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(p. 121) For Families and Loved Ones: How Can I Help? 

(p. 121) For Families and Loved Ones: How Can I Help?
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PRINTED FROM OXFORD CLINICAL PSYCHOLOGY ONLINE ( © Oxford University Press, 2021. All Rights Reserved. Under the terms of the licence agreement, an individual user may print out a PDF of a single chapter of a title in Oxford Clinical Psychology Online for personal use (for details see Privacy Policy and Legal Notice).

date: 22 January 2021

Significant others often ask, “How can I help?” What follows is a list of tips or things to keep in mind while your loved one is in the COPE treatment program:

  1. Tip 1. The traumatic event caused the problem, not your loved one. By viewing PTSD symptoms as a natural response to trauma, you and your loved one can let go of the idea that he is the problem. This is an important first step toward teaming up with one another to recover from PTSD. Focusing on what your loved one is doing well, rather than the problems he is having, can be helpful.

  2. Tip 2. You and your loved one have been doing the best you can. Neither you nor your loved one is to blame for the difficulties that the trauma has caused for you and/or your family. You and your loved one have done the best you can to recover from the trauma, but now need some help in managing some of the consequences of what has happened. You should not feel that coming to therapy means you have failed as a family member, partner or friend in any way. A good, caring significant other knows when to ask for help, and does so, even if it is hard to do.

  3. Tip 3. Be mindful of what you say around your loved one. Individuals with PTSD often feel that what has happened to them is their fault, and they may feel guilty. To help protect your loved one’s feelings, try not to discuss your loved one’s problems with others in his or her presence. Avoid discussing or expressing your own intense emotions in front of your loved one. Remember that he may blame himself for making you upset, or may believe you are angry with him even though you are angry about the trauma. This includes making sure that he doesn’t overhear you on the telephone talking with someone else about the problems he is having, or hear you expressing your emotions about the problem. This does not mean that you should hide your feelings, but rather choose the appropriate time and place to discuss your feelings directly, in a helpful way, so that your loved one is not left to draw his own conclusions about why you are upset or angry.

  4. Tip 4. Be a cheerleader for your loved one. As a cheerleader, you can help motivate your loved one as he begins to confront fears and memories related to the trauma. If you are supportive and neutral, you will help reduce your loved one’s anxiety as he begins confronting anxiety-provoking situations. Criticism or punishment makes symptoms worse because they decrease your loved one’s motivation. Think about PTSD as an illness such as asthma. Just as you wouldn’t criticize your loved one for having asthma, as it is beyond his control, we recommend that you not criticize your loved one for behaviors he is (or is not) engaging (p. 122) in because of PTSD. Also keep in mind that while the tasks chosen for in vivo exposures may seem small and insignificant, they are challenges for your loved one, so it is important for the therapy process that we go at your loved one’s pace. Your support and encouragement will contribute to your loved one’s confidence as he tackles the more difficult tasks. You can also help correct any misconceptions your loved one may have, such as being able to fight all of his symptoms at once. Just as cheerleaders cheer for only the play at hand, you can cheer your loved one on to complete only the homework task at hand and attend the next therapy session.

  5. Tip 5. Your loved one must set the pace to confront his fears. Your loved one had something unpredictable and uncontrollable happen to him. It is very important for the success of therapy that your loved one be given control in choosing when and how to face his fears. As you learn about the treatment strategies we will be using over the next few weeks, you may be tempted to use techniques before your loved one is ready. Please resist the urge, as pushing your loved one too fast will not be helpful.

  6. Tip 6. Be open to hearing about your loved one’s fears and anxieties, but do so when he wants to talk about things. Do not insist that he talk about the trauma. Let your loved one know that you are interested in hearing everything he wants to tell you. If your loved one does talk about the trauma, praise him for doing so. Tell him how glad you are that he is able to tell what happened. Never express horror or anger, as this may frighten your loved one from opening up in future conversations. If what your loved one says is upsetting to you, it is important that you find someone else that you can discuss your own feelings with.

  7. Tip 7. Assist your loved one’s efforts to not use alcohol or drugs. Many people with PTSD use alcohol or drugs as a way to “self-medicate” their PTSD symptoms (e.g., to feel less irritable, to sleep better, to try to block out memories of what happened, to be able to engage in activities they have been avoiding since the trauma). While it makes sense that your loved one wants to feel better, alcohol and drugs only make the symptoms worse over time. Help your loved one by not using any alcohol or drugs yourself, not having any alcohol or drugs in the home, and being a cheerleader for his or her recovery with encouraging statements such as “I’m really proud of you for not drinking,” or “Congratulations on two weeks clean!” Encourage your loved one to talk with you if he is experiencing a craving to use alcohol or drugs (which is very common during recovery) and help to distract him with positive, healthy activities (e.g., go to the gym together, watch a movie together) or discussion until the craving subsides. Most cravings pass within 15 minutes.

  8. Tip 8. Seek additional help if your own emotions are interfering with everyday life. It is important that you are able to set your emotions aside as you help your loved one through recovery, but this does not mean that your emotions are unimportant. In fact, avoiding emotions can cause problems for the significant other in the same way that it does for the person (p. 123) struggling with PTSD. If you are struggling with difficult emotions, talk to your loved one’s therapist. Your loved one’s therapist can help you decide if finding a therapist for yourself, in addition to the work your loved one is doing, would be helpful for you and/or your family.

  9. Tip 9. Assist your loved one in the homework tasks. Helping with homework is always done with your loved one’s permission. For example, your loved one may ask you to accompany him to a location that is on the in vivo exposure list. While your loved one is experiencing the anxiety, you can act as a cheerleader, stating, “Remember the anxious feelings will go away if you stay in the situation long enough,” “You can do it,” or “You’re doing a great job.” Your loved one will also need to listen to audio recordings of the therapy sessions each day at home. You can help by making sure that your loved one has a private, quiet place in the house and the uninterrupted time to do so.

  10. Tip 10. Don’t forget to have fun. Therapy can be challenging at times, so it is important for both you and your loved one to make time for pleasant, fun activities. At least once a week, go out and enjoy a nice dinner together, go see a funny movie, go for a walk or a hike together—anything that will be pleasurable and healthy.