Support a Friend in Crisis

Many of us (especially if raised female) are socialized to only feel valuable when we are helping someone else. We might leap in to rescue a friend in distress, without regard to our own limits. We might get enmeshed in a helper role, always seeing the other person as someone who needs help.

At the same time, we might not know the best ways to be helpful. We might charge forward in Emergency Mode rather than taking time to assess what everyone really needs, including ourselves. Even in emergencies, pausing to assess lets us take more effective action.

Transition in
The transition into a crisis is often abrupt. A sudden change or loss leaves someone grieving. A medical condition is diagnosed, or a scheduled surgery takes place. Even with a gradually worsening chronic illness, there is often a turning point where help is needed more than before.

While Susan Silk’s Ring Theory reminds us not to look for support from the person in crisis, we still get to have our own responses to the situation, including grief, anger, and disorientation. We might need some breathing room to process the shock of sudden change. We can seek support from people outside the crisis.

Listen
When a friend is in distress, our goal is to listen for what they need and do our best to provide it, within our limits. We do not suddenly have to become a nurse, doctor, psychologist, parent, or mind reader.

The most precious gift we can offer someone in crisis is empathy and safe listening space for them to be exactly how they are right now. Let them talk or be silent. Let them cry or rage or be calm. Breathe with them. Listen.

What to say
When a friend is grieving, you could say:

• I am so sorry for your loss.
• I’m sorry you’re hurting.
• I don’t know what to say, and I’m here to listen.
• How can I help?
• I’d like to [practical offer] at [specific time]. Does that work for you? What would be better?

Do not tell them how to feel or try to fix them. Grief is not a problem to fix. Let their experience have the spotlight, rather than launching into your own stories. Do not make religious statements such as, “Your loved one is with God now,” or “We never get more than we can handle.” Leave that to their chosen religious leader.

Practical care
People in crisis, whether emotional or physical, often appreciate a specific offer of practical help. Be ready to modify it if they need something different. Practical offers might include laundry, house cleaning, bringing food, going for a walk together, or simply keeping them company for a while. Remember to check in with yourself about whether you have the inner resources to provide what you are offering.

Medical crisis
Recovering from surgery or other medical crises can be scary and disorienting. The body hurts in unfamiliar ways and needs more help to get around than usual. The body might be busy detoxing anesthesia and metabolizing pain meds, which affect digestion, cognition, and sense of time and place. Feeling helpless and in pain is not only upsetting in the present, but can remind people of terrible times in the past.

Stay present
You can help your friend orient to the present by reminding them gently that it makes sense that they are confused and in pain. They get to feel however they feel right now. You might say, “You’re having a hard time right now.” Your calm companionship will help them find their way back to the present. Some additional ways to stay more present:

• Take a deep breath, feel your breathing
• Drink some water
• Stamp your feet
• Name what you see around you out loud
• Hold a rock
• Say today’s date and time
• (Add your favorite method here)

Support their strength
Support your friend’s autonomy and adulthood. Ask them what they need, and trust them to know. Relate to them as an equal who temporarily needs help. Ask before touching them. Give them time to sense inside and reconnect with their preferences and boundaries after the invasiveness of surgery or other medical interventions. Support them in saying no as well as yes.

• “Would you like [X] right now?”
• “May I touch you to [do X]?”
• “Let me know when you’re ready.”

Self-awareness
It can be difficult to witness a friend’s helplessness and pain. Your own reactions and emotions can get in the way of being calm and supportive. Stay aware of your responses and tender places. Set your reactions aside for later when you can, and take a break if you feel overwhelmed. Stay present with your internal narratives about what it means to be helpless and in pain, and allow what is happening in the room make a new narrative.

Pain and helplessness can trigger shame in both of you, which makes everything harder. Acknowledge the shame and let it be in the room with you. Be mindful of the vulnerability of receiving help.

Transition out
The transition out of a crisis tends to be more gradual than the transition into it. Little by little, the grieving person starts to feel better, or the patient’s health improves. With an ongoing condition, there is a transition from short-term interventions to long-term care.

For some people, receiving help is uncomfortable and they exit the central role as soon as possible. Some people, through habit or privilege, relax into the central role and need to be nudged to start thinking about others’ needs again.

Stay aware of your inner reactions to your caring role. If you notice persistent resentment, irritation, or overwhelm, you might need to step back even if your friend continues to need care or is not ready to relinquish their role. Eventually the give and take in your friendship needs to be rebalanced, or it becomes a caretaking relationship instead.

Already enough
Remember that you are enough, just as you are. Your friend is enough, just as they are. Bring kindness and respect for everyone, including yourself, when you are supporting a friend through a crisis.

Learn more

• Megan Devine’s book It’s Ok That You’re Not Ok is a compassionate and thorough exploration of catastrophic grief, including suggestions for helpers.
• Megan Devine’s webpage for helpers has great suggestions, including a lovely 5 minute animated video about listening.
• Susan Silk and Barry Goldman describe Ring Theory in the article “How not to say the wrong thing.”