How to support someone through anxiety (advice & tips from a CBT therapist)
How to Encourage and Support a Friend or Family Member in Anxiety Treatment
How to encourage and support someone who is engaging in treatment for an anxiety problem
How family or loved ones can help you stay with the anxiety rather than get trapped in an unhelpful cycle of avoidance and reassurance.
Anxiety disorders can be very frustrating for the sufferer and difficult to understand for the family members or loved ones trying to help. Often friends and family can feel helpless and lost about what is the best thing to do or say to help the sufferer.
This article if written as guidance for friends and family to feel more confidently feel able to offer loved ones emotional support as they move forwards on what, at times, can feel like a bumpy road to recovery.
Family and friends can play a hugely important role in keeping people on track and moving forwards, by helping them to feel supported, connected and loved.
During a moment of high anxiety or OCD fear, uncertainty and emotions can often rule over logic.
People with an anxiety problem such as OCD and panic disorder are often extremely capable people, holding down a job or professional career, participating in high level studies or extra activities and hobbies. However, at the same time, when anxiety takes hold the person can engage in ways that seem irrational or unreasonable. Observing a friend or loved one behave in such opposite ways can cause confusion and misunderstanding. It is common for family or friends to question ‘why can’t they just stop it?’, “why is he acting in this way?’.
Rest assured, when outside of the immediate, anxiety fuelled moment, people usually do agree that their fears and behaviours are irrational or at least unnecessary.
When a person is in an anxious state (flooded with emotion), our ability to bring in our rational brain is significantly reduced which is why reasoning in the moment can be very difficult. The feelings of fear and anxiety are so powerful and automatic in trigger situations, once they take over, rather than hearing the logic or reasoning that a friend or family member might be offering, a person with anxiety finds it very hard to connect with others, it can lead to them pushing them away in an effort to get control of the emotions. This in turn can leave them feeling misunderstood and alone.
Until they learn new ways through their therapy to handle uncertainty, to address the thoughts and feelings and other symptoms, they can’t always ‘just stop’, if they could ‘just stop’ they would.
It is important to note, that this is validation of their struggle and efforts to help themselves, it is not approval or validation of the unhelpful behaviours such as avoidance, reassurance seeking.
It is unhelpful to offer judgement or criticism
It is extremely important that you do not judge or criticise the person. An example of this could be “oh no here we go again again, you were fine a moment ago, why do you have to ruin a good time?”, “why don’t you just stop this nonsense?”. This is likely to lead the person to withdrawing from talking about their experiences with you, hiding unhelpful behaviours and suppressing emotions. It can also cause problems within your relationship and make it harder for the person to seek help when they most need it.
Let the person know that they can talk to you honestly and openly without any fear of judgement. Let them know hat you are not going to change the way you think of feel about them based on anything they say.
Examples of validating and encouraging responses
Here I have noted down a few examples of things you could say to validate and support your friend of family member in the moment. These are just ideas and you will need to find your own ways of saying things that feel most comfortable to you.
“I can see this is extremely uncomfortable for you. I know you have handled discomfort in a lot of different scenarios in your life, and I have every confidence that you can do this’.
“I can hear you are struggling with the anxiety today. Remember feelings are transient, they can not harm you. You will get through this. I am here beside you every step of the way”
“I can see that you are struggling. What do you think its making your symptoms particularly bad right now? I am here for you for support and talk to”
‘It makes sense that you are frightened, you have had some bad experiences of this type of thing before. I know you can keep going . You are stronger than you think you are right now. The feelings will go and I am here to support you through this’.
You are not expected to be the expert and know all the answers
I also want to reassure you that you are not expected in any way to know all the answers. You don’t have to fully understand, to help the person to feel validated, loved and cared for. There is nothing wrong with asking them for guidance about how best you can help in line with what they are learn in therapy.
You could ask them “I can see you are really struggling, what would your therapist say?” or ”is there something you have learnt in therapy that could help you move forwards?”.
‘I can see you have been battling a lot of anxiety this morning and I want to support you. Please help me to understand better the words that would best help you when you are struggling?’
The overall aim is to help them to feel loved, understood and to reduce a feeling of shame about what they are struggling with.
Support is listening, trying to understand and encouraging them to go towards their feared beliefs.
Family and friends can feel frustrated, angry, doubtful, disappointed and hopeless at times of high anxiety. Imm an attempt to relieve these horrid feelings they can at times give in to anxiety lead demands, known they are feeding the anxiety. Engaging in safety seeking behaviours can undermine their recovery. It temporarily reduces the sufferers anxiety, but only in the short term. It does’t support long term recovery.
Support does not mean engaging in safety seeking behaviours such as offering reassurance, changing your behaviours or enabling ways of avoiding their fears.
Support means being there beside them, being open to talking about their fears. It means trying to understand. If someone is asking you to do something that you feel is further enabling their anxiety rather than helping them to face it, you could say things such as;
“That sounds like your OCD or anxiety speaking, I want to help you and not your OCD / anxiety”
Show an interest in what they are doing in treatment & offer to complete therapy homework together.
Better still, you could occasionally sit in on the odd treatment session (with their and the therapist’s consent).
Online therapy means that this could easily be arranged at the end of a video therapy appointment without any travel or time off work involved.
Coping will mean feeling the fear and facing the fear.
Talk to them about a plan when they are not anxious, agree together how you could respond and support them to face their fears. If it feels necessary, agree a contract.
Remember to look after yourself too
It is also important not to loose focus of your needs during this time of recovery for them.
It is also ok to ask for support for yourself. This can itself feel validating for him/her and their ability to help you, rather than always being the person who needs support.
Everybody progresses at different rates
As frustrating as it may feel, it is important to remember that there is likely be ups and downs along the way towards recovery. Progress will be gradual and some days it will feel very slow or like they are taking a step back. Remember that anxiety disorders are real and serious, but, entirely treatable problems, and that your friend of family member will not aways feel like this. Try to take a step back yourself and look at the bigger picture of recovery.
Your encouragement is most needed on the tough days when things don’t go so well. Even if it is not going as well as they hoped, encourage them to keep trying.
“I can see you are battling it today, try to remember what you have learnt in treatment so far. You can do this, I know you can. I am so proud of how far you have come. Keep going, I’m right behind you every step of the way”.
Recognise their achievements and acts of courage
If you notice your friend or loved one has done something that previously they would have struggled to do, acknowledge it. An anxiety disorder can make a person think and feel more negatively, which means they can interpret your responses more negatively.
Let them know that you can see their progress however big or small. Highlight your positive emotions such as the pride you feel when you see them achieving positive change. It reinforces the effort and courage they are having to put in day-to-day, to overcome the anxiety.
Finally, please remember, that by engaging fully in evidence based CBT treatment, keeping motivated to do the work between sessions under the guidance of their therapist, their problems really can be overcome.
If you are interested in speaking with an online therapist, contact us directly by email for more information or register you interest via the link below or on our website.
I do hope we can help you or your loved one.
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Lisa Johnston
Cognitive Behavioural Therapist