Sunday, June 2, 2013

When to seek help after a tragedy

I mentioned a couple of weeks ago that there had been a crisis in my family.  In a recent conversation with my mom about what happened she asked me if I thought the family members most affected should seek counseling.  "It depends," I told her.  I realize my response was not particularly helpful.  Unfortunately, there is no universal rule of thumb about when a person should see a counselor or therapist in the immediate aftermath of a traumatic experience.  Many - if not most - people are able to work through a distressing experience by relying on their existing coping mechanisms and natural support networks.  Sadness, grief, anxiety, and anger are all normal emotional responses to tragedy.

"So how will we know if they need help?" my mom asked.  I had no easy answer for this question either.  (You might think having a therapist in the family is useful.  Not so much.  You're better off being related to a lawyer or a doctor).  Personally, I think it's preferable to allow the natural healing process to take place whenever possible.  From time to time I see patients who are struggling with feelings about something that happened a week or two earlier.  My strategy is to caution them against anything that might interfere with the process of healing: don't avoid thinking about it if thoughts arise; don't avoid people, places, or things just because they cause you to remember; don't avoid talking about it; share your feelings with someone you trust; let yourself feel.

As for my family, I think the best thing we can do is to spend as much time together as possible.  In this way we send a very powerful message: we are here for you and we love you.  It also allows us to see for ourselves how everyone is coping.  Hopefully, we will see those who were affected the most begin to resume  life.  If, after several months we realize this is not happening, we can reach out and encourage them to seek help.

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