Emotional First Aid

Helping the emotionally injured after a tragedy
What to say
What not to say
How can you help later

The Basics
What to Say
What Not to Say
How You Can Help Later

The Basics

Reach Out Physically

Position yourself at the victim’s side and at their level.
Gentle touch – unless the victim pulls away.
Use a soft voice.
Use the victim’s name.

Reach Out Emotionally

Ask the victim how they are feeling
Acknowledge the victim’s experience
Don’t minimize the victim’s experience (i.e. “You’ll be OK”)

Don’t Overlook the Quiet Victims

Many victims after a tragic event are stunned and may appear unaffected. Remember that many people can be affected by a tragic event – witnesses, rescuers, children…

Don’t overlook these “invisible victims”
When you suspect someone is affected by a tragic event, reach out with caring and curiosity – “How are you?”

Protect the victim from making impulsive decisions

Most major decisions can wait until the victim is thinking clearly.

Protect the victim from being victimized by others who may not have the best interest of the victim in mind.
Provide for the victim’s physical needs – food, medicine, safe place

Reassure

Many victims have an urgent need for information after a tragic event – “What happened?”; “Why?” Assist the victim in getting the information he needs. The victim may need an Information Advocate.

Victims often blame themselves for the crisis event. Help a guilty victim gain perspective by asking them to tell you the “whole story.”
Try to gently point out to the victim what they did right before, during, or after the tragic event.

Organize

Victims are often paralyzed after a tragic event and often lose their capacity to deal with all of the new demands created by the tragedy. Assist the victim in developing a simple plan.

Suggest – “Let’s focus on what needs to be done now.”

Reinforce

The actions which the victim is taking or wants to take to emotionally survive the tragic event. The victim will struggle to find something or someone to hold onto in the first few hours. You may need to “clear the way” so that the victim is able to do what they want to do.

Summary

In the first few hours after a tragic event, people who have “a job to do” or who have opinions about what the victim should or shouldn’t do often surround the victim. The primary goal of the person providing Emotional First Aid is to enable the victim to act according to their wishes, values, and beliefs and not according to what others think should be done.

Do not over care or do too much for the victim. Remember that the primary psychological challenge for the victim is to be encouraged to make decisions and take action in his own behalf.
Finally, a broken heart cannot “be fixed.” Do not try! A caring presence is what you can offer someone who is emotionally devastated. Just being there is very powerful and will be experienced by the victim as very helpful.

What to Say

“What happened?”
“I’m so sorry.”
“This must be very difficult for you.”
“It’s OK to feel…”
“Can you share with me how you’re feeling?”

What Not to Say

Often people are uncomfortable with the victim’s emotional pain, and then try to use clichés to make things better. In fact, these statements can often make people feel even worse. These are some examples of some things not to say:

“I know how you feel.”
“Calm down.”
“Don’t cry.”
“It could be worse.”
“It’s God’s will.”

How You Can Help Later

There is much that you can do to help – simple things. The following suggests the kinds of attitudes, words, and acts, which are truly helpful.

The importance of such help can hardly be overstated. Bereavement can be a life-threatening condition, and your support may make a vital difference in the mourner’s eventual recovery.

Perhaps you do not feel qualified to help. You may feel uncomfortable and awkward. Such feelings are normal – don’t let them keep you away. If you really care for your sorrowing friend or relative, if you can enter a little into their grief, you are qualified to help. In fact, the simple communication of the feeling of caring is probably the most important and helpful thing anyone can do.

The following suggestions will guide you in communicating that care:

Get in touch. Telephone. Speak either to the mourner or to someone close and ask when you can visit and how you might help. Even if much time has passed, it’s never too late to express your concern.
Say little on an early visit. In the initial period (before burial), your brief embrace, your press of the hand, your few words of affection and feeling may be all that is needed.
Avoid clichés and easy answers, “He is out of pain” and “Aren’t you lucky that…” are not likely to help. A simple “I’m sorry” is better.
Be yourself. Show your natural concern and sorrow in your own way and in your own words.
Keep in touch. Be available. Be there. If you are a close friend or relative, your presence might be needed from the beginning. Later, when close family may be less available, anyone’s visit and phone call can be very helpful.
Attend to practical matters. Find out if you are needed to answer the phone, usher in callers, prepare meals, clean the house, care for the children, etc. This kind of help lifts burdens and creates a bond. It might be needed well beyond the initial period, especially for the widowed.
Encourage others to visit or help. Usually one visit will overcome a friend’s discomfort and allow them to contribute further support. You might even be able to schedule some visitors so that everyone does not come at once in the beginning and fails to come at all later on.
Accept silence. If the mourner doesn’t feel like talking, don’t force conversation. Silence is better than aimless chatter. The mourner should be allowed to lead.
Be a good listener. When suffering spills over into words, you can do the one thing the bereaved needs above all else at that time – you can listen. Is she emotional? Accept that. Does he cry? Accept that too. Is she angry at God? God will manage without your defending him. Accept whatever feelings are expressed. Do not rebuke. Do not change the subject. Be as understanding as you can be.
Do not attempt to tell the bereaved how he or she feels. You can ask (without probing), but you cannot know, except as you are told. Everyone, bereaved or not, resents an attempt to describe their feelings. To say, for example, “You must feel relieved now that he is out of pain,” is presumptuous. Even to say, “I know just how you feel,” is questionable. Learn from the mourner, do not instruct.
Do not probe for details about the death. If the survivor offers information, listen with understanding.
Comfort children in the family. Do not assume that a seemingly calm child is not sorrowing. If you can, be a friend to whom feelings can be confided and with whom tears can be shed. In most cases, incidentally, children should be left in the home and not shielded from the grieving of others.
Avoid talking to others about trivia in the presence of the recently bereaved. Prolonged discussion of sports, weather, or stock market, for example, is resented, even if done purposely to distract the mourner.
Allow the “working through” of grief. Do not whisk away clothing or hide pictures. Do not criticize seemingly morbid behavior. Young people may repeatedly visit the site of the fatal accident. A widow may sleep with her husband’s pajamas as a pillow. A young child may wear his dead sibling’s clothing.
Write a letter. A sympathy card is a poor substitute for your own expression. If you take time to write of your love for and memories of the one who died, your letter might be read many times and cherished, possibly into the next generation.
Encourage the postponement of major decisions. Whatever can wait should wait until after the period of intense grief.
In time, gently draw the mourner into quiet outside activity. They may lose the initiative to go out on their own.
When the mourner returns to social activity, treat him or her as a normal person. Avoid pity – it destroys self-respect. Simple understanding is enough. Acknowledge the loss, the change in the mourner’s life, but don’t dwell on it.
Be aware of needed progress through grief. If the mourner seems unable to resolve anger or guilt, for example, you might suggest a consultation with a member of the clergy or other trained counselor.
A final thought: Helping must be more than following a few rules. Especially if the bereavement is devastating and you are close to the bereaved, you may have to give more time, more care, more of yourself than you imagined. And you will have to perceive the special needs of your friend and creatively attempt to meet those needs. Such commitment and effort may even save a life. At the least, you will know the satisfaction of being truly and deeply helpful.