridiculously cheap and they all shattered.
Another person also dropped her tray of teacups, but one of the teacups on that tray was the last teacup from her favorite grandmother’s set of china.
In both situations, the teacups were destroyed. The end result was the same.
However, because of the meanings each person attached to the value of the teacups, they each view the experience differently.
If one person was tripped by someone else, she would experience that event differently than someone who just lost her balance. If the person who tripped her was someone who was “supposed to” be there for her (like a parent, spouse, or best friend) it may feel like a betrayal. It would add layers of confusion, pain, and distrust to the experience of the broken teacups.
If one person was injured in the event, or her clumsiness ended up injuring someone else, she would experience that event differently than someone without physical harm.
If someone was berated for dropping the teacups, and another was greeted with understanding, each would interpret the experience differently.
We all go through things differently.
We have different life experiences, strengths, weaknesses, relational resources, and ways of attaching meaning to things.
Those differences decide whether something was traumatic or not.
Trauma is a very subjective thing.
We often create meanings about ourselves when we experience something traumatic.
“It was my fault.”
“I am worthless.”
“I am not good enough. I’ll never be good enough.”
“I am not safe.”
“I am bad.”
These meanings can keep our anxiety on overdrive, striving to make sure something like that never happens again. That we always know what to do. If we are perfect, nobody will blame us. If everyone likes us, we can be safe, nobody will know how bad we really are. Logically, we know these things are not true, but we still feel and react like they are true. We usually do not even realize we are doing this.
Our brains will link things that happened in the first memory to anything else that is similar.
Was there a clock chiming the time when we dropped the teacups? That sound is now unsafe.
Did you catch a whiff of sudsy dishwater when the teacups shattered? That smell now means danger.
That shoot of adrenaline that coursed through your body as you were falling – can be the same feeling you have right before you stand at a podium to speak. But it renders you speechless because of the connection to what happened when you dropped the teacups, because your body connects that feeling to imminent danger.
We don’t put all of this together, though. We often don’t know why we have these reactions.
Before we can unlearn those reactions, we need to understand them.
It feels like a big chaotic, disgusting, and often scary mess to sort out.
In keeping with the dishware theme, let’s imagine a kitchen that is just utterly cluttered with dirty dishes.
A person’s traumatic memories can be like those dishes.
We see the whole big overwhelming mess as one looming thing and don’t realize that there are smaller parts to it.
It’s there. Always there.
Many times people cope by keeping the doors to the kitchen locked up and just trying to avoid the kitchen altogether.
We need to deal with the dishes so we can put them away.
We need to examine them and decide where they make sense.
Is this plate even a dirty plate? Or was it just on the counter mixed in with all the rest?
Does it need to be cleaned?
Does it need to soak first?
Does it need to get put away in a cupboard?
Do we even want to keep this? Or throw it away?
It’s a lot of hard work, and it can feel like it is getting worse before it gets better.
It gets trickier when some of those dishes on the counter were left there by you, the supporter. You may not even know that you contributed to this mess at all, because she didn’t have a way that felt safe to tell you. Even now, she may not be able to adequately articulate why she sees you as part of the mess.
Naturally, this feels very unfair to you. You may feel completely blindsided.
She may actually attribute all of the dishes to you before she realizes the dishes were already piling up on the counter before she even met you. She may logically know that a lot of the mess is not actually yours but she since she can identify that you connect to some of it, she may feel like it’s all yours. Knowing and feeling are two very different things when trauma is involved. Remember, initially, she is probably seeing this mess as one big mess instead of small messes that contribute to big overwhelm. It may take some time for her to get her brain around this separation.
Arguing with her about those few dishes that are yours will probably not help her process, and most likely will not help the connection between the two of you.
Instead, you can take responsibility for your dishes. Help her wash those and decide where they need to be stored away.
This does not mean taking the blame for all of it, or never getting to a place where you both can identify the truth of the situation. It means that you are mindful of the timing of doing this and the importance of making sure you are a safe person so she will want to do this work when the time comes.
Dishware analogy aside, what does your help in this process look like?
Being mentally healthy yourself
so you can hear hard things and have a clear understanding of what is yours to own and what is not
so you can take care of yourself for you…and for her
so you know when you need to take a break from hard discussions and have the skills to do so
so you can make sure you stop adding more dishes to the pile
Be a safe person for her to talk to.
Listen with curiosity to understand, not to fix.
Work hard to understand her perspective and how her unique cluster of life experiences impacts her this way.
Communicate accurate support so she doesn’t feel alone.
Empowering her sense of choice and voice
Honor her choices. This means also honoring her decisions about how much she wants to tell you about what she is working on in therapy. She may not have the words to explain it yet. She may not feel convinced (yet) that you are safe enough. She has to get those dishes put away before she can do that.
Keep a big-picture perspective. If she shares something with you that is hard to hear, try to take a step back and think about it in the context of the dish pile. It may be new for her to speak up, and these things are rarely seamless at first. She may swing all the way over to the side of speaking up about all the things all the time before she lands in a place of knowing which dishes are yours and which are not. Keeping that big picture perspective can help you be less reactive as you both experience these new conversations.
Communicate connection. Someone who is working through anxiety probably is battling some serious chatter in her head about what you are thinking about her. She may feel ashamed of the things that feel traumatic.
She needs to know that you love her even though she is dealing with all these dishes. That if she lets you into the kitchen you are not going to reject her, get violent, or think less of her. She may need extra reassurance of this while she is working through her own process. Even if you have never contributed to a single dish on her cluttered counter, because so many other people did (or because some people who were very important to her did) she will have a hard time truly believing that you are safe, that you are not going anywhere, that you love her.
You can’t wash the dishes or put them away for her, although you can certainly help with the ones that are yours. You can keep her company in the kitchen while she does the work.
Be patient.
Even if she has some negative feelings toward you, they may very well work themselves out as she does her work. Her feelings may take her on a journey first before she gets to a place where she can see clearly what is going on.
If you are showing up as trustworthy during this process, you are demonstrating that you are confident in your unconditional love for her.
This does not mean being a punching bag or a doormat. You need to take care of yourself, too. It may be worth getting some professional help from a counselor to sort out how you can set boundaries so her process does not bring you down.
Educate yourself about coping with anxiety
If you understand the process, it is easier for you to support her when she tries out her new coping strategies.
Working on trauma sometimes brings stuff up that she hasn’t thought about in a while. She may be extra sensitive to trauma triggers until she gets to the other side of the work.
She may need to carve out time for some journaling or to use a meditation app.
You can be instrumental in helping her feel grounded; often when we feel dysregulated the people closest to us are the first to notice it. They have the words and wherewithall to remember the strategies (you can read more about this here).
Above all, believe the best.
It is possible to work through trauma and address anxiety in a way that generates lasting life satisfaction. In fact, her life may feel so much better than it was before. Your relationship may become more authentic, more intimate because she knows herself better and has learned that it’s ok to trust you with who she really is.
Once the dishes get washed/put away/thrown away, she can learn how to keep the kitchen clean.
She will set boundaries that limit who can put dishes in there in the first place.
She will develop skills to deal with any new dishes sooner rather than later.
It may feel like it is taking forever to get there. If it feels that way to you, how must it feel to her?
She may need to borrow your hope.
Jennie Sheffe is a National Certified Counselor ™ who helps women find freedom from anxiety and peace in their chaos. She sees clients virtually in the state of Pennsylvania, or in her downtown Carlisle, PA office. She offers Christian counseling and EMDR Therapy.
