Emotional First Aid: Supporting Others in Times of Crisis

By John D. Weaver, MSW, LCSW, BCD, ACSW, CBHE

Without realizing it, whenever you find yourself responding to a family member, a friend, a coworker, or even a total stranger who is under extreme stress, you may be offering emotional or psychological first aid. Emotional first aid is not therapy. Rather, it is a means to get the individual to a safe place in the short run. Allowing someone to talk about the event and then directing them to necessary resources is what is most needed during times of immediate crisis. The supportive responses of natural helpers can have a major, positive impact upon the mental health and overall wellbeing of people in crisis.

Ten Helpful Tips

Here are some helpful hints on how to be effective when supporting others:

1. Remain calm – be an appropriate role model. Do not allow the upset individual or the stressful situation to make you blow your cool or you will quickly become an ineffective helper.

2. If you are helping a stranger, introduce yourself and be very clear with the person about who you are and your intended helping role. You are not a therapist, rather only there to administer emotional first aid.

3. If it seems like you will need to refer the individual to someone else, get needed demographic information immediately, before getting into the detail about the problem(s). This alone can be helpful with calming and focusing people. It also is critical to have name, phone number, and address (or current location), when handling crises, in case the person breaks off the contact (e.g., telephone caller hangs up or person in crisis decides to leave area where you are talking).

4. Be truthful about what is happening and about the help you and others have to offer. Be careful not to overstate it. Some related issues:

• Give honest answers, not platitudes. Better to say “I don’t know, but I can try to find out” than to promise answers and/or establish high expectations and then disappoint the person you are trying to help.
• Openness and honesty are needed with children too. They may not fully understand things but they can read feelings better than many adults. They know when someone is not telling them the truth.
• A measured response may sometimes be best in the short run (e.g., saying “Joe is seriously injured but the ambulance crew is doing everything they can…” rather than offering a more brutally truthful answer that might send someone into shock).

5. Giving “process” details (talking through what will probably happen next) helps lessen fears of the unknown and offers some measure of stress inoculation from common, foreseeable events.

6. Verify attentiveness – people in crisis are always in shock, to some degree. Helpers often need to repeat things several times and may need to write down key information. Have handout available if possible.

7. Listen attentively and allow lots of ventilation. People under stress need to tell their stories, over and over, and have them validated by others.

8. Shun “superman/wonder woman” urges and involve others. Develop a support system for the person in crisis and for yourself. Helpers and others in the support system will all be in better shape if they can share the burden and provide peer support to each other.

9. Know your own limitations – just as persons in crisis cannot always do everything they would like to do, neither can you. Sometimes it is best to turn down situations that are too emotionally charged to allow you to properly handle them. If you have been assisting in a crisis, seek peer debriefing as soon as possible. This will enable you to be more effective as well as taking care of yourself.

10. Usually, it is best not to stop any tears. Instead, get the person a tissue, tell them to let it go, and allow time for a good, cleansing cry.

Sometimes, touching or giving a hug may help. Other times the persons in crisis may become more upset if you violate their personal space. Judge for yourself if putting a hand on someone’s shoulder, patting a back, offering a hug, etc., fits the situation and your personal style. It is also a good idea to ask permission (e.g., “Could you use a hug?”). Never come up behind someone in crisis and touch them by surprise.

Less Is More

Once other key concept is this: LESS IS MORE (KEEP IT SIMPLE). Begin with this fundamental premise: There is nothing you can say or do that will quickly end the shock, ease the pain, or make others feel better. But there are lots of things you can say or do that can make them feel (or act) worse! Examples: “I know what you’re going through” or “Everything is going to be fine.”

Either comment may seem innocent enough, yet often results in an angry response.

Passive Listening

Many times Passive Listening is the best approach – use attentive silence and keep responses to a minimum. Overreaction is counterproductive to cathartic ventilation. There is a concept in communication known as Rehearsal Drop – basically a point in conversation where the listener’s listening ends and his or her formation of a question or response begins. By speaking too much, responding too quickly, or falling into any of the other nervous interviewing patterns, a novice or nervous helper often shoots himself or herself in the foot. Just listen and be present with people who need your support. Doing less really is more helpful in these situations.

Specific training is available for those who would like to be useful in times of cirisis. Critical Incident Stress Management training through various agencies, including the American Red Cross, is readily available.