Authors: Hope Gordon and Dr Adele Victoria

Things which do not bother you, or may simply annoy you, could traumatise someone with PTSD. 

Daily skills and tasks which you find easy may be challenging for someone who is already struggling. 

Don’t walk away.

There’s no need for the perfect solution or reaction. 

If you can do nothing else, just be kind. 

Be aware of body language and respond to cues

• Are you too close?  Step back; approach from the front rather than behind; lower your voice

Take into account physical, emotional and financial barriers to participation 

• Hyperalert, chronic illness means I tire easily

  • phone catchups rather than face-to-face?

• Low income, can’t drive

  • practical ways you could help?  Book cheaper restaurants?  A lift home?

Be patient – Understand that situations which you find difficult are harder for those with PTSD 

• Give leeway; take time to listen even if you never understand; ask – is there anything which would make the situation easier?

Focus on strengths rather than weaknesses

• What do I do well?  How can you support me in that?

Create safe physical, social, emotional spaces

• Could be as easy as moving a chair; lowering music; asking before touching me; flexible deadlines; quiet areas

• Greet me by name; chat to me; let me in front of you in a queue; be delighted to see me – and show it

Role-model kindness

• Didn’t learn kindness or self-care

  • show me how by the way you treat yourself and others

Joke about my behaviour, make insensitive, disparaging or sarcastic comments, unkind jokes, or turn difficult situations into humour

• Hurtful nicknames; insulting comments; making fun of the way I cringe at a noise; practical jokes

Make assumptions

• You do NOT know why I am behaving the way I am, nor what I need, until you have all the information

  • Ask - what is going on and how might you help?

Be an armchair psychologist

• Don’t decide what I need/don’t need 

• I may have self-soothe strategies, but still need help – don’t walk away because you think I should learn to cope

Judge

• Don’t write me off because I cannot do what you can 

• Don’t judge me when I behave in ways you disapprove of

• Don’t compare us, or compare me with other survivors

• Don’t decide that I am not trying hard enough

Sound like a lot? 

Just do what you can. 

Ask if you can help and how you can help.

Just be kind.

The following examples are specific to my journey with complex PTSD, so may not apply to others.

Recognise vulnerability

You may not know I have PTSD, but recognise vulnerability

Be aware of body language

• Tense, jumpy, leaning away, stepping back

  • respond to cues

    • perhaps you are too close.  Stand back

    • approach from the front

    • move slowly

    • soften your voice

  • don’t make a joke of it

    • it makes you feel better, but shames me

Exercise Compassionate Patience: Situations Which are Difficult for You May be Harder for Me

• e.g., Covid-19 raises memories of abuse

  • I might be upset or breaking rules because I have been triggered

  • social distancing increases feelings of isolation

• Give leeway

• Take me seriously rather than as irrational

• Listen to me explain – even if you never understand

  • don’t expect full explanations - I may not want to disclose detailed information or may be vague (e.g., I feel claustrophobic)

• Ask – is there something that would make the situation easier?

  • if you ask the questions, make sure you have the time to listen

• Don’t do it.  Any of it.  Just don’t.

• Practical jokes, headlocks, ‘aping’ me, pushing me into a pool, turning difficult situations into humour retraumatise

• Negative comments hurt

  • nicknames such as “grumpy”

  • talking over the top of me as though I’m not there

  • insults in the guise of ‘helpful’

    • “You’d be so nice if you got therapy for your problems”

    • “If you worked to your potential, imagine what you’d achieve”

  • disparaging asides to others - “she’s screwed up”

  • calling me “incompetent” because I am slow

  • cancelling our coffee because I am “embarrassing”

  • laughing when I cringe in fear

• Pause – how is a tickle from behind likely to be received?  Negatively?  Don’t do it.  You don’t know?  Don’t do it

You do NOT know why:

• I look distracted

  • I am not rude.  I am hyperalert, looking for danger, weapons, exits

    • don’t respond in irritation

      • ask if I need something

      • point out exits

      • move me to a quieter location

• I seem antisocial

  • I lack the capacity to participate - being hyperalert is exhausting

    • don’t withdraw, thinking that I prefer to be alone

    • if you haven’t heard from me, check in

      • don’t assume that someone else is.  They probably aren’t  

• Why I am panicky, crying

  • I’m not attention seeking.  Something may have triggered me

    • e.g., an activity, knives on a bench, laughter

      • can the trigger be removed (e.g., knifes moved; tasks reassigned, music lowered; can the party do without the party poppers?)

      • don’t offer to help, then walk away leaving me to flounder

• Why I look dazed

  • I may be dissociated

    • talk to me slowly and quietly

    • separate me from other people

    • ask what I need

    • check on me

• I am disorganised

  • I am not lazy.  My thinking is scattered

    • provide written instructions

    • pre-pack my medication

    • print a list rather than give me a pile of appointment slips

    • if I’ve lost the phone number you gave me, give it to me again without telling me off

• If you know/think that I have a history of abuse, don’t automatically assume that:

  • I don’t understand boundaries

  • I have self-soothe strategies, so never need assistance

    • if I look like I’m struggling, I probably am

      • ask - what’s going on?  How might you help?

• Don’t test your ‘therapy’ on me

  • Deliberately triggering me is cruel, not kind

    • e.g., grabbing me in a bear hug because you think I should ‘face my fears’ damages

      • the negative reverberations of your action may last for a long time                               

• I have fewer emotional and physical resources

• Don’t compare us, compare me with other survivors, decide I’m not trying hard enough

• Don’t cut me out because I’m ‘incapable’, or dismiss what I can do as ‘stingy’

• Focus on what I CAN do rather than write me off for what I can’t

  • What are my strengths?  How might they be used?  How can you support me?

  • Ask what I can contribute to lunch, rather than tell me to bring something which may be difficult for me to provide
    

• Pre-warn/pre-plan

  • are there specific expectations for participation?  Crowds?  A violent movie?

  • I need to sit at the end of rows and near exits to feel safe

    • if seating is designated, put me at the end of a table

    • move a chair or swap seats

    • reassign desks in an office

• No. Surprise. Parties.

• Move to a less crowded corner of the restaurant

• Point me to toilets which have locks on the door or are more private

• Intervene if people seem like they are overwhelming me

  • engage the person in conversation or lead them away

• Don’t force participation

• Provide areas where there are fewer people moving around

• Ask before touching me, and if I pull away let go

• Be sensitive to how you are touching me – can a hospital ID bracelet be a little looser than it otherwise would?

• Increasing my workload or the complexity of a job so that I can ‘rise to the challenge’ sets me up for failure

  • take 10 minutes of your lunch break to explain a task

  • extend deadlines

  • don’t overload me when I clearly already am

Little things make a difference

• Increases self-worth, makes me feel ‘seen’

  • e.g., greet me by name; let me go before you in a queue; bring my bin in because I look tired; take 5 minutes to ask about my week; don’t just give me directions – walk me there; ignore my moodiness and be delighted to see me – and show it

• PTSD and chronic illness are limiting

  • smaller range of ‘self-care’ options

  • difficult to accept that some days I won’t be able to do what I want to do

    • don’t criticise. Acknowledge. Help me accept that I am doing my best

  • grew up expecting unkindness

    • did not learn self-care or healthy ways to interact

      • role-model it for me by the way you treat yourself and others

Be aware of those around you, who may be more vulnerable. 

• If you or someone you love were living with the reverberations of something truly awful

• If despite the impact you were constantly told you must keep up

• could you do so?

• how would you wish to be treated?

I wish, and I would wish for you, to be treated with kindness

See this video for a recording of the poem read in full by Naomi Shihab Nye.